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L04.3 – Acute Lymphadenitis of the Lower Limb
L04.3 is the ICD-10 code for acute lymphadenitis of the lower limb and hip. It describes a sudden, painful inflammation of lymph nodes in the leg or hip area, most often caused by a bacterial infection.
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L04.3 is the ICD-10 code for acute lymphadenitis of the lower limb and hip. It describes a sudden, painful inflammation of lymph nodes in the leg or hip area, most often caused by a bacterial infection.
Definition
L04.3 is a diagnostic code from the ICD-10 classification (International Classification of Diseases) and stands for acute lymphadenitis of the lower limb and hip. This refers to a sudden, painful inflammation of one or more lymph nodes in the area of the leg, knee, lower leg, foot, or hip.
Causes
Acute lymphadenitis typically develops as a reaction to an infection in the drainage area of the affected lymph node. Common causes include:
- Bacterial infections: for example caused by staphylococci or streptococci, such as in wound infections, erysipelas (skin infection), or deep tissue inflammation (phlegmon) of the leg
- Skin infections or injuries of the foot, lower leg, or hip that allow pathogens to enter via the lymphatic vessels
- Fungal infections (less common), e.g., nail fungus with secondary bacterial infection
- Insect bites or small wounds serving as entry points for pathogens
Symptoms
Typical signs of acute lymphadenitis of the lower limb include:
- Painfully enlarged lymph nodes, especially in the groin region (inguinal lymph nodes)
- Redness, warmth, and swelling in the affected area
- General feeling of illness, possibly with fever and chills
- Occasionally visible red streaks along the lymphatic vessels (lymphangitis)
- Restricted mobility of the affected leg or hip
Diagnosis
The diagnosis is usually made clinically through physical examination and patient history. The following additional measures may be used:
- Blood tests: detection of elevated inflammatory markers (e.g., CRP, white blood cell count)
- Ultrasound: to assess the size, structure, and blood flow of lymph nodes and to rule out abscess formation
- Pathogen detection: swab or blood culture if a systemic infection is suspected
- Rarely: biopsy or advanced imaging (MRI, CT) if a malignant cause must be excluded
Treatment
Treatment depends on the underlying cause and severity of the condition:
- Antibiotics: For bacterial causes, targeted antibiotic therapy is the treatment of choice. Commonly used agents include penicillins, cephalosporins, or clindamycin.
- Local measures: Cooling, elevation of the affected limb, rest
- Analgesics and anti-inflammatory drugs: Pain relievers such as ibuprofen or paracetamol to reduce pain and inflammation
- Surgical intervention: If an abscess forms, surgical opening and drainage may be required
- Treatment of the underlying condition: Wound care, treatment of skin infections or other triggers
Complications
If acute lymphadenitis is not treated promptly, the following complications may occur:
- Abscess formation within the lymph node
- Spread of infection to surrounding tissue (phlegmon)
- Sepsis (blood poisoning) if pathogens enter the bloodstream
- Progression to chronic lymphadenitis
References
- World Health Organization (WHO): International Classification of Diseases, 10th Revision (ICD-10), Code L04.3 – Acute lymphadenitis. www.who.int
- Kasper, D. L. et al.: Harrison's Principles of Internal Medicine, 21st Edition. McGraw-Hill Education, 2022.
- Swartz, M. N.: Lymphadenitis and Lymphangitis. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 9th Edition. Elsevier, 2020.
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