Mycobacterial cervical adenitis in children: medical and surgical management

This is a review of the treatment results of cervicofacial mycobacterial adenitis in 85 children and adolescents. Twenty-three patients were treated with only anti-tuberculous medications (Group A). Thirteen underwent surgical procedures at the time of presentation for drainage of abscess or diagnostic biopsy, followed by treatment with anti-tuberculous medications (Group B). Forty-nine were initially treated with anti-tuberculous medications, with or without needle aspirations, and subsequently required surgery for one of the following reasons: 1) drainage and/or excision of abscess (Group C); 2) diagnostic biopsy (Group D); and 3) excision of persistent, enlarging, or recurrent nodes, or of draining fistulas (Group E). Four patients who were initially treated with surgery required a second procedure for persistent or recurrent disease. The cure rate for patients treated only with medications (Group A) was 95%. The cure rate for patients in the surgical groups after the initial procedures were 50% for Group B, and 100% for Groups C, D, and E. The overall cure rate was 92% for surgical treatment groups B-E and 93% for all 5 treatment groups. The clinical features of the disease, treatment outcome, and guidelines for management are discussed.