Dalhousie University Medical School.
Can J Infect Dis Med Microbiol. 2006 Mar;17(2):123-7. doi: 10.1155/2006/610304.
The present report reviews a decade of experience with nontuberculous mycobacterial adenitis at a pediatric referral centre, noting that patients are often subjected to multiple ineffective antibiotic courses, and that delays in diagnosis and referral for appropriate therapy are common. Notable clinical features include a mean age of presentation of 3.4 years, a male-to-female ratio of 1:1.5 and a gradual onset of painless, unilateral cervical adenopathy. Fever was absent in most patients (77%), and the disease failed to respond to antistaphylococcal antibiotics. The mean time to correct diagnosis was longer than three months (15 weeks). The clinical features of the disease are highlighted and presented with a practical diagnostic approach to the child with subacute/chronic adenitis. New molecular diagnostic tools and emerging mycobacteria are discussed, including the first reports of Mycobacterium malmoense adenitis in Canada.
本报告回顾了一家儿科转诊中心十年来非结核分枝杆菌性淋巴结炎的经验，指出患者通常会接受多次无效的抗生素治疗，且诊断和转介接受适当治疗的延误很常见。显著的临床特征包括就诊时的平均年龄为 3.4 岁，男女比例为 1:1.5，以及无痛性、单侧颈淋巴结病的逐渐出现。大多数患者（77%）无发热，且疾病对抗葡萄球菌抗生素治疗无反应。确诊的平均时间超过三个月（15 周）。强调了疾病的临床特征，并提出了一种针对亚急性/慢性淋巴结炎患儿的实用诊断方法。讨论了新的分子诊断工具和新兴分枝杆菌，包括在加拿大首次报告的马尔莫分枝杆菌淋巴结炎。
