Understanding pediatric cervicofacial non-tuberculous mycobacterial infection

Cervicofacial non-tuberculous mycobacterial infection should be a part of the differential diagnosis for immunocompetent children ages 1 to 5 years who present with painless submandibular or preauricular lymphadenopathy. Although a benign and self-limiting disease, patients can develop a chronically draining fistula if not diagnosed and treated promptly. The diagnostic process can be managed with a combination of microbiological studies, cytology, laboratory tests, and imaging studies. Surgical excision is the most definitive curative measure. Incision and curettage, medical management with antibiotic therapy, or observation are other treatment strategies that may be considered. Frontline clinicians play a pivotal role in identifying which children may have this condition and can facilitate prompt diagnosis and treatment of this uncommon disease.