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Right lateral Cervical Mass

Presenting Manifestation. Right lateral Cervical Mass. Approach to Diagnosis. Symptom with the least number of diseases. Cervical Lymphadenopathy in children. Upper Respiratory Tract infection Tuberculosis Lymphoma Mumps Dental Caries. Approach to Diagnosis. History

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Right lateral Cervical Mass

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  1. Presenting Manifestation Right lateral Cervical Mass

  2. Approach to Diagnosis • Symptom with the least number of diseases

  3. Cervical Lymphadenopathy in children • Upper Respiratory Tract infection • Tuberculosis • Lymphoma • Mumps • Dental Caries

  4. Approach to Diagnosis • History • Duration and laterality of adenopathy and change in size over time • Associated symptoms • Ill contacts • Ingestion of unpasteurized animal milk or undercooked meats • Dental problems or mouth sores • Skin lesions or trauma • Animal exposures • Immunization status • Medications • Geographic location and travel

  5. Approach to Diagnosis • Physical examination  • Examination of the lymphatic system, including assessment of the liver, spleen, cervical lymph nodes, and noncervical lymph nodes should be performed. • Hepatosplenomegaly with generalized adenitis indicates a possible infection with EBV, CMV, HIV, histoplasmosis, TB, or syphilis. • These findings also may be signs of neoplastic disease, collagen vascular disease, or other noninfectious etiology

  6. Approach to Diagnosis • Physical examination • The lymph node number, location, size, shape, consistency, tenderness, mobility, and color should be recorded. •   "Reactive" lymph nodes are usually discrete, mobile, feel rubbery, and are minimally tender. • Infected lymph nodes are usually isolated, asymmetric, tender, warm, and erythematous; they may be fluctuant; they are less mobile and discrete than reactive lymph nodes. • Malignant lymph nodes often are hard, fixed or matted to the underlying structures; they are usually nontender. • Oral cavity —periodontal disease, herpangina, gingivostomatitis, or pharyngitis • Eyes — Conjunctival injection • Skin — generalized rash, pustular or papular lesions

  7. Differentials

  8. Differentials

  9. DifferentialsInfectious Causes

  10. Clinical Impression t/c Koch’s Infection

  11. Approach to Diagnosing a TB symptomatic child who has no/unknown exposure Tuberculosis in Infency and Childhood 3rd ed. 2010 PPS, Inc. p.123

  12. Tuberculosis in Infency and Childhood 3rd ed. 2010 PPS, Inc. p.123

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