Cervicofacial lymphadenitis in children caused by Mycobacterium haemophilum.
BACKGROUND
Nontuberculous mycobacterial (NTM) lymphadenitis in children is most often caused by Mycobacterium avium. In a prospective, multicenter trial of the optimal treatment, 23.7% of the NTM cervicofacial lymphadenitis cases in children were caused by Mycobacterium haemophilum. In this article, we describe the epidemiological and clinical features of M. haemophilum cervicofacial lymphadenitis.


METHODS
The diagnosis of Mycobacterium avium or M. haemophilum infection was established by culture or polymerase chain reaction. Demographic characteristics and data regarding clinical presentation and possible environmental exposure were compared for patients infected with M. avium and those infected with M. haemophilum.


RESULTS
Ninety-four (69.9%) of 135 infections were caused by M. avium, 32 (23.7%) by M. haemophilum, and 9 (6.4%) by other NTM species. The median age of the M. haemophilum-infected children was 72 months, compared with 41 months for the M. avium-infected children (P < .001), with an equal distribution for both sexes. Involvement of multiple lymph nodes was frequently observed among the M. haemophilum-infected patients (56% of patients). Extranodal localizations were only observed in M. haemophilum-infected patients. Children with M. haemophilum infection were more likely to have a non-Dutch background (P = .001), and in most cases, they had a history of contact with swimming water (P = .03), whereas M. avium-infected patients were more likely to have a history of playing in sandpits (P = .01). In a multivariate analysis, only older age and a non-Dutch background were predisposing risk factors for M. haemophilum infection, compared with M. avium infection.


CONCLUSIONS
Higher age, non-Dutch background, and involvement of multiple cervicofacial lymph nodes with extranodal localizations distinguished M. haemophilum infection from M. avium infection.
Lindeboom
Jerome A
JA
Department of Oral and Maxillofacial Surgery, Academic Center for Dentistry, University of Amsterdam, Amsterdam, The Netherlands. j.a.lindeboom@amc.uva.nl
Prins
Jan M
JM
Bruijnesteijn van Coppenraet
Elisabeth S
ES
Lindeboom
Robert
R
Kuijper
Ed J
EJ
D000375:Aging; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008199:Lymphadenitis / Q000382:microbiology* / Q000473:pathology; D008297:Male; D009164:Mycobacterium Infections / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D009162:Mycobacterium avium / Q000302:isolation & purification; D018393:Mycobacterium haemophilum / Q000302:isolation & purification*; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D013551:Swimming Pools