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Understanding pediatric cervicofacial non-tuberculous mycobacterial infection

Eunice Im1, Erin Gawel, Alyson Coppola

  • 1Eunice Im is a student in the College of Human Medicine at Michigan State University in Grand Rapids, Mich. Erin Gawel is a student in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo in Buffalo, N.Y. Alyson Coppola practices at the University at Buffalo Otolaryngology in Williamsville, N.Y. Michele Carr is a professor in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|January 6, 2025
PubMed

Insights

Painless lymphadenopathy in children aged 1-5 may indicate cervicofacial non-tuberculous mycobacterial infection. Prompt diagnosis and treatment are crucial to prevent chronic draining fistulas, with surgical excision being the most effective cure.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Otolaryngology

Background:

  • Cervicofacial non-tuberculous mycobacterial infections present as painless lymphadenopathy in immunocompetent children.
  • Delayed diagnosis can lead to complications like chronically draining fistulas.

Purpose of the Study:

  • To highlight the importance of considering non-tuberculous mycobacterial infection in the differential diagnosis of pediatric lymphadenopathy.
  • To outline diagnostic and management strategies for this condition.

Main Methods:

  • Review of diagnostic modalities including microbiological studies, cytology, laboratory tests, and imaging.
  • Discussion of treatment options: surgical excision, incision and curettage, antibiotic therapy, and observation.

Main Results:

  • Non-tuberculous mycobacterial infection is a significant cause of unilateral cervical lymphadenopathy in young children.
  • Surgical excision offers the most definitive treatment, while other methods may be considered based on individual cases.

Conclusions:

  • Early recognition by frontline clinicians is essential for prompt diagnosis and management.
  • A multidisciplinary approach combining diagnostics and tailored treatment strategies ensures optimal outcomes.

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