免疫功能正常儿童豚鼠耳炎奴卡菌颌下淋巴结炎一例  

Submandibular lymphadenitis caused by Nocardia otitidiscaviarum in a child with normal immune function:a case report

作　　者：娄新睿 华璐伊 贾新慧 韩勇 张志群 LOU Xinrui;HUA Luyi;JIA Xinhui;HAN Yong;ZHANG Zhiqun(The Fourth Clinical School of Zhejiang Chinese Medical University,Zhejiang Province,Hangzhou 310000;Department of Pediatrics,Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Zhejiang Province,Hangzhou 310000)

机构地区：[1]浙江中医药大学第四临床医学院,浙江杭州310000 [2]浙江大学医学院附属杭州市第一人民医院儿科,浙江杭州310000

出　　处：《妇儿健康导刊》2023年第5期74-76,共3页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：杭州市医药卫生科技项目(A20200819)。

摘　　要：2021年9月浙江大学医学院附属杭州市第一人民医院儿科诊治1例免疫功能正常的豚鼠耳炎奴卡菌感染致颌下淋巴结炎的病例。患儿以发热伴颌下肿块为主要临床表现,常规抗生素治疗效果不佳,淋巴结穿刺培养显示为豚鼠耳炎努卡菌感染。首先给予磺胺甲恶唑单药治疗,颌下肿块好转不明显,遂联合利奈唑胺进行治疗。双联抗生素治疗6个月后患儿体温正常、淋巴结肿块消失,病情痊愈。患儿全外显子检查未提示染色体异常。目前免疫功能正常儿童感染豚鼠耳炎努卡菌的报道较罕见,缺乏儿童感染豚鼠耳炎努卡菌的诊治经验,抗生素的选择及疗程仍存在较大争议。本文旨在提高儿科医师对免疫功能正常儿童感染豚鼠耳炎努卡菌的认识,积累治疗经验。A child with normal immune function with submandibular lymphadenitis caused by Nocardia otitidiscaviarum was diagnosed and treated in the Department of Pediatrics,Affiliated Hangzhou First People’s Hospital in September 2021.The main clinical manifestations were fever with submandibular mass and the treatment outcome was not good after conventional antibiotic treatment.The culture result of lymph node puncture fluid was Nocardia otitidiscaviarum positive.After only using Sulfamethoxazole,the submandibular mass did not shrink significantly,so Linezolid was used combined with Sulfamethoxazole.After 6 months of double antibiotic treatment,the patient’s temperature was normal,lymph node mass disappeared.No chromosomal abnormalities were detected by total exon examination.At present,reports of children with normal immune function infected with Nocardia otitidiscaviarum are rare.The diagnosis and treatment experience of such cases are not enough.The purpose of this report is to improve pediatricians’understanding of Nocardia otitidiscaviarum infection in children with normal immune function,and to accumulate clinical experience.

关 键 词：免疫功能 豚鼠耳炎努卡菌 淋巴结炎 

分 类 号：R720.5[医药卫生—儿科]