Nontuberculous Mycobacteria Lymphadenitis: A Case Report

Abstract

Atypical mycobacteria, also known as nontuberculous mycobacteria (NTM) includes acid-fast bacteria other than Mycobacterium tuberculosis. NTM can be isolated from a variety of environmental sources including water, food products, domestic animals, and soil; human exposure is typically from soil to the oral cavity and respiratory tract. Diagnosis of NTM is suspected in children less than five years old with subacute, unilateral, non-tender cervicofacial lymphadenitis in combination with a history of water exposure, penetrating injection, as well as negative routine cultures or response to antistaphylococcal and antistreptococcal antibiotics. The course of the disease is variable and can involve eruption of the lymph node and tract formation with drainage. Management of nontuberculous mycobacteria can include surgical and antimycobacterial therapy. We present a case of a two-year-old African American girl who presented to the clinic with anterior ear lobe and submandibular lymphadenitis due to suspected NTM.

Tender Cervical Lymphadenopathy in a Pediatric Patient

“…2 The presence of tender lymphadenopathy distinguishes KFD from nontuberculous mycobacterial lymphadenitis and Rosai-Dorfman-Destombes disease (RDD), both of which present with painless nodes. 3,4 Additionally, most cases of nontuberculous mycobacterial lymphadenitis occur in children younger than 5 years old, making this diagnosis more unlikely. 4 Although many patients with KFD have a normal complete blood count, leukopenia has been reported in up to 43% of cases.…”

“…3,4 Additionally, most cases of nontuberculous mycobacterial lymphadenitis occur in children younger than 5 years old, making this diagnosis more unlikely. 4 Although many patients with KFD have a normal complete blood count, leukopenia has been reported in up to 43% of cases. 5 Other possible findings include chronic anemia, thrombocytopenia or pancytopenia, elevated erythrocyte sedimentation rate, abnormal liver function tests, and elevated serum lactate dehydrogenase levels.…”

Baseballs, tennis balls, livestock farm manure, the IDH1 mutation, endothelial cell proliferation and hypoxic pseudopalisading (granulomatous) necrosis: Mycobacterium avium subspecies paratuberculosis and the epidemiology, cellular metabolism and histolog

“…Other non-tuberculous mycobacteria can be contracted by direct contact with or inhalation of the mycobacterium in dirt or dust. Children who contract non-tuberculous mycobacteria frequently get infected by putting soil or dirt into their mouths (Krantz et al ., 2016). Baseball pitchers often lick their fingers between pitches after holding balls coated with possibly MAP-contaminated dirt.…”