Unilateral lymphadenopathy in a child, another banal case of illness before the weekend?

Introduction Cervical lymphadenopathy is a common finding in the pediatric population and manifests itself uni- or bilaterally. The causes of an acute cervical lymphadenopathy in general pediatric practice are commonly infections (bacterial or viral). Uncommon causes are immunological diseases such as Kawasaki syndrome and Kikuchi-Fujimoto disease. A progression of the lymph node swelling could lead to abscess.

Methods  We present a clinical case and a systematic literature research on PubMed was performed.

Results A 9-year-old patient who developed a high fever 3 days apart with right cervical lymphadenitis and restricted neck mobility was reported to our hospital. The imaging revealed a lymphadenitis on the right side of the neck with increased inflammation parameters ​​and negative blood cultures. Despite the intensive treatment, the patient´s condition was worsening and was transferred to a pediatric intensive care unit as an emergency, where a previous SARS- CoV- 2 infection was diagnosed as the cause of the symptoms and treated accordingly.

Conclusions  Patients infected from COVID-19 disease report commonly ENT symptoms as loss of smell and taste, nasal obstruction with rhinorrhea and a sore throat. Cervical lymphadenopathy was less common finding. Our research did not come across any description of unilateral lymphadenopathy as an initial symptom of a PIMS. The sonographic evaluation of the cervical lymph nodes is essential in the diagnosis of lymphadenitis colli and decisive for the indication of surgical procedures.

 

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Conflict of Interest

The author declares that there is no conflict of interest.

Publication History

Article published online:
24 May 2022