Saturday, March 23, 2013

Cervical Lymphadenopathy


Cervical Lymphadenopathy
most common neck mass in children.
If - anterior to the sternocleidomastoid muscle.
Infection is the usual cause of enlargement; viral etiology and persist for months.
Acute suppurative submandibular adenitis occur in early childhood (6 mo-3 yrs), is preceded by pharyngitis or URI, the child develops erythema, swelling and cellulitis, and management is antibiotics and drainage.

Chronic adenitis: -

persistent node (> 3 wk., tonsillar),
solitary, non-tender, mobile and soft.
Generally no treatment if < 1 cm,
nodes above 2 cm sizes with rapid growth, clustered, hard or matted do biopsy.
Other causes are: (1) Mycobacterial adenitis- atypical (MAIS complex), swollen, non-tender, nor-inflamed, positive skin test, excision is curative,
(2) Cat-Scratch adenitis- caused by A. Fellis, transmitted by kittens, positive complement fixation test, minimally tender, fluctuant regional nodes, spontaneous resolution.
(3) Hodgkin's disease - teenage and young adults, , non-tender node, associated to weight loss, biopsy is diagnostic.

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