Enlarged lymph nodes are the most likely reason for lumps appearing in a child’s neck. Lymph nodes are tiny swellings which are present all over the body and are part of the immune system. When there is an infection, the lymph nodes in the area close to the site of the infection swell up as the body acts to fight it. At this stage, the nodes can be quite tender to touch. When the child gets better, the lymph nodes shrink back down in size but often do not disappear completely.
Both bacterial and viral upper respiratory tract infections can cause lymph nodes in the neck to enlarge. Bacterial infections with nodes that are very tender and where the skin in the neck becomes red may need treatment with antibiotics. Rarely, an abscess can form in a node and it might need to be drained.
Lymph nodes can also swell up if there has been an insect bite close to them or if there is a patch of inflamed eczema.
This is caused by a virus (Epstein Barr) which is commonly transmitted in saliva. This is why it has been called the ‘kissing disease’ and is often seen in teenagers. Symptoms are a sore throat, a temperature and large lymph nodes in the neck. Those affected are often very tired and it can take a number of weeks for them to recover. Blood tests are used to diagnose the problem.
There are other more unusual causes of neck lumps. If the swelling appears unrelated to infection or if it seems to be growing in size it should be checked. A useful investigation for neck lumps is an ultrasound scan. Sometimes, a neck lump will need to be removed to be sure of what it is. This would involve a short procedure under general anaesthetic.