Chronic lymphadenopathy due to mycobacterial infection. Clinical features, diagnosis, histopathology, and management.
This report provides clinical information, diagnostic criteria, management, and outcome of 153 cases of mycobacterial lymphadenitis; 22 patients (14%) had Mycobacterium tuberculosis (TB) and 131 patients (86%) had nontuberculous mycobacterial (NTM) disease. Correct diagnosis of TB v NTM disease is essential, since antituberculous chemotherapy was effective for TB adenitis, while excisional biopsy was the treatment of choice for NTM adenopathy. Dual (PPD-NTM, PPD-T) Mantoux tests discriminated between TB and NTM adenitis in 151 (99%) of 153 patients, while dual (PPD-Battey [B], PPD-T) tests differentiated between NTM and TB adenitis in 135 (88%) of 153 cases. A PPD-T reaction of 1 to 14 mm suggested either an NTM or TB infection, whereas a PPD-T of 15 mm or greater was strongly associated with TB disease. We recommend the use of PPD-B and PPD-T antigens as reliable diagnostic discriminators between TB and NTM adenitis.
D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D004352:Drug Resistance, Microbial; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D009164:Mycobacterium Infections / Q000175:diagnosis*; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D014374:Tuberculin Test; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery
D000995:Antitubercular Agents