結核性頸部リンパ節炎例

DOI Web Site Web Site 参考文献1件
  • 田口 大藏
    独立行政法人国立病院機構福山医療センター　耳鼻咽喉・頭頸部外科
  • 福島 慶
    独立行政法人国立病院機構福山医療センター　耳鼻咽喉・頭頸部外科
  • 中谷 宏章
    独立行政法人国立病院機構福山医療センター　耳鼻咽喉・頭頸部外科
  • 竹内 裕美
    鳥取大学感覚運動医学講座　耳鼻咽喉・頭頸部外科学分野

書誌事項

タイトル別名
  • A Case of Cervical Tuberculous Lymphadenitis
  • 臨床 結核性頸部リンパ節炎例
  • リンショウ ケッカクセイ ケイブ リンパセツエンレイ

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<p>One of the differential diagnoses of cervical lymphadenitis is tuberculous lymphadenitis, which can be difficult to confirm. Herein, we report a case of cervical tuberculous lymphadenitis, in which the diagnosis was made by polymerase chain reaction (PCR) assay and direct smear examination for acid-fast bacilli.</p><p>A 95-year-old female patient was referred to us with a cervical mass. She had undergone surgical incision and drainage for a left cervical abscess four months previously. One month later, she was referred for plastic surgery to treat a fistula that had developed at the site of incision. Three months thereafter, she was referred to us from the plastic surgery department for a right cervical mass with redness of the overlying skin. Ultrasonography revealed a mass with an irregular margin, poor blood flow, and heterogeneous contents on the right side of her neck. Cervical lymphadenitis was suspected and an antibiotic was prescribed. However, the size of the mass increased and an abscess evolved. The T-SPOT.TB blood test was positive, indicating the diagnosis of tuberculous lymphadenitis. We aspirated pus from the mass, and examination of direct smears of the pus and PCR revealed the causative organism as Mycobacterium tuberculosis.</p><p>Based on this experience, we recommend the use of PCR, direct smear examination, and interferon-γ release assays, such as T-SPOT.TB, for confirming the diagnosis of cervical tuberculous lymphadenitis.</p>

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