Tröbs R-B, Gräfe G, Müller P, Handrick W
Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikums Leipzig AöR.
Klin Padiatr. 2003 Jul-Aug;215(4):208-12. doi: 10.1055/s-2003-41403.
In a retrospective study we evaluated clinical features and diagnostic impact of sonography, white blood cell count, C-reactive protein as well as bacterial etiology of children treated surgically for bacterial cervical lymphadenitis. We report on 38 children at the age between 2.5 months and 14 years who were admitted in our departments between 1990 and June 2002. Leukocytosis (median 16.5 Gpt/l) and/or elevated concentrations of C-reactive protein (median 27 mg/l) occurred in the majority of patients. Clinical appearance and the result of ultrasound examination were relevant for diagnosis of suppurative inflammation. Treatment included incision and drainage in 29 cases, aspiration was performed in 4 children and in 5 cases the affected lymph nodes were removed. We found a predominance of infections due to S. aureus (37%) and group A streptococci (16%). A mixed aerobic-anaerobic infection was observed in 2 (5%) children and atypical mycobacteriosis in 3 (8%) cases. In conclusion, suppurative cervical adenitis has to be taken into account in children with cervical lymph node enlargement. In these cases surgical drainage is a key to appropriate resolution.
在一项回顾性研究中，我们评估了超声检查、白细胞计数、C反应蛋白的临床特征及诊断价值，以及接受手术治疗的细菌性颈淋巴结炎患儿的细菌病因。我们报告了1990年至2002年6月期间在我们科室收治的38例年龄在2.5个月至14岁之间的儿童。大多数患者出现白细胞增多（中位数为16.5 Gpt/l）和/或C反应蛋白浓度升高（中位数为27 mg/l）。临床表现和超声检查结果与化脓性炎症的诊断相关。治疗包括29例切开引流，4例患儿进行了抽吸，5例切除了受影响的淋巴结。我们发现金黄色葡萄球菌感染占主导（37%），A组链球菌感染占16%。2例（5%）患儿观察到需氧菌和厌氧菌混合感染，3例（8%）为非典型分枝杆菌病。总之，颈淋巴结肿大的儿童必须考虑化脓性颈淋巴结炎。在这些病例中，手术引流是实现恰当治愈的关键。
