Lymphadenopathy in Children
Lymphadenopathy means swelling of
the lymph nodes or glands. These are the bean-shaped glands in the neck, armpits,
chest, and abdomen. These glands act as filters for lymphatic fluid. This fluid contains
white blood cells (lymphocytes) that help the body fight infection. Lymphadenopathy
occur in just one area of the body, such as the neck. Or it may affect lymph nodes
throughout the body. The cervical lymph nodes, found in the neck, are the most common
site of lymphadenopathy.
Nearly all children will get lymphadenopathy at some time. That is because enlarged
glands often occur with viral or bacterial infections like colds, the flu, or strep
The lymphatic system is part of the immune system. The immune system fights infection
and other disease. Cells and fluid build up in the lymph nodes to help fight infection
or disease. This causes the lymph nodes to get bigger.
Enlarged lymph nodes are often near the source of infection, so their location can
help find out the cause. For example, a baby with a scalp infection may have enlarged
lymph nodes at the back of the neck. Swollen lymph nodes around the jaw may be a sign
of an infection in the teeth or mouth. Lymphadenopathy may also affect lymph nodes
throughout the body. This is common in some viral illnesses such as mono (infectious
mononucleosis) or chickenpox.
The causes include:
- Infections caused by viruses or bacteria
- Infection of a lymph node or small group of nodes
- Cancer, although other symptoms are often present
- Reactions to medicines, such as some
antibiotics and seizure medicines
- Juvenile arthritis and many other joint conditions that affect children
In children, it's normal to be able
to feel some lymph nodes as small, movable lumps under the skin. But if the nodes
bigger than usual, your child may have an infection or other problem. The most common
- Lumps under the jaw, down the sides or back of the neck, or in the armpits, groin,
chest, or belly
- Pain or tenderness in the area
- Redness or warmth in the area
Depending on the cause, other symptoms may include:
- Respiratory symptoms such as sore
throat, congestion, and cough
- Poor appetite
- Body aches
- Weight loss
The symptoms of lymphadenopathy can
be like other health conditions. Make sure your child sees their healthcare provider
Your child’s healthcare provider
will ask many questions about your child’s health history and current symptoms. For
example, they will ask whether your child has been around others with infections like
strep throat. They may ask if your child has been around a young cat. This is because
scratch may cause enlarged lymph nodes in a mild condition called cat scratch disease.
They will check your child, looking closely at the areas where lymph nodes are enlarged.
The provider will check the size and location of the nodes. The provider will also
to know how long they have been swollen and if they are painful. Your child may need
see a specialist. They may also need some diagnostic tests. They may include:
Lab tests. A complete blood count called a CBC. A
CBC checks the red blood cells, white blood cells, blood clotting cells, and
sometimes young red blood cells. Urine and other blood tests may also be done.
Imaging tests. These can include a chest X-ray to check
for enlarged lymph nodes or other problems. Your child may also have other imaging
tests such as a CT or MRI scan.
Lymph node biopsy. Enlarged lymph nodes may be checked
with biopsy. Samples of lymph node tissue are taken and looked at under a microscope.
They are tested for different causes of enlargement.
Your child may need to see a
surgeon for biopsy. Or they may be referred to specialists in blood disorders and
cancer. These can include a pediatric hematologist and oncologist.
The treatment of enlarged lymph nodes depends on the cause. Enlarged lymph nodes are
often harmless and go away without any treatment. Treatment may include:
- Antibiotic medicines to treat an underlying bacterial infection, such as strep throat,
or ear or skin infections
- Antibiotic medicines and drainage of the lymph node for infection of a lymph node
or small group of nodes
- A follow-up exam to recheck enlarged nodes after waiting for 3 to 4 weeks
- Other medicines or procedures to treat other conditions that caused the enlarged nodes
- Referral to specialists for incision or drainage or more exams, diagnostic tests,
Lymphadenopathy is the body’s normal response to infection and other disease. Ignoring
the enlarged lymph nodes may delay treatment of a serious infection or other disease.
When to Call a Healthcare Provider
Call your child’s healthcare provider if:
- You notice lumps below your child’s
jaw, down the sides of the neck, in the back of the neck, in the armpits, or in the
- Your child’s lymph nodes continue to
be larger than normal, become newly tender, or develop redness of the skin over them,
even after your child sees their healthcare provider.
- Your child complains of any problems or pain when
- You hear any abnormal breathing sounds or your child complains
of having a hard time breathing.
- Lymphadenopathy is the term for swollen glands or swelling of the lymph nodes.
- The lymph glands are part of the immune system and help fight infections and other
disease. They are enlarged when the body is fighting infection or other diseases.
- Since enlarged lymph nodes are often near the source of infection, their location
can help find the cause.
- Diagnosis of lymphadenopathy is often based on the presence of other conditions, such
as an infection.
- Treatment is usually based on the cause of the lymphadenopathy.
- Ignoring lymphadenopathy may delay treatment of a serious infection or other disease.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects are
and when they should be reported.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s
provider after office hours, and on weekends and holidays. This is important if your
child becomes ill and you have questions or need advice.