Martin T, Hoeppner V H, Ring E D
Department of Microbiology, University of Saskatchewan, Saskatoon.
CMAJ. 1988 Mar 1;138(5):431-4.
A total of 43 bacteriologically verified cases of superficial mycobacterial lymphadenitis were reported in Saskatchewan between 1981 and 1986; 35 (81%) were due to Mycobacterium tuberculosis. Among the eight cases (19%) due to nontuberculous mycobacteria the agent most frequently isolated was M. avium-intracellulare. Five additional cases were smear-positive and culture-negative. Direct smears of node tissue or aspirate were positive for acid-fast bacilli in 7 (88%) of the 8 cases of nontuberculous mycobacterial lymphadenitis but in only 16 (46%) of the 35 cases due to M. tuberculosis. Superficial tuberculous lymphadenitis was most frequent in female North American Indian or Asian-born adults and most commonly involved the cervical nodes. Nontuberculous mycobacterial lymphadenitis was most frequent in female white children, and most commonly involved the submandibular nodes. The cases of both tuberculous and nontuberculous mycobacterial lymphadenitis were spread throughout the province. There was an urban concentration of cases of tuberculous lymphadenitis in those of Asian origin. It is important to distinguish between superficial mycobacterial lymphadenitis due to M. tuberculosis and that due to nontuberculous mycobacteria for treatment and management purposes.
1981年至1986年间，萨斯喀彻温省共报告了43例经细菌学证实的浅表性分枝杆菌性淋巴结炎病例；其中35例（81%）由结核分枝杆菌引起。在8例（19%）由非结核分枝杆菌引起的病例中，最常分离出的病原体是鸟分枝杆菌复合群。另外有5例涂片阳性但培养阴性。在8例非结核分枝杆菌性淋巴结炎病例中，有7例（88%）的淋巴结组织或抽吸物直接涂片抗酸杆菌呈阳性，但在35例由结核分枝杆菌引起的病例中，只有16例（46%）呈阳性。浅表性结核性淋巴结炎在北美印第安女性或亚洲出生的成年人中最为常见，最常累及颈部淋巴结。非结核分枝杆菌性淋巴结炎在白人女性儿童中最为常见，最常累及下颌下淋巴结。结核性和非结核分枝杆菌性淋巴结炎病例遍布全省。亚洲裔人群的结核性淋巴结炎病例在城市较为集中。为了治疗和管理目的，区分由结核分枝杆菌引起的浅表性分枝杆菌性淋巴结炎和由非结核分枝杆菌引起的浅表性分枝杆菌性淋巴结炎很重要。
