Non tuberculous mycobacterial lesion of the parotid gland and facial skin in a 4year old girl: A proposed treatment strategy

Nontuberculous Mycobacteria Lymphadenitis: A Case Report

“…Submental and anterior cervical lymph nodes are routinely involved. Lymphadenitis, in combination with a history of water exposure or penetrating injection, as well as negative routine cultures or response to antistaphylococcal and antistreptococcal antibiotics, should increase clinical suspicion of an NTM infection [1]. Pediatric patients are commonly infected after putting wet dirt or soil into their mouths.…”

“…The course of NTM is variable and can involve eruption of the lymph node and tract formation with drainage; the lymph node can also remain indurated [1]. Systemic symptoms are unusual in immunocompetent patients.…”

“…If the patient does not improve on specific therapy after four to six weeks, the regimen can be modified [6]. Patients on long-term antibiotics should be monitored for adverse effects including nausea, weight loss, erythema, and peripheral eosinophilia [1]. NTM complications include penetration into deeper tissues, inoculation of muscle and bones, and a resulting local infection; other significant complications that should be monitored for include tenosynovitis, osteomyelitis, and pyomyositis [3].…”

“…NTM can be isolated from a variety of environmental sources, including water, food products, domestic animals, and soil. Exposure of the human oral cavity and respiratory tract to NTM is typically from soil [1-3]. Incubation periods are variable but can reach up to five years.…”

Lymphadenitis by non‐tuberculous mycobacteria in children

“…Generally, cervical lymphadenitis by NTM presents as a unilateral, non‐tender node that slowly enlarges over several weeks. The lymph nodes most commonly involved include the sub‐mandibular, cervical or pre‐auricular and, rarely, the parotid . In most cases, the overlying skin gradually becomes thin and violaceous and may eventually suppurate through a sinus tract.…”