[Cervicofacial infections due to atypical mycobacteria and tuberculous lymph nodes]

Cold abscesses in the cervical region, without associated general and functional signs, may be tuberculous lymph nodes or infected foci due to atypical mycobacteria. In the former, long-term antibiotic therapy, possibly followed by surgery conducted under conditions applicable to curettage for these lesions, is formally indicated. Treatment is of only moderate value in the second case, and spontaneous healing without other than esthetic sequelae usually occurs. These two lesions are quite different, therefore, but this was not recognized, and confusion still exists in many cases, for two reasons. Firstly, acid-alcohol-resistant bacilli are found in the pus in both cases, and a distinction cannot be made between them without culture. Secondly, pathological examination of specimens removed demonstrates identical appearances. The only way to distinguish between the two lesions, and to avoid excessively long or aggressive treatment, is by means of bacterial culture.