MYCOBACTERIAL INFECTIONS OF THE HEAD AND NECK

Despite the decline of pulmonary tuberculosis in the Western world, th e incidence of cervical mycobacterial infections has remained relative ly unaffected. A retrospective review was conducted of 20 patients tre ated for head and neck tuberculosis from 1984 to 1991. They were mostl y an immigrant group coming from underdeveloped countries close to the equator. All cases were treated with antituberculous chemotherapy; 18 patients also underwent surgical excision of their lymphadenopathy. S ixteen patients showed complete response to combined treatment and one relapse was successfully retreated with antituberculous medication. T hree patients died from unrelated causes-two from human immunodeficien cy virus infection and one from nasopharyngeal carcinoma. The most rel iable indicator of mycobacterial infection was the pathologic specimen , making the need for surgical intervention an important diagnostic co nsideration. As with other reports, most patients in our series had ne gative chest x-ray films, variable responses to skin testing, and nega tive cultures. The epidemiology, pathogenesis, and management of this disease are discussed.