Résumé
Lymphadenitis is a common pediatric disease associated with infection and inflammation. Acute lymphadenitis in children is usually accompanied by systemic viral illness, and subsides within a few days to two weeks. However, chronic lymphadenopathy or lymphadenitis is a rare disease, and is due to a reactive response to infections including tuberculosis, neoplasms, and noninflammatory lesions. The diagnostic evaluation of chronic lymphadenitis may be very complicated and it is important to consider chronic infectious diseases and rare malignancies as possible etiologies. We report a 13-year old boy who was eventually diagnosed with tuberculous lymphadenitis. The patient was initially admitted for enlarged cervical, axillary, and epitrochlear lymph nodes. Biopsy of a cervical lymph node showed the findings compatible with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) associated with EBV infection. During treatment with prednisolone, the enlarged lymph node decreased in size. However, the lymph node enlargement resumed and we performed a second biopsy. At this time the biopsy showed tuberculous lymphadenitis and a culture of gastric juice showed M. tuberculosis. With the initiation of antituberculous treatment, the patient improved clinically.
Sujets)
Adolescent , Enfant , Humains , Mâle , Biopsie , Maladies transmissibles , Infections à virus Epstein-Barr , Suc gastrique , Herpèsvirus humain de type 4 , Lymphadénopathie angio-immunoblastique , Inflammation , Noeuds lymphatiques , Lymphadénite , Maladies lymphatiques , Prednisolone , Maladies rares , Tuberculose , Tuberculose ganglionnaireRésumé
Lymphadenitis is a common pediatric disease associated with infection and inflammation. Acute lymphadenitis in children is usually accompanied by systemic viral illness, and subsides within a few days to two weeks. However, chronic lymphadenopathy or lymphadenitis is a rare disease, and is due to a reactive response to infections including tuberculosis, neoplasms, and noninflammatory lesions. The diagnostic evaluation of chronic lymphadenitis may be very complicated and it is important to consider chronic infectious diseases and rare malignancies as possible etiologies. We report a 13-year old boy who was eventually diagnosed with tuberculous lymphadenitis. The patient was initially admitted for enlarged cervical, axillary, and epitrochlear lymph nodes. Biopsy of a cervical lymph node showed the findings compatible with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) associated with EBV infection. During treatment with prednisolone, the enlarged lymph node decreased in size. However, the lymph node enlargement resumed and we performed a second biopsy. At this time the biopsy showed tuberculous lymphadenitis and a culture of gastric juice showed M. tuberculosis. With the initiation of antituberculous treatment, the patient improved clinically.