Cervical lymphadenopathy in children: a diagnostic approach

ABSTRACT

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