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題名 | Recurrent Acute Suppurative Thyroiditis in a Child: Case Report=小兒復發性急性化膿性甲狀腺炎: 病例報告 |
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作者 | 許振芳; 王志堅; 蔡明志; 黃清峰; 陳遠浩; 朱夢麟; | 書刊名 | 微免與感染雜誌 |
卷期 | 31:3 1998.09[民87.09] |
頁次 | 頁193-196 |
分類號 | 417.5931 |
關鍵詞 | 小兒; 急性化膿性甲狀腺炎; 頸部腫塊; Neck mass; Acute suppurative thyroiditis; Pyriform sinus fistulae; |
語文 | 英文(English) |
中文摘要 | 一位23個月大的女童,自上呼吸道感染後出現持續性發燒和左側前面的頸部區域 有一逐漸脹大的腫塊。 實驗室檢查發現:白血球數增加,紅血球沉降速率和 C-- 反應蛋白 亦增加;甲狀腺功能稍微降低。實施 Tc-99m 甲狀腺核子醫學掃描發現左側甲狀腺對放射性 核種的吸收減少。 左側甲狀腺抽出膿樣引流物經培養長出三種混合菌: viridans streptococci,Prevotella spp 和 Peptostreptococcus magnus 菌。病童經頸部切開引流 手術及十四天盤林西尼治療後健癒出院。術中並無發現仿管,不幸地,病童於出院三個月後 , 再度因類似的發燒和左側前面的頸部腫塊而住院。 左側甲狀腺抽出物經培養再度長出 viridans streptococci 菌,經十四天盤林西尼治療後健癒。食道鋇劑攝影中發現左側甲狀 腺有一左側梨狀隱窩仿管。該病童於八週後接受手術治療而痊癒。 |
英文摘要 | A 23-month-old girl presented with a history of persistent fever and growing left anterior neck mass following an upper respiratory tract infection. Laboratory studies revealed leukocytosis, elevated levels of the erythrocyte sedimentation rate and C-reactive protein, and a mild impairment of thyroid function. Thyroid scan showed a decreased radioactive iodine uptake of the left thyroid gland. Culture of the thyroid aspirate grew the mixed flora, viridans streptococci, Prevotella spp, and Peptostreptococcus magnus. She was discharged after a surgical drainage and a 14-day course of penicillin-G therapy. Unfortunately, she was readmitted for the resembling problems, the fever and progressing left anterior neck mass 3 months later. Culture of thyroid aspirate also grew the viridans streptococci. She recovered after a 14-day course of penicillin-G therapy. A left pyriform sinus fistula was found by barium esophagogram. A selective operation was performed 8 weeks later. |
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