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Tuesday, March 18, 2014

Cervical Adenitis






A bacterial infection of the lymph nodes of the neck

  • Lymph nodes are collections of cells that fight infections.  They are found in chains throughout the body.  Although any of these lymph nodes can become infected, in children the lymph nodes in the neck are the most commonly affected nodes.

  • Painful mass in the lateral neck, along the large "strap" muscle, called the "sternocleidomastoids," which tightens when one looks upwards and rotates the head simultaneously
  • Fever
  • Warmth and redness in the area of the mass
  • In severe cases, a feeling of "fullness," as if there were a balloon filled with fluid in the area, may be noted.
  • Recent history (within the last several weeks) of an upper respiratory tract infection ("cold"), or sinus or ear infection

  • A localized bacterial infection in one of a series of lymph nodes found running along the sides of the neck
  • Other causes, such as Tuberculosis, are rare.

  • History and physical examination
  • Minimal laboratory testing, e.g., Tuberculosistest
  • If an area of fullness is found on examination, or if a child fails to respond to initial antibiotic therapy, an ultrasound or CAT scan may be needed to look for a possible abscess, a collection of fluid surrounded by a wall, that antibiotics often fail to penetrate.

  • Antibiotics
  • In older patients with less severe symptoms, oral antibiotics are usually sufficient.  Sometimes, one or two injections of antibiotics will be given as well. 
  • In younger children, or those who fail to show rapid improvement on oral medication, IV antibiotics or possibly tissue sampling, may be necessary.
  • If an abscess is found, this must be drained, since neither IV nor oral antibiotics can penetrate the abscess.  Depending upon the size and location of the abscess, this may be done by a pediatrician, radiologist, or otolaryngologist (an ENT, or ear-nose-throat specialist).
  • With proper antibiotic therapy, the majority of children with this condition do very well.  It should be noted, however, that the enlarged lymph node itself will continue to be enlarged for several months after the actual infection has been cured.

  • See your pediatrician immediately.

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