A 7 year old girl presents to the clinic with a neck mass. It was noticed by a parent 3 days ago and remarked it has increased in size.
The child has been febrile. There have been no sick contacts. Her immunizations are delayed. The child has been growing well.
Past Medical History: The child is allergic to peanuts.
Family History: positive for breast cancer in the mother and grandmother.
On examination the child appears unwell. There is a unilateral 3 cm mass located in the right anterior cervical chain. The mass is not warm, non-tender, firm 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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