Lymphadenopathy (Swollen Lymph Nodes) in Children

What Causes Swollen Lymph Nodes in Children?  

The lymph nodes are an essential part of the immune system. They can enlarge to many times their normal size when infection-fighting cells and fluid accumulate while the body battles infections or other diseases.  

Swollen lymph nodes are often found near the source of an infection, so their location can help signal the cause. For example, a baby with a scalp infection may have enlarged lymph nodes at the back of the neck. Swollen lymph nodes around the jaw may be a sign of an infection in the teeth or mouth. Viral illnesses like chickenpox or mononucleosis may affect lymph nodes throughout a child’s body.  

Causes of lymphadenopathy include:  

• Infections caused by viruses or bacteria — this is the most common cause of swollen lymph nodes in children
• Immune responses triggered by a vaccine or nearby infection
• Inflammatory conditions such as juvenile arthritis or lupus 
• Cancers such as lymphoma or leukemia, although other symptoms are often present
• Reactions to medications such as some antibiotics or seizure medicines (rare) 

What Are Symptoms of Lymphadenopathy? 

In children, it is normal to be able to feel some lymph nodes as small, movable lumps under the skin. However, if the nodes become larger than usual, your child may have an infection or other problem.  

The most common symptoms of lymphadenopathy are:  

• Swollen, enlarged lumps in the neck, back of the head, jaw, armpits, groin, chest or abdomen
• Pain or tenderness of the nodes, although nodes may not be painful if the child is no longer ill
• Warmth or redness of the skin over the lymph nodes
• Fever 
• History of illness

Additional symptoms may include respiratory symptoms (sore throat, congestion, cough), poor appetite, body aches or headache, fatigue, weight loss or rash. Because the symptoms of lymphadenopathy may resemble other medical conditions, your child should see a health care provider for a diagnosis. 

How Are Swollen Lymph Nodes Diagnosed?

Diagnosis of lymphadenopathy is often based on the presence of other conditions, such as an infection.  

At Lurie Children’s, diagnosis involves a combination of:  

• Medical history: The doctor will ask about your child’s symptoms, recent illnesses and possible exposure to any communicable diseases or animals that transmit illness.
• Physical examination: Your provider will examine the enlarged lymph nodes and other areas of the body, ask how long nodes have been swollen and if they are painful. 
• Lab tests such as a complete blood count (CBC), a urine test or other blood tests can help identify infections or other conditions causing lymphadenopathy.  
• Imaging tests: A chest X-ray, CT scan or MRI (magnetic resonance imaging) may be ordered to get a better look at enlarged lymph nodes and surrounding tissues. 
• Biopsy: A small tissue sample may be removed from the lymph node, examined under a microscope and tested for different causes of enlargement. 
• Consultation with specialists: Your child’s doctor may consult with otolaryngologists, surgeons, radiologists, infectious disease specialists, hematologist/oncologists and other specialists with experience in diagnosing and treating lymphadenopathy.  

What Are the Treatment Options for Lymphadenopathy? 

Enlarged lymph nodes are the body’s normal response to infection and disease. They are often harmless and go away without any treatment. But ignoring lymphadenopathy may delay treatment of a serious infection or other disease. 

Treatment for lymphadenopathy depends on the cause. Your child’s physician will recommend specific treatment based on expectations for the course of the condition; your child’s age, overall health and medical history (including their tolerance for specific medications, procedures or therapies); and your opinion or preference. 

Treatment options include: 

• Antibiotics or antiviral medications to treat an underlying bacterial or viral infection 
• Continued observation and follow-up evaluation(s) to monitor the size and location of enlarged nodes. Pain relievers and warm compresses can help reduce discomfort during this waiting period. 
• Other medications or procedures to treat conditions that may have caused the lymph node enlargement 
• Referral to specialists for additional exams, diagnostic tests and treatment 

Who Is Most at Risk for Lymphadenopathy? 

Certain factors can increase a child’s risk of developing swollen lymph nodes, such as: 

• Frequent infections (children who often get colds, ear infections or other illnesses)
• Exposure to illnesses (close contact with sick individuals) 
• Autoimmune conditions such as lupus or juvenile arthritis 
• Family history of lymphatic or immune system disorders 

When to See a Doctor about Swollen Lymph Nodes 

Understanding the potential causes and knowing when to seek medical attention can help ensure your child receives appropriate care. Consult a doctor if your child has any of the following symptoms: 

• Persistent swelling: Lymph nodes that remain enlarged for more than a few weeks. 
• Rapid growth: Nodes that grow quickly or are larger than one centimeter 
• Severe pain: Significant pain or tenderness in the node, or pain when swallowing 
• Difficulty breathing, swallowing or drinking due to swollen nodes 
• Appearance: Hard, fixed (non-movable) or irregularly shaped nodes; redness in the skin over the nodes 
• Accompanying symptoms such as fever, night sweats, weight loss or fatigue 

Lymphadenopathy is often a benign response to infections but it can sometimes indicate a more serious condition. If you notice any of these symptoms or have concerns about your child’s health, it’s important to seek medical advice promptly.