[Postoperative antibiotic therapy of cervical lymphadenitis caused by nontuberculous, atypical mycobacteria].
BACKGROUND
Cervical lymphadenitis caused by atypical mycobacteria is increasingly observed in immunocompetent children between 1 and 5 years of age. Surgical excision of all affected lymph nodes represents the treatment of choice. However, due to the infiltrative nature of the disease, surgery is occasionally unable to provide a complete cure and is associated with a high risk of recurrence. Such cases might derive benefit from an additional antibiotic therapy.


METHODS
The study includes 4 children with demonstrated or clinically suspected nontuberculous mycobacterial lymphadenitis, in whom partial surgery had been performed. Postoperatively, two patients were treated with clarithromycin, rifabutin, and protionamide, the others with clarithromycin alone. Antibiotics were administered orally for 6-12 weeks and were continued four weeks after local signs of inflammation were no longer detectable.


RESULTS
In all cases, symptoms of lymphadenitis resolved within 1-2 months and did not recur. One patient was affected by WHO grade I leukopenia after 6 weeks, which soon disappeared after administration of rifabutin and protionamid had been discontinued.


CONCLUSIONS
Postoperative antibiotic therapy seems to be an effective approach to treat residual disease following incomplete surgery. It remains to be clarified, however, if such a therapy should comprise combinations of agents or if administration of clarithromycin alone might be sufficient.
Jäckel
M C
MC
HNO-Universitätsklinik Göttingen.
Witt
O
O
Eber
S W
SW
Eiffert
H
H
Laskawi
R
R
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D008197:Lymph Node Excision; D008199:Lymphadenitis / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy* / Q000601:surgery; D009333:Neck; D014388:Tuberculosis, Lymph Node / Q000188:drug therapy / Q000601:surgery
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular