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Adenopatia supraclavicular no lactente: um desafio diagnóstico
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RESUMO
Introdução: As adenopatias na criança são um motivo
frequente de consulta e representam um desafio diagnóstico. O
diagnóstico diferencial inclui principalmente a patologia infecciosa,
a congénita e a neoplásica.
Caso Clínico: Descrevemos o caso de um lactente de sete
meses de idade com uma adenopatia supraclavicular unilateral,
indolor, com três meses de evolução. O estudo analítico não demonstrou
alterações e na radiografia pulmonar observou-se um
infiltrado hilar bilateral. A prova tuberculínica foi positiva com uma
induração de 20mm. O exame anatomo-patológico evidenciou
alterações compatíveis com linfadenite tuberculosa.
Conclusão: Salientamos que a tuberculose deverá ser
incluída no diagnóstico diferencial de uma adenopatia supra-clavicular, especialmente nos países de alta prevalência.
ABSTRACT Introduction: Lymph nodes enlargement is a common clinical concern in children and a diagnostic challenge. The differential diagnosis includes infections, congenital pathology, and neoplasms. Case report: We report a case of seven months-old male with unilateral painless left supraclavicular swelling noticed for three months. Laboratory tests were normal and the chest radiograph revealed a bilateral hilar infiltrate. He had a positive Mantoux test with 20mm of induration. The histological sections were compatible with tuberculosis lymphadenitis. Conclusion: With this case we highlight the importance of tuberculosis being included in the differential diagnosis of a supraclavicular adenopathy, especially in countries with high prevalence.
ABSTRACT Introduction: Lymph nodes enlargement is a common clinical concern in children and a diagnostic challenge. The differential diagnosis includes infections, congenital pathology, and neoplasms. Case report: We report a case of seven months-old male with unilateral painless left supraclavicular swelling noticed for three months. Laboratory tests were normal and the chest radiograph revealed a bilateral hilar infiltrate. He had a positive Mantoux test with 20mm of induration. The histological sections were compatible with tuberculosis lymphadenitis. Conclusion: With this case we highlight the importance of tuberculosis being included in the differential diagnosis of a supraclavicular adenopathy, especially in countries with high prevalence.
Descrição
Palavras-chave
Linfadenite tuberculosa linfadenopatia tuberculose extrapulmonar Extrapulmonary tuberculosis lymphadenopathy tuberculosis lymphadenitis
Contexto Educativo
Citação
Nascer e Crescer 2012; 21(4): 256-259