[免疫功能正常患者空洞型肺结核治疗期间的反常淋巴结病]

[Paradoxical lymphadenopathy during treatment of cavitary tuberculosis in an immunocompetent patient].

作者信息

Rakotoson J L, Rakotomizao J R, Andrianasolo R L, Rakotoharivelo H, Andrianarisoa A C F

机构信息

Unité de soins, de formations et de recherches (USFR) de pneumologie, CHU d'Antananarivo, Antananarivo, Madagascar.

出版信息

Rev Pneumol Clin. 2011 Oct;67(5):318-21. doi: 10.1016/j.pneumo.2010.11.006. Epub 2011 Mar 17.

DOI:10.1016/j.pneumo.2010.11.006

PMID:22017953

Abstract

The paradoxical reactions during antituberculosis treatment are defined as a transient, clinical and/or radiological increase in preexisting tuberculous lesions or as the emergence of new symptoms, while treatment is adapted and correctly taken. The authors report a case of paradoxical left axillary lymphadenopathy during the treatment of cavitary tuberculosis, which appeared after seven months of treatment. No consensus on the therapeutic management of this entity has been developed to date but many authors propose an extension of antituberculosis treatment, a short corticosteroid therapy, an aspiration puncture and/or a surgical excision of the lymphadenopathy.

摘要

抗结核治疗期间的矛盾反应被定义为在治疗方案合理且正确服药时，原有结核病灶出现短暂的临床和/或影像学加重，或出现新症状。作者报告了1例空洞型肺结核治疗期间出现矛盾性左腋窝淋巴结病的病例，该情况在治疗7个月后出现。迄今为止，对于该病症的治疗管理尚未达成共识，但许多作者建议延长抗结核治疗时间、进行短期皮质类固醇治疗、穿刺抽吸和/或手术切除肿大淋巴结。