Cervical Lymphadenopathy is the enlargement of the cervical lymph nodes commonly occurs with viral infections. These "reactive" nodes are usually small, firm and non-tender and they may persist for weeks to months. Cervical lymph nodes are weigh stations of lymphatic drainage. These nodes are commonly identified in cervical lymphadenitis, while the supraclavicular and posterior triangle nodes are involved less commonly. Cervical lymphadenopathy may be either an important clue to an underlying disease process or a specific clinical syndrome. Cervical lymphadenitis is the most common manifestation of nontuberculous mycobacteria in healthy children. The incidence is difficult to estimate, since probably only 25% of cases are reported. This organism is found most commonly in soil, water, and milk. Most commonly implicated organisms are M-Avium-intracellulare, M-scrofula, and M-kansasii. About 90% of mycobacteria positive nodes in children ages 0-12 are from nontuberculous bacteria. Cervical Lymphadenopathy is a directly interior to the fibrous capsule is the subcapsular sinus. This allows lymph, an ultrafiltrate of blood, to traverse from the afferent lymph vessels, through the sinuses, and out the efferent vessels.
Sign and Symptoms of Cervical Lymphadenopathy
Cervical lymphadenopathy is seen in about 50%-75% of patients, but interestingly, it is paradoxically prominent. It is not a subtle finding, although the other features are seen in 90% of cases. This lymphadenopathy is not fluctuant. Exposure to animals and biting insects, chronic use of medications, infectious contacts, and a history of recurrent infections are essential in the evaluation of persistent lymphadenopathy. Tuberculous cervical lymphadenitis is the most common extrapulmonary presentation of TB and is seen in about 5%-10% of tuberculous children.
Causes of Cervical Lymphadenopathy
By the 1950s nontuberculous mycobacteria had been recognized as a cause of cervical lymphadenitis. Exposure to animals and biting insects, chronic use of medications, infectious contacts, and a history of recurrent infections are essential in the evaluation of persistent lymphadenopathy.
Cervical Lymphadenopathy Treatment
Surgical care usually involves a biopsy. If lymphadenitis is present, aspirate may be needed for culture, and removal of the affected node may be indicated.
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