Acute adenitis in children: clinical course and factors predictive of surgical drainage.
OBJECTIVE
To describe clinical course of children hospitalized for a first episode of acute unilateral infectious adenitis and to identify factors predictive of surgical lymph node drainage.


METHODS
We reviewed medical records of children from 0 to 17 years of age discharged from a tertiary care pediatric center with a diagnosis of adenitis between 1 April 1996 and 31 March 2001. Patients were included if they had acute (< or = 10 days) unilateral lymph node swelling greater or equal to 2.5 cm on initial physical examination. Exclusion criteria were: bilateral adenitis or adenitis at more than one site; prior adenitis; underlying chronic disease.


RESULTS
Two hundred and eighty-four patients were included in this study. The mean age was 4.0 years (3.1 SD). Twenty-three per cent of infected nodes were > 5 cm in size and 92.6% were cervical. Thirteen of 252 blood cultures were positive (5.2%), of which one showed Streptococcus pneumoniae and 12 contaminants. Mean length of stay was 4.2 days (2.2 SD). Surgical node drainage was performed in 60 (21.1%) patients. Factors significantly associated with increased risk of surgical drainage were age < 1 year (adjusted OR: 14.5; 95% CI: 5.0-42.2) and node involvement > 48 h (adjusted OR: 2.9; 95% CI: 1.2-7.2). There were no major complications. Follow-up was documented in 183 patients, of whom 92.3% achieved complete healing.


CONCLUSIONS
Children hospitalized for a first episode of acute unilateral infectious adenitis generally do well. Younger patients and those with longer duration of node involvement before admission have an increased risk of surgical node drainage.
Luu
Thuy Mai
TM
Department of Pediatrics, Hôpital Sainte-Justine, Montreal, Québec, Canada.
Chevalier
Isabelle
I
Gauthier
Marie
M
Carceller
Ana Maria
AM
Bensoussan
Arie
A
Tapiero
Bruce
B
D000038:Abscess / Q000601:surgery; D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004322:Drainage; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008199:Lymphadenitis / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008485:Medical Audit; D011792:Quebec; D012189:Retrospective Studies