A 3 year old boy presents to the clinic with a neck mass. It was noticed by a parent 4 days ago and remarked it has markedly grown in size.
The child has been febrile. There have been no sick contacts. His immunizations are delayed. The child has been growing well.
Past Medical History: The child has a history of mild asthma.
Family History: unremarkable.
On examination the child appears unwell. There is a unilateral 3 cm mass located in the right anterior cervical chain. The mass is hot, painful, fluctuant and mobile. The overlying skin is erythematous.
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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