Management of nontuberculous mycobacterial lymphadenitis in a tertiary care children's hospital: A 20year experience.
OBJECTIVE
Nontuberculous mycobacteria are uncommon cause of chronic cervicofacial lymphadenitis in healthy children. We describe clinical features and management strategies of cervicofacial nontuberculous mycobacterium lymphadenitis in a tertiary pediatric hospital.


METHODS
Retrospective analysis of medical records of children discharged from 1992 to 2014 with a diagnosis of cervicofacial nontuberculous mycobacterium was made. Diagnosis certainty was based on microhistological investigations. Clinical stage was evaluated according to lymph node size and presence of fistulas. Successful therapy was defined by the regression of the lymph node enlargement (>75%) or complete surgical excision without relapse.


RESULTS
Cervicofacial nontuberculous mycobacterium was diagnosed in 33 patients. Complete excision was performed in 73% of cases primarily observed in our hospital, while 83% of those referred from other hospitals required further surgical treatment. No case of relapse was observed after one year of follow-up.


CONCLUSIONS
We recommend surgical approach as the first therapeutic option in the management of cervicofacial nontuberculous mycobacterium lymphadenitis.


METHODS
Prognosis and Retrospective Study - Level II.
Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy.
Aldo
A
Naselli
Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy.
Giuseppe
G
Losurdo
Pediatric Surgery Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy.
Stefano
S
Avanzini
Otorhinolaryngology Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy.
Vincenzo
V
Tarantino
Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy.
Emilio
E
Cristina
Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy.
Elisabetta
E
Bondi
Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy. Electronic address: eliocastagnola@gaslini.org.
Elio
E
Castagnola
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008197:Lymph Node Excision; D008199:Lymphadenitis / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000601:surgery*; D009333:Neck; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome
Cervicofacial lymphadenitis; Management; Nontuberculous mycobacteria; Pediatrics; Treatment