GLANDS IN THE NECK AND ELSEWHERE
Lymph glands, like fever, help us fight infection.
SYMPTOMS: Tiny pea-sized
glands may be seen behind or in front of the neck, and also in other parts of the
body like the groin and armpits in young children. They are not
painful or tender. The child is otherwise well. These glands do not increase in size but, once noticed,
remain for months
without causing any harm to the child. They are often secondary
to a minor infection in the head, arms or legs. Your doctor
will probably ask for no tests in such a case and will just reassure you. More notice is to be taken if glands are
suddenly observed in different parts of the body in a
younger infant, especially if he also looks pale and sickly.
Serious attention also needs to be given if there is
rapid enlargement of a gland or glands, or if a ‘big
pea-sized’ or a still bigger gland remains persistently enlarged.
A sore throat due to a viral or bacterial infection, or
infection of the teeth and gums can cause enlargement of the
glands in front of the neck. Infection of the scalp over the head
like boils and infection secondary to scratching due to lice, dandruff or chickenpox can cause swollen
the neck. Small tender glands in this region can also be
seen in viral infections like German measles and big non-tender glands due to glandular fever (also called Infectious
Glands in the armpits and groin can be enlarged due to a local infection (injury, boils, cat
chickenpox). A gland just above the collarbone should be taken more seriously. It
could be due to an infection in the lungs
and more rarely due to a tumour in the chest. Sometimes, it can
follow vaccination with BCG.
Tuberculosis can also present as a glandular swelling in different parts of the body. In
tuberculosis, there is a significant enlargement of the gland. The swelling often
gets adhered to the overlying skin. Sometimes, more than one gland is enlarged in the same region and
appear to get matted (stuck) to each other.
Viral infections accompanied by a rash (German measles, glandular fever) can result in
enlargement of glands in different parts of the body.
Tuberculosis can present as a localised glandular
swelling or as a more generalised disease.
Malignant disorders like leukaemia and lymphomas and infections like AIDS are to be kept in
mind in any
persistent glandular swelling, especially if associated with
unexplained fever, severe anaemia, tenderness in the bones, and
bleeding from any part of the body.
MANAGEMENT: In any
persistent or significant enlargement of glands, your doctor will probably ask for
a blood test, a skin test (Mantoux Test), and a chest
X-ray. If required, an ultrasonography of the abdomen may be asked for. If no definite cause is found, a biopsy of
gland may have to be undertaken.
Most glands secondary to local causes or glands due to
viral infections get better on their own. Sometimes,
antibiotics may be required to treat the local cause. Occasionally, the gland
becomes severely inflamed with redness being noticed on
the overlying skin. It is painful and the child has fever.
Besides antibiotics, such children may need hot fomentation and even surgery.
7 March, 2016