Cervical lymphadenopathy in children : a diagnostic approach

Abstract EN

Objective : to determine the common causes of persistent cervical lymphadenopathy in children and to test a diagnostic approach.

Methods : this study was conducted at King Hussein Medical Center / pediatric clinic over one year period to look for all children between ages of 6 months and 14 years with persistent lymph node enlargement.

Persistent enlargement is defined as a lymph node > 1 cm in diameter, and > 2 weeks duration.

A management algorithm was proposed and followed in the management.

Results : One hundred and thirty children presented to infectious diseases clinic with persistent lymph nodes enlargement.

In 70 children (53 %) the nodes regressed in 2 weeks' time, in another 30 children (23%) they regressed in 4 weeks' time.

Fifteen children (12 %) had tuberculosis lymphadenitis ; 10 children (8 %) had lymph node abscess; 3 children (2 %) had Epstein Barr virus infection and 2 children (1.5 %) had Hodgkin’s lymphoma on initial presentation.

Conclusion : reactive lymphadenitis is the commonest cause of cervical lymph node enlargement in children.

Majority of lymph nodes regress in 4 weeks' time.

Persisting lymph nodes more than 4 weeks warrant histological examination.

Tuberculosis is a common cause of cervical lymphadenopathy among Jordanian children.