Association between the Clinical, Laboratory and Ultrasound Characteristics and the Etiology of Peripheral Lymphadenopathy in Children

Association between the Clinical, Laboratory and Ultrasound Characteristics and the Etiology of Peripheral Lymphadenopathy in Children

Peripheral lymphadenopathy affects most children at least once in a lifetime and represents a major reason for concern. Therefore, we aimed to identify the most common causes of peripheral lymphadenopathy in hospitalized children and to determine the clinical, laboratory and ultrasound characteristi...

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Bibliographic Details
Published in:Children (Basel) Vol. 10; no. 10; p. 1589
Main Authors: Berce, Vojko, Rataj, Nina, Dorič, Maja, Zorko, Aleksandra, Kolarič, Tjaša
Format: Journal Article
Language:English
Published: Basel MDPI AG 23-09-2023
MDPI
Subjects:
Abscesses
Antibiotics
bacterial lymphadenitis
Biopsy
Blood
Blood cell count
C-reactive protein
cat scratch disease
Causes and theories of causation
children
Cytomegalovirus
Development and progression
Disease
Diseases
Enzymes
Epstein-Barr virus
Etiology
Fever
Infections
infectious mononucleosis
Laboratories
Lymphadenopathy
Lymphatic system
Pediatrics
peripheral lymphadenopathy
Ultrasonic imaging
Viral infections
Slovenia
United States > US
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Summary:Peripheral lymphadenopathy affects most children at least once in a lifetime and represents a major reason for concern. Therefore, we aimed to identify the most common causes of peripheral lymphadenopathy in hospitalized children and to determine the clinical, laboratory and ultrasound characteristics that enable fast, easy and accurate etiological diagnosis. We performed a cross-sectional study including 139 children who were hospitalized because of peripheral lymphadenopathy. Ultrasound of lymph nodes was performed in 113 (81.3%) patients. Lymphadenopathy was generalized in nine (6.5%) patients. Malignant etiology was established in only three (2.2%) patients. Bacterial lymphadenitis, infectious mononucleosis (IM) and cat scratch disease (CSD) were diagnosed in 66 (47.5%), 31 (22.3%) and 29 (20.9%) patients, respectively. Bacterial lymphadenitis was significantly associated with neutrophilia (p < 0.01), and increased C-reactive protein levels (p < 0.01). IM was associated with pharyngitis (p < 0.01), leukocytosis without neutrophilia (p = 0.03) and increased blood liver enzyme levels (p < 0.01). CSD was associated with recent contact with a cat (p < 0.01), absence of a fever (p < 0.01) and normal white blood cell count (p < 0.01). Thorough history and clinical examination in combination with a few basic laboratory tests enable fast and accurate differentiation between the most common etiologies of lymphadenopathy in children to avoid unnecessary procedures and hospitalizations.
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ISSN:2227-9067
2227-9067
DOI:10.3390/children10101589