What is the role of lab studies in the workup of lymphadenitis?

Updated: Feb 12, 2019
  • Author: Elizabeth Partridge, MD, MPH, MS; Chief Editor: Russell W Steele, MD  more...
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Laboratory studies are as follows [8] :

  • Gram stain of aspirated tissue - To evaluate bacterial etiologies

  • Culture of aspirated tissue or biopsy specimen - To determine the causative organism and its sensitivity to antibiotics

  • Monospot or Epstein-Barr virus (EBV) serologies - To confirm the diagnosis of infectious mononucleosis

  • Bhenselae serologies - To confirm the diagnosis of catscratch disease (if exposed to cats)

  • Skin testing or purified protein derivative (PPD) - To confirm the diagnosis of tuberculous lymphadenopathy; alternative is interferon-gamma release assays (IGRA)

  • CBC count - Elevated WBC count may indicate an infectious etiology

  • Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) - Elevated ESR and CRP are nonspecific indicators of inflammation

  • Liver function tests - May indicate hepatic or systemic involvement; elevated transaminase levels can be seen in infectious mononucleosis

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