Chronic Lymphadenopathy due to Mycobacterial Infection

Tuberculin Skin Testing Is Useful in the Screening for Nontuberculous Mycobacterial Cervicofacial Lymphadenitis in Children

“…To determine a diagnosis of nontuberculous mycobacterial (NTM) cervicofacial lymphadenitis, a positive culture of NTM is required. This is often problematic, because recovery rates of cultures have been estimated to be ∼50% [1][2][3]. In addition, isolation and identification of NTM species may take 16 weeks, resulting in a delay in treatment.…”

Dot-ELISA vs. PCR of Fine Needle Aspirates of Tuberculous Lymphadenitis

“…16,18 FNAC avoids the physical and psychological trauma occasionally encountered after open surgical biopsy. 19 However, several conditions, including mycosis and bacterial and viral adenitis, can present the same cytology as does TBLN. 4 FNA of a tubercular lymph abscess contains more AFB than do early tubercular lymph nodes.…”

The Tuberculin Skin Test: A Useful Screen for Nontuberculous Mycobacterial Lymphadenitis in Regions with a Low Prevalence of Tuberculosis?

“…Historically, tuberculous lymphadenitis due to Mycobacterium tuberculosis and Mycobacterium bovis was predominant, typically arising during youth as a metastatic manifestation of uncontrolled primary infection acquired by the respiratory or oral rout. After 1950, as tuberculosis (TB) waned and M. bovis disease virtually disappeared from "developed" countries, nontuberculous mycobacteria (NTM) emerged as major agents of CCL, mainly in young children [2][3][4][5].…”

“…This strategy is effective in that it provides optimal material for culture and histopathology and is usually curative in localized NTM disease [2,5,9,13]. However, it begs the question of chemotherapy for mycobacterial lymphadenitis.…”

“…One may also question the actual "usefulness" of the proposed TST screening [10] (i.e., how often the result would modify physicians' diagnostic and therapeutic maneuvers). Some may feel uncomfortable in presuming NTM infection given a child with undiagnosed lymphadenitis and a TST result of 5-14 mm (a larger induration should heighten concern about TB as the correct diagnosis) [2,13].…”