White M P, Bangash H, Goel K M, Jenkins P A
Arch Dis Child. 1986 Apr;61(4):368-71. doi: 10.1136/adc.61.4.368.
Most cases of mycobacterial lymphadenitis in children are caused by non-tuberculous mycobacteria, previously called the atypical mycobacteria. It is important to differentiate non-tuberculous mycobacterial lymphadenitis from tuberculous lymphadenitis as the treatment is different. We reviewed 19 children (12 girls and seven boys) with non-tuberculous mycobacterial lymphadenitis to define likely presenting features, helpful diagnostic measurements, and optimum management. Mean age at diagnosis was 5.2 years. Most had no systemic upset and clear chest x ray films. Cervical nodes were the commonest affected, and enlargement was usually unilateral. Mean duration of swelling was 6.6 weeks, and 63% of the nodes had an appearance suggestive of cold abscess. Routine haematology was unhelpful, and standard tuberculin testing performed in 47% yielded negative results in two thirds. Differential Mantoux testing with human purified protein derivative and an avium-intracellular antigen may be more useful. Antituberculous drugs were ineffective. The organism was usually highly resistant. Total excision is the treatment of choice. Antituberculous drugs are unnecessary.
儿童分枝杆菌性淋巴结炎多数病例由非结核分枝杆菌引起，以前称为非典型分枝杆菌。将非结核分枝杆菌性淋巴结炎与结核性淋巴结炎区分开来很重要，因为治疗方法不同。我们回顾了19例非结核分枝杆菌性淋巴结炎患儿（12名女孩和7名男孩），以确定可能的临床表现、有用的诊断方法和最佳治疗方案。诊断时的平均年龄为5.2岁。大多数患儿无全身不适，胸部X光片清晰。颈部淋巴结是最常受累部位，肿大通常为单侧。肿胀的平均持续时间为6.6周，63%的淋巴结外观提示为寒性脓肿。常规血液学检查无帮助，47%的患儿进行标准结核菌素试验，其中三分之二结果为阴性。用人纯化蛋白衍生物和鸟分枝杆菌-胞内分枝杆菌抗原进行鉴别曼托试验可能更有用。抗结核药物无效。该病原体通常具有高度耐药性。手术完全切除是首选治疗方法。无需使用抗结核药物。
