Lymphadenitis caused by non-tuberculous mycobacteria in a university hospital in Taiwan: predominance of rapidly growing mycobacteria and high recurrence rate.
OBJECTIVE
Lymphadenitis is the most common manifestation of infection due to non-tuberculous mycobacteria (NTM) in otherwise healthy children. This disease is rare in adults and its geographic variations in etiology and clinical manifestations remain unclear. The aim of this study was to describe the etiology, clinical presentation, treatment, and outcome of NTM lymphadenitis.


METHODS
Medical records of patients with culture-proven NTM lymphadenitis treated at a university hospital in Taiwan from January 1997 through December 2004 were retrospectively reviewed.


RESULTS
In total, 12 patients with NTM lymphadenitis were identified, including 6 males and 7 adults (> or = 16 years). The majority (83%) of patients presented with an enlarged palpable mass and 9 (75%) had preceding constitutional symptoms. The most common site of lymphadenitis was the cervical area (83%) and 8 patients (75%) had multiple lymph node involvement. Rapidly growing mycobacteria (RGM) accounted for 75% of the etiology of NTM lymphadenitis, followed by Mycobacterium avium complex (MAC) [2 patients]. A high recurrence rate (42%) after primary treatment was noted among those patients who received clarithromycin-containing regimens for a median of 6 months.


CONCLUSIONS
This study found that both previously healthy children and adults were susceptible to NTM lymphadenitis. RGM was the most common etiology rather than MAC among NTM species causing lymphadenitis. Inadequate surgical excision of the diseased lymph nodes and insufficient coverage of antimycobacterial therapy both contributed to the high recurrence rate.
Ding
Liang-Wen
LW
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Lai
Chih-Cheng
CC
Lee
Li-Na
LN
Huang
Li-Min
LM
Hsueh
Po-Ren
PR
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008199:Lymphadenitis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000453:epidemiology; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy