Cervical (and other) Adenitis
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þ Cervical Adenitis that doesn't improve with antibiotics
 - Strong consideration should be given to the possibility of a mycobacterial
   infection if cervical adenitis doesn't improve with antibiotics.
   Therefore, a PPD should be placed. Neoplasm, branchial cleft cyst, and cat
   scratch disease are other possibilities.  Therefore, needle aspiration
   should also be performed in patients who do not respond to antibiotic
   therapy. [Schwartz , Prinicples and Practice of Emergency Medicine, 3rd ed.
   p 2525-6.]
 - Also, it might be ulceroglandular tularemia from a tick bite on the scalp,
   in which case switch to doxycycline for adults (personal experience with
   the infection --KC)

þ Clinical Signs of Adenitis:
 - Children with cervical adenitis present with a firm, tender cervical node
   that is 2 cm in diameter or larger.  The pain may cause the child to refuse
   to turn the head left or right.  In the chunkier child, the node may not be
   noticed early in the course of the disease, and refusal to turn the head
   left or right may be the only initial symptom.
   [Schwartz , Prinicples and Practice of Emergency Medicine, 3rd ed. p 2525.]