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Column originally published Sep 18, 2012

Lymphadenitis Is Not Cancer

Question: Our five-year-old son was sick recently. He had a fever and several painful swollen glands in his neck. I was worried and looked up his symptoms on the internet. What I read confirmed my worst fear: cancer. I took him to our family doctor, and he immediately consulted a paediatrician. After a lot of questions, a thorough examination, and some blood tests, she told us that our son has an infection of the lymph glands in his neck. It was a great relief for all of us. He got better on antibiotic, and the glands in his neck are much smaller now. However, I still have this lingering worry about cancer. Is there any way that we can find out for certain.


I am very glad to hear that your son is getting better after taking antibiotic prescribed by the paediatrician. It is unfortunate that you are alarmed by Dr Google, or whatever search engine that you used on the internet.

Your son has a very common infection called bacterial lymphadenitis, which is an infection of the lymph glands. We have a lot of lymph glands in our body; their function is to trap germs locally and to prevent them from spreading throughout the body.

Before the invention of antibiotics, our body’s immune system is all that we have to fight infections. If we have an injured finger, germs will get in through the wound, and can start an infection there. Certain white blood cells called neutrophils will go to the injured site to fight any bacteria entering through the wound.

Depending on how many germs get in through that wound, as well as the type of germs involved, and the state of the person’s immune system, an infection like this can quickly recover if it is not serious, and if the immune system is strong.

However, if lots of powerful germs are involved, our local immune system can be overwhelmed. When that happens, the infection can spread locally as well as through the lymphatic channels to the closest lymph glands, which would be in the armpit. Inside the lymph glands, the germs are trapped there to give our body another chance to localize the infection.

More white blood cells will pour into the lymph glands to fight the infection. Sometimes, an abscess can form as a result, which may require surgical drainage. In short, our body has a very sophisticated immune system to fend off infection and keep us healthy most of the time. Of course, there are germs that can still overpower all of our immune system; unless effective antibiotics are given early enough, people can still die from overwhelming infection.

In your son’s situation, the infection most likely started in his throat and the germs entered through the tonsils into the lymph glands in his neck. There are many lymph glands in the neck because our throat is the place where we come into contact with germs around us.

If this is left untreated, most likely his body’s immune system can still eliminate the bacteria, although this will take much more time, and he may be left with some fairly enlarged lymph glands in his neck. As I mentioned earlier, abscesses can form inside the lymph glands that may require surgical drainage. In this day and age, it is wise to use a course of antibiotic to get the infection under control sooner.

I understand your concern about cancer, because cancer can originate from our lymph glands, or spread from other parts of the body to the lymph glands. Fortunately, cancer is still relatively uncommon in children. One of the important features that can distinguish an infection from cancer is pain: swollen lymph glands caused by infection is painful, while cancer in lymph gland is usually painless. Another reassuring thing is that cancer will not respond to an antibiotic. Since his lymph glands have started to decrease in size and he is getting better after receiving antibiotic, this should be enough evidence to say that he has had an infection.

It is not necessary to perform more test to prove that he doesn’t have cancer. Many tests involve painful procedures, it should not be done unless it is really necessary. Furthermore, I would suggest that you don’t rely on the internet to give you information related to health issues. There are many websites that provide misleading information, and it is very difficult to discern what is true, and what is not true. Sometimes the anxiety caused by misinformation can be very damaging to our health. Instead, work with your family physician as well as the specialists in your community.