诊断非结核性宫面部淋巴腺炎:一个系统的审查
Elias S Saba1, Ghedak Ansari1, Jacob Hoerter1
1Kaiser Permanente Oakland Medical Center, 3600 Broadway, Oakland, CA, 94611, United States of America.
American journal of otolaryngology
|September 2, 2023
概括
这项系统性审查发现,PPD-Avium (PPD-A) 和PPD-Scrofulaceum (PPD-S) 皮肤测试显示了在儿童中诊断非结核性菌根性宫面膜淋巴炎 (NTMCL) 的最高灵敏度. 这些测试对于准确的诊断和指导儿科NTMCL病例的治疗决策至关重要.
科学领域:
- 儿童传染病 儿童传染病
- 菌根菌感染 菌根菌感染
- 诊断准确性研究 诊断准确性研究
背景情况:
- 非结核菌性宫面淋巴腺炎 (NTMCL) 是免疫能力不足儿童的一种不常见的感染,以部质量呈现.
- 准确的诊断是必不可少的,但各种诊断方法的实用性仍在研究中.
- 本系统性审查评估了不同诊断方法对儿科NTMCL的敏感性.
研究的目的:
- 系统地审查和评估不同诊断方法对儿科NTMCL的敏感性.
- 确定儿童中NTMCL最有效的诊断方法.
主要方法:
- 使用PRISMA指南进行了系统审查,搜索PubMed,EMBASE和Web of Science,查找2022年5月10日之前发表的英语研究.
- 包括的研究包括至少15名儿科患者的确诊或疑似NTMCL,并报告了诊断方法.
主要成果:
- 21项研究符合纳入标准,评估方法包括培养,PPD皮肤测试 (PPD-Tb,PPD-A,PPD-S,PPD-K),染色技术和干扰素玛释放试验 (IGRA).
- 对于已确认的NTMCL,PPD-Avium (PPD-A) 显示了最高的灵敏度 (0.94),其次是PPD-Scrofulaceum (PPD-S) (0.75).
- 在怀疑NTMCL的情况下,联合PPD-S+A+K (0.92),PCR (0.82) 和PPD-A (0.72) 显示出最高的灵敏度.
结论:
- 皮肤检测PPD-Avium和PPD-Scrofulaceum对于诊断儿科NTMCL非常敏感.
- 建议使用干扰素-释放试验 (IGRA) 来排除疑似NTMCL和阳性PPD-Tb的患者的结核淋巴炎.
- 进一步的管理可能涉及手术干预或基于临床怀疑和测试结果的NTM抗原皮肤测试.
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