What are the common causes of enlarged cervical lymph nodes in children

Lymph nodes are tiny glands which are normally found all over the body. These lymph nodes work to fight infection and keep the child healthy. Lymph nodes are part of the child’s immune system. Since lymph nodes are usually small in size we don’t feel them under the skin.

Lymph nodes in the neck are called “Cervical” lymph nodes. Lymph nodes are usually small in size of less than a centimeter. The lymph nodes in the neck or “cervical lymph nodes” are seen around the side and back of the neck. Since they are small and deep inside the soft tissues and muscles we cannot feel them. When these glands enlarge in size or get swollen they are described as lymphadenopathy or "swollen glands,". When lymph nodes are enlarged they shall be felt as small bumps, but they might grow significantly and would be seen as a large swelling.


What are the causes of enlarged cervical lymph nodes?
There might be several causes of enlarged neck or cervical lymph nodes. These causes could be a simple cough/cold, throat infections or tonsillitis. Infections of the scalp areas like lice infestation can also lead to enlarged lymph nodes. Dental and ear infections can also lead to enlarged lymph nodes in the neck. Tuberculosis (TB) is also an important cause of enlarged lymph nodes in India. Enlarged lymph nodes can also be secondary to certain cancers like Lymphomas.

When do we worry about enlarged neck or cervical lymph nodes?
Most commonly the enlarged neck lymph nodes are caused by normal infections. In such situations the enlarged lymph node is temporary and would reduce in size to normal when the underlying infection gets treated. Sometimes, the lymph nodes do not go away after antibiotics and seem to be enlarging. In this situation they might indicate an underlying tuberculosis or cancer.

What could be the other symptoms associated with enlarged lymph nodes?
Children with enlarged cervical lymph nodes can have redness, pain and tenderness at the local site of lymph node enlargement. Occasionally, the lymph nodes can form pus and burst to release it. There could be other enlarged lymph nodes like in the armpits (axilla) or in the groin (inguinal), chest (mediastinal) or in the tummy (abdominal). Children can have symptoms like fever, reduced appetite and weight loss.

How do we investigate a child with enlarged lymph nodes?
The evaluation of the child with enlarged cervical or neck lymph nodes depends on the size of the nodes, other lymph node groups involved and other symptoms. Children would be meticulously evaluated for ear, throat and scalp infections. In case of suspicion of Tuberculosis or Cancer the child needs to undergo a Fine Needle Aspiration of the lymph node. In this procedure a small amount of material is taken with a small needle for detailed examination and microbiological tests. Sometimes, an excision biopsy (where a part of the lymph node is surgically removed) is required for making a diagnosis.

In case your child is having enlarged cervical lymph nodes you need to consult a pediatric pulmonologist for detailed examination, appropriate investigations and treatment.

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