A 5 year old girl presents to the clinic with a neck mass. It was noticed by a parent 2 days ago and remarked it has markedly grown in size.
The child has felt warm. There have been sick contacts. Her immunizations are incomplete. The child has been growing well.
Past Medical History: The child has mild eczema.
Family History: positive for Crohn's disease in the father.
On examination the child appears tired. There is a unilateral 2 cm mass located in the right anterior cervical chain. The mass is hot, exquisitely tender, non-fluctuant and fixed. The overlying skin is 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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