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Dr. A. Clark
Dr. A. Clark, Pediatrician
Category: Pediatrics
Satisfied Customers: 4437
Experience:  33 years of experience as a general pediatrician in private practice and in pediatric urgent care.
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My daughter has had enlarged lymph nodes- one behind each ear,

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My daughter has had enlarged lymph nodes- one behind each ear, and two towards back of head since last October. Did a CBC back in January and blood work came back normal. Fast forward to present date- Last week after strep infection, I noticed that her posterior cervical nodes were enlarged on both sides, two on each side. I then started looking for other nodes and found that she also has enlarged nodes in the groin area, one or two on each side can be felt. I cannot feel any above her clavicle or armpit areas. Of course, I am very worried and thinking worse case scenarios. What is your opinion on take on this? Is it normal to be able to feel all of these, in these areas, on a toddler?
Submitted: 9 months ago.
Category: Pediatrics
Expert:  Dr. Su S. replied 9 months ago.
Greetings,

Thank you for your question.

I am Dr. Su S. and I will try my best to help you.

How large are the nodes?

Are they increasing in size?

How many are there in total?

Does she have any other symptom, weight loss?

Did she have any skin infection of scalp, feet?

Customer: replied 9 months ago.
Hi there.
All of them range in size from a cooked kernel of corn to a baked bean.
The ones behind her ears and back of head have been the same size for a year.
The other ones in her groin and the posterior cervical i just recently found. In the last week I found them they have not increased.
She had cradle cap, minor case, from the time of being an infant up until about last January. . .
And most recently had a stomach flu bug followed up a strep infection a few weeks ago.


Customer: replied 9 months ago.
There is one behind each ear and two at back of head- those have been there about a year.

2 on each side of neck and 2 on each side of groin.
Customer: replied 9 months ago.
Relist: Other.
Expert never got back with me.
Expert:  Dr. A. Clark replied 9 months ago.
I'm happy that you have asked me to assist you with your child and hope that you can benefit from my many years of helping parents like you.

First, let me reassure you that this is NOT cancer, lymphoma or leukemia.

Lymph nodes are distributed all over the body and are responsible for helping to concentrate white blood cells to areas of inflammation or infection. The fact that they have been there for so long is not worrisome at all and actually the main reason I say that this is not cancer.

Lymph nodes behind the ears are nearly always due to inflammation on the scalp and cradle cap is a common cause, as are bites, scrapes, cuts, etc. Once swollen they do NOT go away so don't hold your breath waiting for any of her nodes to go back down. In children, with all of the stimulation of the immune system from the multiple infections, cuts, bites, scrapes, etc they never really get the chance to shrink back down since they are little factories for helping to fight off these problems.

It is truly a rare child I examine at her age who does not have lymph nodes palpable in the groin and in the posterior and anterior cervical chains of the neck. I would be more concerned if I did not feel them as that would mean your child is overprotected from injuries, accidents, and common childhood infections!

Please let me know if you have any questions but again, you really don't need to worry about what is really normal adenopathy in a toddler.
Customer: replied 9 months ago.
Thank you for that information. When I got on the internet to look into this I read that lymph nodes above the clavicle, which I already knew and she to my knowledge doesn't have, and the posterior cervical lymph nodes are cause for concern for malignancy. My friend who is a nurse told me that the strep wouldn't affect those lymph nodes only the anterior cervical chain. . .so knowing that those are enlarged on her doesn't seem to you to be a concern?Also, she does have occasional night sweats when sleeping whether at night or during her nap. It's always around her head and neck area. Not her whole body and sometimes she gets very wet. This is another reason why I am concerned.
Expert:  Dr. A. Clark replied 9 months ago.
Posterior cervical nodes don't mean much in kids as they ALL have them, especially when they've had a chronic scalp irritation like seborrhea (cradle cap) or a recent bite, cut, etc on the scalp. Strep does not commonly cause these nodes to swell but many viruses do, such as Mono, though that is not likely at her age and even if she had it we don't treat it anyway.

Enlarged lymph nodes are only one sign we see in childhood cancer with fever, bone pain, lethargy, frequent infections, anemia, etc being more common. I generally will do a CBC for the parent's benefit knowing full well that it will be normal but just to reassure all that cancer, leukemia, lymphoma are not the cause. Her doctor has already done this and the main reason I'm sure she is fine is that these nodes have been there so long. Were she to have had a neoplastic disease it would be far advanced by now and she would have been very ill with the complications of cancer.

I would not give this another thought, but knowing that you will, just remind her pediatrician of your concern each time she goes in for a checkup or sick visit.
Customer: replied 9 months ago.
She did have anemia when she was around 1 year old but it has since corrected itself. The night sweats don't seem like a red flag though?

And yes, being a parent it is hard not to worry. I am taking her to pediatrician but wanted a second opinion before I go.
Expert:  Dr. A. Clark replied 9 months ago.
Not at all. Nights sweats can occur with some infections such at TB but not a concern for your daughter nor is anemia at a year, which is common.

I'm sure her pediatrician will go over her exam carefully and if you want can do a CBC to reassure you. No other tests would be helpful so if it is normal you can rest assured she is healthy.
Dr. A. Clark, Pediatrician
Category: Pediatrics
Satisfied Customers: 4437
Experience: 33 years of experience as a general pediatrician in private practice and in pediatric urgent care.
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