Risk factors for invasive interventions in hospitalized children with suppurative cervical lymphadenitis

INTRODUCTION: Suppurative cervical lymphadenitis sometimes resolves with oral antibiotic treatment; however, many children are hospitalized for intravenous treatment due to lack of improvement. When there is no substantial improvement, an invasive procedure is recommended, indicating the possibility of a liquification process. We examined, among pediatric patients hospitalized with suppurative cervical lymphadenitis, clinical and laboratory predictors for invasive intervention that may lead to early intervention, hasten recovery and shorten length of hospitalization.
METHODS: We compared laboratory and clinical characteristics of pediatric patients hospitalized with suppurative cervical lymphadenitis during 2010-2017, according to three treatments: needle aspiration (N=54), open surgical drainage (N=37) and conservative adequate antibiotic treatment (N=292).
RESULTS: The average length of hospitalization and length of antibiotic treatment pre- hospitalization were longer among children who underwent interventions, and for whom local erythema and fluctuation were described in physical examinations. There were no associations to laboratory parameters.
DISCUSSION AND CONCLUSION: In hospitalized pediatric patients diagnosed with suppurative cervical lymphadenitis, no laboratory risk factors were identified as being associated with the need for intervention. The main predictors of outcomes involved clinical assessment and physical examination. Lack of clinical improvement during oral antibiotic treatment should prompt consideration of hospitalization and invasive intervention.