If possible, please arrange FBC, blood film, LFTs, ESR, consider Monospot (if aged > 5 years and clinical suspicion of acute EBV), consider ASOT/CMV/EBV serology if thought to be relevant.įor cases where there is clinical uncertainty or you would like to discuss the patient, please contact paediatrics via Kinesis.
Unexplained axillary, epitrochlear or supraclavicular lymph nodes of more than 1cm diameter. Unexplained inguinal lymphadenopathy more than 1.5cm in diameter. Cervical lymphadenopathy more than 2cm in diameter and increasing in size or present for more than 2 weeks. The following would be indications for referral to rapid access clinic (which is currently accessed by ERS and marked as ‘urgent’) The child is very likely to need further investigations including a blood test. If there are any acute concerns as listed above, then refer in to acute paediatrics via the GP referral phone. Many of these causes may also result in lymphadenopathy elsewhere in the body. The most common causes of mesenteric lymphadenopathy are neoplastic, inflammatory, and infectious processes. If no response to oral antibiotics, systemic illness, fluctuant mass or more than 5cm then refer to acute paediatrics on-call for consideration of admission for IV (intravenous) antibiotics. Although the detected lymph nodes may be normal, there is a large number of disease processes that may lead to mesenteric lymphadenopathy. If the child is well, consider treating with co-amoxiclav orally. Suspect bacterial lymphadenitis if there is a short history of infection and lymph node is red and/or tender. It is normal for the lymph nodes to get bigger and smaller in future with intercurrent infections. Lymph nodes are categorized by their location in the body. A lymph node is part of the lymphatic system and functions to trap bacterial and cancer cells. Lymph nodes are likely to slowly decrease over time, though this may take 2-4 weeks. Precarinal lymph nodes are located in the precarinal space, which is in the chest and surrounded by the ascending aorta, the tracheal bifurcation and the right and left pulmonary arteries. 
In cases of reactive lymphadenopathy, please reassure the child and family that this is a normal response to infection. Most enlarged lymph nodes require no management or further referral unless there are any red flags.
0 kommentar(er)
