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Neck Mass

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History of Present Illness:

  • A 5-year-old female is brought to the ED for  5 days of cough and 2 days of painful right posterior neck swelling.
  • Family denies any fever or other swollen nodes
  • She has no significant past medical history

Vital Signs & Physical Exam:

  • Vital signs are normal
  • Physical exam is normal except for the right posterior cervical mass shown below

Initial Differential Diagnosis:

  • Swollen lymph node
  • Abscess
  • Something else

Initial Diagnostic Testing:

  • CXR was clear

QUESTIONS:

  1. What does the case image show?  (click two times to enlarge)
  2. What should you do next?  
  3. Where can one get a quick refresher on this topic?  

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ANSWERS:

  1. What does the case image image show?  The image shows an isolated cervical lymph node
  2. What should you do next?  Send home with Keflex.
  3. Where can one get a quick refresher on this topic?  See yellow highlighted area below from purple book above…

1-Minute Consult on the EM topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

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CASE CONCLUSION: Lymph node resolved over the next week and a half

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