Suppurative cervical lymphadenitis in infancy: microbiology and sociology

Clin Pediatr (Phila). 2015 Jun;54(7):629-34. doi: 10.1177/0009922815584548.


Objective: To investigate the associations between patient age, sociological factors, and the microbiology of pediatric neck infections.

Methods: Retrospective chart review of children up to 5 years old who underwent surgical management of suppurative cervical lymphadenitis.

Results: A total of 76 individuals met inclusion criteria; 93% of culture-positive infections were caused by Staphylococcus aureus in infants, compared with 59% in children between 13 months and 5 years of age (P = .002). Of the S aureus isolates, 51% were methicillin-resistant S aureus (MRSA) and 49% were methicillin-sensitive S aureus. Methicillin resistance was associated with African American race (P = .004); 67% of participants received empirical antibiotics prior to admission. Of these, 73% received antibiotics in the β-lactam class, and 25% received treatment with clindamycin.

Conclusions: Incidence of MRSA is high in infants with cervical lymphadenitis who fail empirical antibiotic therapy and require surgical management. Empirical coverage for cervical lymphadenitis with β-lactam antibiotics may provide inadequate coverage for early infection in this population.

Keywords: abscess; infant; methicillin-resistant Staphylococcus aureus; staphylococcal infections.

MeSH terms

  • Age Factors
  • Anti-Bacterial Agents / therapeutic use
  • Causality
  • Child, Preschool
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology*
  • Community-Acquired Infections / surgery
  • Female
  • Humans
  • Infant
  • Lymphadenitis / drug therapy
  • Lymphadenitis / epidemiology*
  • Lymphadenitis / surgery
  • Male
  • Methicillin-Resistant Staphylococcus aureus
  • Microbial Sensitivity Tests
  • Racial Groups / statistics & numerical data
  • Retrospective Studies
  • Socioeconomic Factors
  • Sociology
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / surgery


  • Anti-Bacterial Agents