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Acute adenitis in children: Clinical course and factors predictive of surgical drainage
Author(s) -
Luu Thuy Mai,
Chevalier Isabelle,
Gauthier Marie,
Carceller Ana Maria,
Bensoussan Arie,
Tapiero Bruce
Publication year - 2005
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2005.00610.x
Subject(s) - medicine , adenitis , drainage , general surgery , surgery , intensive care medicine , ecology , biology
Objectives: To describe clinical course of children hospitalized for a first episode of acute unilateral infectious adenitis and to identify factors predictive of surgical lymph node drainage. Methods: We reviewed medical records of children from 0 to 17 years of age discharged from a tertiary care pediatric center with a diagnosis of adenitis between 1 April 1996 and 31 March 2001. Patients were included if they had acute (≤10 days) unilateral lymph node swelling greater or equal to 2.5 cm on initial physical examination. Exclusion criteria were: bilateral adenitis or adenitis at more than one site; prior adenitis; underlying chronic disease. Results: Two hundred and eighty‐four patients were included in this study. The mean age was 4.0 years (3.1 SD). Twenty‐three per cent of infected nodes were >5 cm in size and 92.6% were cervical. Thirteen of 252 blood cultures were positive (5.2%), of which one showed Streptococcus pneumoniae and 12 contaminants. Mean length of stay was 4.2 days (2.2 SD). Surgical node drainage was performed in 60 (21.1%) patients. Factors significantly associated with increased risk of surgical drainage were age <1 year (adjusted OR: 14.5; 95% CI: 5.0–42.2) and node involvement >48 h (adjusted OR: 2.9; 95% CI: 1.2–7.2). There were no major complications. Follow‐up was documented in 183 patients, of whom 92.3% achieved complete healing. Conclusions: Children hospitalized for a first episode of acute unilateral infectious adenitis generally do well. Younger patients and those with longer duration of node involvement before admission have an increased risk of surgical node drainage.