Cervical lymphadenitis due to non-tuberculous mycobacteria: surgical treatment and review

A retrospective study was carried out on 57 children, presenting with non-t uberculous mycobacterial (NTM) lymphadenitis of the head and neck, over a 1 2 year period. Cultures recovered 56 Mycobacterium avium-intracellulare (MA I), and one Mycobacterium kansnsaii. Anti-mycobacterial agents were used in seven patients only. On the basis of the initial operation there were two groups. Group 1 (11 patients) had an excision, and Group 2 (46 patients) ha d incision and drainage (30 patients), incision and curettage (13 patients) , or aspiration (three patients). There was no significant difference in th e makeup of these two groups. However, Group 1 had significantly lower numb er of re-operations than Group 2, P < 0.01, and achieved a significantly gr eater healing rate than Group 2, P < 0.001. In Group 2 those who had an exc ision following failure of the first operation were significantly more like ly to heal than those who did not, P < 0.005. Operative excision gives a lo wer rate of re-operation, and a higher rate of healing than other procedure s. The treatment, natural history, clinical presentation, pathogenesis, and diagnosis of NTM cervical lymphadenitis are discussed. (C) 2000 Elsevier S cience Ireland Ltd. All rights reserved.