Pediatric emergency medicine trisk 0784 0784
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (130.18 KB, 1 trang )
pestis transmitted via flea bites carries a high mortality and is rare in the United
States. Bubonic plague, the most common form, causes regional exquisitely
tender lymphadenitis (bubo) with overlying erythema in the area of the bite, and
the inguinal nodes are the most common site. Ulceroglandular tularemia is
transmitted by tick bites and can cause inguinal adenopathy and adenitis that
often precede the appearance of a small papule that later ulcerates at the portal of
entry on the lower extremity. Both plague and tularemia exist in pneumonic forms
that have become agents of bioterrorism (see Chapter 132 Biological and
Chemical Terrorism ). Filariasis, a parasitic disease transmitted by fly or
mosquito bites and found in the tropics, can produce adenopathy or adenitis
associated with lower extremity lymphedema and scrotal pathology. Treatment is
dependent on the extent of disease (see treatment options in Table 39.2 ).
TABLE 39.1
CAUSES OF INGUINAL MASSES
Painful
a Torsion of an undescended testicle
a Trauma (e.g., dislocated testicle, hematoma)
a Incarceration or strangulation of an indirect or direct inguinal hernia
a Herniation of the ovary and/or fallopian tube
Lymphadenitis (+/− suppurative)
Hidradenitis suppurativa
Usually or comparatively painless
Hernia (intermittent, reducible)
Lymphadenopathy
Tumor, benign or malignant
Retractile or undescended testicle
Hydrocele of the spermatic cord
a Urgent
or emergent condition.
Sexually transmitted infections can result in inguinal adenopathy or adenitis
(see Chapter 92 Gynecology Emergencies ). Herpes simplex is a common cause
of genital ulcerations and bilateral lymphadenitis. Occasionally, enlarged lymph
nodes precede the appearance of vesicles. The chancre of primary syphilis is
painless and has a raised, indurated border and a clean surface. Bilateral (70%) or
unilateral, nontender inguinal adenopathy is common. Chancroid, more common
