Community Health Network

Lymph Nodes - Swollen
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Lymph Node Swelling - Axillary

Definition

Increased size of a lymph node in the neck, armpit or groin
Usually larger than the corresponding node on the other side of the body
Normal nodes are usually less than Â½ inch (12 mm) across (size of pea or baked bean)

Causes

Swollen nodes with a viral infection are usually Â½ to 1 inch (12 -25 mm) across.
Swollen nodes with a bacterial infection are usually over 1 inch (25 mm) across (size of a quarter).

Return to School

Swollen lymph nodes alone are not contagious. If the swollen nodes are associated with a cold, sore throat or other infection, your child can return to school after the fever is gone and your child feels well enough to participate in normal activities.

If not, see these topics

Swollen node is in the neck and sore throat is the main symptom, see SORE THROAT

Should I
Call?

Care at
Home

When to Call Your Doctor

	Call Your Doctor Now (night or day) If
	Your child looks or acts very sick Node in the neck causes difficulty with breathing, swallowing or drinking Fever over 104Â° F (40Â° C) and not improved 2 hours after fever medicine Overlying skin is red Rapid increase in size of node over several hours
	Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
	You think your child needs to be seen 1 or more inches in size by measurement Very tender to the touch Interferes with moving the neck, arm or leg Fever present for more than 3 days
	Call Your Doctor During Weekday Office Hours If
	You have other questions or concerns In the neck and also has a sore throat Large nodes at multiple locations Cause of the swollen node is unknown Age under 1 month old Large node persists over 1 month
	Parent Care at Home If
	Mildly swollen lymph node and you don't think your child needs to be seen

Symptom
Description

Care at
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HOME CARE ADVICE FOR SMALL LYMPH NODES

Reassurance for Normal Nodes: If you have discovered a pea-sized or bean-sized node (smaller than ½ inch), this is a normal lymph node. Don't look for lymph nodes, because you can always find some (especially in the neck and groin).
Reassurance for Swollen Nodes from a Viral Infection: Â Viral throat infections and colds can cause lymph nodes in the neck to double in size. Slight enlargement and mild tenderness means the lymph node is fighting the infection and doing a good job.
Fever or Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen as needed for fever above 102Â° F (39Â° C) or pain. Otherwise no treatment is needed.
Avoid Squeezing: Don't squeeze lymph nodes because it may keep them from shrinking back to normal size. Tell your child not to fidget with them.
Contagiousness: Swollen lymph nodes alone are not contagious. If the swollen nodes are associated with a cold, sore throat or other infection, your child can return to school after the fever is gone and your child feels well enough to participate in normal activities.
Expected Course: After the infection is gone, the nodes slowly return to normal size over 2 to 4 weeks. However, they won't ever completely disappear.
Call Your Doctor If:
- Node enlarges to over 1 inch in size
- Node over Â½ inch persists over 1 month
- Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 6/24/2008

Content Set: Pediatric HouseCalls Online