For urgent queries, please call switchboard, and ask to speak to the on call Paediatrics Team via the PAU Telephone. If possible, please arrange FBC, blood film, LFTs, ESR, consider Monospot (if aged > 5 years and clinical suspicion of acute EBV), consider ASOT/CMV/EBV serology if thought to be relevant.įor cases where there is clinical uncertainty or you would like to discuss the patient, please contact paediatrics via Kinesis.
Unexplained axillary, epitrochlear or supraclavicular lymph nodes of more than 1cm diameter. Unexplained inguinal lymphadenopathy more than 1.5cm in diameter. Cervical lymphadenopathy more than 2cm in diameter and increasing in size or present for more than 2 weeks. The following would be indications for referral to rapid access clinic (which is currently accessed by ERS and marked as ‘urgent’) The child is very likely to need further investigations including a blood test. If there are any acute concerns as listed above, then refer in to acute paediatrics via the GP referral phone. If no response to oral antibiotics, systemic illness, fluctuant mass or more than 5cm then refer to acute paediatrics on-call for consideration of admission for IV (intravenous) antibiotics. If the child is well, consider treating with co-amoxiclav orally. Swollen lymph node is the indication that body is fighting against the disease whether originated by the internal process or caused by the external stimuli such as bacteria and virus. Suspect bacterial lymphadenitis if there is a short history of infection and lymph node is red and/or tender. It is normal for the lymph nodes to get bigger and smaller in future with intercurrent infections. Lymph nodes are likely to slowly decrease over time, though this may take 2-4 weeks. If a lymph node is very painful or draining pus or other material, people should see a doctor right away. In cases of reactive lymphadenopathy, please reassure the child and family that this is a normal response to infection. In Male the lymph nodes are near the penis are in the groin and inside the stomach or ‘abdomen’. Most enlarged lymph nodes require no management or further referral unless there are any red flags.
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