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PS-373 Optimising A Diagnostic Algorythm In Patiens Presenting For Adenopathy In Primary Care Settings
  1. R Bogdan,
  2. M Oros,
  3. C Codleanu,
  4. C Radu,
  5. O Dedu,
  6. A Dumineca,
  7. C Momirla
  1. Pediatrics, Medicover Clinic, Bucharest, Romania

Abstract

Aim To describe the etiologic spectrum, clinical characteristics and evaluate the adequateness of the tests performed in order to establish diagnosis of adenopathies in children.

Materials and method Our group analysed 279 children with adenopathies consulted in the primary care paediatric clinic in a 4 years period 2009–2013. There were noted: the presence and localization of the adenopathies, the diagnosis, the tests performed and the outcome.

Results Out of the 279 cases, 106 represented unspecific multiple adenopathies following past diseases and had no clinical significance. 77 cases were confirmed to be viral unspecific infections of the upper respiratory system, 16 cases were confirmed as Infectious mononucleosis, 22 cases were Acute bacterial Tonsilitis and 11 were confirmed as Group A Streptococcus Tonsilitis. Further investigation of cases with large adenopathies of unknown origin revealed less common etiologies as Toxocara and Toxoplasma infections. There was 1 case of Hodgkin lymphoma easily diagnosed based on clinical characteristics, confirmed and treated in the oncology hospital. 7 cases presented with typical left axilar satellite adenopathy following BCG vaccination. The history and clinical signs suggested the diagnosis in all the cases. In 27 of the cases with unique large adenopathies the parents refused further diagnostic tests.

Conclusions A complete history and a meticulous clinical examination represented the most important steps in establishing the etiologic diagnosis of the adenopathies in children. Specific blood tests and other investigations must be used with caution, in order to avoid unnecessary painful diagnostic procedures and unjustified costs.

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