Surgical Treatment of Atypical Mycobacterial Cervicofacial Adenitis in Children

Fergusson, James; Simpson, Erroll T.

doi:10.1046/j.1440-1622.1999.01593.x

Cited by 25 publications

(14 citation statements)

References 20 publications

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“…Nearly all of their patients experienced relapse of the disease and required a second procedure. Fine‐needle aspiration, favored by Fergusson and Simpson (32), also resulted in continuous draining, prolonged healing, and multiple interventions. Therefore these preliminary procedures should only be used as a planned, staged approach, reserved for patients with extensive progression of the disease, involvement of salivary gland masses, and risk of vital structures.…”

Section: Discussionmentioning

confidence: 99%

Cervicofacial Lymphadenitis Due to Atypical Mycobacteria: A Surgical Disease

Pumberger

Hallwirth

Pawlowsky

et al. 2004

Pediatric Dermatology

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Despite the increasing prevalence of cervicofacial lymphadenitis due to atypical mycobacteria (AMB) in children, the true nature of AMB infection in clinical practice is poorly understood. The purpose of our study was to define the most common signs and symptoms, and to establish a workable scheme of diagnosis and treatment. Patients fulfilling the criteria of AMB infection (i.e., clinical signs, positive cultures or polymerase chain reaction, histologic features) were included in the study. All children underwent a standard surgical procedure, depending on pretreatment and the course of the disease. Sixteen infants presented with characteristic unilateral lymphadenopathy predominantly involving the submandibular area (13/16). Eight children had been initially treated at various institutions by fine-needle puncture or incision, and 7 of the 16 patients had received antituberculous multidrug treatment for a varying length of time. Complete excision of the affected lymph nodes was the definitive treatment in all patients. Three children had transient marginal mandibular nerve paralysis that resolved within a few months in all cases. Recognition of the characteristic features of AMB adenitis may permit early diagnosis and appropriate surgical treatment.

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Section: Discussionmentioning

confidence: 99%

Cervicofacial Lymphadenitis Due to Atypical Mycobacteria: A Surgical Disease

Pumberger

Hallwirth

Pawlowsky

et al. 2004

Pediatric Dermatology

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“…Aspiration, which may result in 50% cure rate, can be performed when surgical excision is limited because of the proximity of adenitis to the facial nerve or its branch [57]. Curettage, which may result in 70% cure rate, can also be made when the lesion is in proximity to the nerve or there is extensive skin necrosis [17,58]. Simple incision and drainage are associated with prolonged postoperative wound discharge and hypertrophic scarring [59].…”

Section: Treatmentmentioning

confidence: 99%

Mycobacterial Cervical Lymphadenitis

Bayazıt

Namıduru

2004

ORL

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Cervical lymphadenitis is the most common head and neck manifestation of mycobacterial infections. The incidence of mycobacterial cervical lymphadenitis has increased. It may be the manifestation of a systemic tuberculous disease or a unique clinical entity localized to neck. It remains a diagnostic and therapeutic challenge because it mimics other pathologic processes and yields inconsistent physical and laboratory findings. A high index of suspicion is needed for the diagnosis of mycobacterial cervical lymphadenitis. A unilateral single or multiple painless lump, mostly located in posterior cervical or supraclavicular region can occur. A thorough history and physical examination, tuberculin test, staining for acid-fast bacilli, radiologic examination, fine-needle aspiration and PCR will be instrumental in arriving at an early diagnosis early institution of treatment before a final diagnosis can be made by biopsy and culture. It is important to differentiate tuberculous from nontuberculous mycobacterial cervical lymphadenitis because their treatment protocols are different. Tuberculous adenitis is best treated as a systemic disease with antituberculosis medication. Atypical infections can be addressed as local infections and are amenable to surgical therapy.

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“…In our study, we reserved this procedure to 12.4% of the cases only, because of the high risk for facial nerve injury in performing more aggressive surgical procedures. Incision and curettage have been suggested in case of fluctuant lymphadenitis with necrotic overlying skin or in case of lymph node proximity to the facial nerve [53], and we reported four cases (3.8%) managed with this surgical procedure herein.…”

Section: G Spinelli Et Al International Journal Of Pediatric Otorhimentioning

confidence: 83%