Management strategy of mycobacterial cervical lymphadenitis

Abstract

The objectives of this study were to investigate the typical clinical presentation, diagnosis and treatment of mycobacterial cervical lymphadenitis (MCL). Medical records of 87 patients who were treated for MCL were retrospectively reviewed. Definitive diagnosis of MCL was made when a neck mass persisted for several weeks or months and one or more of the following was obtained: (1) positive mycobacterial cultures from biopsy material; (2) Positive mycobacterial staining of biopsy material; (3) Granulomatous inflammation and caseating necrosis on histopathological examination of biopsy material. Clinical findings were reviewed prior to treatment. The treatment included standard antituberculous medications followed by surgery in which either total excision or selective nodal dissection of the cervical lump was made. Follow-up results are presented. The chief complaint was a cervical mass that was localized mostly to the posterior cervical or submandibular regions. A fistula formation was encountered in 11.5 per cent. All patients recovered from MCL by combined antituberculous drug and surgical treatments. Clinical presentation of the disease and histopathological assessment are important in the diagnosis of MCL as well as in the differential diagnosis of tuberculous and nontuberculous MCL. Utilizing the combined medical and surgical treatment options, both tuberculous and non-tuberculous cervical adenitis can be treated successfully.

Head and neck mycobacterial infections in pediatric patients

“…Mycobacterial lymphadenopathies are scarcely invasive and easily identifiable; however a differential diagnosis from MOTT and MTB should be made, mainly because the treatment of both is thoroughly different [10].…”

Mycobacterial Cervical Lymphadenitis

“…Lymphadenitis is the most common clinical presentation of extrapulmonary tuberculosis [4]. It may present as a unilateral single or multiple painless lump, mostly located in the posterior cervical or supraclavicular region [2,5]. There is a history of tuberculous contact in 21.8%, and tuberculous infection in 16.1% of the cases [2].…”

“…Mycobacterial cervical lymphadenitis, which is also referred to as scrofula, may be manifestation of a systemic tuberculous disease or a unique clinical entity localized to neck. It can result from direct extension or hematogenous spread of the infection [2]. Mycobacterial cervical lymphadenitis remains a diagnostic and therapeutic challenge because it mimics other pathologic processes and yields inconsistent physical and laboratory findings [3].…”

Rapid and Specific Diagnosis of Extrapulmonary Tuberculosis by Immunostaining of Tissues and Aspirates With Anti-MPT64

“…1 EPTB constitutes about 15% to 20% of all cases of TB with a wide variability range (4% to 48%) among the reporting countries of notified TB cases. [2][3][4] Its annual global incidence has been increasing in the last decade due to the changing TB control practices, the population growth, and the spread of human immunodeficiency virus (HIV). The rate of EPTB is reported to be >50% in patients with HIV coinfection.…”