Cytomegalovirus may cause a mononucleosis-like syndrome with generalized adenopathy, fever, atypical lymphocytes, and hepatosplenomegaly. Juvenile rheumatoid arthritis should be considered if a child has unexplained fever and persistent lymphadenopathy. Serum sickness can correspond with generalized tender lymphadenopathy. Other disorders Kawasaki disease usually presents with cervical adenopathy that is unilateral, firm, nontender and over 1.5 cm in diameter. The overlying skin may be erythematous but not warm.
Drug use can affect lymph nodes.
Mesantoin may cause enlargement of lymph nodes, most commonly in the cervical region, fever, eosinophilia, rash, and hepatosplenomegaly. Hydantoin may also produce lymphadenopathy as a side effect. Almost all patients with sarcoidosis demonstrate either generalized or hilar lymphadenopathy. The bilateral cervical nodes, when enlarged, are firm, rubbery, and discrete with little tendency to coalesce. Other symptoms include fatigue, cough, fever, dyspnea, and weight loss.