Non-tuberculous mycobacterial lymphadenitis.
Most cases of mycobacterial lymphadenitis in children are caused by non-tuberculous mycobacteria, previously called the atypical mycobacteria. It is important to differentiate non-tuberculous mycobacterial lymphadenitis from tuberculous lymphadenitis as the treatment is different. We reviewed 19 children (12 girls and seven boys) with non-tuberculous mycobacterial lymphadenitis to define likely presenting features, helpful diagnostic measurements, and optimum management. Mean age at diagnosis was 5.2 years. Most had no systemic upset and clear chest x ray films. Cervical nodes were the commonest affected, and enlargement was usually unilateral. Mean duration of swelling was 6.6 weeks, and 63% of the nodes had an appearance suggestive of cold abscess. Routine haematology was unhelpful, and standard tuberculin testing performed in 47% yielded negative results in two thirds. Differential Mantoux testing with human purified protein derivative and an avium-intracellular antigen may be more useful. Antituberculous drugs were ineffective. The organism was usually highly resistant. Total excision is the treatment of choice. Antituberculous drugs are unnecessary.
M P
MP
White
H
H
Bangash
K M
KM
Goel
P A
PA
Jenkins
D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008198:Lymph Nodes / Q000601:surgery; D008199:Lymphadenitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D009164:Mycobacterium Infections / Q000175:diagnosis*; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000601:surgery; D014374:Tuberculin Test; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis