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Acute cervical lymphadenitis in children
1Newcastle Mater Misericordiae Hospital, Newscastle, New South Wales, Australia.
Insights
Antibiotic treatment failed in most children with acute cervical lymphadenitis, leading to abscesses, especially in those under two. Penicillin-resistant Staphylococcus was the most common cause, indicating a need for alternative first-line antibiotics.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Clinical Microbiology
Background:
- Acute cervical lymphadenitis is a common pediatric infection.
- Abscess formation complicates treatment outcomes.
- Emergence of antibiotic resistance is a growing concern.
Purpose of the Study:
- To evaluate treatment outcomes for acute cervical lymphadenitis in children.
- To identify risk factors for abscess formation.
- To determine the causative organisms and their antibiotic sensitivities.
Main Methods:
- Retrospective study of 78 children treated over 9 years.
- Analysis of treatment success, abscess formation, and patient demographics.
- Microbiological investigation of isolated organisms and antibiotic resistance patterns.
Main Results:
- Abscesses formed in 50 children despite antibiotic therapy.
- Children under 2 years were more prone to abscess development.
- Penicillin-resistant Staphylococcus was the predominant pathogen, followed by Beta-haemolytic Streptococcus.
Conclusions:
- Current first-line antibiotics (penicillin, amoxicillin) are often inadequate.
- Early admission for intravenous beta-lactamase-resistant antibiotics is recommended for severe or unresponsive cases.
- Age under 2 is a significant risk factor for abscess formation in pediatric cervical lymphadenitis.
Abstract:
A retrospective study of 78 children with acute cervical lymphadenitis treated in Newcastle over the last 9 years revealed that abscesses formed in 50 children despite antibiotic treatment. Children under 2 years of age were more likely to form an abscess than older children. The commonest organism isolated was penicillin-resistant Staphylococcus. Beta-haemolytic Streptococcus was isolated less commonly and isolation of penicillin-sensitive staphylococci was rare. Penicillin and amoxycillin alone are unsuitable as first line antibiotics. Severe infections and those failing to respond rapidly to initial antibiotic treatment should be admitted to a paediatric unit for intravenous beta-lactamase-resistant antibiotics.