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Reactive Lymphadenopathy Management — RACP Paediatrics MCQ

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EasyInfectious DiseaseReactive Lymphadenopathy ManagementRACP Paediatrics

A 4-year-old presents with a 2-cm cervical lymph node that has been present for 6 weeks. It is non-tender, mobile, and soft. He is otherwise well. FBC and CRP are normal. What is the most appropriate initial management?

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Correct answer: E — Observation for 4-6 weeks with review – most cervical lymphadenopathy in children is reactive

Most cervical lymphadenopathy in children is reactive (viral URTI). Features suggesting benign aetiology: <3 cm, mobile, soft, non-tender, bilateral. Red flags for biopsy: >3 cm, hard/fixed, supraclavicular, >6 weeks without improvement, systemic symptoms (weight loss, night sweats).

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Lymphadenopathy