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Nontuberculous mycobacterial cervical adenitis

D L Suskind1, S D Handler, L W Tom

  • 1Division of Otolaryngology, Children's Hospital of Philadelphia, PA 19104, USA.

Clinical Pediatrics
|July 1, 1997
PubMed

Insights

Granulomatous inflammation in children

Area of Science:

  • Pediatric Pathology
  • Infectious Diseases
  • Head and Neck Surgery

Background:

  • Granulomatous inflammation is frequently observed in pediatric chronic lymphadenopathy.
  • Diagnostic and management challenges exist for these lesions.
  • Nontuberculous mycobacteria (NTM) are a significant cause.

Purpose of the Study:

  • To review nontuberculous mycobacteria (NTM) in pediatric head and neck granulomatous lesions.
  • To discuss the clinical presentation, diagnostic difficulties, and treatment of NTM infections.
  • To analyze outcomes of surgical management for these conditions.

Main Methods:

  • Retrospective review of 81 pediatric cases with biopsy-confirmed head and neck granulomatous lesions over 10 years.
  • Identification of causative agents, focusing on nontuberculous mycobacteria (NTM).
  • Analysis of clinical presentation, treatment modalities, and patient outcomes.

Main Results:

  • Nontuberculous mycobacteria (NTM) accounted for 67 of 81 cases (83%).
  • Typical presentation: nontender cervicofacial mass, present for weeks to months, unresponsive to antimicrobials.
  • Surgical excision was curative in 54 patients; 13 required further procedures.

Conclusions:

  • Nontuberculous mycobacteria (NTM) are the predominant cause of granulomatous inflammation in pediatric head and neck lymphadenopathy.
  • Early diagnosis and appropriate treatment, often involving surgical excision, are crucial.
  • Further research into diagnostic and therapeutic strategies for NTM is warranted.

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