CERVICAL LYMPHADENOPATHY

Cervical Lymphadenopathy : An enlarged lymph node is the most common neck mass in children. Most are anterior to the sternocleidomastoid muscle. Infection is the usual cause of enlargement; viral etiology and persist for months. Acute suppurative submandibular adenitis occur in early childhood (6 mo-3 yrs), is preceded by pharyngitis or URI, the child develops erythema, swelling and cellulitis, and management is antibiotics and drainage. Chronic adenitis: persistent node (> 3 wk., tonsillar), solitary, non-tender, mobile and soft. Generally no tx if < 1 cm, for nodes above 2 cm sizes with rapid growth, clustered, hard or matted do biopsy.
Other causes are:
(1) Mycobacterial adenitis- atypical (MAIS complex), swollen, non-tender, nor-inflamed, positive skin test, excision is curative, chemotx is of no value.
(2) Cat-Scratch adenitis- caused by A. Fellis, transmitted by kittens, positive complement fixation test, minimally tender, fluctuant regional nodes, spontaneous resolution.
(3) Hodgkin's disease mostly teenager and young adults, continuing growth, nontender node, associated to weight loss, biopsy is diagnostic.