appearing patients, admission and treatment with intravenous (IV) antibiotics are appropriate Cervical lymphadenitis may also be caused by viral infections including rhinovirus, parainfluenza virus, RSV, Cytomegalovirus, and EBV In addition to prominent posterior cervical nodes, EBV classically presents with a mononucleosis-like illness including fever, headache, malaise, and tonsillar hypertrophy Diffuse lymphadenopathy and the presence of hepatosplenomegaly are also frequently present Treatment for mononucleosis is generally supportive Exudative pharyngitis warrants evaluation for concurrent GAS, and should be treated with antibiotics if positive Corticosteroids (prednisolone/prednisone at mg/kg/day often prescribed as a short burst and then a taper) may be useful in patients with airway obstruction Cat-scratch disease also causes regional lymph node enlargement in children, typically presenting to weeks after a cat or kitten scratch Scratches to the head and neck result in cervical lymph node enlargement in 33% to 50% of those affected Fever and malaise precede the development of a single, enlarged node in 30% This is followed by local erythema, warmth, tenderness, and induration of the area Labs for Bartonella henselae (the causative agent), will be positive in approximately 84%, and 16% of patients within to weeks of symptoms, and to weeks of symptoms, respectively Needle aspiration has both therapeutic and diagnostic potential Conversely, surgical excision may create a draining sinus Bartonella henselae can be identified via immunofluorescent antibody assay to both IgM and IgG antibodies Symptomatic treatment generally results in resolution over to months Indications for antibiotic treatment include painful adenitis, systemic symptoms (hepatic or splenic involvement, endocarditis), or immunocompromise Azithromycin is the first-line antibiotic choice Rifampin, ciprofloxacin, parenteral gentamicin, and trimethoprim-sulfamethoxazole are moderately to highly effective in treating severe disease (hepatosplenic disease, persistent temperature >39.5°C, or severe systemic signs) Parenteral ceftriaxone and gentamicin, with or without oral doxycycline, are suggested for those with culture-negative endocarditis Bartonella-positive endocarditis is generally treated with doxycycline and gentamicin Mycobacterial infection of the cervical lymph nodes can be caused by the atypical strains of Mycobacterium avium-intracellulare (MAI), Mycobacterium scrofulaceum, or less frequently, Mycobacterium tuberculosis (M tb) Atypical mycobacterial infection presents with enlarged, erythematous, “rubbery” nodes which are generally submandibular in location, and minimally tender to palpation In contrast, the supraclavicular lymphadenopathy caused by M tb is more