Lymphadenitis cervicalis due to Mycobacterium interjectum in immunocompetent children

Abstract

This report presents two cases of cervical lymphadenitis due to Mycobacterium interjectum in healthy young children, identified by sequencing of the 16S rRNA gene. Surgical resection combined with chemotherapy resulted in cure. Conclusion: The attention of clinicians needs to be drawn to an emerging mycobacterial pathogen which might be overlooked or misidentified in routine laboratory testing.

Submandibular lymphadenitis caused by Mycobacterium interjectum: contribution of new diagnostic tools

“…The true prevalence of M. interjectum infection is probably underestimated because conventional identification methods based on phenotypical and biochemical characteristics may produce ambiguous results and misidentification (e.g., M. scrofulaceum) [6]. So far, only nine patients with infection caused by M. interjectum in children have been published (Table 1) [3,6,[10][11][12][13][14]. All INH isoniazid, RIF rifampin, PZA pyrazinamide, EMB ethambutol, R resistant, S suceptible patients were younger than 4 years (range 18 months to 3 years) and presented with isolated and unilateral chronic cervical lymphadenitis like most other MOTT infection except two patients who had adenitis located in the cheek and over the thyroid isthmus.…”

The First Case of <i>Mycobacterium interjectum</i> Pulmonary Disease in Japan: A Case Report

“…Since the first report of M. interjectum in 1993 (1), several reports have described it as a causative agent of lymphadenitis in healthy children. Table 1 shows the details from previous reports of extrapulmonary lesions (1,2,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In many cases, the infection is refractory to antimicrobial agents and is treated surgically.…”

DisseminatedMycobacterium interjectumInfection with Bacteremia, Hepatic and Pulmonary Involvement Associated with a Long-Term Catheter Infection

“…The identification of mycobacteria was traditionally based upon phenotypic and biochemical characteristics, nucleic acid probes (available for only a limited number of NTM), and high-performance liquid chromatography [ 7 ], all of which have been largely supplanted by 16S rRNA sequencing [ 8 ]. M. interjectum identification has been unsuccessful with biochemical and phenotypic techniques [ 7 ], since it has similar characteristics with other mycobacteria such as M. scrofulaceum , M. gordonae , and M. simiae [ 5 , 7 , 9 ]. Species level identification usually requires 16S rRNA gene sequencing [ 5 , 7 ], although use of sequence data from the hsp65 or rpoB genes has been described to be valuable tool in AFB identification [ 8 , 10 ].…”