Dual infection with atypical mycobacteria and Mycobacterium tuberculosis causing cervical lymphadenopathy in a child

The most common presentation of mycobacterial infection encountered in otol aryngological practice is cervical lymphadenitis. We report a child with an unusual cause of cervical lymphadenopathy, i.e. dual tuberculous infection s. This had clinical ramifications as, initially Mycobacterium avium-intrac ellulare was grown in culture and was resistant to standard anti-tuberculou s agents, and hence treated with excision of the lymph node. However, the c ultures from the excised lymph node grew out Mycobacterium tuberculosis tha t was sensitive to standard anti-tuberculous drugs. To our knowledge, no su ch presentation has been reported previously. We also review the literature on cervical lymphadenitis due to atypical mycobacteria and Mycobacterium t uberculosis, with particular emphasis on clinical presentation, diagnosis a nd management.