非結核菌之分枝桿菌引起的小兒頜下淋巴腺炎

Pediatric Submandibular Lymphadenitis Caused by Non-tuberculous Mycobacteria

唐高宏(Kao-Hung Tang) ； 王仲祺(Chen-Chi Wang) ； 關寶祥(Po-Cheung Kwan)

《台灣耳鼻喉頭頸外科雜誌》 39卷s-2期 (2004/12) Pp. 111-114

https://doi.org/10.6286/2004.39.s-2.111

摘要

頸部淋巴腺發炎多為細菌或病毒性感染為主，但偶爾也可見到其他病原菌之感染。如廣泛存在於大自然中之非結核菌之分枝桿菌(non-tuberculous mycobacteria)，能造成機緣性感染。一般來說，非結核菌之分枝桿菌感染在小孩子常以頭頸部唾液腺炎或淋巴腺炎來表現。因非結核菌之分枝桿菌對抗結核菌藥物常有抗藥性且少有全身侵犯，故治療方式文獻上多建議以手術切除為主。本科在2000年4月經歷1名7歲女孩，罹患右側下頜下區一約3cm直徑大小之發炎性腫塊，經抗生素治療無效後以手術切除。切片結果病理變化為下頜下區肉芽腫性淋巴腺炎(granulomatous lymphadenitis)，且培養結果為非結核菌之分枝桿菌。術後病人無全身感染及局部復發跡象，並定期在門診追蹤治療中。

關鍵字

非結核菌之分枝桿菌 ； 細針抽吸活體組織切片 ； 肉芽腫性淋巴腺炎

並列摘要

Cervical lymph node inflammation is usually caused by bacteria or viral infection, but sometimes by other pathogens such as non-tuberculous mycobacteria (NTM) which are widespread in the environment. NTM infection commonly manifests in children as sialoadenitis of major salivary gland or cervical-facial lymphadenitis. Because NTM is usually resistant to the antituberculous agents and systemic invasion is rare, total excision of cervical-facial mass is recommended by most review papers. In April 2000, we encountered a 7-year-old girl with a right submandibular inflammatory mass about 3cm in diameter. She received antibiotics treatment at first, but in vain. Then the mass was excised and pathology revealed granulomatous lymphadenitis of the submandibular space. Tissue culture disclosed NTM infection. The patient followed up regularly at our outpatient department after operation without symptoms and signs of local recurrence or systemic invasion.

並列關鍵字

non-tuberculous mycobacteria ； fine needle aspiration cytology ； granulomatous lymphadenitis