Mycobacterial species causing cervicofacial infection in Turkey

Abstract

The aim of the study was to determine the mycobacterial species causing cervical lymphadenitis at Cukurova University Hospital, Adana, Turkey. To this end, culture and differential tests were performed on excisional or incisional biopsy specimens from patients with mycobacterial cervical disease (MCD). The diagnosis was confirmed by skin tests, histopathological examination and positive cultures. In 15 of 40 cases diagnosed as MCD, mycobacteria were isolated in Lowenstein-Jensen medium. The etiological agents were tuberculous mycobacteria (Mycobacterium tuberculosis in 9 cases and M. bovis in 3 cases). Of the 3 non-tuberculous cases, 2 were due to M. kansasii and the other to M. fortuitum. Antituberculous chemotherapy was given in all cases over an average period of 18 months. A combination of three of four drugs was used including isoniazid, ethambutol, rifampin and/or streptomycin. At the end a follow-up period of at least 3 years, there were no recurrences or persistences of infection and no surgical treatment was necessary to remove residual lymph nodes.

Diagnostic Challenges in Cervical Tuberculous Lymphadenitis: a review

“…However, a negative culture result should not exclude the diagnosis of CTL [28]. Isolation of mycobacterium by culture is possible in 10–69% of the cases [6, 24, 40]. And also the long duration of culture (6–8 weeks) cause delay in initiation of treatment and is assessed as time-consuming.…”

Mycobacterial Cervical Lymphadenitis

“…Cultures are positive in 10-69% of the cases [2,19,28]. Mycobacterial cervical lymphadenitis is caused by tuberculous mycobacteria in 64% and nontuberculous mycobacteria in 36% of the cases [2].…”

“…Mycobacterial cervical lymphadenitis is caused by tuberculous mycobacteria in 64% and nontuberculous mycobacteria in 36% of the cases [2]. In tuberculous adenitis, M. tuberculosis is the most common causative agent (cultured in 50%), followed by M. bovis [14,28]. In nontuberculous adenitis, M. avium-intracellulare complex is the most common causative agent [11,24,29,30], and can be cultured in 68.8% of the cases [23].…”

“…It is a common causative agent of mycobacterial cervical lymphadenitis in children less than 3 years [31]. M. kansasii and M. fortuitum are rare causes [28].…”

Duodenal ulcers preceding cervical tuberculous lymphadenitis

“…M. bovis may penetrate the gastrointestinal mucosa or invade lymphatic tissue of the oropharynx when ingested with milk containing large numbers of organisms. Human infection with M. bovis has decreased significantly in developed countries as a result of the pasteurization of milk and effective tuberculosis control programmes for cattle (24,26,27). Published data describing tuberculosis in Europe in the 1930s and 1940s show that bovine tuberculosis was considered to be a significant zoonosis and M. bovis was responsible for more than 50% of cervical lymphadenitis cases in children (24).…”