SEVERE STREPTOCOCCAL AXILLARY LYMPHADENITIS

THIS report describes four adults with severe axillary lymphadenitis, a streptococcal infection that is now unusual. The syndrome was characterized by the acute onset of fever, severe pain in the axilla, and in three patients moderate-to-marked edema of the arm, axilla, shoulder, pectoral area, and supraclavicular fossa. In one patient, inflammation and edema in these areas caused thrombosis of the axillary and subclavian veins. One patient had an abscess adjacent to the pectoral muscle with an accompanying bacteremia. Ipsilateral pleural effusions occurred in two patients. Streptococcus pyogenes was recovered from two patients, and the other two had serologic evidence of. © 1990, Massachusetts Medical Society. All rights reserved.