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[Bacterial cervical lymphadenitis--surgical aspects]
1Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikums Leipzig AöR. trob@medizin.uni-leipzig.de
Insights
Bacterial cervical lymphadenitis in children often presents with elevated white blood cell count and C-reactive protein. Surgical drainage is crucial for resolving this condition, with Staphylococcus aureus being a common cause.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Diagnostic Imaging
Background:
- Cervical lymphadenitis is common in children, requiring accurate diagnosis and management.
- Bacterial infections are a significant cause of suppurative cervical lymphadenitis.
Purpose of the Study:
- To evaluate clinical features, diagnostic tools, and bacterial causes of pediatric bacterial cervical lymphadenitis.
- To assess the impact of sonography, laboratory tests, and surgical interventions.
Main Methods:
- Retrospective study of 38 children (2.5 months to 14 years) treated surgically for bacterial cervical lymphadenitis.
- Analysis of clinical presentation, ultrasound findings, white blood cell count, C-reactive protein, and bacterial etiology.
- Review of surgical treatments including incision and drainage, aspiration, and lymph node removal.
Main Results:
- Leukocytosis (median 16.5 Gpt/l) and elevated C-reactive protein (median 27 mg/l) were observed in most patients.
- Ultrasound examination and clinical appearance were key diagnostic indicators of suppurative inflammation.
- Staphylococcus aureus (37%) and group A streptococci (16%) were the predominant pathogens. Atypical mycobacteriosis occurred in 8% of cases.
Conclusions:
- Suppurative cervical adenitis should be considered in pediatric cervical lymph node enlargement.
- Surgical drainage is essential for effective management of bacterial cervical lymphadenitis in children.
- Prompt diagnosis and appropriate surgical intervention lead to favorable outcomes.
Abstract:
In a retrospective study we evaluated clinical features and diagnostic impact of sonography, white blood cell count, C-reactive protein as well as bacterial etiology of children treated surgically for bacterial cervical lymphadenitis. We report on 38 children at the age between 2.5 months and 14 years who were admitted in our departments between 1990 and June 2002. Leukocytosis (median 16.5 Gpt/l) and/or elevated concentrations of C-reactive protein (median 27 mg/l) occurred in the majority of patients. Clinical appearance and the result of ultrasound examination were relevant for diagnosis of suppurative inflammation. Treatment included incision and drainage in 29 cases, aspiration was performed in 4 children and in 5 cases the affected lymph nodes were removed. We found a predominance of infections due to S. aureus (37%) and group A streptococci (16%). A mixed aerobic-anaerobic infection was observed in 2 (5%) children and atypical mycobacteriosis in 3 (8%) cases. In conclusion, suppurative cervical adenitis has to be taken into account in children with cervical lymph node enlargement. In these cases surgical drainage is a key to appropriate resolution.