[Bacterial cervical lymphadenitis--surgical aspects].

In a retrospective study we evaluated clinical features and diagnostic impact of sonography, white blood cell count, C-reactive protein as well as bacterial etiology of children treated surgically for bacterial cervical lymphadenitis. We report on 38 children at the age between 2.5 months and 14 years who were admitted in our departments between 1990 and June 2002. Leukocytosis (median 16.5 Gpt/l) and/or elevated concentrations of C-reactive protein (median 27 mg/l) occurred in the majority of patients. Clinical appearance and the result of ultrasound examination were relevant for diagnosis of suppurative inflammation. Treatment included incision and drainage in 29 cases, aspiration was performed in 4 children and in 5 cases the affected lymph nodes were removed. We found a predominance of infections due to S. aureus (37%) and group A streptococci (16%). A mixed aerobic-anaerobic infection was observed in 2 (5%) children and atypical mycobacteriosis in 3 (8%) cases. In conclusion, suppurative cervical adenitis has to be taken into account in children with cervical lymph node enlargement. In these cases surgical drainage is a key to appropriate resolution.