Lymphadenopathy in Children
What is lymphadenopathy in children?
Lymphadenopathy means swelling of the lymph nodes or glands. These are the bean-shaped
glands in the neck, armpits, groin, 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 can 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
What causes lymphadenopathy in a child?
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
What are the symptoms of lymphadenopathy in a child?
In children, it's normal to be able to feel some lymph nodes as small, movable lumps
under the skin. But if the nodes get bigger than usual, your child may have an infection
or other problem. The most common symptoms include:
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:
The symptoms of lymphadenopathy can be like other health conditions. Make sure your child
sees their healthcare provider for a diagnosis.
How is lymphadenopathy diagnosed in a child?
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 a 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 want to know how long they have been
swollen and if they are painful. Your child may need to 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.
How is lymphadenopathy treated in a child?
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,
What are possible complications of lymphadenopathy in a child?
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 should I call my child’s 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 groin.
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
Your child complains of any problems or pain when swallowing.
You hear any abnormal breathing sounds or your child complains of having a hard time
Key points about lymphadenopathy in a child
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