Cited by 69Mycobacterium research and diagnosisActinomycetales infections and treatmentDiagnosis and treatment of tuberculosis

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Management of Nontuberculous Mycobacterial Cervical Lymphadenitis

Mandell, David L., Wald, Ellen R., Michaels, Marian G., Dohar, Joseph E.·2003·Archives of Otolaryngology–Head & Neck Surgery

DOI 10.1001/archotol.129.3.341

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Abstract

OBJECTIVE: To review the treatment and outcome of patients with nontuberculous mycobacterial (NTM) cervical lymphadenitis. DESIGN: Retrospective chart review. SETTING: Tertiary care children's hospital. PATIENTS: Thirty consecutive immunocompetent patients (median age, 32 months; age range, 11-147 months) diagnosed as having NTM cervical lymphadenitis over a 77-month period. INTERVENTIONS: Primary therapy for 34 foci of NTM cervical lymphadenitis in 30 children consisted of excisional biopsy (n = 8), incision and drainage procedures (n = 14), fine-needle aspiration biopsy (n = 7), observation only (n = 4), and antimycobacterial chemotherapy only (n = 1). MAIN OUTCOME MEASURES: (1) Time to cure, (2) recurrent adenitis, and (3) complications associated with therapy were determined for each therapeutic option. The average duration of follow-up was 32 months (range, 6-78 months). RESULTS: Nearly all patients (97%) were cured of their disease regardless of which therapeutic option was used. Excisional biopsy, while associated with transient marginal mandibular nerve injury in 1 patient, typically resulted in the most rapid resolution of disease. Observation alone did result in eventual cure, although the disease course was protracted. Simple incision and drainage without curettage was associated with prolonged postoperative wound discharge and hypertrophic scarring. CONCLUSIONS: A variety of therapeutic options were used in children with NTM cervical lymphadenitis. Resolution of infection was an eventual outcome regardless of treatment option, although duration of disease, potential for facial nerve injury, and incidence of hypertrophic scarring varied among the different treatments. An individualized management approach is recommended, with excisional biopsy as the preferred option when feasible.

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Authors: Mandell, D. L., Wald, E. R., Michaels, M. G., & Dohar, J. E.
Affiliations: Children's Hospital of Pittsburgh (US)
Corresponding author: Mandell, David L.
ORCID: Mandell, David L.
Wald, Ellen R.
Michaels, Marian G.
Dohar, Joseph E.
Venue: Archives of Otolaryngology–Head & Neck Surgery
Publisher: American Medical Association (AMA)
Published: 2003-03-01
Volume: 129
Issue: 3
Pages: 341
ISSN: 0886-4470 (ISSN-L)
DOI: 10.1001/archotol.129.3.341
OpenAlex: W1994254421
Cited by: 69
References: 20
Citations by year: 2025: 4 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 6 · 2014: 6 · 2013: 2 · 2012: 3
FWCI: 1.69
Type: journal article
Language: en
Open access: closed
Locations: Archives of Otolaryngology - Head and Neck Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Mycobacterium research and diagnosis
Health Sciences › Medicine › Microbiology (medical) › Actinomycetales infections and treatment
Health Sciences › Medicine › Infectious Diseases › Diagnosis and treatment of tuberculosis
Keywords: nontuberculous mycobacteria, cervical lymphadenitis, pediatric patients, excisional biopsy, incision and drainage, fine-needle aspiration, observation, marginal mandibular nerve injury, hypertrophic scars, treatment outcomes
MeSH terms: Anti-Bacterial Agents, Biopsy, Child, Child, Preschool, Curettage, Drainage, Female, Humans, Infant, Lymphadenitis, Male, Mycobacterium Infections, Postoperative Complications, Retrospective Studies, Skin, Treatment Outcome, Clarithromycin, Cicatrix, Hypertrophic, Trigeminal Nerve Injuries

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Management of Nontuberculous Mycobacterial Cervical Lymphadenitis

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