Necrotizing Cervical Lymphadenitis—November 19, 1995

Necrotizing Cervical Lymphadenitis—November 19, 1995

This disease has a rather aggressive clinical course. In recent years, I have encountered four cases: one involving Chen Yijun, a staff member of our hospital; one involving Liu, the wife of a pharmaceutical merchant from Longxi; one involving the daughter of farmer Bao from Wushan (age 9); and one involving the son of a farmer from Dingxi. Of these four cases, three were female and one male, all young adults and children, consistent with the literature. The etiology of this disease is quite aggressive; people often consider a cancer diagnosis, and all four cases were initially suspected of this, but were later confirmed through pathology. The third case was complicated by malignant lymphoma, the first by connective tissue disease, and the fourth by persistent high fever, leading to suspicion of subsepsis. Comprehensive analysis indicates that the immune system in this disease is highly dysregulated, likely related to autoimmunity. Therefore, my treatment approach involves using Penicillin VⅠ and Metronidazole in large doses, followed by prednisone (for acute high fever, administer dexamethasone), along with traditional Chinese medicine. The TCM prescription combines Gui Zhi Shao Yao Zhi Mu Tang with Wu Wei Xiao Du Yin and Dang Gui Liu Huang Tang.