NONTUBERCULOUS MYCOBACTERIAL CERVICAL ADENITIS

Granulomatous inflammation is a common finding in pathologic evaluatio n of surgically excised chronic lymphadenopathy in children. Confusion exists regarding diagnosis and management of these lesions. Over a 10 -year period at The Children's Hospital of Philadelphia, a total of 81 children were identified with biopsy-confirmed granulomatous lesions of the head and neck, with nontuberculous mycobacteria (NTM) accountin g for 67 of the cases. The typical presentation was that of a nontende r mass in the cervicofacial area present for weeks to months, unrespon sive to antimicrobials. All underwent surgical excision, which was cur ative in 54 patients; 13 children required additional procedures. This paper reviews NTM, its typical clinical presentation, difficulty in d iagnosis, and the methods of treatment.