Schuit K E, Powell D A
Am J Dis Child. 1978 Jul;132(7):675-7. doi: 10.1001/archpedi.1978.02120320035007.
A total of 42 cases of childhood mycobacterial adenitis have been studied to define the optimal steps that lead to the correct diagnosis of this disease. Antigens from the atypical mycobacteria are not currently available, so the usefulness of tuberculin skin testing as a diagnostic tool was examined. Skin testing differentiates mycobacterial adenitis from infection caused by pyogenic bacteria. In addition, repetitive skin testing with tuberculin over a three- to six-month period is also useful in differentiating adenitis caused by atypical mycobacteria from that due to Mycobacterium tuberculosis. Children with atypical mycobacterial adenitis have a decreasing tuberculin response to repeated testing, while children with tuberculous adenitis have a stable response. Other factors that assist in the differentiation of adenitides include a history of recent exposure to tuberculosis and evidence of extralymphatic tuberculosis. Needle aspiration or partial excision in mycobacterial adenitis may lead to drainage and sinus tract information. A PPD skin test should be done prior to surgical manipulation of enlarged nodes. Children with reactive skin tests should undergo complete excision.
共对42例儿童分枝杆菌性腺炎进行了研究，以确定能正确诊断该病的最佳步骤。目前尚无非典型分枝杆菌的抗原，因此对结核菌素皮肤试验作为诊断工具的实用性进行了研究。皮肤试验可将分枝杆菌性腺炎与化脓性细菌感染区分开来。此外，在三到六个月的时间内重复进行结核菌素皮肤试验，对于区分非典型分枝杆菌引起的腺炎和结核分枝杆菌引起的腺炎也很有用。非典型分枝杆菌性腺炎患儿对重复试验的结核菌素反应会逐渐降低，而结核性腺炎患儿的反应则较为稳定。有助于区分腺炎的其他因素包括近期接触结核病的病史和淋巴结外结核病的证据。分枝杆菌性腺炎的针吸活检或部分切除可能导致引流和窦道形成。在对肿大淋巴结进行手术操作之前，应进行PPD皮肤试验。皮肤试验呈阳性反应的患儿应进行完整切除。
