1Associate Professor in Pediatrics, Andaman & Nicobar Islands Institute of Medical Sciences, Port Blair
2Associate Professor in General Surgery, Andaman & Nicobar Islands Institute of Medical Sciences, Port Blair
To determine the common causes of cervical lymphadenopathy in children presenting to our hospital, with a view to make their management more evidence based.
A prospective observational study in children, without any intervention other than standard practice, for the evaluation of possible influencing factors in a Medical College Hospital Out Patient Department in a tropical island setting.
157 children, below the age of 12 years, presenting with the complaint of enlarged neck lymph nodes in the OPDs of the Departments of Surgery and Pediatrics were included. Only children with other primary complaints were excluded. After recording baseline data in a predesigned proforma, all the patients were investigated and treated as per standard practice They were reviewed initially twice weekly and later every two weeks, till they resolved or till they were biopsied at 6 weeks and the details of their management were noted.
Of the 157 cases enrolled in our study, we found that 103 cases (65.6%) subsided over the next four weeks on antibiotics; 18 cases (11.5%) needed aspiration or incision drainage; 16 (10.2%%) had a diagnosis of non-specific inflammation and 12 (7.6%) had a diagnosis of tuberculosis and only 1 (0.6%) had a diagnosis of cancer. FNAC yielded a specific diagnosis in only 19% of cases whereas excision biopsy yielded a specific diagnosis in 50% cases.
Most cases of pediatric cervical lymphadenopathy have benign causes and respond to observation and antibiotics within four to six weeks. Only 7.6% of our cases proved to be tubercular and the diagnosis of malignancy was found in less than 1%.
Child, Prospective studies, Lymphatic diseases, Biopsy
