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L04.2 – Acute Lymphadenitis of Face, Head & Neck
L04.2 is the ICD-10 code for acute lymphadenitis of the face, head, and neck. It describes an inflammation of lymph nodes, most commonly caused by a bacterial infection.
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L04.2 is the ICD-10 code for acute lymphadenitis of the face, head, and neck. It describes an inflammation of lymph nodes, most commonly caused by a bacterial infection.
What is L04.2?
The ICD-10 code L04.2 refers to acute lymphadenitis of the face, head, and neck. Lymphadenitis is an inflammation of one or more lymph nodes, typically occurring as a response to a nearby infection. Lymph nodes are part of the immune system and filter pathogens and foreign substances from the lymphatic fluid. When they become overwhelmed or directly infected, they can become inflamed and swollen.
Causes
In most cases, acute lymphadenitis in the head and neck region is triggered by bacterial infections. Common causes include:
- Bacterial skin infections (e.g., furuncles, erysipelas, infected wounds)
- Dental and jaw infections (e.g., dental root abscesses, periodontitis)
- Throat and tonsil infections (pharyngitis, tonsillitis)
- Infections of the salivary glands or ears
- Less common pathogens such as mycobacteria (e.g., in tuberculosis) or fungi
The most common bacterial agents are staphylococci and streptococci, which travel through the lymphatic vessels to reach the regional lymph nodes.
Symptoms
Acute lymphadenitis in the face, head, and neck region typically presents with classic signs of inflammation:
- Swelling of the affected lymph nodes (e.g., at the jaw angle, along the neck, or in front of the ear)
- Pain and tenderness when the nodes are touched or pressed
- Redness and warmth of the overlying skin
- General feeling of illness, elevated body temperature, or fever
- In severe cases: liquefaction of the lymph node with abscess formation
Diagnosis
Diagnosis is usually established through a clinical examination. The physician palpates the lymph nodes and evaluates their size, consistency, mobility, and tenderness. Additional diagnostic tools may include:
- Blood count and inflammatory markers (e.g., CRP, leukocytes) to assess the extent of the infection
- Ultrasound examination (sonography) for detailed imaging of the lymph nodes and to detect possible abscess formation
- Swab or aspiration for microbiological identification of the pathogen in cases of abscess or uncertain findings
- In rare cases: advanced imaging (CT or MRI) when deep infection or complications are suspected
Treatment
Treatment depends on the underlying cause and severity of the lymphadenitis:
- Antibiotic therapy: For bacterial causes, oral or intravenous antibiotics are used, commonly penicillin, amoxicillin, or cephalosporins. Flucloxacillin may be used when staphylococcal infection is suspected.
- Surgical treatment: If an abscess has formed, incision and drainage to release the pus is required.
- Treatment of the underlying cause: The primary infection is treated simultaneously, such as a root canal procedure or tonsillitis therapy.
- Symptomatic relief: Pain relievers such as ibuprofen or paracetamol to reduce pain and fever.
When to See a Doctor?
Swollen, painful lymph nodes in the face or neck area that persist for more than a few days should be evaluated by a healthcare professional. Fever, significant swelling, skin redness, or a general feeling of illness are signs that prompt medical attention is needed to prevent complications such as abscess formation or spread of the infection.
References
- World Health Organization (WHO): ICD-10 Version 2019, Code L04.2 – Acute lymphadenitis of face, head and neck. Available at: icd.who.int
- Brook I. - Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. Journal of Oral and Maxillofacial Surgery. 2004;62(12):1545-1550.
- Leung AKC, Davies HD. - Cervical Lymphadenitis: Etiology, Diagnosis, and Management. Current Infectious Disease Reports. 2009;11(3):183-189.
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