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Unilateral cervical lymphadenopathy

Last updated: December 10, 2019

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Unilateral cervical lymphadenopathy (UCL) refers to the localized swollen lymph node(s) on one side of the neck and is usually associated with bacterial infections. Acute UCL is most commonly caused by S. aureus and Streptococcus species, while chronic UCL is the result of tuberculous or nontuberculous mycobacterial infections. UCL is most often seen in children under 5 years of age and typically affects the submandibular or deep cervical lymph nodes. In acute UCL, these are often tender, warm, and mobile, and may be accompanied by fever and malaise. Chronically inflamed lymph nodes are typically nontender and become indurated and matted over time. Laboratory tests for inflammatory markers, serology, and bacterial cultures from pus samples are used to monitor the course of the disease and detect pathogens. Biopsies may be needed to rule out malignant etiologies. Most cases of UCL are treated empirically with antibiotics such as clindamycin to cover the most common pathogens. Surgical incision and drainage may be indicated in cases with suppurative lymphadenitis.

  • Age: most common in children < 5 years

References:[1]

Epidemiological data refers to the US, unless otherwise specified.

References:[1][2][3]

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The differential diagnoses listed here are not exhaustive.

References:[2]

  1. Healy CM. Cervical Lymphadenitis in Children: Etiology and Clinical Manifestations. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/cervical-lymphadenitis-in-children-etiology-and-clinical-manifestations.Last updated: January 13, 2016. Accessed: March 27, 2017.
  2. Leung AK, Robson WL. Childhood cervical lymphadenopathy. J Pediatr Health Care. 2004; 18 (1): p.3-7. doi: 10.1016/j.pedhc.2003.08.008 . | Open in Read by QxMD
  3. Puiu I, Stancu P, Bulucea D, Niculescu C, Nicolescu VE, Stoian F. Diagnosis of tuberculosis lymphadenitis in children. Pediatrics. 2008; 121 (Suppl 2). doi: 10.1542/peds.2007-2022RRRR . | Open in Read by QxMD
  4. Cervical Lymphadenitis.
  5. Kanwar VS. Lymphadenopathy. Lymphadenopathy. New York, NY: WebMD. http://emedicine.medscape.com/article/956340-overview#showall. Updated: February 14, 2017. Accessed: March 27, 2017.