ATYPICAL MYCOBACTERIAL INFECTION IN CHILDHOOD - A SURGICAL DISEASE

Atypical mycobacterial (AMB) infection is an important cause of lymph node enlargement in children. Over the period, January 1992 to Decembe r 1993, 17 patients with lymphadenitis because of AMB infection were t reated at the Royal Hospital for Sick Children in Glasgow. The case no tes of the patients were reviewed. The mean age at presentation was 5. 37 years (range 1.5-10.6 years). The patients had a shea history (1-11 weeks) of unilateral single focus, usually cervicofacial (16/17), dis ease. The tuberculin skin test was not helpful in diagnosis (negative in 14/15). Primary excision was curative (11/11). Incision and drainag e of an abscess or drainage with partial excision led to chronically d ischarging sinus in all cases (6/6). AMB were not always seen on stain ing (11/17) of drained or excised material and cultures were negative in eight cases. The diagnosis in the remaining patients was made on th e basis of clinical features and particular histopathological patterns . We are currently assessing the use of polymerase chain reaction (PCR ) techniques for making the diagnosis in non-cultured cases.