Somerset Pediatrics
LYMPH NODES OR GLANDS, SWOLLEN
DEFINITION
Diagnostic Findings
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Normal nodes are less than ½ inch across (often the size of a pea or baked bean).
Active nodes with viral infection are usually ½ to 1 inch across. Slight enlargement and mild tenderness mean the lymph node
is fighting infection and succeeding.
Nodes seriously infected with bacteria are usually more than 1 inch across and tender to the touch. If they are over 2 inches
across or the overlying skin is pink, the nodes are not controlling the infection and may contain pus.
Cause
Lymph glands stop the spread of infection and protect the bloodstream from invasion (blood poisoning). They enlarge with cuts,
scrapes, scratches, splinters, burns, insect bites, rashes, impetigo, or any break in the skin. Try to locate and identify the cause of the
swollen gland by remembering that the groin nodes drain from the legs and lower abdomen, the armpit nodes drain the arms and upper
chest, the back-of-the-neck nodes drain the scalp, and the front-of-the-neck nodes drain the lower face, nose, and throat. Most
enlarged neck nodes are due to colds. A disease such as chickenpox can cause all the nodes to swell.
Expected Course
With the usual viral infections or skin injuries, nodes quickly swell to a peak size in 2 or 3 days and then slowly return to normal size
over 2 to 4 weeks. However, you can still see and feel nodes in most normal children, especially in the neck and groin. Don’t check for
lymph nodes because you can always find some normal ones.
HOME CARE
Facts about Nodes.
The body contains more than 500 lymph nodes. They can always be felt in the neck and groin.
Normal nodes are largest at age 10 to 12. At this age they an be twice the normal adult size. Minor skin infections and irritations can
cause lymph nodes to double in size. It may take 1 month for them to return to normal size. However, they won’t completely disappear.
HANDS OFF: Poking and squeezing lymph nodes may keep them from shrinking back to normal size. Don’t check them more than
once each month, and be sure your child doesn’t fidget with them.
TREATMENT: No treatment is necessary for the nodes, just for the underlying disease (for example, remove the sliver or treat the
skin rash).
CALL OUR OFFICE IMMEDIATELY if:
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The node becomes 2 or more inches across.
The node becomes quite tender to the touch.
Red streaks develop near the node, or the overlying skin becomes red.
The node interferes with moving the neck, breathing, or swallowing.
Your child starts acting very sick.
During regular hours if:
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The node becomes 1 to 2 inches across.
The node remains larger than ½ inch for more than 1 month.
An unexplained fever (over 100º F [37.8º C]) occurs.
You feel your child is getting worse.
You have other concerns or questions.
Instructions for Pediatric Patients by Barton D. Schmitt, M.D., Pediatrician
Adapted from YOUR CHILD”S HEALTH, copyright ©1991 by Barton Schmitt, M.D.
Reprinted by permission of Bantam Books
© 1992 by W.B. Saunders Company