How often do parents come to the ER woried about swollen lymph nodes? Most of the time you spend reassuring them that it is a natural course of the illness, not to worry, yada, yada.

What about when mom points to the large lump on the side of her childs neck? Hmm. Most lymph nodes aren’t that visible. It hurts, too, and it just started this morning.

Thinking that what I’m ordering is overkill, I get a contrasted CT of the neck and a chest x-ray and CBC looking for evidence of lymphoma, while suspecting it’s probably a lymph node abcess. Nope. Neither.

How about I let you make a few guesses regarding the differential diagnosis?