Management of Infectious Lymphadenitis in Children.
Management of Infectious Lymphadenitis in Children.
复制标题
儿童感染性淋巴结炎的治疗。
DOI：
10.3390/children8100860
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发表时间：
2021-09-27
期刊：
影响因子：
--
通讯作者：
Esposito S
中科院分区：
文献类型：
--
作者：
Pecora F;Abate L;Scavone S;Petrucci I;Costa F;Caminiti C;Argentiero A;Esposito S
淋巴结病是一种淋巴结大小和质地的不规则，在儿童时期很常见。当淋巴结的扩大是由炎症和感染过程引起的，它被称为淋巴结炎。本文的主要目的是总结儿童淋巴结炎的常见感染病因和表现，为临床实践提供管理指导。PubMed使用“淋巴结炎”和“儿童”等关键词搜索截至2021年4月发表的所有研究。文献分析表明，小儿淋巴结炎的鉴别诊断是广泛的。虽然儿童淋巴结肿大通常是良性和自限性的，但重要的是要排除恶性病因。在大多数情况下，病史和体格检查允许确定正确的诊断，并开始适当的治疗，迅速解决淋巴结病。然而，特别是在持续性淋巴结炎的情况下，确定淋巴结肿大的原因可能很困难，尽管进行了广泛的调查，但确切的病因可能无法确定。进一步的研究应该开发和验证一种算法，以帮助儿科医生诊断和及时治疗淋巴结炎，建议在哪些情况下观察等待可能被认为是一种安全的方法，哪些情况下应给予经验性抗生素治疗，以及哪些情况下需要及时诊断。
Lymphadenopathy is an irregularity in the size and texture of the lymph nodes, which is quite common in childhood. When the enlargement of lymph nodes is caused by inflammatory and infectious processes, it is called lymphadenitis. The main objective of this manuscript is to summarize the common infectious etiologies and presentations of lymphadenitis in children providing a management guide for clinical practice. PubMed was used to search for all of the studies published up to April 2021 using keywords such as “lymphadenitis” and “children”. Literature analysis showed that the differential diagnosis for lymphadenitis in pediatrics is broad. Although lymph node enlargement in children is usually benign and self-limited, it is important to exclude malignant etiology. In most cases, history and physical examination allow to identify the correct diagnosis and start a proper treatment with a prompt resolution of the lymphadenopathy. However, particularly in the case of persistent lymphadenitis, determining the cause of lymph node enlargement may be difficult, and the exact etiology may not be identified despite extensive investigations. Further studies should develop and validate an algorithm to assist pediatricians in the diagnosis and timely treatment of lymphadenitis, suggesting situations in which a watchful waiting may be considered a safe approach, those in which empiric antibiotic therapy should be administered, and those requiring a timely diagnostic work-up.
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