A 7 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 noted to have a fever. There have been no sick contacts. His immunizations are up to date. 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 3 cm mass located in the left anterior cervical chain. The mass is warm, painful, fluctuant and mobile. The overlying skin is mildly 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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