Management of atypical mycobacterial lymphadenitis in childhood: A review based on 380 cases

Schaad, Urs B.; Votteler, Theodore P.; McCracken, George H.; Nelson, John D.

doi:10.1016/s0022-3476(79)80506-5

Cited by 175 publications

(112 citation statements)

References 19 publications

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“…Most of these cases are the result of infection due to the MAC, M. scrofulaceum, or the etiologic agent of cat scratch disease. Mycobacterial lymphadenitis usually presents as an insidious, painless, unilateral process involving one or more nodes in a regional distribution (20,170,264,293,417,468); axillary and inguinal nodes are occasionally involved (98). Spontaneous sinus tract formation occurs in approximately 6% (264).…”

Section: Subacute Lymphadenitismentioning

confidence: 99%

The Mycobacterium avium complex

1993

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Mycobacterium avium complex (MAC) disease emerged early in the epidemic of AIDS as one of the common opportunistic infections afflicting human immunodeficiency virus-infected patients. However, only over the past few years has a consensus developed about its significance to the morbidity and mortality of AIDS. M. avium was well known to mycobacteriologists decades before AIDS, and the MAC was known to cause disease, albeit uncommon, in humans and animals. The early interest in the MAC provided a basis for an explosion of studies over the past 10 years largely in response to the role of the MAC in AIDS opportunistic infection. Molecular techniques have been applied to the epidemiology of MAC disease as well as to a better understanding of the genetics of antimicrobial resistance. The interaction of the MAC with the immune system is complex, and putative MAC virulence factors appear to have a direct effect on the components of cellular immunity, including the regulation of cytokine expression and function. There now is compelling evidence that disseminated MAC disease in humans contributes to both a decrease in the quality of life and survival. Disseminated disease most commonly develops late in the course of AIDS as the CD4 cells are depleted below a critical threshold, but new therapies for prophylaxis and treatment offer considerable promise. These new therapeutic modalities are likely to be useful in the treatment of other forms of MAC disease in patients without AIDS. The laboratory diagnosis of MAC disease has focused on the detection of mycobacteria in the blood and tissues, and although the existing methods are largely adequate, there is need for improvement. Indeed, the successful treatment of MAC disease clearly will require an early and rapid detection of the MAC in clinical specimens long before the establishment of the characteristic overwhelming infection of bone marrow, liver, spleen, and other tissue. Also, a standard method of susceptibility testing is of increasing interest and importance as new effective antimicrobial agents are identified and evaluated. Antimicrobial resistance has already emerged as an important problem, and methods for circumventing resistance that use combination therapies are now being studied.

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Section: Subacute Lymphadenitismentioning

confidence: 99%

The Mycobacterium avium complex

1993

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“…The study is well supported by similar views from the following authors. 26,27,28,29 Even though complete excision the glands in non-TB lymphadenitis is the standard treatment. 30,31,32,33,34 More recently many studies are reporting successful treatment with antimicrobial antibiotics and observation alone.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Cervical Lymphade Nopathy in 78 Children in Tertiary Hospital : In Kerala

P¹,

Santhosh²,

Ahmed³

2015

jemds

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“…They usually show normal chest radiograph and have no fever, malaise, or weight loss. 10,11 Contrastenhanced CT scan typically demonstrates asymmetrical cervical lymphadenitis and contiguous low-density, necrotic, ring-enhancing masses but with minimal inflammatory stranding of the subcutaneous fat, a finding that may distinguish lymphadenitis caused by NTM from other conventional bacteria. 12,13 Among NTM, M. fortuitum is an extremely rare cause of isolated lymphadenitis or neck abscess.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Among NTM, M. fortuitum is an extremely rare cause of isolated lymphadenitis or neck abscess. 4,10,11,13 A history of dental procedures or defects in the immune system such as human immunodeficiency virus infection may provide insight to the cause of such an infection. 4 However, in the present case, she was neither an immunocompromised patient nor receiving any dental procedure; CT scan ruled out cervical lymphadenitis.…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium fortuitum–induced persistent parotitis: Successful therapy with clarithromycin and ciprofloxacin

Chen

et al. 2007

Head & Neck

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Background. Parotitis caused by nontuberculous mycobacteria, a very rare disease entity, has never been reported to be caused by Mycobacterium fortuitum (M. fortuitum) in the literature.Methods and Results. An 8-year-old girl was seen with painful swelling of the right parotid gland despite antibiotic treatment of more than 1 month. Elevated serum amylase activity and diffuse contrast-enhanced CT of the parotid gland confirmed the diagnosis of parotitis. Histopathological study of specimens taken from the right parotid tail mass showed granulomatous inflammation with acid-fast positive bacilli; culture later confirmed M. fortuitum. After administration of clarithromycin and ciprofloxacin for 9 consecutive months, the parotitis and parotid tail mass were completely resolved at follow-up examination.Conclusion. To our knowledge, this is the first case report of parotitis caused by M. fortuitum and its successful medical treatment. V

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Management of atypical mycobacterial lymphadenitis in childhood: A review based on 380 cases

Cited by 175 publications

References 19 publications

The Mycobacterium avium complex

The Mycobacterium avium complex

A Prospective Study of Cervical Lymphade Nopathy in 78 Children in Tertiary Hospital : In Kerala

Mycobacterium fortuitum–induced persistent parotitis: Successful therapy with clarithromycin and ciprofloxacin

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