For children, swollen and inflamed lymph nodes in the neck are often a reaction of the lymphatic system to infections such as pharyngitis, tonsillitis, or upper respiratory viral infections. Normally, neck lymph nodes are small (under one cm), soft, and mobile. When inflammation occurs, the lymph nodes enlarge, feel firmer, remain mobile, and cause mild pain. They gradually reduce in size as the infection is controlled.

Neck lymph nodes in children are categorized into three main groups. The most common are reactive lymph nodes, which typically appear after pharyngitis, tonsillitis, or viral infections. These lymph nodes are small (under one to two cm), soft, mobile, cause little pain, and gradually decrease as the primary illness is managed.

However, parents should be vigilant for signs of more severe conditions. The second group includes severe infectious lymph nodes, characterized by rapid swelling, intense pain, red and warm skin over the lymph node, and potential pus formation (abscess), which requires drainage. Less common are pathological lymph nodes associated with hematological diseases or tumors. In these cases, the lymph nodes are usually large, hard, less painful, poorly mobile, and may be accompanied by prolonged fever, weight loss, and fatigue.

A child with inflamed neck lymph nodes typically experiences swelling in one or more nodes, along with varying degrees of pain. Some children may also have a fever, sore throat, cough, loss of appetite, or fatigue. As the condition progresses, a child might experience difficulty swallowing, hoarseness, or even breathing difficulties. Most cases of inflamed neck lymph nodes do not require specific treatment. Doctors recommend monitoring for two to four weeks, as the lymph nodes can shrink on their own once the infection is controlled. If a bacterial infection is suspected, antibiotics are prescribed.

Parents should ensure the child rests, eats nutritious meals, and drinks plenty of fluids. Avoid massaging the lymph nodes, applying traditional herbal remedies, or giving medication without a doctor's prescription. Parents need to seek early medical attention if the lymph nodes increase rapidly in size, cause severe pain, are accompanied by a high fever, difficulty swallowing or breathing, or if the lymph nodes are hard, fixed, and poorly mobile.

Master, doctor, first degree specialist Nguyen Huu Dung, Department of Pediatric Surgery, examining and consulting on cervical lymphadenitis for a child patient. Illustration photo: Tam Anh General Hospital

If lymph node swelling persists for four to six weeks or if there are other unusual signs, doctors may order an ultrasound, blood tests, or fine-needle aspiration and biopsy to determine the cause. If complications like an abscess develop, the child may require surgical drainage of the pus or other surgical intervention. Children exhibiting symptoms such as weight loss, prolonged fatigue, night sweats, or lymph nodes that do not decrease in swelling after four to six weeks also require examination to rule out less common causes like tuberculous lymphadenitis, parasitic infections, autoimmune diseases, or malignancies (such as lymphoma).

Regarding your daughter's symptoms of one-sided neck lymph node swelling, accompanied by fatigue and pain radiating to her back, it could be lymphadenitis. However, head and neck infections or an abscess also need to be ruled out. You should take your daughter for an early check-up. Medical facilities with a pediatric surgery department can diagnose and treat neck lymph node conditions, from mild cases to those requiring surgical intervention. A doctor will examine her, order necessary tests, and conduct imaging diagnostics to determine the cause and provide appropriate treatment.

Master, Doctor, First Degree Specialist Nguyen Huu Dung

Department of Pediatric Surgery

Tam Anh General Hospital, Ho Chi Minh City