Rafaty F M
Arch Otolaryngol. 1977 Sep;103(9):547-9. doi: 10.1001/archotol.1977.00780260077011.
Toxoplasmosis is not a rare disease. Infestation occurs in 75% of the general world population and in 35% of the US population. Lymphadenopathy, primarily of the cervical type, is one of the most common signs of acquired toxoplasmosis. During the past 15 years a great number of reports have appeared in the medical literature regarding toxoplasmosis. However, it seems that most clinicians do not consider this disease as a possibility when they encounter patients with unexplained cervical adenopathy in whom the usual tests for infectious mononucleosis are negative. In fact, the majority of such patients come to the operating room with a suspected diagnosis of malignant neoplasm, particularly of malignant lymphoma. Thus, a great deal of unnecessary anxiety is generated and, at times, unnecessary surgery is performed. These may be avoidable. A total of 38 cases of acquired toxoplasmosis manifested by lymphadenopathy (82% in the cervical region) are analyzed with respect to symptomatology, differential diagnosis, clinical and laboratory diagnosis, and treatment. Toxoplasmosis should be included in the differential diagnosis of patients with cervical tumors.
弓形虫病并非罕见疾病。全球75%的普通人群以及35%的美国人群都曾感染过。淋巴结病,主要是颈部淋巴结病,是获得性弓形虫病最常见的症状之一。在过去15年里,医学文献中出现了大量关于弓形虫病的报道。然而,当临床医生遇到不明原因颈部淋巴结病且传染性单核细胞增多症常规检测呈阴性的患者时,似乎大多数医生并未将这种疾病考虑在内。事实上,这类患者大多是带着恶性肿瘤,尤其是恶性淋巴瘤的疑似诊断进入手术室的。因此,会产生大量不必要的焦虑,有时还会进行不必要的手术。这些都是可以避免的。本文对38例以淋巴结病为表现的获得性弓形虫病病例(82%为颈部淋巴结病)进行了症状学、鉴别诊断、临床及实验室诊断以及治疗方面的分析。弓形虫病应纳入颈部肿瘤患者的鉴别诊断之中。