Clinical Pharmacology, Merck Research Laboratories, 126 East Lincoln Avenue, RY34-A500, Rahway, NJ 07065, USA.
Curr Infect Dis Rep. 2009 Sep;11(5):383-8. doi: 10.1007/s11908-009-0054-y.
Suppurative lymphadenitis is an important and common form of soft tissue infection. Most acute cases of suppurative lymphadenitis are caused by Staphylococcus aureus or by Streptococcus pyogenes. Empiric antibiotic therapy is frequently successful in the early stages of the disease process, but increasing prevalence of methicillin-resistant S. aureus in particular has necessitated a shift in antibiotic choice that is dictated primarily by specific local resistance patterns. Several other organisms and noninfectious inflammatory processes may give rise to a clinical syndrome suggestive of suppurative lymphadenitis. Failure to respond to empiric antibiotics should trigger a diagnostic re-evaluation to determine the need for surgical intervention and/or the possibility of alternative microbiologic diagnoses.
化脓性淋巴结炎是一种重要且常见的软组织感染形式。大多数化脓性淋巴结炎的急性病例是由金黄色葡萄球菌或化脓性链球菌引起的。在疾病早期，经验性抗生素治疗通常是有效的，但耐甲氧西林金黄色葡萄球菌（MRSA）的流行率不断上升，这使得抗生素的选择发生了变化，主要取决于特定的局部耐药模式。其他几种病原体和非传染性炎症过程也可能导致类似于化脓性淋巴结炎的临床综合征。如果经验性抗生素治疗无效，应重新进行诊断评估，以确定是否需要手术干预和/或是否有可能存在其他微生物学诊断。
