PDF(Pubmed)
Abstract：
Axillary lymphadenitis in adults presents a diagnostic challenge due to its diverse etiology and variable clinical manifestations. We present a rare case of suppurative Group A Streptococcus (GAS) axillary lymphadenitis secondary to a puncture wound, emphasizing the critical importance of differential diagnosis and immediate intervention. A 36-year-old male initially presented with left axillary pain and discomfort following a traumatic injury to the left thumb. Despite multiple healthcare encounters and misdiagnoses including viral illness and shingles, the patient\'s condition deteriorated, manifesting as fever, edema, and erythema in the left axilla. This case underscores the paramount significance of considering lymphadenitis in patients with axillary symptoms, particularly following trauma or skin breaches. Early recognition and appropriate management are crucial to prevent grave complications such as abscess formation, thrombophlebitis, and bacteremia. Streptococcal axillary lymphadenitis should be included at the forefront of the differential diagnosis to expedite treatment and mitigate potential life-threatening consequences associated with delayed diagnosis.
摘要：
成人腋窝淋巴结炎由于其不同的病因和可变的临床表现而提出了诊断挑战。我们介绍了一例罕见的化脓性A组链球菌（GAS）继发于穿刺伤口的腋窝淋巴结炎，强调鉴别诊断和立即干预的重要性。一名36岁的男性最初在左手拇指外伤后出现左腋窝疼痛和不适。尽管多次医疗保健和误诊，包括病毒性疾病和带状疱疹，病人的病情恶化，表现为发烧，水肿,左腋窝有红斑.此病例强调了在有腋窝症状的患者中考虑淋巴结炎的最重要意义，特别是在外伤或皮肤破裂之后。早期识别和适当的管理是至关重要的，以防止严重的并发症，如脓肿形成，血栓性静脉炎,和菌血症.应将链球菌性腋窝淋巴结炎纳入鉴别诊断的最前沿，以加快治疗并减轻与延迟诊断相关的潜在危及生命的后果。
