Wahab M F, El-Gindy I M, Fathy G M
Tropical Medicine Departments, Faculty of Medicine, Ain Shams University.
J Egypt Public Health Assoc. 1998;73(5-6):538-62.
During a two years period, 16 cases having cervical lymphadenopathy presenting as prolonged fever were studied in Abbassia fever hospital, Cairo, Egypt. Patients were subjected to careful history, thorough clinical examination, complete blood picture, tuberculin test, chest x-ray, Monospot test, indirect fluorescent antibody test for toxoplasmosis, detection of cytomegalovirus antibodies and lymph node biopsy with histopathological examination. Ten within normal subjects were taken as controls. The patients were grouped on histopathological basis into 5 groups: (1) One (6%) of the cases was non-specific lymphadenitis diagnosed by clinical examination of the scalp and leucocytosis with polymorphonuclear predominance. (2) Reactive lymphadenitis included 6 (38%) of the cases. Infectious mononucleosis cases were diagnosed by clinical triad of fever, pharyngitis and cervical lymphadenopathy, relative lymphocytosis, monocytosis and positive monospot test. Cytomegalovirus case was diagnosed by lymphocytosis, monocytosis and negative monospot test. Toxoplasmosis cases were diagnosed by monocytosis, negative tuberculin test and positive indirect fluorescent antibody test. (3) Granulomatous lymphadenitis comprised 6 (3%) of the cases. Tuberculous cases were diagnosed by high ESR and highly positive tuberculin test. Sarcoidosis cases were diagnosed by negative tuberculin test and presence of hilar lymphadenopathy. (4) Non-Hodgkin lymphoma case (6%) was diagnosed by clinical deterioration and total lymph node biopsy. 15) Systemic infections were diagnosed by clinical examination, blood culture for salmonellae and brucellae, Widal and Brucella agglutination tests. It is concluded from this study that screening tests are important aids in the diagnosis of cases of cervical lymphadenopathy presenting by prolonged fever especially if lymph node biopsy and histopathological examination are not available or contraindicated. Tub
在两年期间，埃及开罗阿巴西亚发热医院对16例以长期发热为表现的颈部淋巴结病患者进行了研究。对患者进行了详细的病史询问、全面的临床检查、全血细胞计数、结核菌素试验、胸部X光检查、嗜异性凝集试验、弓形虫间接荧光抗体试验、巨细胞病毒抗体检测以及淋巴结活检和组织病理学检查。选取10名健康受试者作为对照。根据组织病理学结果将患者分为5组：(1) 1例（6%）病例为非特异性淋巴结炎，通过头皮临床检查和以多形核白细胞为主的白细胞增多症诊断。(2) 反应性淋巴结炎包括6例（38%）病例。传染性单核细胞增多症病例通过发热、咽炎和颈部淋巴结病的临床三联征、相对淋巴细胞增多、单核细胞增多以及阳性嗜异性凝集试验诊断。巨细胞病毒病例通过淋巴细胞增多、单核细胞增多以及阴性嗜异性凝集试验诊断。弓形虫病病例通过单核细胞增多、阴性结核菌素试验和阳性间接荧光抗体试验诊断。(3) 肉芽肿性淋巴结炎包括6例（3%）病例。结核病例通过血沉加快和结核菌素试验强阳性诊断。结节病病例通过阴性结核菌素试验和肺门淋巴结病的存在诊断。(4) 1例（6%）非霍奇金淋巴瘤病例通过临床病情恶化和全淋巴结活检诊断。(5) 全身感染通过临床检查、沙门菌和布鲁菌血培养、肥达试验和布鲁菌凝集试验诊断。本研究得出结论，筛查试验对于诊断以长期发热为表现的颈部淋巴结病病例是重要的辅助手段，特别是在无法进行或禁忌进行淋巴结活检和组织病理学检查的情况下。管
