The swelling of the lymph nodes in the neck is a symptom of other diseases. Only those swellings that either persist for many weeks or cause considerable discomfort as part of an acute disease process are noticed.

The following diseases are common in childhood:

• Viral infections can lead to localized swelling of lymph nodes. These swellings are not very painful and slowly disappear without further treatment.

• Bacterial infections are often associated with considerable clinical symptoms (redness, tenderness, fever, swelling of the surrounding area). If antibiotic treatment does not "work", a possible abscess formation must be suspected and treated surgically.

• A special case is when so-called atypical mycobacteria have colonized the lymph nodes. In these cases, therapy consists of antibiotic and surgical treatment.

• Lymph nodes can also be enlarged in connection with leukemic diseases. If this is suspected, a tissue sample must be taken from one of the affected lymph nodes and examined by a pathologist.

As a rule, children with swelling of the cervical lymph nodes are only referred to us after extensive preliminary diagnostics. If these examinations are incomplete, we supplement them with blood tests and/or an imaging procedure (e.g. ultrasound or cross-sectional imaging, e.g. MRI).

 

Treatment depends on the suspected cause:

• Swelling of the lymph nodes caused by a viral or bacterial inflammation is opened under anesthesia. If an abscess is present and pus has already accumulated, it must be drained and the wound flushed for a few days. These surgical measures are usually accompanied by the administration of antibiotics.

• If there is a suspicion that leukemia could be the cause of the lymph node swelling, further diagnosis and treatment is carried out together with our colleagues from the Department of Pediatric Oncology and Hematology at the MHH (Pediatric Oncology). Surgical intervention is then limited to removing one of the suspicious lymph nodes and having it examined under the microscope. If the suspicion of leukemia is confirmed, further treatment is carried out by the pediatric oncology department.

 

 

The follow-up examinations depend on the underlying cause. After splitting an inflammatory lymph node, we follow the patient until the wound begins to heal. Afterwards, the patient is checked by the referring pediatrician.
Patients with oncological diseases remain at the MHH for further treatment anyway, so that we can see these children again here in the pediatric clinic on the ward.