Development of an algorithm for the management of cervical lymphadenopathy in children: consensus of the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Society of Pediatric Infectious Diseases and the Italian Society of Pediatric Otorhinolaryngology
Development of an algorithm for the management of cervical lymphadenopathy in children: consensus of the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Society of Pediatric Infectious Diseases and the Italian Society of Pediatric Otorhinolaryngology
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DOI：
10.1586/14787210.2015.1096777
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发表时间：
2015-12-02
影响因子：
5.7
通讯作者：
de Martino, Maurizio
中科院分区：
文献类型：
--
作者：
Chiappini, Elena;Camaioni, Angelo;de Martino, Maurizio
由于疾病范围广泛，颈部淋巴结肿大是儿童常见的疾病。在完整的病史和体格检查的基础上，儿科医生必须从绝大多数患有良性自限性疾病的儿童中选择那些有其他更复杂疾病风险的儿童，这些疾病需要进行实验室检查、影像学检查，最后进行组织取样。同时，不必要时应避免进行昂贵的侵入性检查。意大利预防和社会儿科协会与意大利儿科传染病协会、意大利儿科耳鼻喉科协会和其他科学协会联合发布了一份全国共识文件，该文件基于最新的文献发现，包括儿童颈部淋巴结肿大的治疗算法。方法：遵循意大利国家计划指南，采用共识会议方法。通过对 MEDLINE 和 Cochrane 系统评价数据库从其建立到 2014 年 3 月 21 日期间的系统评价，确定了相关的英文出版物。 结果：根据文献结果，开发了一种算法，包括几种可能的临床情况。考虑到严重潜在疾病的风险，需要采取观察等待策略的情况、需要经验性抗生素治疗的情况以及需要立即诊断检查的情况都已确定。结论：本算法是医院和门诊环境中小儿颈部淋巴结肿大管理的实践工具。多学科方法至关重要。其在临床领域的验证还需要进一步的研究。
Cervical lymphadenopathy is a common disorder in children due to a wide spectrum of disorders. On the basis of a complete history and physical examination, paediatricians have to select, among the vast majority of children with a benign self-limiting condition, those at risk for other, more complex, diseases requiring laboratory tests, imaging and, finally, tissue sampling. At the same time, they should avoid expensive and invasive examinations when unnecessary. The Italian Society of Preventive and Social Pediatrics, jointly with the Italian Society of Pediatric Infectious Diseases, the Italian Society of Pediatric Otorhinolaryngology, and other Scientific Societies, issued a National Consensus document, based on the most recent literature findings, including an algorithm for the management of cervical lymphadenopathy in children. Methods: The Consensus Conference method was used, following the Italian National Plan Guidelines. Relevant publications in English were identified through a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through March 21, 2014. Results: Basing on literature results, an algorithm was developed, including several possible clinical scenarios. Situations requiring a watchful waiting strategy, those requiring an empiric antibiotic therapy, and those necessitating a prompt diagnostic workup, considering the risk for a severe underling disease, have been identified. Conclusion: The present algorithm is a practice tool for the management of pediatric cervical lymphadenopathy in the hospital and the ambulatory settings. A multidisciplinary approach is paramount. Further studies are required for its validation in the clinical field.