title: Cervical abscess in an immunocompetent patient with Mycobacterium malmoense pulmonary disease.
abstract: BACKGROUND
  Mycobacterium malmoense is a nontuberculous mycobacteria seen mainly in two age groups and with different clinical presentations. Most patients are male adults presenting clinical symptoms and signs similar to those of pulmonary tuberculosis. The second group is formed by immunocompetent children with localized cervical lymphadenitis. Although cervical adenitis is the main extrapulmonary manifestation of M. malmoense, virtually all cases of cervical disease were documented in children. Disseminated disease is rare and has been reported in patients with severely impaired immunity.
  
  
  METHODS
  We report a case of a 47-year-old immunocompetent man with a cervical abscess, in whom we identified a M. malmoense pulmonary disease with multiple cervical, thoracic and abdominal adenopathies.
  
  
  CONCLUSIONS
  Extrapulmonary infection due to M. Malmoense needs to be considered on the differential diagnosis of cervical masses and adenopathies, not only in pediatric patients but also in adults with no impaired immunity. A high index of suspicion for nontuberculous mycobacteria is essential for the diagnosis and prognosis.
authors: Maxillofacial Surgery Department, University Hospitals of Coimbra, Avenida Bissaya Barreto, 3000-076, Coimbra, Portugal. joaondrt@gmail.com
authors: Joao N
authors: JN
authors: Duarte
authors: Nuno
authors: N
authors: Marques
authors: Leonor
authors: L
authors: Barroso
authors: Isabel
authors: I
authors: Ramos
authors: Rosa
authors: R
authors: Sá
authors: David
authors: D
authors: Sanz
authors: Artur
authors: A
authors: Ferreira
authors: Saraiva
authors: S
authors: da Cunha
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D000995:Antitubercular Agents / Q000627:therapeutic use; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D007121:Immunocompetence; D008171:Lung Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009170:Nontuberculous Mycobacteria; D014057:Tomography, X-Ray Computed; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000995:Antitubercular Agents