Back of neck lymph nodes swollen4/17/2024 Very common, usually with history of a viral prodrome. Further examination should be guided by history and differential diagnosisÄifferential diagnosis Acute cervical lymphadenopathy Cervical lymphadenitis secondary to viral infection.Other focus of infection: scalp, face, ear, nose, throat or teeth.Features on palpation: eg soft, rubbery, firm, matted, fluctuant, discharging,.Characterise the lump: location, size, colour, warmth, mobility, tenderness, overlying skin changes.Immunisation status (diphtheria, measles, mumps, rubella).Overseas travel, including possible exposure to tuberculosis.Features of deep tissue head and neck infection (eg trismus, muffled voice).Growth over time, colour, pain, and overlying skin changes.Acute bacterial lymphadenitis is characterised by enlarged nodes, which are tender, usually unilateral and may be fluctuant.These enlarged "reactive" nodes may persist for weeks to months Viral upper respiratory tract infection is the most common cause of cervical lymphadenopathy in children.Most cases are benign and self-limited, however, the differential diagnosis is broad.Cervical lymphadenopathy is abnormal enlargement of lymph nodes (LNs) in the head and neck usually >1 cm.Cervical lymph nodes are often palpable in well children.Observation and reassurance without investigation is usually appropriate for the well appearing child with cervical lymphadenopathy.Cervical lymphadenopathy is common and may be found in more than one third of otherwise healthy children.
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