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Q: My three-year-old frequently has swollen glands in his neck. Should I be concerned about this?
A: There are many lymph nodes (what most people call glands) in the neck. Their job is to help drain areas of infection. The lymph nodes in the neck get enlarged whenever there is any type of infection or inflammation in the head, throat, or neck. Thus, with most viral colds, there will be some enlargement of the nodes in the front part of the neck. Viral sore throats and strep throat infections will cause swelling of the nodes in the neck. Infections or irritation of the scalp cause enlargement of the nodes on the back part of the neck.
As long as the nodes are not getting progressively larger, and become smaller when an acute infection goes away (which can take several weeks), I would not be overly concerned. Reasons for more concern would include a red, hot, very tender node; a node that continually enlarges; a large node that is associated with enlarged nodes in other parts of the body (under the arm, and in the groin), or a node that drains fluid to the surface of the skin.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.