title: Diagnosis, management and surgical treatment of non-tuberculous mycobacterial head and neck infection in children.
abstract: The aim of this study was to present our experience with the clinical characteristics of non-tuberculous mycobacterial (NTM) head and neck lymph node infections, the use of modern diagnostic tools and the appropriate therapeutic measures. We have reviewed the cases of 14 Caucasian children with NTM head and neck lymphadenitis who were treated in our clinic in the last 5 years. Three of the patients were male and 11 were female. Their age ranged from 15 to 98 months (mean age 45.7 +/- 21.76 months). Cervical lymph nodes were involved in all of our cases, while the submandibular region was found to be the area mostly affected. Overlying skin was involved in 7 cases. Diagnosis was based on intradermal skin testing with specific antigens for atypical mycobacteria, histological examination and specimen culture. Skin tests were positive for NTM in all of the patients with a predilection for Mycobacterium avium complex. The diagnosis was confirmed by histological examination in 13 cases. Specimen culture was positive in 9 cases, most of them growing M. avium-intracellulare complex. Treatment included complete surgical excision of the affected lymph nodes and the overlying skin, as well as functional neck dissection when required. A second procedure was performed in 2 patients. Successful evaluation of NTM infections of the head and neck lymph nodes should include a detailed history, thorough physical examination and specific laboratory investigations. The treatment of choice is complete surgical excision of all affected tissue.
authors.affiliation: Head and Neck Surgery Department, Ghent University Hospital, Ghent, Belgium. vdanielidis@hotmail.com
authors.forename: Vasilis
authors.initials: V
authors.lastname: Danielides
authors.forename: George
authors.initials: G
authors.lastname: Patrikakos
authors.forename: Mieke
authors.initials: M
authors.lastname: Moerman
authors.forename: Katrien
authors.initials: K
authors.lastname: Bonte
authors.forename: Catharina
authors.initials: C
authors.lastname: Dhooge
authors.forename: Hubert
authors.initials: H
authors.lastname: Vermeersch
mesh_terms: D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006257:Head; D006801:Humans; D007223:Infant; D008197:Lymph Node Excision; D008199:Lymphadenitis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000601:surgery*; D009333:Neck