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Infective causes
The most common scenario of acute cervical lymphadenopathy is enlargement of bilateral lymph nodes in the correct nodal drainage chain during an acute infection. This represents a self-limiting, transient response of lymphatic tissue hyperplasia to a local infective process that improves with resolution of the viral illness.
Ebstein-Barr virus (EBV) and cytomegalovirus (CMV) infections may be more common in older children of school-going age and adolescents. Children with EBV infection often present with a clinical picture of infectious mononucleosis, characterised by generalised lymphadenopathy, sore throat, fatigue and fever. This may be accompanied by exudative tonsillitis and hepatosplenomegaly.
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