Cervical lymphadenitis due to non-tuberculous mycobacteria: surgical treatment and review.
A retrospective study was carried out on 57 children, presenting with non-tuberculous mycobacterial (NTM) lymphadenitis of the head and neck, over a 12 year period. Cultures recovered 56 Mycobacterium avium-intracellulare (MAI), and one Mycobacterium kansasaii. Anti-mycobacterial agents were used in seven patients only. On the basis of the initial operation there were two groups. Group 1 (11 patients) had an excision, and Group 2 (46 patients) had incision and drainage (30 patients), incision and curettage (13 patients), or aspiration (three patients). There was no significant difference in the makeup of these two groups. However, Group 1 had significantly lower number of re-operations than Group 2, P<0.01, and achieved a significantly greater healing rate than Group 2, P<0.001. In Group 2 those who had an excision following failure of the first operation were significantly more likely to heal than those who did not, P<0. 005. Operative excision gives a lower rate of re-operation, and a higher rate of healing than other procedures. The treatment, natural history, clinical presentation, pathogenesis, and diagnosis of NTM cervical lymphadenitis are discussed.
Flint
D
D
Department of Otorhinolaryngology, Starship Childrens Hospital, Auckland, New Zealand.
Mahadevan
M
M
Barber
C
C
Grayson
D
D
Small
R
R
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D019909:Mycobacterium kansasii / Q000302:isolation & purification*; D012189:Retrospective Studies; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery*