Childhood cervical lymphadenopathy.
Childhood cervical lymphadenopathy.
复制标题
DOI：
10.1016/j.pedhc.2003.08.008
复制
发表时间：
2004-01
期刊：
影响因子：
--
通讯作者：
Robson WL
中科院分区：
文献类型：
--
作者：
Leung AK;Robson WL
颈部淋巴结肿大是儿童的常见问题。这种情况最常见的是对良性局部或全身感染的短暂反应，但有时也可能预示着更严重疾病的存在。急性双侧颈部淋巴结肿大通常由病毒性上呼吸道感染或链球菌性咽炎引起。急性单侧颈部淋巴结炎是由链球菌或葡萄球菌感染引起的，40%～80%的病例是由链球菌或葡萄球菌感染引起的。亚急性或慢性淋巴结炎最常见的原因是猫抓病、分枝杆菌感染和弓形体病。锁骨上或颈后淋巴结肿大患恶性肿瘤的风险比颈前淋巴结肿大高得多。全身淋巴结肿大通常由病毒感染引起，少数情况下由恶性肿瘤、胶原血管疾病和药物引起。大多数患有颈部淋巴结肿大的儿童不需要进行实验室检查。大多数淋巴结肿大病例是自限性的，不需要治疗。在没有已知主要来源的情况下，治疗急性细菌性颈淋巴结炎应充分覆盖金黄色葡萄球菌和 A 组 β 溶血性链球菌。
Cervical lymphadenopathy is a common problem in children. The condition most commonly represents a transient response to a benign local or generalized infection, but occasionally it might herald the presence of a more serious disorder. Acute bilateral cervical lymphadenopathy usually is caused by a viral upper respiratory tract infection or streptococcal pharyngitis. Acute unilateral cervical lymphadenitis is caused by streptococcal or staphylococcal infection in 40% to 80% of cases. The most common causes of subacute or chronic lymphadenitis are cat scratch disease, mycobacterial infection, and toxoplasmosis. Supraclavicular or posterior cervical lymphadenopathy carries a much higher risk for malignancies than does anterior cervical lymphadenopathy. Generalized lymphadenopathy is often caused by a viral infection, and less frequently by malignancies, collagen vascular diseases, and medications. Laboratory tests are not necessary in the majority of children with cervical lymphadenopathy. Most cases of lymphadenopathy are self-limited and require no treatment. The treatment of acute bacterial cervical lymphadenitis without a known primary source should provide adequate coverage for both Staphylococcus aureus and group A beta hemolytic streptococci.