Lymphadenopathy in Children
What is lymphadenopathy?
Lymphadenopathy is the term for swelling of the lymph nodes or glands. These are the
bean-shaped glands in the neck, armpits, groin, chest, and abdomen. They act as filters
for the lymph fluid as it flows through the body. 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?
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. Or swollen lymph nodes around the jaw may be
a sign of an infection in the teeth or mouth. But 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
- Drug reactions to medicines such as some antibiotics and seizure medicines
- Juvenile arthritis and many other joint conditions that affect kids
What are the symptoms of lymphadenopathy?
In children, it is 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:
- Respiratory symptoms such as sore throat, congestion, and cough
- Poor appetite
- Body aches
The symptoms of lymphadenopathy can be like other health conditions. Make sure your child
sees his or her healthcare provider for a diagnosis.
How is lymphadenopathy diagnosed?
Your child’s healthcare provider will ask many questions about your child’s health
history and current symptoms. For example, he or she will ask whether your child has
been around others with infections like strep throat. Or he or she 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. He or she 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. He or she will also want to know how long they
have been swollen and if they are painful. Your child may need to see a specialist.
He or she 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.
- Chest X-ray. Pictures of the chest to check for enlarged lymph nodes or other problems.
- Lymph node biopsy. After 3 to 4 weeks, enlarged lymph nodes may be checked with biopsy. Samples of lymph
node tissue are taken and looked at under a microscope.
Your child may need to see a surgeon for biopsy. Or he or she may be referred to specialists
in blood disorders and cancer. These can include a pediatric hematologist and oncologist.
How is lymphadenopathy treated?
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 the complications of lymphadenopathy?
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, even after your child
sees his or her healthcare provider
Key points about lymphadenopathy
- 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:
- Before your visit, write down questions you want answered.
- At the visit, write down the names of new medicines, treatments, or tests, and any
new instructions your provider gives you for your child.
- 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. This is important
if your child becomes ill and you have questions or need advice.