Lymphadenitis due to nontuberculous mycobacteria in children: Presentationand response to therapy

The most common manifestation of infection due to nontuberculous mycobacter ia (NTM) in children is cervical lymphadenitis in an otherwise healthy pati ent. We identified and reviewed 19 cases of proven or presumptive lymphaden itis due to NTM seen at our hospital over the course of 13 months. Nine pat ients underwent initial surgical excision of involved lymph nodes. Ten chil dren did not have involved lymph nodes excised initially and were treated w ith macrolide-containing antibiotic regimens. Of these patients, five requi red subsequent surgical excision and five were cured with combination chemo therapy. Six patients underwent radiographic imaging of the head and neck t hat revealed asymmetrical adenopathy with ring-enhancing masses but minimal inflammatory stranding of the subcutaneous fat, a finding that may disting uish adenitis caused by NTM from staphylococcal and streptococcal adenitis. Our data suggest that if surgical excision is not considered feasible, ant imicrobial therapy for adenitis due to NTM may be beneficial for some patie nts.