Viral Cervical Adenitis, No Antibiotics (Child)

Lymph nodes help the body fight infection. There are lymph nodes in many parts of the body, including the neck. If a virus enters the body through the nose or mouth, it may travel to lymph nodes in the neck. This causes the neck lymph nodes to swell. This is called viral cervical adenitis. It's common in children.

Symptoms of viral cervical adenitis include a swollen neck. It may be painful to the touch. The skin may be warm and red. Your child may have a fever. They may be fussy and not want to eat. Your child may have recently had a cold, sore throat, or earache.

Children with viral cervical adenitis may be treated for pain and fever. Viral cervical adenitis will usually go away in a few days to weeks.

Cervical adenitis can also be caused by bacteria or things that aren't infections.

Home care

Your child may be given medicine for pain and fever. Follow all instructions for giving these medicines to your child. Don’t give aspirin or any product with aspirin in it to a child younger than age 19. Aspirin use in children younger than 19 has been linked to a serious condition called Reye syndrome.

General care

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

  • Make sure that your child drinks plenty of fluids. Contact your child’s healthcare provider if your child refuses to eat or drink, or urinates less often than normal.

  • Check your child’s lymph nodes for changes in size. The healthcare provider may draw around the lymph nodes with a marker to help you see if the swelling changes over time.

Follow-up care

Follow up with your child’s healthcare provider as advised.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever of 100.4°F (38°C) or higher, or as directed by the provider

  • Chills

  • Refusal to eat or drink

  • Lymph glands that are swollen and tender for more than 5 days

  • Swelling or redness that doesn’t get better, or gets worse

  • Pain that doesn’t get better, or gets worse

  • Trouble swallowing or breathing

  • Lymph nodes that get bigger, or get softer or harder

  • Swollen lymph nodes that continue on 1 side of the neck only

  • Pain in the back of the neck over the spine

  • Tiredness or loss of appetite

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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