Blood chemistries including renal and hepatic function tests and urinalysis Perform if malignancy is suspected

3. Blood culture. Can help guide antibiotic therapy if positive.

4. Gram stain, aerobic and anaerobic cultures of abscess contents. Obtained through needle aspiration or incision and drainage; may reveal causative agent in the diagnosis of acute cervical lymphadenitis or abscess and retropharyngeal abscess. Avoid if M tuberculosis is suspected (leads to chronic drainage).

5. Purified protein derivative skin testing. Recommended for children with subacute or chronic cervical lymphadenitis to rule out M tuberculosis, especially if risk factors are present or there is poor response to initial treatment.

6. Other laboratory tests. Depending on history and clinical suspicion, consider other tests, including B henselae and B quintana titers for cat-scratch disease, and Monospot and antibody titers for EBV. Warthin-Starry silver stain may be used to identify bacilli in cat-scratch disease, but this test is not specific for B henselae.

7. Histopathologic evaluation of tissue. Perform following exci-sional biopsies to determine if malignancy is present.

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