Zusammenfassung
Die atypische Mykobakteriose ist eine seltene Ursache der zervikalen Lymphadenitis und betrifft in der Regel immunkompetente Kinder zwischen dem 1. und 5. Lebensjahr. Der typische klinische Befund äußert sich in einer unilateralen, indolenten, derben Halsschwellung. Die unspezifischen klinischen Zeichen und Laborparameter erschweren die Diagnostik und somit das therapeutische Management. Verschiedene Therapieformen, wie die Operation, die medikamentöse Therapie oder das abwartende Verhalten, werden in der Literatur diskutiert. Als Therapie der Wahl ist die komplette chirurgische Exzision etabliert. Es fehlen jedoch kontrollierte randomisierte Studien, die klar den Nutzen einer bestimmten Behandlungsform herausstellen.
Abstract
Atypical mycobacteriosis is a rare cause of cervical lymphadenitis that most frequently affects immunoincompetent children between the ages of 12 months and 5 years. The typical clinical manifestation is a painless unilateral cervical mass. The nonspecific clinical symptoms and laboratory parameters complicate diagnosis and, therefore, therapeutic management. Various therapeutic options, including surgery, antimycobacterial drug therapy and wait-and-scan approaches are discussed in the literature. Complete surgical excision has become the established treatment of choice. However, controlled randomized studies that clearly demonstrate the benefits of a particular type of therapy are lacking.
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Interessenkonflikt. T. van Bremen, E. Biesinger, F. Göke, S. Keiner, F. Bootz und A. Schröck geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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van Bremen, T., Biesinger, E., Göke, F. et al. Management der zervikalen atypischen Mykobakteriose im Kindesalter. HNO 62, 271–275 (2014). https://doi.org/10.1007/s00106-013-2812-2
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DOI: https://doi.org/10.1007/s00106-013-2812-2