Nontuberculous mycobacterial cervical adenitis

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.