Management of atypical mycobacterial lymphadenitis after incomplete surgical excision

The treatment of choice of atypical mycobacterial cervical lymphadenitis is complete surgical excision of all involved lymph nodes. However, a high re currence rate of infection following incomplete surgery has been described. We report on 3 children with atypical mycobacterial cervical lymphadenitis who underwent incomplete surgery of lymph nodes in order to preserve crani al nerves and blood vessels. After surgery, the patients were treated with clarithromycin alone or in combination with protionamid and rifabutin over a period of 6 weeks to 3 months. All 3 patients were. completely cured with no recurrence of lymphadenitis. Discussion: In case of an infiltrative character of a cervical lymphadeniti s caused by atypical mycobacteria, surgical resection is often incomplete. A postoperative antibiotic treatment might prevent recurrence of lymphadeni tis in these cases.