Generalized lymphadenopathy in a child with tuberculosis may indicate a hematogenous spread of tubercle bacilli. Localized involvement is most common in the mediastinal, mesenteric, or anterior cervical nodes. The nodes are initially discrete, firm, mobile, and tender. If untreated, they become soft, fluctuant, matted, and adherent to the overlying skin, which may become erythematous. Bilateral involvement is characteristic of this condition.
Pulmonary disease is common.
Atypical mycobacteria can manifest cervical or submandibular involvement identical to TB, except the involvement is usually unilateral. Group B streptococcal cellulitis and adenitis may occur in infants younger than 2 months. Brucellosis may accompany chronic or intermittent lymphadenopathy. Yersinia enterocolitica may be associated with cervical lymphadenitis. Salmonella infection can correspond with generalized adenopathy.