Regás J S, Ezzedine H, Martín N, Tresserra L, García-Vaquero J A, Cobos N, Liñan S, Boix-Ochoa J
Departamento de Cirugía Pediátrica, Hospital Materno-Infantil Valle de Hebrón, Barcelona.
Cir Pediatr. 1990 Apr;3(2):62-6.
The authors believe that the greater part of chronic cervicofacial adenitis actually observed in our hospitals, are not caused by M. tuberculosis or M. bovis but by scrofulaceum mycobacterium, M. avium, M. fortuitum and M. Kansasii, and above all, by the first two of these. They present their experience with 16 cases of cervico-facial adenitis due to atypical mycobacterium (CAAM) treated in our centre during the last years, in which period no case of cervical tuberculosis (CT) was observed. It is important to establish an early differential diagnosis between both etiologies, seeing as treatment is different. Whilst tuberculostatics can solve the phymic infection, surgical extirpation is the only solution for CAAM. The diagnosis of these types of infection is achieved by means of a very characteristic clinical procedure and by cutaneous tests specific for each bacteria. Faced with the clinical suspicion, the total extirpation should be effected of the adenopathic block affected. The exact diagnosis can only be made by the culture of the operatory mass.
作者认为，在我们医院实际观察到的慢性颈面部腺炎，大部分并非由结核分枝杆菌或牛分枝杆菌引起，而是由瘰疬分枝杆菌、鸟分枝杆菌、偶然分枝杆菌和堪萨斯分枝杆菌引起，尤其是前两种。他们介绍了过去几年在我们中心治疗的16例非典型分枝杆菌所致颈面部腺炎（CAAM）的经验，在此期间未观察到一例颈椎结核（CT）。鉴于治疗方法不同，早期鉴别这两种病因很重要。虽然抗结核药可解决结核感染，但手术切除是CAAM的唯一解决办法。这些类型感染的诊断通过非常有特征性的临床程序以及针对每种细菌的皮肤试验来实现。面对临床怀疑，应将受影响的腺病块彻底切除。只有通过手术切除肿块的培养才能做出准确诊断。
