Cervical Adenitis, Antibiotic Treatment (Child)

Adenitis means inflammation of a lymph node. Lymph nodes are found throughout the body and play a role in your immune system. Another term for this is lymphadenitis. Cervical adenitis is inflammation of a lymph node in the neck. . An infection in the mouth, throat, sinuses, or other areas of the head, face, or neck may cause the lymph nodes in the neck to increase in size as they fight infection. If the enlargement is from a bacterial infection, the condition is called bacterial cervical adenitis. It's fairly common in children. But, the most common cause of cervical adenitis is children is a viral infection of the throat, nose, sinuses, or upper airway.

Symptoms of bacterial cervical adenitis include swelling of part of the neck. The swelling may affect one or more glands and be on one or both sides of the neck, depending on the cause. The neck is tender and painful to the touch. The child may be feverish, irritable or fussy, and not interested in eating.

Bacterial cervical adenitis is usually treated with antibiotics. The child may also be given medicine for pain and fever. In severe cases, the areas may need to be drained. Bacterial cervical adenitis usually resolves a few days after the child starts taking antibiotics. Children younger than 5 years old may have symptoms that come and go over a period of time. When cervical adenitis is caused by a virus, antibiotics are not needed.

Home care

The healthcare provider may advise over-the-counter medicine for pain, and fever and other medicines to treat the problem causing the infection (such as medicine to lessen congestion). Follow the provider’s instructions for giving these medicines to your child. If an antibiotic is prescribed for your child, be sure to have they take it until it's gone. Do this even if the swelling goes away and the child feels better.

General care

  • Allow your child plenty of time to rest. Plan quiet activities for a few days.

  • Ensure that your child drinks plenty of water and other healthy fluids. Contact your child's healthcare provider if your child refuses to eat or drink.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Unless your child's healthcare provider advises otherwise, call the provider right away if:

  • Your child has a fever (see Fever and children, below)

  • Your child continues to refuse to eat or drink.

  • Your child has symptoms such as swelling, pain, or tenderness, that are not getting better or are getting worse.

  • Your child has trouble swallowing or breathing.

  • Your child has a severe headache, pain in the back of the neck, or is difficult to arouse.

  • Your child’s lymph nodes don't get smaller over the next 1 to 2 weeks after completion of antibiotics.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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