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Chiappini E, Camaioni A, Benazzo M, Biondi A, Bottero S, De Masi S, Di Mauro G, Doria M, Esposito S, Felisati G, Felisati D, Festini F, Gaini RM, Galli L, Gambini C, Gianelli U, Landi M, Lucioni M, Mansi N, Mazzantini R, Marchisio P, Marseglia GL, Miniello VL, Nicola M, Novelli A, Paulli M, Picca M, Pillon M, Pisani P, Pipolo C, Principi N, Sardi I, Succo G, Tomà P, Tortoli E, Tucci F, Varricchio A, de Martino M, Italian Guideline Panel For Management Of Cervical Lymphadenopathy In Children. Development of an algorithm for the management of cervical lymphadenopathy in children: consensus of the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Society of Pediatric Infectious Diseases and the Italian Society of Pediatric Otorhinolaryngology. Expert Rev Anti Infect Ther 2015; 13:1557-67. [PMID: 26558951 DOI: 10.1586/14787210.2015.1096777] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
UNLABELLED Cervical lymphadenopathy is a common disorder in children due to a wide spectrum of disorders. On the basis of a complete history and physical examination, paediatricians have to select, among the vast majority of children with a benign self-limiting condition, those at risk for other, more complex, diseases requiring laboratory tests, imaging and, finally, tissue sampling. At the same time, they should avoid expensive and invasive examinations when unnecessary. The Italian Society of Preventive and Social Pediatrics, jointly with the Italian Society of Pediatric Infectious Diseases, the Italian Society of Pediatric Otorhinolaryngology, and other Scientific Societies, issued a National Consensus document, based on the most recent literature findings, including an algorithm for the management of cervical lymphadenopathy in children. METHODS The Consensus Conference method was used, following the Italian National Plan Guidelines. Relevant publications in English were identified through a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through March 21, 2014. RESULTS Basing on literature results, an algorithm was developed, including several possible clinical scenarios. Situations requiring a watchful waiting strategy, those requiring an empiric antibiotic therapy, and those necessitating a prompt diagnostic workup, considering the risk for a severe underling disease, have been identified. CONCLUSION The present algorithm is a practice tool for the management of pediatric cervical lymphadenopathy in the hospital and the ambulatory settings. A multidisciplinary approach is paramount. Further studies are required for its validation in the clinical field.
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Affiliation(s)
- Elena Chiappini
- a Paediatric Infectious Disease Unit, Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy
| | - Angelo Camaioni
- b ENT Department , San Giovanni-Addolorata Hospital , Rome , Italy
| | - Marco Benazzo
- c Department of Otorhinolaryngology, "San Matteo" Hospital , University of Pavia , Pavia , Italy
| | - Andrea Biondi
- d Paediatric Haematology-Oncology Department and "Tettamanti" Research Centre , Milano-Bicocca University, "Fondazione Mbbm", San Gerardo Hospital , Monza , Italy
| | - Sergio Bottero
- e ENT Unit, Department of Surgery and Transplantation Centre , Bambino Gesù Children's Hospital, IRCCS , Rome , Italy
| | | | | | | | - Susanna Esposito
- i Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico , Università Degli Studi Di Milano, Milan , Milan , Italy
| | - Giovanni Felisati
- j Department of Otolaryngology , San Paolo Hospital, University of Milan , Milan , Italy
| | - Dino Felisati
- j Department of Otolaryngology , San Paolo Hospital, University of Milan , Milan , Italy
| | - Filippo Festini
- k Department of Health Science , University of Florence , Florence , Italy
| | - Renato Maria Gaini
- l Department of Otorhinolaryngology , San Gerardo Hospital , Monza , Italy.,m Department of Surgery and Translational Medicine , University of Milano-Bicocca , Milan , Italy
| | - Luisa Galli
- a Paediatric Infectious Disease Unit, Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy
| | - Claudio Gambini
- n Pathology Unit , Istituto Giannina Gaslini , Genua , Italy
| | - Umberto Gianelli
- o Fondazione Ircss Ca' Granda-Ospedale Maggiore Policlinico , Italy University of Milan , Milan , Italy
| | | | - Marco Lucioni
- q Otolaryngology Unit , Vittorio Veneto Hospital , Vittorio Veneto , Italy
| | - Nicola Mansi
- r ENT Unit , Santo Bono Posillipo Hospital , Naples , Italy
| | - Rachele Mazzantini
- a Paediatric Infectious Disease Unit, Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy
| | - Paola Marchisio
- i Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico , Università Degli Studi Di Milano, Milan , Milan , Italy
| | - Gian Luigi Marseglia
- s Department of Pediatrics , University of Pavia, Fondazione Irccs Policlinico San Matteo , Pavia , Italy
| | | | - Marta Nicola
- u Department of Molecular Medicine , University of Pavia , Pavia , Italy
| | - Andrea Novelli
- v Department of Health Sciences, Section of Pharmacology , University of Florence , Florence , Italy
| | - Marco Paulli
- w Department of Pathology, Fondazione Irccs Policlinico San Matteo, and Department of Molecular Medicine , University of Pavia , Pavia , Italy
| | | | - Marta Pillon
- y Oncoemaology Unit, Department of Paediatrics , University of Padua , Padua , Italy
| | - Paolo Pisani
- z Otorhinolaryngology Unit, Head and Neck Department , San Paolo Hospital, University of Milan , Milan , Italy
| | - Carlotta Pipolo
- aa Department of Cardiovascular Surgery , Ncc Città Di Alessandria Hospital , Alessandria , Italy
| | - Nicola Principi
- i Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico , Università Degli Studi Di Milano, Milan , Milan , Italy
| | - Iacopo Sardi
- ab Neuro-Oncology Unit, Meyer Meyer Univeristy Hospital , Florence , Italy
| | - Giovanni Succo
- ac Otorhinolaryngology Service, Department of Oncology , San Luigi Gonzaga Hospital, University of Turin , Turin , Italy
| | - Paolo Tomà
- ad Department of Diagnostic Imaging , Children's Hospital Bambino Gesù , Rome , Italy
| | | | - Filippo Tucci
- af University Hospital Pediatric Department , Bambino Gesù Children's Hospital, Rome , Rome , Italy
| | | | - Maurizio de Martino
- a Paediatric Infectious Disease Unit, Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy
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