see also:

• lymphadenopathy
• RCH guideline - cervical lymphadenitis

• enlarged cervical lymph nodes are common and usually occur in response to an URTI or tonsillitis
• they may also occur with other local infections including dental or cutaneous
• occasionally they may form an abscess within the node which may require surgical drainage
• more chronic enlargement may be due to atypical forms of TB or neoplasia - metastatic or lymphoma

• this is exceedingly common and thus generally non-specific
• viral URTI's
• tonsillitis
• pharyngitis
• mandibular infections
• local skin infections
• many viral infections including EBV / glandular fever / infectious mononucleosis, cytomegalovirus (CMV) may cause it
• less commonly,
  • neoplasia of head and neck or lymphoma
  • Kawasaki disease
  • mycobacterium avium complex (MAC / MAIS) - usually chronic unilateral Cx nodes in children
• Kikuchi-Fujimoto disease (KFD) - rare, self-limiting, mainly young adults in Japan with Cx LNs (usually posterior Cx nodes rather than anterior) and fevers, and rarely rubella-like rash or splenomegaly
  • see https://en.wikipedia.org/wiki/Kikuchi_disease

• the finding of enlarged posterior cervical lymph nodes is generally more diagnostic in excluding bacterial tonsillitis than the far more commonly enlarged anterior LNs as the common differentials are reduced to:
  • EBV / glandular fever / infectious mononucleosis
  • cytomegalovirus (CMV)
  • rubella
  • local bacterial infections of the scalp including cradle cap in infants
  • and much less commonly, neoplasia including lymphoma
  • Kikuchi-Fujimoto disease (KFD) - rare, mainly young women with Cx LNs (60-90% have 1-2cm post Cx nodes) and fevers, and rarely rubella-like rash or splenomegaly, Dx on biopsy; possible future SLE risk;