Acute bilateral cervical lymphadenitis

Acute bilateral cervical lymphadenitis is uncommon in adults; if present, consider noninfective causes.

Acute bilateral cervical lymphadenitis often occurs secondary to a viral upper respiratory tract infection, but can also follow pharyngitis caused by Streptococcus pyogenes (group A streptococcus [GAS]) – see Sore throat for assessment and management. Acute infectious bilateral cervical lymphadenitis may also be due to infectious mononucleosis caused by Epstein–Barr virus (EBV), or cytomegalovirus (CMV).

Typically, acute bilateral cervical lymphadenitis caused by a viral infection resolves within 1 to 2 weeks without complication; investigations and antibiotic therapy are not needed. If bacterial infection is suspected (eg fluctuant or pointing abscess), treat as for acute unilateral cervical lymphadenitis.