Learn about cervical lymphadenitis, an infection of one or more lymph nodes in the neck.
Key points
Cervical lymphadenitis is an infection of one or more lymph nodes in the neck.
The most common cause of lymphadenitis on one side of the neck is a bacterial infection.
Antibiotics are needed to treat lymphadenitis caused by bacteria.
Sometimes an abscess develops in or near the infected lymph node and requires surgery.
Introduction
What is cervical lymphadenitis?
If your child has fever and their lymph nodes are large, very tender and the surrounding skin turns red, a lymph node may be infected. When the lymph nodes in the neck are infected, it is called cervical lymphadenitis. Bacteria are the most common germs that cause cervical lymphadenitis affecting one lymph node or one side of the neck. This article focuses on cervical lymphadenitis caused by bacterial infections.
More information
What are lymph nodes?
Cervical lymph nodes
Lymph nodes are an important part of the immune system. They act like tiny filters, catching viruses and bacteria for white blood cells to destroy. They also produce substances that help kill infection-causing germs.
The body has over 600 lymph nodes. These are located all around the body except for the brain and heart. Most lymph nodes are found in groups under the skin in the armpit, groin and neck. They are also found deep in the chest and abdomen.
Lymph nodes usually measure 0.5 to 1.5 cm across, depending on where they are located. In general, lymph nodes are about the size of a pea.
Why do lymph nodes get swollen?
Lymph nodes often get larger when the body is fighting an infection. Young children are constantly being exposed to viral infections, so their lymph nodes are often larger than those of adults. Many infections that cause fever, congestion or sore throat in children can also lead to swollen lymph nodes.
Most common viral infections cause swelling on both sides of the neck. However, bacteria are more likely to infect a single lymph node on one side of the neck, causing it to get larger than the others. Other conditions that are not infections may also cause fever and a swollen lymph node on one side of the neck in children, including Kawasaki disease and MIS-C.
Cervical lymphadenitis
Signs and Symptoms
Signs and symptoms of cervical lymphadenitis
Children with cervical lymphadenitis caused by bacteria may have:
fever
swelling and tenderness on one side of the neck
redness or warmth of the skin
difficulty turning their neck
symptoms that develop over a short time (usually one to two days)
a recent viral infection
Diagnosis
How is cervical lymphadenitis diagnosed?
A health-care provider can diagnose cervical lymphadenitis by asking you questions and examining your child. If your child appears more ill or if the health-care provider suspects that there is an abscess, they may order blood tests and an ultrasound.
Treatment
How is cervical lymphadenitis treated?
Antibiotics are required to treat cervical lymphadenitis caused by bacteria. Children with dental infections, recent travel, exposure to animals or who have risk factors for MRSA or tuberculosis may need further testing to confirm the cause and treat their infection.
Children with mild infections can be treated with oral antibiotics at home. Children who appear ill or who have a lot of pain or difficulty drinking or swallowing may need to be admitted to hospital for IV antibiotics (antibiotics given through the vein). Children who have not improved after a few days of oral antibiotics may also need admission to hospital for IV antibiotics.
Children who develop an abscess also require surgery to drain the abscess and treat the infection.
Complications
What are the possible complications of cervical lymphadenitis?
Some children develop an abscess within or near a lymph node that is infected with bacteria. An abscess is a collection of pus and bacteria that cannot be reached by antibiotics. When an abscess develops, most children also require surgery to drain the abscess and treat the infection.
Follow-up care
What to expect after treatment for cervical lymphadenitis
Even after the infection is successfully treated, your child’s lymph nodes may take several weeks or months to slowly return to their normal size.
When to Seek Medical Attention
Take your child to a health-care provider if:
Your child has a swollen, tender or red lymph node on one side of their neck.
Your child has cervical lymphadenitis and is not improving after two days of antibiotics.
Your child is being treated for cervical lymphadenitis, and the swelling is getting larger and more painful.
Your child may show physical changes when their condition is serious or when their condition gets worse. Parents and caregivers can learn how to spot these signs in order to seek help from a health-care provider.
