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[Three toddlers with a swelling in the neck]
J A Gerrits1, T F W Wolfs, S P M Geelen
1Universitair Medisch Centrum, Locatie Wilhelmina Kinderziekenhuis, afd. Infectieziekten, Postbus 85.090, 3508 AB Utrecht.
Nederlands Tijdschrift Voor Geneeskunde
|March 8, 2003
Summary
Unilateral cervical lymphadenitis in children is often infectious, caused by bacteria like Streptococcus or Bartonella, or mycobacteria. Prompt diagnosis and treatment lead to recovery, with malignancy being rare.
Area of Science:
- Pediatrics
- Infectious Diseases
- Otolaryngology
Background:
- Cervical lymphadenopathy is a common presentation in pediatric patients.
- Differentiating infectious causes from malignancy is crucial for appropriate management.
Observation:
- Three children presented with unilateral cervical lymphadenitis.
- Case 1: Acute bacterial lymphadenitis (Group A Streptococcus).
- Case 2: Painless lymphadenitis (Mycobacterium avium-intracellulare) with spontaneous drainage.
- Case 3: Rapidly developing lymphadenitis (Bartonella henselae) with systemic symptoms.
Findings:
- Infectious lymphadenitis is the most frequent cause of cervical masses in young children.
- Specific pathogens identified included Group A Streptococcus, Mycobacterium avium-intracellulare, and Bartonella henselae.
- All patients recovered after appropriate interventions such as drainage, dissection, and/or antibiotic therapy.
Implications:
- Clinical history and characteristics often aid in diagnosing infectious lymphadenitis.
- Tissue examination is essential when malignancy cannot be ruled out.
- Early and accurate diagnosis of pediatric cervical lymphadenitis ensures favorable outcomes.