hilar lymph node
Introduction
Introduction to hilar lymphadenopathy Hilar lymphatic tuberculosis is common in children and adolescents. It is called primary syndrome with primary tuberculosis and lymphangitis. Primary syndrome is the characteristic of primary tuberculosis. Primary tuberculosis is also called childhood tuberculosis. It is the main type of tuberculosis in children after the initial invasion of tuberculosis. It includes primary syndrome and bronchial lymphadenopathy. More common in children or adolescents. basic knowledge The proportion of illness: 0.012% Susceptible people: good for children Mode of infection: respiratory transmission Complications: pneumothorax, bronchiectasis, empyema
Cause
Causes of hilar lymphatic tuberculosis
Mycobacterium tuberculosis belongs to the actinomycetes, mycobacteria of the mycobacteria family, and is a pathogenic acid-fast bacteria. Mainly divided into human, cattle, birds, mice and other types. People who are pathogenic to humans are mainly human bacteria, and bovine bacteria are rarely infected. The resistance of tuberculosis to drugs can be formed by the development of congenital drug-resistant bacteria in the flora, or it can be quickly developed due to the use of an anti-tuberculosis drug alone in the human body. bacteria. Drug-resistant bacteria can cause treatment difficulties and affect the efficacy.
Prevention
Hilar lymphatic tuberculosis prevention
1. Vaccination with BCG
BCG should be vaccinated in uninfected persons such as neonates, recruits and new trainees with negative serotonin test, young workers in new TB medical units, and adolescents undergoing kidney transplantation.
2. Chemoprevention: Selective chemoprevention of infected persons is as follows:
(1) Close contacts of patients with bacteriucin, such as children with positive serotonin test (no BCG), strong positive adolescents.
(2) The children and adolescents were tested positively, and the adult sputum test was strongly positive.
(3) Inactive tuberculosis is one of the following: 1 long-term large amount of glucocorticoids, immunosuppressive agents, cytotoxic drugs. 2 radiation therapy. 3 before and after gastrectomy. 4 recruits, new students, strong test positive. 5 tuberculosis and HIV double infection, AIDS patients with positive test. 6 Kidney transplant recipients have tuberculosis, or have inactive tuberculosis. 7 diabetes combined with inactive tuberculosis. 8 patients with silicosis (silicosis) who were positive for the test.
For chemoprevention, the isoniazid adult is 0.3g/d, the child is 6-8mg/(ks·d), and the treatment lasts for 6 months.
3. Eliminate the source of infection
Sputum smear positive (smear positive) tuberculosis is the main source of infection, eliminating the source of infection is the fundamental countermeasure to control tuberculosis. The initial treatment of smear-positive pulmonary tuberculosis and re-treatment of smear-positive pulmonary tuberculosis is the main target of chemotherapy.
Complication
Pulmonary lymphadenopathy complications Complications, pneumothorax, bronchiectasis
1, pneumothorax
When the lung cavity and cheese-like lesions are close to the pleural area, it can cause tuberculous pus. Miliary tuberculosis can cause bilateral spontaneous pneumothorax.
2. Endobronchial stenosis
Caused by endobronchial lesions.
3, bronchiectasis
Repeated progression and fibrosis of tuberculosis lesions, resulting in the destruction of the normal structure of the bronchus in the lungs, can cause secondary bronchiectasis, often repeated hemoptysis. Often located in the upper lobe, called dry branch expansion. Can cause fatal hemoptysis.
4, empyema
The pleural effusion of exudative pleurisy, if not treated in time, can be gradually cheeseified or even purulent, becoming tuberculous empyema. It is the result of the progression of cardiovascular and cavitary lung tuberculosis infection, often occurring after pneumothorax, accompanied by failure and loss of resistance to infection.
Symptom
Lymphatic tuberculosis symptoms Common symptoms High fever cough, loss of appetite, weight loss, difficulty breathing, low fever
This type of tuberculosis can be mild or severe in clinical manifestations, light can be asymptomatic, even when physical examination, when chest transfusion is found, severe cases may have symptoms of tuberculosis, such as long-term low fever, light cough, loss of appetite, weight loss, etc. More common children, older manifestations of acute morbidity, more common in infants and young children, sudden high fever for 2 to 3 weeks, then low fever, but the general situation is acceptable, but also with symptoms of tuberculosis. If the enlarged lymph nodes compress the trachea and bronchus, there may be paroxysmal cough or asthmatic dyspnea.
Examine
Examination of hilar lymphatic tuberculosis
1, physical examination of the lungs can be no positive signs, only the superficial lymph nodes.
2, blood routine examination: white blood cell count may increase, the nuclear left shift. ESR increased. Bacterial culture is sometimes positive. Most tuberculin tests were strongly positive.
3, X-ray examination: the primary syndrome can be seen bipolar dumbbell-like signs, bronchial lymphatic tuberculosis, visible hilar lymphadenopathy, or with hilar inflammatory infiltration.
Diagnosis
Diagnosis and diagnosis of hilar lymphatic tuberculosis
Diagnosis can be performed based on clinical performance and laboratory tests.
