因肉芽肿性颈部淋巴腺病而接受手术治疗的儿童中可识别病原体的发生率

Beth Osterbauer, Grace Sahyouni, Christopher LePhong, Jennifer Dien Bard, My H Vu, Jeffrey Koempel
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摘要

目的:在儿科人群中,非结核分枝杆菌引起的颈淋巴结病的发病率正在上升。由于医疗服务提供者和家长都希望确定致病病原体,因此我们的研究目标是回顾肉芽肿性颈腺炎儿科患者的数量,并确定确定特定病原体的发生率。方法对 2017 年至 2023 年期间在一家大型三级儿童医院就诊的患者进行回顾性病历审查。因淋巴腺病接受手术治疗的儿童均被纳入研究范围。研究人员对病理学、微生物学和其他实验室报告进行了审查,以记录是否存在肉芽肿性颈部腺炎以及特定生物体的鉴定率。收集的其他数据包括患者的人口统计学特征和手术类型。结果:在审查的 1538 份病历中,163 名患者接受了纳入手术。患者平均年龄为 10.7 岁(2.4 个月-20 岁),70 名(43%)患者为女性,25 名(15%)患者患有肉芽肿性宫颈腺炎,其中 9 名患者的病原体被确定。结论尽管有多种辅助检查手段,但我们的数据表明,在肉芽肿性宫颈淋巴结炎病例中发现特异性病原体的情况非常罕见。因此,医生应做好准备,主要依靠病史和体格检查结果来确定诊断以及内科和/或外科治疗方案。
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Incidence of an Identifiable Organism in Children Who Underwent a Surgical Procedure for Granulomatous Cervical Lymphadenopathy.

Objectives: The incidence of cervical lymphadenopathy due to nontuberculous mycobacteria is rising in the pediatric population. Our goal with this study was to review the number of pediatric patients with granulomatous cervical adenitis and determine the incidence of identification of a specific organism as both healthcare providers and parents are interested in identifying the causative pathogen. Methods: A retrospective chart review was conducted of patients at a high-volume tertiary care children's hospital between 2017 and 2023. Children were included if they underwent a surgical procedure for lymphadenopathy. Pathology, microbiology, and other laboratory reports were reviewed to document the presence of granulomatous cervical adenitis and the incidence of identification of a specific organism. Additional data collected included patient demographics and type of procedure. Results: Of the 1538 charts reviewed, 163 patients underwent an inclusionary procedure. Mean patient age was 10.7 years (range 2.4 months-20 years), 70 (43%) were female, 25 (15%) had granulomatous cervical adenitis, and a specific organism was identified in 9 of these. Conclusion: Despite the availability of a number of ancillary tests, our data demonstrate that the identification of a specific pathogen in cases of granulomatous cervical lymphadenitis is rare. As a result, physicians should be prepared to rely primarily on the history and physical exam findings to determine a working diagnosis as well as a medical and/or surgical treatment plan.

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