Springdale Mason Pediatrics

Lymph Node Infection - Viral


  • A viral infection of lymph nodes
  • Main symptom is swollen nodes

Call or Return If

  • Node becomes 1 inch (2.5 cm) or larger in size
  • Swollen nodes last more than 1 month
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • Increased size of lymph nodes, usually in the neck
  • Swollen nodes with a viral infection are usually ½ to 1 inch (12 -25 mm) across.
  • Usually several nodes on both sides of the neck are swollen.
  • Normal nodes are usually less than ½ inch (12 mm) across. This is the size of a pea or baked bean. They also feel soft and are easy to move.
  • Symptoms of a cold or sore throat are also usually present.


  • Viral infections in the nose, sinuses, mouth and throat cause the nodes to react.
  • Most respiratory infections drain to the nodes in the neck.

Common Objects Used to Guess the Size

  • Pea or pencil eraser- 1/4 inch or 6 mm
  • Dime- 3/4 inch or 18 mm
  • Quarter- 1 inch or 2.4 cm
  • Golf ball- 1 1/2 inches or 3.6 cm
  • Tennis Ball- 2 1/2 inches or 6 cm

After Care Advice

  • Viral throat infections and colds can cause neck lymph nodes to get bigger. They may double in size. They may also become a little tender.
  • This reaction is normal. It means the lymph nodes are fighting the infection and doing a good job.
  • Here is some care advice that should help.
Pain Medicine:
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
Antibiotics Not Needed:
  • Only bacterial infections are helped by antibiotics.
  • Antibiotics will not kill viruses.
Avoid Squeezing:
  • Don't squeeze lymph nodes.
  • Reason: This may slow down the return to normal size.
What to Expect:
  • After the infection is gone, the nodes will slowly return to normal size.
  • This may take 2 to 4 weeks.
  • However, they won't ever completely go away.
Return to School:
  • Your child can go back to school after the fever is gone.
  • Your child should also feel well enough to join in normal activities.
  • Infected lymph nodes alone cannot be spread to others.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
Article 2663