eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease
Lymphadenitis: Differential Diagnoses & Workup
Updated: Nov 19, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Other Problems to Be Considered
Lymphoma
Mycobacterial infection
Kikuchi disease
Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome
Workup
Laboratory Studies
The following studies may be indicated in patients with lymphadenitis:
- Gram stain: Staining can be performed on aspirated tissue. Gram staining is a quick method used to evaluate bacterial etiologies.
- Culture of aspirated tissue or biopsy specimen: Culturing is performed to determine the causative organism and sensitivity to antibiotics.
- Monospot: Monospot (in older children) or Epstein-Barr virus (EBV) serologies are useful to confirm the diagnosis of infectious mononucleosis.
- B henselae serologies: These can be used to confirm the diagnosis of catscratch disease.
- Skin testing: Purified protein derivative testing can be helpful in confirming the diagnosis of tuberculous lymphadenopathy and may be suggestive of atypical mycobacterial infection.
- CBC count: A high WBC count may indicate an infectious etiology.
- Erythrocyte sedimentation rate: A high erythrocyte sedimentation rate is a nonspecific indicator of inflammation.
- Liver function tests: These may indicate hepatic or systemic involvement. An elevation may occur in infectious mononucleosis.
Imaging Studies
- Ultrasonography: Images may be helpful in detecting the extent of the spread of lymphadenopathy.9
- Chest radiography: Radiography may be helpful in determining pulmonary involvement or spread of lymphadenopathy to the chest.
Procedures
- Needle aspiration
- Partial or excisional biopsy
A lymph node biopsy is performed. Note that a marking pen has been used to outline the node before removal and that a silk suture has been used to provide traction to assist the removal.
- Incision and drainage
More on Lymphadenitis |
| Overview: Lymphadenitis |
 Differential Diagnoses & Workup: Lymphadenitis |
| Treatment & Medication: Lymphadenitis |
| Follow-up: Lymphadenitis |
| Multimedia: Lymphadenitis |
| References |
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References
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Pepper S, Islam HK, Jayabose S, et al. Neuroblastoma masquerading as cervical lymphadenitis. J Pediatr Hematol Oncol. Apr 2007;29(4):260-1. [Medline].
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Green M. Lymphadenopathy. In: Pediatric Diagnosis. 5th ed. WB Saunders Co; 1992:393-7.
Hazra R, Robson CD, Perez-Atayde AR, Husson RN. Lymphadenitis due to nontuberculous mycobacteria in children: presentation and response to therapy. Clin Infect Dis. Jan 1999;28(1):123-9. [Medline].
Koybasi S, Saydam L, Gungen Y. Histiocytic necrotizing lymphadenitis of the neck. Am J Otolaryngol. Sep-Oct 2003;24(5):344-7. [Medline].
Loeffler AM. Treatment options for nontuberculous mycobacterial adenitis in children. Pediatr Infect Dis J. Oct 2004;23(10):957-8. [Medline].
[Guideline] Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. Oct 26 2004;110(17):2747-71. [Medline].
Peters TR, Edwards KM. Cervical lymphadenopathy and adenitis. Pediatr Rev. Dec 2000;21(12):399-405. [Medline].
Thomas KT, Edwards KM. Periodic fever syndrome. Pediatr Infect Dis J. Jan 1999;18(1):68-9. [Medline].
Further Reading
Keywords
lymphadenitis, adenopathy, lymphadenopathy, lymph node enlargement, lymph node inflammation, lymph node infection, periodic fever, PFAPA syndrome, Kawasaki disease, Castleman disease, benign giant lymph node hyperplasia
