Observation & Medication for Head & Neck Masses in Children

If diagnostic tests confirm that a head or neck mass is caused by an infection that has led to lymph node swelling, specialists at Hassenfeld Children’s Hospital at NYU Langone may recommend observation or antibiotics to manage it.

Surgery is sometimes needed to drain pus from an abscess that has developed on an infected lymph node.

Observation

A viral infection is a common cause of swollen lymph nodes, which may lead to a head or neck mass. Most of the time, an infection goes away on its own in days or weeks. Our doctors recommend closely monitoring the mass and your child’s symptoms.

If symptoms persist and the mass does not shrink after one month, or if it grows larger or causes increased discomfort, our specialists recommend that you take your child to a doctor immediately.

Antibiotics

If test results indicate that a mass is caused by a bacterial infection, our otolaryngologists—ear, nose, and throat doctors—work with infectious disease specialists to prescribe antibiotics. These medications destroy bacteria and prevent them from spreading throughout the body.

Antibiotics are taken by mouth or given through a vein with intravenous (IV) infusion. Your child’s doctor usually prescribes liquid antibiotics, which are taken by mouth, to treat an infected head or neck mass. This medication is taken twice a day for about 10 days.

A child may need an immediate infusion of antibiotics if a mass appears to be severely infected. Signs include tight and shiny skin, redness, inflammation, and pain. The mass may also feel warm to the touch. In rare instances, an infected head or neck mass may have an abscess, an area beneath the skin where pus—a thick fluid that contains dead white blood cells—collects. An abscess may resemble a very large pimple.

IV infusion takes place in a hospital. A doctor performs this procedure by inserting a slim, flexible tube, called a catheter, into a vein. The doctor injects medication into the catheter, which delivers it into the body. Usually, a child remains in the hospital for 48 hours while receiving antibiotic therapy, though it depends on the type and severity of the infection. Often, doctors provide additional antibiotics to be taken by mouth for several days after a child goes home.

Most of the time, antibiotics relieve the symptoms of an infection, including an abscess. If symptoms are still present after about a month, however, a physician may perform a biopsy to obtain more information about a head or neck mass. Depending on the results of the biopsy, the doctor may recommend surgery to remove the mass.