[Cervical lymph node inflammation in children].

Abstract

One hundred and twenty seven cases of cervical lymph node infection were seen between 1974 and 1986 in children aged between 1 month and 10 years. The point of origin of the infection wa identified in 30% of cases and was, in decreasing order: cutaneous, in the cervico-cephalic region; pharyngo-tonsillar via the lymphatic structures of the pharynx or by direct effraction of the buccopharyngeal mucosa; and, finally, dental. The site of the secondary lymph node infection was generally below and behind the angle of the jaw and in some cases submandibular. Two thirds of cases progressed to suppuration and were evaluated bacteriologically. Four organisms were identified: Staphylococcus, very much in the majority. The origin of the infection was almost always cutaneous. There was a predilection for the child aged under 5 with a majority under 2. The streptococcus was in second place far behind the staphylococcus. The origin of the infection was pharyngo-tonsillar, with the beta-haemolytic streptococcus predominant, bucco-dental, with the alpha-haemolytic predominant, and a very small number of cases with a cutaneous origin. The age of these children was greater than in the staphylococcal infection group: the great majority were over 2 and all cases with a dental origin were aged over 5. There were a small number of anaerobic infections. In 2 of the 3 bacteriologically confirmed cases, the origin was pharyngo-tonsillar and development was obviously favored by the initial antibiotics prescribed. Management took into account the predominance of the staphylococcus, the resistance of this organism to penicillin G and its usual sensitivity to methicillin.(ABSTRACT TRUNCATED AT 250 WORDS)