Cervical Lymphadenopathy

  • Andrew M. Margileth


Enlarged lymph nodes are a common finding in children and adolescents. Lymphadenopathy in these age groups is defined as a nontender lymph node larger than 10 mm in most anatomic sites, with two exceptions: An epitrochlear node 5 mm or larger is considered abnormal, and an inguinal node 15 mm or smaller is likely to be normal. In healthy adults, inguinal nodes 0.5 cm to 2 cm in diameter frequently are normal. In all ages, cervical lymphadenopathy most often is a transient response to benign local or generalized infections, primarily of the upper respiratory tract and skin.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.



  1. 1.
    Fournier PE, et al.: Outbreak of Rickettsia africae infections in participants of an adventure race in South Africa. Clin Infect Dis 1988; 27:316–323.CrossRefGoogle Scholar
  2. 2.
    Henry PH, Longo DL: Enlargement of lymph nodes and spleen. In Harrison’s Principles of Internal Medicine, edn 14. Edited by Fanci AS, et al. New York: McGraw Hill; 1998: 345.Google Scholar
  3. 3.
    Netter FH: Atlas of Human Anatomy. Summit, NJ: Ciba-Geigy; 1989.Google Scholar
  4. 4.
    Geneser F: Color Atlas of Histology. Philadelphia: Lea & Febiger; 1986.Google Scholar
  5. 5.
    Hammersen F: Color Atlas of Microscopic Anatomy,edn 3. Baltimore: Urban & Schwarzenberg; 1985; 80–83.Google Scholar
  6. 6.
    Wenger JK: Supraglottitis and group A streptococcus. Pediatr Infect Dis J 1997; 16: 1005–1007.PubMedCrossRefGoogle Scholar
  7. 7.
    Margileth AM, Baehren DF: Chest-wall abscess due to cat-scratch disease (CSD) in an adult with antibodies to Bartonella clarridgeiae: case report and review of the thoracopulmonary manifestations of CSD. Clin Infect Dis 1998, 27: 353–357.PubMedCrossRefGoogle Scholar
  8. 8.
    English CK, Wear DJ, Margileth AM, et al.: Cat-scratch disease: isolation and culture of the bacterial agent. JAMA 1988, 259:1347–1352.PubMedCrossRefGoogle Scholar
  9. 9.
    Margileth AM: Cervical adenitis. Pediatr Rev 1985, 7: 16.CrossRefGoogle Scholar
  10. 10.
    Wear DJ, Margileth AM, Hadfield T, et al.: Cat scratch disease, a bacterial infection. Science 1983; 221:1403–1405.PubMedCrossRefGoogle Scholar
  11. 11.
    Margileth AM, Zawadsky PM: Chronic lymphadenopathy in children and adolescents. Am Fam Physician 1985, 31: 160–180.Google Scholar
  12. 12.
    Margileth AM, Hatfield T: A new look at old cat scratch. Contemp Pediatr 1990, 7: 27.Google Scholar
  13. 13.
    Haas WH, Amthor B, Engelmann G, et al.: Preoperative diagnosis of Mycobacterium avium lymphadenitis in two immunocompetent children by polymerase chain reaction of gastric aspirates. Pediatr Infect Dis J 1998, 17:1016–1020.PubMedCrossRefGoogle Scholar
  14. 14.
    Margileth AM: Nontuberculous [atypical] mycobacterial disease. Semin Pediatr Infect Dis 1993, 4: 307–315.Google Scholar
  15. 15.
    Longfield JM, Margileth AM: Intraobserver and method variability in tuberculin skin testing. Pediatr Infect Dis J 1984, 3: 323.CrossRefGoogle Scholar
  16. 16.
    Lampe RL, et al.: Cervicofacial nocardiosis in children. J Pediatr 1981, 99:563–565.CrossRefGoogle Scholar
  17. 17.
    Kneen R, Pham NG, Solomon T, et al.: Penicillin vs. erythromycin in the treatment of diphtheria. Clin Infect Dis 1998,27:845–850.PubMedCrossRefGoogle Scholar
  18. 18.
    Kimberlin DW: Human herpesviruses 6 and 7: identification of newly recognized viral pathogens and their association with human disease. Pediatr Infect Dis J 1998, 17:59–68..PubMedCrossRefGoogle Scholar
  19. 19.
    Petursson G, Helgason S, Gudmundsson S, Sigurdsson JA: Herpes zoster in children and adolescents. Pediatr Infect Dis J 1998, 17: 905–908.PubMedCrossRefGoogle Scholar
  20. 20.
    Salzman MB, Garcia C: Postexposure varicella vaccination in siblings of children with active varicella. Pediatr Infect Dis J 1998, 17: 256–257.PubMedCrossRefGoogle Scholar
  21. 21.
    Gerson AA, LaRussa PS: Varicella vaccine. Pediatr Infect Dis J 1998, 17: 248–249.CrossRefGoogle Scholar
  22. 22.
    Adler SP, Hempfling SH, Starr SE, et al.: Safety and immunogenicity of the Towne strain cytomegalovirus vaccine. Pediatr Infect Dis J 1998, 17:200–206.PubMedCrossRefGoogle Scholar
  23. 23.
    Saez-Llorens X, Ramilo O: Early experience with protease inhibitors in human immunodeficiency virus-infected children. Pediatr Infect Dis J 1998, 17: 728–738.PubMedCrossRefGoogle Scholar
  24. 24.
    Weston WL, Morelli JG: Neonatal tinea capitis. Pediatr Infect Dis J 1998, 17: 257–258.PubMedCrossRefGoogle Scholar
  25. 25.
    Wallon M, Caudie C, Rubio S, et al.: Value of cerebrospinal fluid cytochemical examination for the diagnosis of congenital toxoplasmosis at birth in France. Pediatr Infect Dis J 1998,17:705–710.PubMedCrossRefGoogle Scholar
  26. 26.
    Burns JC, Capparelli EV, Brown JA, et al.: Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group. Pediatr Infect Dis J 1998,17:1144–1148.PubMedCrossRefGoogle Scholar

Selected Bibliography

  1. American Academy of Pediatrics: HIV Infections. In Red Book Report of Committee on Infectious Diseases, edn 24. Edited by Peter G. Elk Grove, IL: Edited by Peter G. 1997: 279–304; 547.Google Scholar
  2. Bass JW, Freitas BC, Freitas AD, et al.: Prospective randomized double blind placebo controlled evaluation of azithromycin for treatment of cat scratch disease.Google Scholar
  3. Brook I: Aerobic and anaerobic bacterology of cervical adenitis in children. Clinical Pediatrics 1980, 19: 693–696.PubMedCrossRefGoogle Scholar
  4. Chesney PJ: Cervical lymphadenitis and neck infections. In Pediatric Infectious Diseases, edn 14. Edited by Long SH, Pickering, LK, Prober GC. New York: Churchill Livingstone; 1997: 186–197.Google Scholar
  5. Henry PH, Longo DL: Enlargement of lymph nodes and spleen. In Harrison’s Principles of Internal Medicine, edn 14. Edited by Fanci AS, et al. New York: McGraw Hill; 1998: 245–347.Google Scholar
  6. Margileth AM: Cat scratch disease. In Nelson Textbook of Pediatrics, edn 15. Edited by Behrman RE, Kiegman RM, Arvin AM. Philadelphia: W.B. Saunders; 1996: 865–867.Google Scholar
  7. Margileth AM: Recent advances in diagnosis and treatment of cat scratch disease. Curr Infect Disease Rep 2000, 2: 141–146.CrossRefGoogle Scholar
  8. Margileth AM: Sorting out the causes of lymphadenopathy. Contemp Pediatr 1995; 12: 23–40.Google Scholar
  9. Mazur PM, Kornberg AE: Lymphadenopathy. In Textbook of Pediatric Emergency Medicine, edn 3. Edited by Fleisher GR, Ludwig S. Baltimore: Williams & Wilkins: 1993: 310–317.Google Scholar
  10. McCluskey DR, Buckley MRE, McCluggage WG: Night sweats and swollen glands. Lancet 1998, 351: 722.PubMedCrossRefGoogle Scholar
  11. Seibel NL, Cossman J, Magrath IT: Lymphoproliferative disorders. In Principles and Practice Pediatric Oncolgy, edn 3. Edited by Pizzo PA, Poplack DG. Philadelphia: Lippincott Raven; 1997: 601–609.Google Scholar
  12. Schwartz RH, Gerber MA, McKay K: Pharyngeal findings of Group A streptococcal pharyngitis. Arch Pediatr Adoles Med 1998, 152: 927–928.Google Scholar
  13. Whitley RJ, Kimberlin DW, Roizman B: Herpes simplex viruses. Clin Infect Dis 1998, 26: 541–545.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Andrew M. Margileth

There are no affiliations available

Personalised recommendations