Introduction
Lymph nodes can be found all over the body. They are connected to each other by lymph channels and together with the lymphatic organs form the lymphatic system. A swelling of lymph nodes in the groin can be an indication of a wide variety of diseases. In doing so, attention must be paid to the differentiated symptomatology of benign and malignant diseases.
Causes of lymph node swelling in the groin
While lymph nodes in the neck or head area can already be enlarged in the case of a common infection, such as a cold, this type of disease is not a cause in inguinal lymph nodes. This does not mean, however, that cancer must be expected immediately. Even slight inflammations can be the cause and heal without further problems.
It is important that the patient has a feeling for his own body and documents changes in his thoughts and communicates them to his family doctor when the opportunity arises. In the case of rapidly progressing swellings or painful pressure, a doctor can be consulted at any time to initiate further diagnostics. In general, swollen lymph nodes can easily be roughly classified into most likely good versus malignant on the basis of a few criteria.
The occurrence of a painful swelling within a short period of time, as well as a temporal association with trauma or inflammation in adjacent parts of the body, indicates a benign change. In contrast, a slowly increasing swelling without pain and possibly developing adhesions with surrounding tissue structures is indicative of a potentially malignant swelling. Surgery always poses a high risk of infectious diseases, as there is a large entrance port for pathogens into the body, depending on the size of the skin incision.
Especially after major orthopedic surgery, which is performed with long incisions in the skin, pathogens have a wide area to enter the body. In hospitals, inflammation with resistant bacteria is the main focus. Even despite high hygiene requirements, the number of illnesses after operations is very high.
Years of development have resulted in pathogens that are resistant to a large number of common antibiotics. Lymph nodes in the groin region are mainly localized in inflammations in the leg area. Major operations that promote lymph node swelling are hip or knee operations.
Shingles is a viral disease caused by the so-called “varicella zoster virus”. Shingles is a reactivation of the chickenpox disease. Those affected have suffered from chickenpox in childhood or adulthood and the virus is stored in the body for life.
Particularly in old age, the likelihood of the viral disease recurring in the form of shingles increases and leads to other symptoms that are restricted to a certain part of the skin. This is accompanied by a strong feeling of illness, pain, swollen lymph nodes and skin symptoms. Nowadays, children are often vaccinated against chickenpox, which makes shingles less likely to occur.
An insect bite from mosquitoes or horseflies usually causes mild symptoms at the bite site. The venom that is transmitted to humans usually causes redness with itching. In some people, an insect bite can lead to hypersensitivity reactions up to anaphylactic shock.
Severe redness, general symptoms and circulatory problems can be the result. If there is a swelling of the lymph nodes, this is an indication of a pathogen infection as a result of the insect bite. Through the bite, the insect breaks through the intact skin barrier, just like a small injury.
This allows bacterial or other pathogens to find their way into the body and cause an inflammation, which is noticeable in swollen lymph nodes. In most cases, these are not threatening inflammations, but a doctor should be consulted as blood poisoning can develop. Shaving itself does not pose a health risk to the body.
However, shaving with sharp blades can always cause minor injuries to the skin. Bleeding is a sign that the skin has been damaged and the body’s protective barrier has been broken. Using an after shave minimizes the risk of small inflammations caused by pathogens.These are alcoholic solutions, which have a disinfecting and antibacterial effect.
If small inflammations occur nevertheless, the surrounding lymph nodes can swell. Nowadays there are vaccinations against numerous diseases, especially against the typical childhood diseases like measles, mumps, rubella or chickenpox. The majority of vaccinations are administered in infancy, as soon as the immune system is mature enough to produce antibodies.
Vaccines are injected into the muscle, which stimulates the body to produce antibodies against certain components of a virus. Near the injection site, which in children is often on the thigh, the lymph nodes may swell in response to the vaccination. The swelling is considered harmless and disappears within a short time.
Tick bites are harmless in most cases. Only a small number of ticks carry a bacterium, which is transmitted to humans through the bite. The bacteria can cause a so-called “borreliosis”, which should be treated urgently, as it can lead to serious damage in the long term.
If a tick bite causes a circular redness around the bite site and swelling of the lymph nodes, a doctor must be consulted. In this case, the doctor will immediately prescribe an antibiotic against the bacterium. You can find more detailed information on how to diagnose Lyme disease under How to recognize Lyme disease An abscess is characterized by an encapsulated inflammation of the tissue.
Inside the capsule there can be pathogens and immune cells of the body. The capsule provides the abscess with a palpable cover. Typically, abscesses can impress in performance as well as lymph node swellings as painfully palpable “nodes”.
An abscess in the groin is often preceded by a superficial infection of the skin from which the abscess can develop. But also an abscess of single intestinal loops that are advancing into the inguinal canal (inguinal hernia, inguinal hernia) can present itself as an inguinal swelling. This topic could also be interesting for you: Abscess in the groin – causes and treatmentSwelling of all kinds of lymph nodes can also occur in healthy people.
Sometimes there are anatomically permanently enlarged lymph nodes, which can be attributed to individual development. The symptomatology of lymph node swelling depends on whether the underlying disease is benign or malignant. In the case of infections, in this case benign, patients report permanent pain and/or pressure dolence (pressure pain).
The swelling can occur on the left or right side. The lateral weighting gives an indication of the location of the infection or whether a malignant tumor exists, since these usually only form on one side. General symptoms of the disease can be accompanied by swelling of the lymph nodes, such as fever, fatigue, headache, aching limbs and malaise.
If there is a malignant tumor of a lymph node, a so-called B-symptom (“B” because of B-cell lymphoma) often occurs. The patient should report constant fever, excessive night sweats and unwanted weight loss. In contrast, in most cases an inflammatory disease is the cause of painful lymph node swelling in the groin.
Infections of the genitals are often involved. Both men – with an inflammation of the glans (balanitis) or the epididymis (epididymitis) – and women – with an inflammation of the vagina (vaginitis) or the external sexual organs (vulvitis) – are affected. The inflammation is caused by a variety of pathogens: bacteria, viruses and fungi.
Sexually transmitted diseases play a special role. The best known bacterial infections are chlamydial infections, syphilis (caused by Treponema pallidum) and gonorrhea (caused by Neisseria gonorrhea). A fungal infection with Candida albicans is rather a disease that affects many elderly people.
With insufficient personal hygiene and constantly damp skin, the fungus can settle down and also cause swelling of the lymph nodes as the body tries to defend itself. In addition to the pathogens already mentioned, there are infections in which not only the inguinal lymph nodes are specifically affected, but can also be involved. Viral childhood diseases such as rubella, measles or chickenpox, combined with various other symptoms (usually skin changes), can lead to swelling of the lymph nodes in the body.Another viral pathogen can also lead to swelling of the lymph nodes in the groin – a herpes infection.
Many people think that herpes can only develop on the lip, but that is wrong. The so-called lip herpes (Herpes labialis) is caused by herpes simplex virus 1, whereas genital herpes (Herpes genitalis) is mainly caused by the less common herpes simplex virus 2. It causes swelling of the lower genitals, itching, discharge and possibly other general symptoms of the disease.
Not only bacteria and viruses can cause swelling of the lymph nodes: Toxoplasma gondii is a unicellular organism, is transmitted by cats, among others, and triggers the clinical picture of toxoplasmosis. The disease usually only develops when the immune system is already weakened. Therefore, the pathogen is particularly widespread in HIV-infected persons.
During pregnancy, the disease is particularly dangerous for the unborn child. Toxoplasmosis causes severe damage to the brain, blindness and other organ damage in the foetus. HIV infection (Human Immunodeficiency Virus) is known to affect the patient’s immune system and is mainly transmitted sexually, but also through contaminated needles or blood transfusions (the latter is actually no longer found in industrialized countries today).
Immediately after infection, the patient may have swelling of the lymph nodes, which, however, in combination with other flu-like symptoms, is usually not interpreted as a sign of HIV infection. In the final stage of an often long-standing infection, AIDS (Acquired Immune Deficiency Syndrome) will eventually occur. In the course of the complete destruction of the immune system, the patients are very susceptible to infection.
The infections in turn lead to swelling of lymph nodes in the body. Injuries also activate the immune system and lead to an enlargement of the corresponding lymph node. In the case of inguinal lymph nodes, these can be injuries from the foot up to the height of the groin, i.e. including the entire leg.
Injuries to the foot have often involved stepping into a sharp or pointed object, such as a nail or shard. A contaminated wound can lead to blood poisoning (sepsis), which affects almost all organ systems and causes the body to collapse in its functions if no antibacterial treatment is given. One consequence of sepsis is lymphangitis – the inflammation of the lymph vessels and subsequently the lymph nodes.
This is also accompanied by swelling. As a late consequence of vaccination, swelling of the lymph nodes has often been observed. This can occur in the neck, armpits (swelling of lymph nodes in the armpits), but also in the groin.
The background to this is that the body is administered modified live or dead pathogens or pathogen components against which the immune system has to form defense cells on its own. Since the lymph nodes in the region are stressed, lymph node swelling in the groin can occur, especially when vaccination is administered into the buttocks (for example, tetanus vaccination). The swelling should be examined by a doctor, but usually disappears by itself.
If the swelling of the lymph nodes develops quickly and is not painful under pressure, this may indicate a malignant disease. The tumor can develop directly in the lymph node, as is the case with Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Symptomatically different are tumor diseases in which masses of immune cells are flushed into the lymph nodes, as in acute and chronic leukemias or cutaneous T-cell lymphomas.
In addition to these primary tumors, almost every malignant tumor disease can metastasize to adjacent or distant lymph nodes. This generally worsens the prognosis. Since other reasons for swelling in the groin must be excluded in order to strengthen the finding of a swollen lymph node, differential diagnosis for hernias must be checked.
Hernias refer to the penetration of abdominal viscera through the abdominal wall, between muscles or ligaments. The two relevant soft tissue hernias in this case are the femoral hernia (hernial content below the inguinal ligament) and the inguinal hernia (hernial content above the inguinal ligament). A rash accompanied by a swelling of the lymph nodes in the groin is a typical symptom constellation indicating an inflammation caused by the pathogen.
A variety of pathogens can cause rashes.The exact appearance of the rash can often provide clear indications as to whether it is a fungal disease, a bacterial infection or an infection with the typical childhood diseases. A measles rash can almost always be distinguished from chickenpox or a fungal infection by the skin symptoms. In a disease like measles, the entire skin is usually affected and enlarged lymph nodes can be felt in the groin as well as in the neck, armpit and shoulder.
In the case of local infections with certain pathogens, for example those caused by small wounds, the enlarged lymph nodes are located in the lymph drainage area of the rash. In the case of lymph node swelling in the groin, the legs or genitals are accordingly frequently affected by rashes. Fever is often the first symptom of infections with certain pathogens.
It is accompanied by chills, aching limbs, weakness and fatigue. In particular, diseases such as chickenpox, measles, glandular fever and other viral infections are accompanied by high fever and swollen lymph nodes. Such an infection often develops within a few hours to days and usually subsides by itself within a maximum of two weeks.
If fatigue and slightly elevated temperatures and painlessly swollen lymph nodes in the groin occur over several weeks, a doctor should be consulted. These can be early symptoms of a possible malignant disease. Pain in the lymph nodes is a typical sign of inflammatory reactions.
In an acute infection, the pathogens in the lymph nodes are recognized and produce antibody cells. In the process, they swell to twice to three times their size and release inflammatory substances that cause pain when touched. After several days when the infection has healed, the pain in the lymph node stops.
If it does not for a long time, you should consult a doctor for clarification. A swollen lymph node in the groin that is not painful does not necessarily indicate a malignant disease. Infections can also lead to non-painful lymph nodes. A fat tumor can also occur. Such a lipoma is completely painless and feels like a lymph node from the outside.
