Late recurrence in surgically managed pediatric atypical mycobacterial lymphadenitis: A case report and review of the literature

Abstract

ObjectiveThe purpose of this study is to identify existing literature on recurrent atypical mycobacterial cervicofacial lymphadenitis to augment our understanding of a unique patient who presented to our tertiary‐care center 5‐years posttreatment with recurrence following curettage.Data SourcesOVID Medline, Scopus, and Web of Science.MethodsA literature search was conducted yielding 49 original articles which were screened twice by two independent reviewers resulting in 14 studies meeting inclusion criteria for data extraction using Covidence software. Two independent reviewers extracted data on recurrence of atypical mycobacterial cervicofacial lymphadenitis and consensus was reached on data points from all included studies.ResultsThis study illuminated the paucity of recurrence reporting in the literature regarding atypical mycobacterial lymphadenitis. Sixteen studies identified in our review included discussions on recurrence with few elaborating beyond the rate of recurrence to describe their management. Fourteen out of sixteen studies provided recurrence rates for their cohort, 11 out of 14 specified the initial treatment modality, and only five out of eight studies that described initial treatment with surgery differentiated recurrence rates between complete and incomplete excision. The mean length of follow‐up in the included studies was 20 months. There was one previously reported case of late recurrence at 5‐years.ConclusionsWe identified few reports that discussed the management of recurrence of atypical mycobacterial cervicofacial lymphadenitis. There was minimal data on recurrence rates between surgical treatment modalities. The case discussed in our study showcases that treatment with curettage has the potential to present with late recurrence.

Current management of cervicofacial nontuberculous mycobacterial infections in the pediatric population

“…Recurrence has been reported up to seven years after the original treatment [7,43], but rates vary widely based on treatment modality used. One study of 117 children reported a rate of 10% in patients treated with a nonsurgical approach from 1 to 4 years after initial resolution [44].…”