From the Research
The most common causes of posterior auricular and occipital lymphadenitis in infants and children are scalp infections, particularly those caused by Staphylococcus aureus and group A Streptococcus. These lymph nodes drain the posterior scalp and upper neck regions, making them susceptible to enlargement when infections occur in these areas. Specific conditions that frequently lead to posterior auricular and occipital lymphadenopathy include:
- Tinea capitis (fungal scalp infection)
- Pediculosis capitis (head lice)
- Impetigo of the scalp
- Seborrheic dermatitis with secondary infection
- Otitis externa Systemic viral infections like Epstein-Barr virus (causing infectious mononucleosis), cytomegalovirus, and rubella can also cause generalized lymphadenopathy including these nodes, as discussed in various studies 1, 2, 3. In infants specifically, group B streptococcal infections acquired during birth can lead to this presentation. Treatment depends on the underlying cause - bacterial infections typically require appropriate antibiotics (such as cephalexin 25-50 mg/kg/day divided three times daily for 7-10 days for S. aureus), while tinea capitis requires oral antifungal therapy like griseofulvin (20-25 mg/kg/day for 6-8 weeks), as noted in studies on antimicrobial therapy 4, 5. Viral causes are usually self-limiting and require only supportive care. When evaluating a child with posterior auricular or occipital lymphadenitis, careful examination of the scalp and ears is essential to identify the primary source of infection.