Gerogianni Irini, Papala Maria, Kostikas Konstantinos, Ioannou Maria, Karadonta Argiroula-Vasiliki, Gourgoulianis Konstantinos
Department of Respiratory Medicine, Medical School, University of Thessaly, Larissa 41110, Greece.
J Med Case Rep. 2009 Dec 3;3:9316. doi: 10.1186/1752-1947-3-9316.
In cases of patients with disseminated lymphadenopathy, the differential diagnosis has to include both benign and malignant causes, including sarcoidosis, metastatic disease, lymphoma and, although rarely present, tuberculosis. Tuberculosis is still one of the most frequently occurring infectious diseases worldwide. However, disseminated mycobacterial lymphadenitis is rare in immunocompetent patients.
We present the case of a 56-year-old Caucasian Greek male, who was immunocompetent and HIV negative, with a two-month history of recurring fever, loss of appetite and disseminated lymphadenopathy. The patient was diagnosed with mycobacterial lymphadenopathy.
This case highlights the need for suspicion in order to identify mycobacterial infection in patients with generalized lymphadenopathy, since misdiagnosis is possible and may lead to fatal complications for the patient.
对于出现全身性淋巴结肿大的患者,鉴别诊断必须涵盖良性和恶性病因,包括结节病、转移性疾病、淋巴瘤,以及虽然罕见但仍需考虑的结核病。结核病仍是全球最常见的传染病之一。然而,免疫功能正常的患者发生播散性分枝杆菌性淋巴结炎较为罕见。
我们报告一例56岁免疫功能正常且HIV阴性的白种希腊男性患者,有两个月反复发热、食欲不振及全身性淋巴结肿大的病史。该患者被诊断为分枝杆菌性淋巴结病。
本病例强调,对于出现全身性淋巴结肿大的患者,必须保持怀疑态度以识别分枝杆菌感染,因为误诊是有可能的,且可能给患者带来致命并发症。