apical lung pleura and upper lung fields The most common presentation is an isolated enlarged node that is nontender; though with progression, the node will become fixed and matted, adhering to overlying skin In children with suspected tuberculous lymphadenitis, it is important to elicit any history of family members or close contacts with a diagnosis of tuberculosis, symptoms of active disease, or risk factors for acquisition (travel, homelessness, incarceration, human immunodeficiency virus [HIV] infection) Diagnosis is made by a combination of skin testing, chest radiograph, and if possible, culture data from the involved node In addition, newly available serum interferon-γ–release assays (QuantiFERON-TB Gold In-Tube test or T-SPOT.TB test) detect interferon-γ generated by T cells in response to antigens found in M tuberculosis and are available to aid in diagnosis Treatment of cervical lymphadenitis consists of antimycobacterial therapy, and should follow established recommendations, such as those from the Centers for Disease Control (CDC) (see Chapter 94 Infectious Disease Emergencies )