Title : Posterior Cervical Adenopathy
 
Clinical Problem : A 12 years old girl presented with recurrent bilateral posterior cervical adenopathy 5 mm in size, mobile, non tender since past 5 years. There is no otorrhoea, recurrent cough, cold or dental caries. Her mantoux test was done which was 25 mm. Chest X-Ray was normal.
 
Question : Should this child be treated with anti-tuberculous therapy_?
 
Expert Opinion : This child has non-matted lymph nodes that wax and wane in size over a period of 5 years. These nodes are in the posterior cervical region. Hence they are unlikely to be tuberculosis. Mantoux test does not tell us whether this child currently has active TB. It only states that child is either exposed to TB bacillus in the past or has received BCG or has been exposed to atypical mycobacteria.
Common causes of posterior cervical adenopathy are dental caries, ear infection or head lice. In this child, she was detected to have head lice. Treatment of head lice lead to resolution of the cervical nodes.

E-published: May 2012 Vol 9 Issue 5 Art No. 31
 
Funding : None
 
Conflict of Interest : None
 
DOI No. : 10.7199/ped.oncall.2012.31
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