Risk Factors for Invasive Intervention in Hospitalized Children with Suppurative Cervical Lymphadenitis

Introduction: Suppurative cervical lymphadenitis is an infectious inflammatory process involving lymph nodes in the cervical region. While some cases resolve with oral antibiotic treatment alone, many children are admitted for IV treatment due to lack of improvement. However, if no significant improvement is observed, invasive procedures such as needle aspiration or open surgical drainage is recommended. The optimal setting and timing for this procedure as well as clinical and laboratory parameters indicating its necessity are not well described in literature.

Aims of study: To examine clinical and laboratory predictors for invasive intervention in hospitalized children with Suppurative cervical lymphadenitis at admission, that may lead to early imaging and intervention and hasten recovery.

Methods: Retrospective study that included pediatric patients with diagnosis of suppurative lymphadenitis who were hospitalized during 2010-2017. Data from Electronic charts was extracted, including demographic, clinical and laboratory details. Cases were categorized and compared according to the presence of needle aspiration or open surgical drainage.

Result: 383 pediatric patients diagnosed with Suppurative cervical lymphadenitis were hospitalized. Presence of local erythema and fluctuation in physical examination were the only risk factors found for invasive intervention. There were no association with laboratory parameters. Average length of hospitalization and length of antibiotic treatment pre- hospitalization were longer in children who underwent invasive intervention

Conclusion: The main predictor for invasive intervention in hospitalized pediatric patients diagnosed with Suppurative cervical lymphadenitis is clinical assessment and physical examination of the pediatrician. No laboratory risk factors were found to be significantly associated with intervention.