Lymphadenopathy

Advice for Professionals

If your child has any of the following:

  • Is pale, mottled and feels abnormally cold to touch
  • Is going blue around the lips or has pauses in their breathing (apnoeas) or has an irregular breathing pattern
  • Severe difficulty in breathing - too breathless to talk or eat/drink
  • Has a fit/seizure
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (see the 'Glass Test')
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Develops pain and redness of the lymph node
  • Lymph nodes increasing in size - bigger than a 10 pence coin
  • Unexplained bruising
  • Losing weight

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If your child:

  • Continues to have enlarged lymph nodes that are slowly improving but he/she is otherwise healthy
  • Small lymph nodes may persist for years

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

  • Use painkillers such as ibuprofen and paracetamol to keep your child comfortable - please read and follow the instructions on the medicine container.

  • It is normal for lymph nodes in your child's neck to be enlarged when they have an infection such as a sore throat. This is your child's normal response to fighting common infections. Antibiotics are not normally required.
  • Children with severe eczema often have enlarged lymph nodes. This will improve with treatment of your child's eczema.

  • Occasionally, enlarged lymph nodes can become infected. If the lymph node is painful, red and hot, your child will need to see a healthcare professional because they may need treatment with antibiotics.
  • If your child has been prescribed antibiotics for an infection of their lymph nodes and still has a fever after 2 days, they will need to be seen again.

  • Your child should start getting better within a couple of days but their lymph nodes may take 2-4 weeks to improve. Small lymph nodes may persist for years.

 

This guidance is written by healthcare professionals from across Hertfordshire and West Essex