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[A toddler with a red swelling in the neck]
S Willemse1, M Oomens, L Karssemakers
1AMC, afd. MKA-chirurgie, Amsterdam.
Background:
The differential diagnosis in a child with a swelling in the neck is broad. Chronic lymphadenopathy in children quite often leads to extensive blood tests. Cervicofacial non-tuberculous mycobacterial (NTM) lymphadenitis is, however, not revealed by blood tests. It is a rare condition, which is mostly seen in young children.
Case Description:
A 4-year-old girl had a 9-week history of a swelling in her neck; the skin covering the swelling had been red and flaking for the past week. Extensive blood tests did not provide a firm diagnosis and ultrasound revealed 3 heterogeneous abscessing lymph glands with fistulas to the subcutaneous layer, leading to a probable diagnosis of cervicofacial NTM lymphadenitis. The infected lymph node package was excised, and microbiological culture was positive for Mycobacterium haemophilum.
Conclusion:
NTM infections in young children are persistent infections that should be treated surgically at an early stage for the best cosmetic and functional result.
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