A 6 year old boy presents to the clinic with a neck mass. It was noticed by a parent 5 days ago and remarked it has not changed in size.
The child has been febrile. There have been sick contacts. His immunizations are delayed. The child has been growing well.
Past Medical History: The child was born at 36 weeks.
Family History: older sibling with asthma.
On examination the child appears well. There is a unilateral 2 cm mass located in the right anterior cervical chain. The mass is warm, tender, hard and mobile. The overlying skin is normal.
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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