Suppurative lymphadenitis.

Suppurative lymphadenitis is an important and common form of soft tissue infection. Most acute cases of suppurative lymphadenitis are caused by Staphylococcus aureus or by Streptococcus pyogenes. Empiric antibiotic therapy is frequently successful in the early stages of the disease process, but increasing prevalence of methicillin-resistant S. aureus in particular has necessitated a shift in antibiotic choice that is dictated primarily by specific local resistance patterns. Several other organisms and noninfectious inflammatory processes may give rise to a clinical syndrome suggestive of suppurative lymphadenitis. Failure to respond to empiric antibiotics should trigger a diagnostic re-evaluation to determine the need for surgical intervention and/or the possibility of alternative microbiologic diagnoses.