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Aseptic abscess syndrome as first manifestation of Crohn's disease – a case report
Noninfectious (aseptic) abscesses or persistent lymphadenitis can be an early extraintestinal sign of IBD in children. Recognizing this link can prompt appropriate imaging and endoscopic evaluation that may lead to earlier diagnosis of Crohn’s disease.
Pediatric patients with unexplained persistent lymphadenitis, parents/caregivers, pediatricians, pediatric gastroenterologists, and clinicians evaluating nonresolving neck abscesses or granulomatous lymphadenitis.
What To Know
This pediatric case report describes aseptic abscess syndrome presenting as recurrent cervical (submandibular) lymphadenitis that led to investigation and diagnosis of Crohn’s disease, highlighting a rare extraintestinal manifestation in children. A 10-year-old girl had recurrent submandibular/cervical lymphadenitis that did not respond to antibiotics.
Surgical removal and histology showed suppurative granulomatous inflammation. Blood testing found positive ASCA antibodies and imaging (bowel ultrasound, MR enterography) showed inflammatory changes in the terminal ileum. Endoscopy with biopsy confirmed Crohn’s disease involving the terminal ileum and rectum.
Standard guideline-based treatment led to remission and no recurrence of the lymphadenitis. The report suggests clinicians should consider aseptic abscess syndrome and underlying IBD in children with nonresolving lymphadenitis.
The authors state this may be the first published pediatric case of cervical lymph node aseptic abscess syndrome as an initial manifestation of Crohn’s disease. This is a single case report, so it illustrates a possible but uncommon presentation rather than establishing frequency or changing practice.
The article includes diagnostic workup details (imaging, endoscopy, histology) and treatment followed current guidelines.
This is a single pediatric case report describing an uncommon presentation. It does not provide population-level risk estimates or change treatment recommendations; it mainly highlights a diagnostic consideration. Readers should consult full article for diagnostic and histologic details.
