Desnos J, Carbonnelle B, Dubin J
Ann Otolaryngol Chir Cervicofac. 1982;99(9):391-6.
Cold abscesses in the cervical region, without associated general and functional signs, may be tuberculous lymph nodes or infected foci due to atypical mycobacteria. In the former, long-term antibiotic therapy, possibly followed by surgery conducted under conditions applicable to curettage for these lesions, is formally indicated. Treatment is of only moderate value in the second case, and spontaneous healing without other than esthetic sequelae usually occurs. These two lesions are quite different, therefore, but this was not recognized, and confusion still exists in many cases, for two reasons. Firstly, acid-alcohol-resistant bacilli are found in the pus in both cases, and a distinction cannot be made between them without culture. Secondly, pathological examination of specimens removed demonstrates identical appearances. The only way to distinguish between the two lesions, and to avoid excessively long or aggressive treatment, is by means of bacterial culture.
颈部冷脓肿,若无相关全身及功能体征,可能是结核性淋巴结或非典型分枝杆菌所致的感染灶。对于前者,正式的治疗方案是长期抗生素治疗,之后可能需在适用于这些病变刮除术的条件下进行手术。在第二种情况下,治疗效果仅为中等,通常会自发愈合,仅留下美观方面的后遗症。因此,这两种病变截然不同,但由于两个原因,这种差异未被认识到,许多病例中仍存在混淆。首先,两种情况下的脓液中均发现抗酸酒精杆菌,未经培养无法区分它们。其次,切除标本的病理检查显示外观相同。区分这两种病变并避免过长或过度积极治疗的唯一方法是进行细菌培养。