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Cervical Adenitis, Antibiotic Treatment (Child)

Adenitis means inflammation of a lymph node. Another term for this is lymphadenitis. Lymph nodes are found throughout the body and play a role in your immune system. Cervical adenitis is inflammation of a lymph node in the neck. An infection in the mouth, throat, sinuses, or other areas of the head, face, or neck may cause the lymph nodes in the neck to increase in size as they fight infection. If the enlargement is from a bacterial infection, the condition is called bacterial cervical adenitis. It's fairly common in children. But the most common cause of cervical adenitis in children is a viral infection of the throat, nose, sinuses, or upper airway.

Symptoms of bacterial cervical adenitis include swelling of part of the neck. The swelling may affect 1 or more lymph nodes and be on 1 or both sides of the neck. The lymph nodes are tender and painful to the touch. Your child may be feverish, irritable or fussy, and not interested in eating.

Bacterial cervical adenitis is usually treated with antibiotics. Your child may also be given medicine for pain and fever. In severe cases, the areas may need to be drained. Bacterial cervical adenitis usually gets better a few days after the antibiotics are started. Children younger than 5 years old may have symptoms that come and go over a period of time. When cervical adenitis is caused by a virus, antibiotics don't work as a treatment.

Home care

The doctor may advise over-the-counter medicine for pain and fever and other medicines to treat the problem causing the infection. This may include medicine to reduce congestion. Follow the doctor’s directions for giving these medicines to your child. If an antibiotic is prescribed for your child, be sure to have them take it until it's gone. Do this even if the swelling goes away and the child feels better. Do not give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.

General care

  • Allow your child plenty of time to rest. Plan quiet activities for a few days.

  • Make sure that your child drinks plenty of water and other healthy fluids. Contact your child's doctor if your child refuses to eat or drink.

Follow-up care

Follow up with your doctor, or as advised.

When to contact your child's doctor

Contact your child's doctor right away if:

  • Your child has a fever (see Fever and children, below).

  • Your child continues to refuse to eat or drink.

  • Your child has symptoms, such as swelling, pain, or tenderness, that are not getting better or are getting worse.

  • Your child’s lymph nodes don't get smaller over the next 1 to 2 weeks after finishing the antibiotics.

Call 911

Call 911 if:

  • Your child has trouble swallowing.

  • Your child has trouble breathing.

  • Your child has a severe headache.

  • Your child has pain in the back of the neck.

  • It's hard to wake your child up.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child’s fever, tell them which type you used.

Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.

When to call a doctor about your child’s fever

For a baby under 3 months old:

  • First, ask your child’s doctor how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

  • A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

  • Rectal or forehead: 102°F (38.9°C) or higher

  • Ear (only for use over age 6 months): 102°F (38.9°C) or higher

  • A fever of ___________ as advised by the doctor

In these cases:

  • Armpit temperature of 103°F (39.4°C) or higher in a child of any age

  • Temperature of 104°F (40°C) or higher in a child of any age

  • A fever of ___________ as advised by the doctor

Online Medical Reviewer: Dan Brennan MD
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Online Medical Reviewer: Sabrina Felson MD
Date Last Reviewed: 9/1/2025
© 2000-2025 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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