[Lymphadenitis colli due to non-tuberculous mycobacteria (NTM): a case-series and review of the literature].
OBJECTIVE
Lymphadenitis colli due to NTM should always be considered in children with cervical Lymphadenitis. For Germany there is a lack of data concerning the incidence, the epidemiology, the diversity and frequency of the different bacteria, the diagnosis, the clinical manifestation and the medical treatment.


METHODS
By means of a questionnaire, which was retrospective for 1985 to 1994 and was sent to 277 children's hospitals in Germany, we collected data on Lymphadenitis colli in Germany. In our study we also incorporated cases from the "National Laboratory for Mycobacteria" in Borstel as well as six cases from our hospital in Mainz. Therefore our data includes both clinical (28) and laboratory (30) cases. Additionally we screened the literature on "Lymphadenitis colli in children due to NTM".


RESULTS
A total of 51 cases of Lymphadenitis due to NTM could be identified. The illness occurs typically in young children up to six years of age. The most frequent cause were species of the Mycobacterium avium-intracellulare-scrofulaceum complex. Except for the local diagnosis of a cervical Lymphadenitis other clinical symptoms are missing, just as specific laboratory parameters with a subacute or chronic course. The tuberculin skin test can be false positive. The diagnosis is confirmed by biopsy and histology as well as through microbiological tests.


CONCLUSIONS
The best treatment is complete surgical excision, whereas the importance of additional or exclusive treatment with Clarithromycin, Rifabutin and other antibiotics could not be clarified completely. But in patients with AIDS Rifabutin and other drugs could perhaps be useful, even for prophylaxis. Also if complete excision is impossible, treatment with certain drugs (Clarithromycin or Azithromycin in combination with Rifampicin) will be recommended. It still remains in question if NTM infections in children are really increasing.
Knuf
M
M
Pädiatrische Immunologie und Infektiologie, Kinderklinik der Johannes-Gutenberg-Universität Mainz.
Habermehl
P
P
Zepp
F
F
Schmidtke
P
P
Mannhardt-Laakmann
W
W
Huppertz
H-I
HI
Rüsch-Gerdes
S
S
Erdnüss
F
F
Kowalzik
F
F
Schmitt
H-J
HJ
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage / Q000627:therapeutic use; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008199:Lymphadenitis / Q000150:complications / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D015359:Mycobacterium scrofulaceum; D009333:Neck; D012189:Retrospective Studies; D017828:Rifabutin / Q000627:therapeutic use; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D017828:Rifabutin; D017963:Azithromycin; D017291:Clarithromycin; D012293:Rifampin