A 2 year old boy 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 been afebrile. There have been sick contacts. His immunizations are up to date. 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 3 cm mass located in the left anterior cervical chain. The mass is hot, exquisitely tender, non-fluctuant 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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