Pediatric Lymphadenitis

Lymphadenitis, an infection of the lymph nodes, is a common diagnosis in children of all ages. Typically caused by either a viral or bacterial infection, lymphadenitis is inflammation of the lymph nodes. A singular node or multiple nodes can be affected at one time. The most commonly affected lymph nodes are located in the neck, armpits and groin.

Why Pediatric Lymphadenitis Occurs

• Lymph nodes are a part of the lymphatic system. The lymphatic system produces lymph fluid, which is used by the body to fight infection. It is the job of the lymph nodes to make white blood cells that fight infection as well as to filter lymph fluid. When an infection or attacking material, such as cancer cells, appears in the lymph fluid, the lymph nodes will produce more white blood cells, which cause the nodular swelling seen in pediatric lymphadenitis.

Causes

• Pediatric lymphadenitis is most commonly caused by viral infections although it can also be caused by bacterial and parasitic infections. Luckily, these causes are easily treatable if caught early on. Some of these common infections include strep throat, mononucleosis, ear infection, toxoplasmosis (a parasitic infection caused by contact with cat feces or undercooked meats), dental problems and the common cold. Unfortunately, there are also more serious causes of lymphadenitis in which the swelling of the lymph nodes is only one of many symptoms. These underlying causes include cancers, such as lymphoma and leukemia, as well as human immunodeficiency virus (HIV) and lupus. Swelling of the lymph nodes is also an indication of infections, such as tuberculosis and syphilis (which can be passed from mother to child in utero or at birth).

Symptoms

• While swelling is the most obvious symptom of lymphadenitis, other signs may include tenderness and pain at the site of swelling, redness, fever, sore throat and runny nose. Occasionally, nodes may become so swollen that a blockage will occur, leading to the swelling of an entire limb. A child with lymphadenitis may also present as irritable, unable to sleep, unwilling to eat or unable to swallow. In addition, symptoms common to the underlying cause of lymph swelling may be noted, such as complaints of ear pain or tugging at the ears in children with ear infections, or oral abscesses and cavities in those where dental problems are the culprit.

Diagnosis

• Your doctor will be able to make a diagnosis of lymphadenitis based on your child’s symptoms, a physical assessment and a series of tests. A physical assessment will be done to check the size of swollen nodes as well as tenderness or warmth at the site. Your doctor will also ask about any other symptoms your child is experiencing in addition to nodular swelling. A complete blood count (CBC), used to detect infection, cancer or other causes of lymphadenitis, may be ordered by your doctor. A CT scan, ultrasound or x-ray may also aid in the diagnosis of lymphadenitis.

Treatment

• The treatment prescribed for pediatric lymphadenitis will depend on the underlying cause. If the cause of nodular swelling is bacterial in nature, treatment with antibiotics will usually be necessary. Common antibiotics used in the treatment of lymphadenitis include penicillin, nafcillin, cephalosporin and erythromycin. If a viral infection is the cause of nodular swelling, the child should improve once the viral infection has run its course as there is no medical cure for viral infections. If the swelling is a symptom of a more significant problem, such as cancer, care will be based on treating the primary diagnosis. In addition, warm compresses and over-the-counter pain relievers, such as ibuprofen and acetaminophen, can help with pain and swelling. It is also important to make sure that children with lymphadenitis get enough rest and are well hydrated.