Definition: what is normal?
Lymph nodes are normal structures whose function is to stop and process infective organisms that have entered the body.Lymph nodes are very small (the size of a pea or smaller) and they are not generally noticed. When an infection occurs lymph nodes swell up and can be felt by touch. The areas in the body where lymph nodes are more likely to be noticed during an infection are the neck, armpit and inguinal folds. During childhood, infections are very common and therefore it is much more likely to feel lymph nodes in children than in adults. This is especially true in children that have very little fat, where even normal sized lymph nodes are noticeable.
During the usual childhood illnesses, lymph nodes will swell to a size between 1/2 to 3 cm (1/4 to 1 inch) and then start to diminish in size within a week. In these circumstances the swollen lymph nodes appear in several areas of the body. A swollen lymph node present only in one area generally is associated with scratches, minor wounds, boils or other localized infections. As the localized infection subsides, the lymph nodes return to their normal size.
CAUSES OF CONCERN: WHEN TO CALL THE DOCTOR
lymph nodes are tender and/or fever is present
lymph node that has redness over it or streaking toward it
Any cough or difficulty in breathing
If your child appears acutely ill
Lymph node larger than 3-4 cm (more than 1-1/2")
Lymph node present in the area just above the collarbone
(especially on the left)
Lymph node larger than 1-1/2 cm (3/4") or longer than 2 weeks.
Lymph node that is rapidly enlarging
Enlarged lymph node associated with weight loss and/or nightsweats are present.
MANAGEMENT: what to expect !
Most enlarged lymph nodes do not require any treatment and will
improve on their own. Your doctor may prescribe medication aimed to relieve symptoms, such as tylenol. In some cases,your doctor may decide to treat the enlarged lymph node with antibiotics for 10-14 days. In few cases, your doctor may decide that additional testing may be needed to clarify the reason for the swelling of the lymph node. Generally a
single blood drawing, and a chest X-ray is all that may be required.