A 9 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 a one day history of fever. There have been no sick contacts. Her immunizations are delayed. The child has been growing well.
Past Medical History: The child had a febrile seizure as a baby.
Family History: unremarkable.
On examination the child appears tired. There is a unilateral 4 cm mass located in the left anterior cervical chain. The mass is warm, exquisitely tender, firm and mobile. 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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