FIGURE 47.2 Lymph nodes of the body (Reprinted with permission from Anderson MK Foundations of Athletic Training 5th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2012.) A third commonly encountered cause of cervical adenopathy in children and adolescents is infectious mononucleosis caused by EBV, a herpes virus EBV typically causes bilateral anterior and posterior cervical lymph node swelling that is tender to palpation Nodes may be large and usually peak in size over the first week of illness, gradually subsiding over the next few weeks The classic presentation of mononucleosis is a prodrome of malaise, headache, and elevated temperature prior to the development of an exudative pharyngitis, tender cervical adenopathy, and fever Splenomegaly, abdominal pain, and anorexia may be present Facial edema can accompany significant cervical adenopathy, presumably reflecting obstructed lymphatic drainage Younger children with EBV infection may present less typically, with fever alone, symptoms of an upper