Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency care for difficulty breathing, severe difficulty swallowing, rapidly increasing neck swelling, coughing up a significant amount of blood, confusion, or collapse.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Contact your healthcare service promptly if you have a neck lump together with:
Ongoing fever, night sweats, or unplanned weight loss
A persistent cough or known exposure to tuberculosis
New swelling after starting treatment
Medicine side effects such as jaundice, vision changes, or a widespread rash
A weakened immune system
Do not stop tuberculosis medicine on your own because a node enlarges or a side effect appears; contact the treating service promptly so the cause can be assessed safely.
3
Does any of this apply?
Book an appointment
Arrange a medical assessment soon if you have a neck lump that persists, grows, or has no clear explanation.
You should also seek assessment for a node that becomes soft, changes the skin colour, or starts draining.
Routine follow-up is appropriate for a stable lump that is already being assessed or treated, unless new symptoms develop.
Every sign above is quoted from the sofidex article on Scrofula. If you are not sure, err upward — it is always reasonable to be checked.