- The majority of children have mild disease and require no investigations
- Indicated only if systemic symptoms, suspicion of underlying infection or in immunocompromised patient
- FBC, CRP and Blood cultures are indicated in the unwell child who appears septic
Cervical lymphadenitis (acute)
Reactive Lymph Node (LN)
- Nodes are usually small, discrete, mildly or non tender
- LN are most commonly reactive due to viral URTI and may persist for some weeks
- Management is expectant with clinical review by GP
Acute Bacterial Cervical Lymphadenitis
- Large (>1cm), discrete, tender cervical LN +/- overlying cellulitis
- Usually anterolateral neck, may have scalp or dental source
- Antibiotics – Skin, Soft Tissue and Orthopaedic Infections ChAMP Empiric Guidelines
- Abscess requires surgical review for incision and drainage
- In lesions that persist for more than 2 weeks, consider atypical pathogens such as non-tuberculous mycobacteria, Bartonella henselae or non-infectious conditions.
- Apply emla if patient condition is suggestive of requiring intravenous antibiotics
- Baseline observations include heart rate, respiratory rate, oxygen saturations and temperature.
- Minimum of hourly observations should be recorded whilst in the emergency department.
- Any significant changes should be reported immediately to the medical team.
- WA Health Child and Adolescent Health Service. Skin, Soft Tissue and Orthopaedic Infections ChAMP Empiric Guidelines Version 2, August 2014
External Review: Christopher Blyth (Infectious Diseases Consultant) September 2015
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