Legionella -associated Granulomatous Cervical Lymphadenitis in Three Pediatric Patients: Utility of Broad-range...

Area of Science:

• Pediatric infectious diseases
• Molecular diagnostics
• Microbiology

Background:

• Cervical lymphadenitis is common in children.
• Infections can stem from bacteria, viruses, fungi, and mycobacteria.
• Traditional culture methods have limitations for certain pathogens.

Purpose of the Study:

• To evaluate the utility of broad-range polymerase chain reaction (PCR) for identifying pathogens in pediatric cervical lymphadenitis.
• To investigate the causative agent in clinically unsuspected cases.
• To explore the association between specific pathogens and histopathological findings.

Main Methods:

• Fresh frozen tissue samples were analyzed using broad-range PCR.
• Comparison with traditional culture methods was considered.
• Histopathological examination for granulomatous inflammation was performed.

Main Results:

• Legionella species were identified as the pathogen in 3 pediatric cases of cervical lymphadenitis via broad-range PCR.
• These Legionella infections were clinically unsuspected.
• All 3 cases exhibited granulomatous inflammation, a pattern not previously associated with Legionella.

Conclusions:

• Broad-range PCR is a valuable tool for diagnosing pediatric cervical lymphadenitis, especially for difficult-to-culture organisms like Legionella.
• Legionella should be considered in the differential diagnosis of pediatric cervical lymphadenitis with granulomatous inflammation.
• Molecular methods enhance the detection of unexpected pathogens in pediatric infections.