Infectious causes of acute bilateral cervical lymphadenitis in children

Infection	Associated clinical features
Common causes
Influenza virus	URI symptoms, fever
Epstein-Barr virus*^¶	Infectious mononucleosis (malaise, headache, fever, tonsillopharyngitis, fatigue, splenomegaly)
Cytomegalovirus*^¶	Mononucleosis-like illness
Herpes simplex virus	Gingivostomatitis or cold sore
Adenovirus	URI symptoms, pharyngitis, conjunctivitis
Enterovirus	URI symptoms, oral lesions, lesions on hands and feet
Rhinovirus	URI symptoms
Group A Streptococcus	Exudative pharyngitis
Arcanobacterium haemolyticum	Exudative pharyngitis, scarlatiniform rash; predominantly occurs in adolescents and young adults
Mycoplasma pneumoniae	Headache, malaise, fever, pharyngitis, cough
Uncommon causes
Roseola^¶	Fever, irritability, rash
Parvovirus B19^¶	Fever, "slapped cheek" rash
Rare causes
Corynebacterium diphtheria	Sore throat, malaise, fever, exudative pharyngitis, pseudomembrane; edema of the soft tissues of the neck
Rubella^¶	Rash that spreads from face to trunk and extremities
Measles	Prodrome of fever, conjunctivitis, coryza, and cough followed by rash that spreads from face to trunk and extremities; lack of immunization, international travel
Mumps^¶	Tenderness and swelling of parotid gland

URI: upper respiratory infection.
* Infection can persist and become more chronic in appearance.
¶ Often associated with generalized lymphadenopathy.

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