eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease

Lymphadenitis: Follow-up

Author: Ulfat Shaikh, MD, MPH, Assistant Professor of Pediatrics, Department of Pediatrics, University of California Davis Medical Center
Coauthor(s): Dean A Blumberg MD, Associate Professor of Pediatrics, Section of Pediatric Infectious Disease, University of California Davis School of Medicine; Acting Chief, Section of Pediatric Infectious Disease, UC Davis Medical Center
Contributor Information and Disclosures

Updated: Apr 14, 2008

Follow-up

Further Inpatient Care

  • Contact the primary medical physician for follow-up care, coordination of care, and referrals, if required.
  • Contact a surgeon for procedures such as excision, incision, and drainage.

Further Outpatient Care

  • Contact the primary care provider to ensure lesion resolution and treatment compliance.

Complications

  • Cellulitis
  • Suppuration
  • Systemic involvement
  • Internal jugular vein thrombosis
  • Septic embolic phenomena
  • Carotid artery rupture
  • Mediastinal abscess
  • Purulent pericarditis

Prognosis

  • Prognosis depends on the etiology of the lymphadenopathy and when intervention is started. Infectious processes usually have better outcome if treatment is initiated early.

Patient Education

  • Instruct patients and parents in the use and importance of medications and regular follow-up.

Miscellaneous

Medicolegal Pitfalls

  • Knowledge of the many and sometimes rare causes of lymph node enlargement is important to initiate the appropriate workup.
  • Patients with lymph node enlargement are usually concerned about malignancy; address these concerns early on.
  • Misdiagnosis of potentially life-threatening etiologies may have medicolegal implications for the physician.
 


More on Lymphadenitis

Overview: Lymphadenitis
Differential Diagnoses & Workup: Lymphadenitis
Treatment & Medication: Lymphadenitis
Follow-up: Lymphadenitis
References
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References

  1. Friedmann AM. Evaluation and management of lymphadenopathy in children. Pediatr Rev. Feb 2008;29(2):53-60. [Medline].

  2. Fraser L, Moore P, Kubba H. Atypical mycobacterial infection of the head and neck in children: a 5-year retrospective review. Otolaryngol Head Neck Surg. Mar 2008;138(3):311-4. [Medline].

  3. Guss J, Kazahaya K. Antibiotic-resistant Staphylococcus aureus in community-acquired pediatric neck abscesses. Int J Pediatr Otorhinolaryngol. Jun 2007;71(6):943-8. [Medline].

  4. Guffey MB, Dalzell A, Kelly DR, Cassady KA. Ulceroglandular tularemia in a nonendemic area. South Med J. Mar 2007;100(3):304-8. [Medline].

  5. Pepper S, Islam HK, Jayabose S, et al. Neuroblastoma masquerading as cervical lymphadenitis. J Pediatr Hematol Oncol. Apr 2007;29(4):260-1. [Medline].

  6. Chuang CH, Yan DC, Chiu CH, et al. Clinical and laboratory manifestations of Kikuchi's disease in children and differences between patients with and without prolonged fever. Pediatr Infect Dis J. Jun 2005;24(6):551-4. [Medline].

  7. Rigante D, La Torraca I, Rossodivita A, et al. Unilateral cervical mass as a main clue raising the diagnostic suspicion of Kawasaki syndrome. Rheumatol Int. Nov 2007;28(1):73-6. [Medline].

  8. Simanovsky N, Hiller N. Importance of sonographic detection of enlarged abdominal lymph nodes in children. J Ultrasound Med. May 2007;26(5):581-4. [Medline].

  9. Ahuja A, Ying M, Yuen YH, Metreweli C. Power Doppler sonography of cervical lymphadenopathy. Clin Radiol. Dec 2001;56(12):965-9. [Medline].

  10. Chao SS, Loh KS, Tan KK, Chong SM. Tuberculous and nontuberculous cervical lymphadenitis: A clinical review. Otolaryngol Head Neck Surg. Feb 2002;126(2):176-9. [Medline].

  11. Elden LM, Grundfast KM, Vezina G. Accuracy and usefulness of radiographic assessment of cervical neck infections in children. J Otolaryngol. Apr 2001;30(2):82-9. [Medline].

  12. Eriksson M, Bennet R, Danielsson N. Non-tuberculous mycobacterial lymphadenitis in healthy children: another "lifestyle disease"?. Acta Paediatr. Nov 2001;90(11):1340-2. [Medline].

  13. Green M. Lymphadenopathy. In: Pediatric Diagnosis. 5th ed. WB Saunders Co; 1992:393-7.

  14. 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].

  15. Koybasi S, Saydam L, Gungen Y. Histiocytic necrotizing lymphadenitis of the neck. Am J Otolaryngol. Sep-Oct 2003;24(5):344-7. [Medline].

  16. Loeffler AM. Treatment options for nontuberculous mycobacterial adenitis in children. Pediatr Infect Dis J. Oct 2004;23(10):957-8. [Medline].

  17. Peters TR, Edwards KM. Cervical lymphadenopathy and adenitis. Pediatr Rev. Dec 2000;21(12):399-405. [Medline].

  18. Thomas KT, Edwards KM. Periodic fever syndrome. Pediatr Infect Dis J. Jan 1999;18(1):68-9. [Medline].

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Further Reading

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Keywords

lymphadenitis, adenopathy, lymphadenopathy, lymph node enlargement, lymph node inflammation, lymph node infection, postauricular node, supraclavicular node, epitrochlear node, popliteal node, tuberculous lymphadenitis, regional adenopathy, cervical adenopathy, splenomegaly, human immunodeficiency virus infection, HIV infection, torticollis, dysphagia, dyspnea, stridor, pleural effusion, upper respiratory symptoms, sore throat, earache, coryza, conjunctivitis

impetigo, dental caries, dental abscess, stomatitis, pharyngitis, scalp infections, seborrheic dermatitis, scalp pediculosis, periodic fever, PFAPA syndrome, Yersinia pestis, bubonic plague, atypical mycobacteria, tularemia, Yersinia enterocolitica, Salmonella infection, rubella, parvovirus infection, tuberculosis, chronic sinusitis, histoplasmosis, candidiasis, coccidioidomycosis, bronchiectasis, Hodgkin disease, atopic eczema, group B streptococcal cellulitis, adenitis, hepatosplenomegaly, preauricular adenopathy

Parinaud oculoglandular syndrome, catscratch disease, chlamydial conjunctivitis, listeriosis, brucellosis, adenovirus type 3, epidemic keratoconjunctivitis, Bartonella henselae, cytomegalovirus, toxoplasmosis, Gianotti-Crosti syndrome, juvenile rheumatoid arthritis, serum sickness, graft versus host disease, acute leukemia, lymphosarcoma, reticulum cell sarcoma, non-Hodgkin lymphoma, malignant histocytosis, histocytic lymphoma, nonendemic Burkitt tumor, nasopharyngeal rhabdomyosarcoma, neuroblastoma, thyroid carcinoma, chronic lymphocytic thyroiditis, histiocytosis X, Kikuchi disease, benign sinus histiocytosis

angioimmunoblastic lymphadenopathy, immunoblastic lymphadenopathy, chronic granulomatous disease of childhood, acquired immunodeficiency syndrome, AIDS, hyperimmunoglobulin E (Job) syndrome, Gaucher disease, Niemann-Pick disease, cystinosis, sickle cell anemia, thalassemia, congenital hemolytic anemia, autoimmune hemolytic anemia, Kawasaki disease, Castleman disease, benign giant lymph node hyperplasia

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Contributor Information and Disclosures

Author

Ulfat Shaikh, MD, MPH, Assistant Professor of Pediatrics, Department of Pediatrics, University of California Davis Medical Center
Ulfat Shaikh, MD, MPH is a member of the following medical societies: American Academy of Pediatrics and American Public Health Association
Disclosure: Nothing to disclose.

Coauthor(s)

Dean A Blumberg MD, Associate Professor of Pediatrics, Section of Pediatric Infectious Disease, University of California Davis School of Medicine; Acting Chief, Section of Pediatric Infectious Disease, UC Davis Medical Center
Dean A Blumberg MD is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, California Medical Association, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Sierra Sacramento Valley Medical Society
Disclosure: Novartis Grant/research funds clinical research investigator; GlaxoSmithKline Grant/research funds clinical research investigator; Merck speaking fees paid to university, not self Speaking and teaching; sanofi pasteur speaking fees paid to university, not self Speaking and teaching

Medical Editor

Gary J Noel, MD, Department of Pediatrics, Clinical Associate Professor, Weill Medical College of Cornell University
Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Larry I Lutwick, MD, Professor of Medicine, State University of New York, Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus
Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

CME Editor

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Consulting; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching; sanofi pasteur Grant/research funds Unrestricted research grant; sanofi pasteur  Consulting; sanofi pasteur Honoraria Speaking and teaching; Tap Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD, Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association
Disclosure: None None None

 
 
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