Olteanu M, Niţu Mimi, Golli Andreea
Department of Pneumology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 2-4 Petru Rareş Street, Craiova, Romania.
Rom J Morphol Embryol. 2012;53(3 Suppl):835-40.
A 41-year-old female patient was admitted into Surgery Clinic accusing abdominal pain, diarrhea, fever and chills. Based on clinical, biological and imaging data, it was established a diagnosis of pelviperitonitis and it was initiated an antibiotic and anti-inflammatory treatment. As fever and abdominal pain continued, it was decided to go on with surgery that revealed suppurated and perforated mesenteric adenopathy. Pus was sampled for bacteriological exam and also biopsy was performed for pathological exam. The result of pathological exam was suggestive for a specific granulomatous lesion (TB lesion). It was established diagnosis of TB mesenteric adenopathy and it was initiated specific anti-TB treatment according to WHO guidelines. After three, respectively five months of treatment, patient developed a right laterocervical adenopathy that fistulized in both cases, despite the correct treatment administered. No resistant TB strain and no atypical mycobacteria was discovered.
一名41岁女性患者因腹痛、腹泻、发热和寒战入住外科诊所。根据临床、生物学和影像学数据，诊断为盆腔腹膜炎，并开始进行抗生素和抗炎治疗。由于发热和腹痛持续存在，决定进行手术，术中发现肠系膜淋巴结化脓并穿孔。采集脓液进行细菌学检查，并进行活检以进行病理检查。病理检查结果提示为特异性肉芽肿病变（结核病变）。确诊为结核性肠系膜淋巴结炎，并根据世界卫生组织指南开始进行特异性抗结核治疗。经过三个月和五个月的治疗后，尽管给予了正确的治疗，但患者均出现了右侧颈外侧淋巴结病，且两种情况下均形成了瘘管。未发现耐药结核菌株和非典型分枝杆菌。
