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Staphylococcus aureus and Group A Streptococcus are the most common causes of cervical lymphadenitis in children.

Cervical lymphadenitis is a common bacterial infection in children is typically caused by Staphlococcus aureus and Group A Streptococcus.

Other pathogens include Bartonella henselae, anerobes (with dental pathology), gram negative bacteria, non-tuberculosis mycobacteria, Group B Streptococcus (neonates) and Francisella tularensis

Empiric therapy is generally targeted to S aureus and Group A Streptococcus.

Some cases develop abscess that can be evaluated with ultrasound and may require incision and drainage.

Commonly used agents are Cephalexin, Clindamycin. There are many potential alternatives including Linezolid, Amoxicillin, Amox/Clav, TMP/SMX, Azithromycin

References:

Neff L, Newland JG, Sykes KJ, Selvarangan R, Wei JL. Microbiology and antimicrobial treatment of pediatric cervical lymphadenitis requiring surgical intervention. Int J Pediatr Otorhinolaryngol. 2013 May;77(5):817-20. PMID 23531371

Bradly JS (ed.) (2018) Nelson's Pediatric Antimicrobial Therapy 24th edition. Itasca, IL:American Academy of Pediatrics