A 5 year old girl presents to the clinic with a neck mass. It was noticed by a parent 3 days ago and remarked it has markedly grown in size.
The child has been afebrile. There have been no sick contacts. Her immunizations are delayed. The child has been growing well.
Past Medical History: The child was born at 36 weeks.
Family History: positive for Crohn's disease in the father.
On examination the child appears unwell. There is a unilateral 1 cm mass located in the right anterior cervical chain. The mass is not warm, painful, fluctuant and fixed. The overlying skin is mildly red.
This child most likely has cervical adenitis due to the acute history, increased temperature (on monitor), signs of inflammation on physical exam. Cervical adenitis should be treated with antibiotics.
Friedmann AM. Evaluation and Management of Lymphadenopathy in Children. Pediatrics in Review 2008; 29: 53-60.
Nice comprehensive review.
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