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What do I do if my lymph nodes are enlarged?

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The body fights infection in many ways. One of its techniques is by having areas around the body (lymph nodes) where the cells that fight infection (the white blood cells) can help isolate infection. There are many lymph nodes in the head and neck area. When a child is sick, the doctor will often feel to see if any of these lymph nodes are enlarged or tender. They may become large and tender because of many types of infections (viral, bacterial, etc.), so the fact that they hurt and are big does not give a specific cause. However, by careful examination they may help pinpoint where the original infection began and may raise a suspicion of a bacterial cause that most often requires antibiotics as opposed to a viral cause which will go away by itself.

Sometimes a lymph node may become overwhelmed with trying to isolate/fight the infection and become an area of growing infection itself. When this lymph node occurs in the neck it is called cervical adenitis. Sources of the original infection are often from infected scratches, bug bites, cat scratches (causing cat scratch disease), tooth decay (in children with teeth), and strep throat to name a few. However, the cause of the original infection which subsequently leads to cervical adenitis is most often never identified. Bad luck is most often to blame.

Rarely, a child may have an underlying cause for being more susceptible to this type of infection. These include a cyst in the neck or a problem with the immune system, but usually there are other clues that this may be going on. Bacteria exist all around us on the skin, in the mouth, and throughout the environment. Most of the time they cause no problem, but occasionally they get in the body and cause disease.

It is not surprising that your doctor could not find the reason why your son developed this infection. This is most often the case, and your son’s environment should not be blamed for this. His lymph node got so big because it first enlarged to help fight infection, but then when it became infected itself, the swelling and infection added to its dimensions. Cervical adenitis is pretty common in children and usually requires time and/or oral antibiotics to go away, however, sometimes the infection requires additional more invasive intervention.

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