Antibiotics may be used to treat acute unilateral cervical lymphadenitis, especially in children with systemic symptoms. Biopsy options include fine-needle aspiration, core needle biopsy, or open excisional biopsy. The workup may include blood tests, imaging, and biopsy depending on clinical presentation, location of the lymphadenopathy, and underlying risk factors. Palpable supraclavicular, popliteal, and iliac nodes are abnormal, as are epitrochlear nodes greater than 5 mm in diameter. Risk factors for malignancy include age older than 40 years, male sex, white race, supraclavicular location of the nodes, and presence of systemic symptoms such as fever, night sweats, and unexplained weight loss. Generalized lymphadenopathy, defined as two or more involved regions, often indicates underlying systemic disease. Patients with localized lymphadenopathy should be evaluated for etiologies typically associated with the region involved according to lymphatic drainage patterns. When the cause is unknown, lymphadenopathy should be classified as localized or generalized. The history and physical examination alone usually identify the cause of lymphadenopathy. Etiologies include malignancy, infection, and autoimmune disorders, as well as medications and iatrogenic causes. Lymphadenopathy is benign and self-limited in most patients.
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