Mycobacterial infections of the head and neck

Abstract

Despite the decline of pulmonary tuberculosis in the Western world, the incidence of cervical mycobacterial infections has remained relatively unaffected. A retrospective review was conducted of 20 patients treated for head and neck tuberculosis from 1984 to 1991. They were mostly an immigrant group coming from underdeveloped countries close to the equator. All cases were treated with antituberculous chemotherapy; 18 patients also underwent surgical excision of their lymphadenopathy. Sixteen patients showed complete response to combined treatment and one relapse was successfully retreated with antituberculous medication. Three patients died from unrelated causes--two from human immunodeficiency virus infection and one from nasopharyngeal carcinoma. The most reliable indicator of mycobacterial infection was the pathologic specimen, making the need for surgical intervention an important diagnostic consideration. As with other reports, most patients in our series had negative chest x-ray films, variable responses to skin testing, and negative cultures. The epidemiology, pathogenesis, and management of this disease are discussed.

Tuberculous Lymphadenitis in Manitoba: Incidence, Clinical Characteristics and Treatment

“…A single enlarged cervical lymph node was the most common presentation, with symptoms localized to the involved lymph node site. This has been well described in the literature (5)(6)(7)(19)(20)(21)(22)(23).…”

“…While other studies have focused on peripheral TBL disease alone, this study included cases of TBL with a site of active TB elsewhere (6,20,21). We found 18% of our TBL cases with active TB documented elsewhere, both in HIV-infected and uninfected individuals (22).…”

Comparison of clinical aspects and Mantoux test in tuberculosis versus non-tuberculosis superficial lymphadenitis

“…The most common site of lymph node enlargement in order of occurrence is the neck (cervical), axilla, inguinal and submandibula. 10,13,19 This finding did not differ from the previous study. We found that in both groups, lymph node enlargement mostly occurred in the neck (44% and 60% respectively) and submandibula (16% and 23% respectively).…”

“…[10][11][12] Enlargement of the lymph nodes outside the cervical area indicates a serious form of TB with systemic process. 7,13 Another opinion stated that multiple process is frequently found in the enlargement of superficial lymph nodes caused by MTB. 7,11,14 The aim of this study was to investigate the clinical aspects and result of Mantoux test in superficial lymphadenitis caused by Mycobacterium tuberculosis compared to that caused by non-tuberculosis organism.…”

“…Manolidis 13 found few symptoms of night sweating and malaise in tuberculosis lymphadenitis. In this study, there were 16% of children with night sweating and malaise in the TSL group.…”