Q. What is the treatment for swollen lymph nodes in a 5-year-old kid?

Answered by
Dr. Faisal Abdul Karim Malim
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 12, 2022

Hello doctor,

My 5-year-old kid has had swollen lymph nodes on his neck for over ten weeks. Ten weeks ago, I noticed swollen lymph nodes and waited to see if they would go down because I know it can take some time for them to go down. Because they did not shrink, I took him to his doctor. The doctor said it was good that we came and gave him antibiotics and did not do blood work, etc. As I am giving my healthy kid antibiotics, I ask myself what is the reason for an antibiotic if the doctor did not do blood work or confirmed that he has a bacterial infection that caused swollen lymph. He has no other symptoms. What test would you recommend? Before I noticed swollen lymph ten weeks ago, he was not sick for months. So I can not link swollen lymph to a cold or fever and say that lymph nodes have swollen and just did not shrank.



Welcome to

I understand your concern.

Please note that it is normal for children below the age of eight years to have such swollen lymph nodes intermittently during times of illness. The most common viral cause of swollen lymph nodes is EBV (Ebstein Barr virus). However, a course of antibiotics is worth a try. If, after four days of antibiotics, things do not improve at all, then investigations may be required depending on the clinical scenario. Investigations suggestions for this particular case are mentioned below.

  • CBC (complete blood count).
  • CRP (C-reactive protein, quantitative).
  • PSMP (peripheral smear for the malarial parasite).
  • Dengue NS1 (antigen detection).
  • IgG (immunoglobulin G) and IgM evaluation.
  • SGPT (serum glutamate pyruvate transaminase).
  • Urine routine and microscopy.
  • EBV VCA IgM (anti-Epstein-Barr virus capsid antigen IgM).
  • TB (tuberculosis) IGRA (interferon-gamma release assays).

Lymph node biopsy is usually not suggested but may be decided based on the above investigations and clinical scenarios.

I hope you find it helpful.

Kind regards.

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