Definition

• A viral infection of lymph nodes
• Main symptom is swollen nodes

Health Information

Symptoms

• Increased size of lymph nodes, usually in the neck
• Swollen nodes with a viral infection are usually ½ to 1 inch (12-25 mm) across.
• Usually several nodes on both sides of the neck are swollen.
• Normal nodes are usually less than ½ inch (12 mm) across. This is the size of a pea or baked bean. They also feel soft and are easy to move.
• Symptoms of a cold or sore throat are also usually present.

Causes

• Viral infections in the nose, sinuses, mouth and throat cause the nodes to react.
• Most respiratory infections drain to the nodes in the neck.

Common Objects Used to Guess the Size

• Pea or pencil eraser- ¼ inch or 6 mm
• Dime- ¾ inch or 18 mm
• Quarter- 1 inch or 2.4 cm
• Golf ball- 1½ inches or 3.6 cm
• Tennis Ball- 2½ inches or 6 cm

Care Advice

1. Overview:
   • Viral throat infections and colds can cause neck lymph nodes to get bigger. They may double in size. They may also become a little tender.
   • This reaction is normal. It means the lymph nodes are fighting the infection and doing a good job.
   • Here is some care advice that should help.
2. Pain Medicine:
   • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
3. Fever:
   • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
   • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
4. Antibiotics Not Needed:
   • Only bacterial infections are helped by antibiotics.
   • Antibiotics will not kill viruses.
5. Avoid Squeezing:
   • Don’t squeeze lymph nodes.
   • Reason: This may slow down the return to normal size.
6. What to Expect:
   • After the infection is gone, the nodes will slowly return to normal size.
   • This may take 2 to 4 weeks.
   • However, they won’t ever completely go away.
7. Return to School:
   • Your child can go back to school after the fever is gone.
   • Your child should also feel well enough to join in normal activities.
   • Infected lymph nodes alone cannot be spread to others.

Call Your Doctor If

• Node becomes 1 inch (2.5 cm) or larger in size
• Swollen nodes last more than 1 month
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

#AAP