Rudin C, Wernli R, Rutishauser M, Ohnacker H
Pediatric Clinic, University of Basel, Switzerland.
Helv Paediatr Acta. 1987 Jun;42(1):35-40.
A 14-year-old girl was hospitalized with fever, jaundice, vomiting and right sided abdominal pain. A laparotomy was performed because of muscular defence and ascites. There was a mass of enlarged red and blue colored lymph nodes in the mesentery of the lower ileum loop. The histologic diagnosis of HNL without granulocytic infiltration was made. A septic-toxic shock developed after surgery. Respiratory insufficiency necessitated the use of a respirator, and acute renal failure with oliguria made hemodialysis necessary. The dramatic clinical course of the illness and the localization of the affected lymph nodes in the abdomen are unusual for an HNL; the lack of granulocytic infiltration contradicts the clinical picture of a bacterial infection. Neither a bacterial nor a viral pathogen could be found. However, the patient had been treated with antibiotics before.
一名14岁女孩因发热、黄疸、呕吐和右侧腹痛入院。因有肌紧张和腹水而行剖腹探查术。在回肠下段肠袢系膜中有一团肿大的红蓝色淋巴结。作出了无粒细胞浸润的组织学诊断为组织细胞坏死性淋巴结炎。术后发生感染性中毒性休克。呼吸功能不全需要使用呼吸机，少尿型急性肾衰竭需要进行血液透析。该病戏剧性的临床病程以及受累淋巴结在腹部的定位对于组织细胞坏死性淋巴结炎来说是不寻常的；缺乏粒细胞浸润与细菌感染的临床表现相矛盾。未发现细菌或病毒病原体。然而，该患者此前曾接受过抗生素治疗。
