Dual infection with atypical mycobacteria and Mycobacterium tuberculosis causing cervical lymphadenopathy in a child

Abstract

The most common presentation of mycobacterial infection encountered in otolaryngological practice is cervical lymphadenitis. We report a child with an unusual cause of cervical lymphadenopathy, i.e. dual tuberculous infections. This had clinical ramifications as, initially Mycobacterium avium-intracellulare was grown in culture and was resistant to standard anti-tuberculous agents, and hence treated with excision of the lymph node. However, the cultures from the excised lymph node grew out Mycobacterium tuberculosis that was sensitive to standard anti-tuberculous drugs. To our knowledge, no such presentation has been reported previously. We also review the literature on cervical lymphadenitis due to atypical mycobacteria and Mycobacterium tuberculosis, with particular emphasis on clinical presentation, diagnosis and management.

Mycobacterium tuberculosis and Mycobacterium fortuitum Osteomyelitis of the Foot and Septic Arthritis of the Ankle in an Immunocompetent Patient

“…Recently, a dual mycobacterial lymphadenitis was described in a pediatric patient [11]. However, we believe that the present case is the first report of associated tubercular and nontubercular mycobacterial bone infection in an immunocompetent host.…”

Application of Real-time PCR to Recognize Atypical Mycobacteria in Archival Skin Biopsies

“…Dual infections have been described before and it is suggested that superinfections of previously established granulomas can occur. [18][19][20][21] For another patient a positive culture for M. marinum had originally been obtained but real-time PCR remained repeatedly negative, although it was suitable for the detection of this species. This could be caused by the degrading of DNA, a sensitivity problem or nonhomogenous distribution of the bacteria in the sample.…”

Multiplex PCR in diagnosis of M. tuberculosis and M. avium co-infection from lymph node in an AIDS patient

“…Later, the culture of excised lymph node grew M. tuberculosis and treatment was modifi ed. [6] Both these cases depended on conventional methodologies like staining and culture, and hence the delay in diagnosis and treatment.…”

“…[5] CHIKV is normally responsible for an acute infection, characterised by high fever, poly-arthralgia, headache and rash. [6] Neurological complications due to CHIKV have been reported from several parts of India. [7] Although in West Bengal the virus had already affected many districts of the state, but to date, no such cases have been reported from this state as well as from Eastern part of India.…”