There is not much that you can do about enlarged lymph nodes. If your child is having other symptoms, such as a sore throat, you can address those. But the nodes themselves should shrink over time.
Occasionally, an anti-inflammatory such as ibuprofen (Advil or Motrin) will help minimize node swelling. Ibuprofen is especially helpful if the swelling is associated with inflammation in the throat and painful swallowing.
Your child may not want to eat much, and that’s okay. But drinking is very important because it will keep him well hydrated. Cool drinks tend to go down better than warm ones, especially with an associated sore throat. Popsicles can be a good way to get some fluids into your child.When does my doctor need to be involved?
Call your doctor if the lymph nodes are remarkably enlarged or if there are associated symptoms such as high fever, painful swal¬lowing, or vomiting.
Your doctor definitely needs to see your child if the swollen lymph nodes are unilateral (only on one side of the neck) or warm and tender to the touch. You should also call your doctor if the nodes do not disappear over time.
What tests need to be done, and what do the results mean?
Since the most common cause of lymphadenopathy is a viral infection, often no tests are done. If your doctor suspects strep throat, a strep test can be per¬formed. This is a simple swab of the throat that looks for bacteria. There is a 5-minute test (rapid strep test) and a 48-hour test (cul¬ture). The culture is sent only if the rapid test is negative or unavailable. If the doctor suspects that the cause of the lymph node enlargement is mono or CMV, lab tests will be done. These include a complete blood count, specific EBV and CMV tests, and often a chemistry panel to look at liver function. The last test is important because both EBV and CMV can cause liver inflamma¬tion (hepatitis). If there is concern that there may be other causes of the lym-phadenopathy— such as a bacterial infection of the blood, an inflammatory illness, or cancer — a similar set of lab tests will be done. More specific lab tests can be added based on the level of suspicion.
Very occasionally, it is necessary to biopsy the lymph node in order to diagnose the problem. A biopsy is performed by an oto¬laryngologist (ear, nose, and throat doctor), a general surgeon, or a pathologist.