Skip to Main content Skip to Navigation
Master Thesis

Description de la prise en charge des adénopathies cervicales localisées de l’enfant aux urgences pédiatriques de Pellegrin : proposition d’un protocole de prise en charge

Abstract : Introduction: cervical lymphadenopathy in children is a frequent reason for consultation. It may be adenitis or the symptom of a localized or generalized infectious pathology, malignant or inflammatory. The exact etiology is only found in 40 to 50% of cases. Protocols for diagnostic and therapeutic care do exist but they are not well suited to a liberal practice of medicine. Objectives: to describe the diagnostic care of localized cervical lymphadenopathy in children. To compare the data with the literature, in particular with a thesis that was prepared in the same location 11 years earlier. To put forward a protocol for the care of cervical lymphadenopathy in children. Method: a unicentric, retrospective and descriptive study of practices at the pediatric emergency ward of Pellegrin Hospital (Bordeaux), during the year 2017, in the presence of localized cervical lymphadenopathy. Results: 92 patients were included in the study. Most of them had come to the emergency ward as a first choice. The evolution of lymphadenopathy was acute in 93,5% of cases. 34,8% of lymphadenopathies presented criteria of seriousness. The main criterion was a size greater than 3 cm. The prescription of biological examinations and serologies was not always justified. For complicated forms, the use of ultrasound was debatable and seemed less relevant than performing a cervical scan. Ganglionic puncture was requested in 4 situations. The only ganglionic biopsy that was performed resulted in facial paralysis. In the end, lymphadenopathy was reactional in 70% of cases. There were 1 case of Kawasaki syndrome and 4 cases of mycobacterial adenitis. No malignant lymphadenopathy was detected. 37% of the children were reassessed within the CHU. Conclusion: a semiological description of the lymphadenopathy and a complete clinical examination are essential for the etiological diagnosis. The most common clinical situation is a lymphadenopathy resulting from a benign infectious process and it requires neither further examination nor antibiotic therapy. The current protocols result in numerous examinations and are not well suited to a situation of acute and localized lymphadenopathy. A clinical reassessment of the patient is of the utmost importance to avoid underestimating a serious pathology.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [52 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02495963
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Monday, March 2, 2020 - 4:26:23 PM
Last modification on : Saturday, March 7, 2020 - 1:20:12 AM
Long-term archiving on: : Wednesday, June 3, 2020 - 3:32:46 PM

File

Med_generale_2019_Gueguen.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02495963, version 1

Collections

Citation

Marine Gueguen. Description de la prise en charge des adénopathies cervicales localisées de l’enfant aux urgences pédiatriques de Pellegrin : proposition d’un protocole de prise en charge. Médecine humaine et pathologie. 2019. ⟨dumas-02495963⟩

Share

Metrics

Record views

54

Files downloads

1