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Mycobacterial lymphadenitis in Western Australia
1Chest Service, Health Department of Western Australia, Perth.
Tubercle and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|December 1, 1992
Summary
Mycobacterial lymphadenitis in Western Australia shows distinct patterns: Mycobacterium tuberculosis affects adults, particularly Asian migrants, while non-tuberculous mycobacteria impact children. Treatment outcomes vary between these mycobacterial infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Mycobacterial lymphadenitis is a significant infection affecting lymph nodes.
- Different mycobacterial species cause lymphadenitis with varying epidemiological patterns.
- Understanding these patterns is crucial for diagnosis and treatment.
Purpose of the Study:
- To analyze the etiological agents and clinical characteristics of mycobacterial lymphadenitis.
- To compare the epidemiology and outcomes of tuberculous (TBC) versus non-tuberculous mycobacterial (NTM) lymphadenitis.
- To evaluate diagnostic tools for NTM lymphadenitis.
Main Methods:
- Retrospective review of 172 culture-positive mycobacterial lymphadenitis cases in Western Australia (1972-1989).
- Analysis of patient demographics, mycobacterial species, disease distribution, clinical presentation, and treatment outcomes.
- Evaluation of the double Mantoux test for NTM lymphadenitis diagnosis.
Main Results:
- Mycobacterium tuberculosis caused 89% of adult cases, predominantly in Asian migrants.
- Mycobacterium avium complex (74%) and M. scrofulaceum (20%) were common in children under 7.
- TBC lymphadenitis presented with longer symptom duration but fewer local complications than NTM lymphadenitis.
- Medical treatment for TBC lymphadenitis showed excellent response; surgical excision was curative for NTM lymphadenitis.
- The double Mantoux test demonstrated 79% sensitivity and 69% specificity for NTM disease in children.
- NTM lymphadenitis prevalence decreased, while TBC lymphadenitis remained steady in the last decade.
Conclusions:
- Mycobacterial lymphadenitis exhibits distinct age and ethnic distributions for TBC and NTM infections.
- TBC lymphadenitis is primarily an adult disease in migrants, while NTM lymphadenitis affects non-Aboriginal children.
- Effective treatment strategies exist for both TBC and NTM lymphadenitis, with differing approaches.
- Diagnostic methods like the double Mantoux test can aid in identifying NTM lymphadenitis.