MYCOBACTERIUM-GORDONAE AS A RARE CAUSE OF CERVICAL LYMPHADENITIS IN AN IMMUNOLOGICALLY NORMAL-PATIENT

History and findings: A 76-year-old man went to an ENT outpatient clin ic because of stabbing pain in the left throat and difficult swallowin g. He was found to have tonsillitis on the left and cervical lymphaden itis. The symptoms regressed on treatment with amoxycillin and clavula nic acid, but the cervical lymphadenitis persisted. Fine-needle biopsy of the cervical swelling was not diagnostic. Computed tomography of t he neck showed an encapsulated liquid space-occupying lesion with infi ltration of surrounding soft tissues. Treatment and course: The cervic al lymph-node mass was excised and histologically found to contain epi thelioid granulomas with a few giant cells and scattered centrally cas eous necroses. Tuberculostatic treatment was started; drainage fluid f rom the wound grew acid-fast bacilli, identified by gene probe as Myco bacterium gordonae. Conclusions: Mycobacterium gordonae is ubiquitous in the environment and is being identified ever more frequently in mic robiological laboratories, usually as contaminant. It rarely causes in fections of soft tissues and the lungs or systemically.