Nontuberculous mycobacterial infections of the head and neck

Albright, James T.; Pransky, Seth M.

doi:10.1016/s0031-3955(03)00024-5

Cited by 68 publications

(47 citation statements)

References 33 publications

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“…If a MTB infection is mistakenly diagnosed, as it frequently happens, antibiotics will fail with consequent further enlargement and fluctuation of the lesion up to fistulization [11].…”

Section: Discussionmentioning

confidence: 99%

Head and neck mycobacterial infections in pediatric patients

Caruso

Passali

Salerni

et al. 2009

International Journal of Pediatric Otorhinolaryngology

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Objective: Lymph nodal disease is one of the most common manifestations of head and neck tuberculosis and is particularly frequent in paediatric patients with an increasing incidence in the last decade. It may represent the manifestation of a systemic tuberculous disease or a clinical entity specific of the neck. Aim of this paper is to retrospectively analyse mycobacterial cervical adenopathies observed in two Paediatric European Centers between 1986 and 2004 and the outcomes of medical or surgical treatment. Methods: 353 children were examined for mycobacterial cervical lymphadenopaties since January 1986 to December 2004. Demografic data about the sample are showed. The retrospective evaluation of the sample underlined distribution according to etiologic patterns, head and neck adenopathies localization. Previous or simultaneous medical or surgical treatment were analyzed. Statistical analysis with Chi Square test was performed. Results: 281 (79.60%) cases showed a higher localization and 72 (20.40%) a lower localization. In relation to the etiological agent, 8 (2.27%) Mycobacterium tuberculosis (MTB) and 222 (62.89%) mycobacteria other than tuberculosis (MOTT) lymphadenopaties were observed in the upper localization as opposed to 21 (5.95%) MTB and 39 (11.05%) MOTT in the lower plane. Two (0.56%) were detected as upper lymph nodal tumefaction in the median line. In 86 (24.36%) cases at the MRI the so-called "iceberg effect" was noted. 163 (62.45%) patients underwent primary excisional biopsy whereas 74 (28.35%) underwent exeresis after other unsuccessfull therapies, 9 underwent only drainage, and 15 drainage with subsequent antibiotic therapy. Number of relapses after surgery was 16 (6.13%). Conclusions:A not homogeneous therapeutic approach to the mycobacterial cervical adenitis arises from literature and WHO guidelines does not give indications for the treatment of the cervical pattern.A therapeutic strategy based on the etiology is mandatory. In case of MBT adenopathy the therapy of choice includes the association, in variable way, of different chemotherapic drugs; surgery is reserved to advanced cases. Conversely, in cases of MOTT adenopathy, surgery is the treatment of choice.

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“…If a MTB infection is mistakenly diagnosed, as it frequently happens, antibiotics will fail with consequent further enlargement and fluctuation of the lesion up to fistulization [11].…”

Section: Discussionmentioning

confidence: 99%

Head and neck mycobacterial infections in pediatric patients

Caruso

Passali

Salerni

et al. 2009

International Journal of Pediatric Otorhinolaryngology

View full text Add to dashboard Cite

show abstract

“…Also, while the microbiological yield in our study was low compared to the 50%-60% yield described in the literature, we established that our isolates were mainly derived from Mycobacterium haemophilum or Mycobacterium fortuitum, unlike in developed countries where Mycobacterium avium-intracellulare complex predominate. (9) Although the reasons for the low yield in our present study were not immediately obvious, it could have been related to sampling issues.…”

Section: Discussionmentioning

confidence: 69%

“…Contrastingly, historical series have shown NTM to account for most granulomatous lesions of the head and neck in children. (7)(8)(9) While one series showed a predominance of either Mycobacterium avium complex (MAC) or Mycobacterium scrofulaceum, Mycobacterium malmoense has been reported by others as the second most common pathogen after MAC in northern Europe and the United Kingdom. (7,(10)(11)(12)(13)(14) Distinguishing between the NTM and tuberculous forms of lymphadenitis is important because both conditions can appear identical histologically.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, NTM lymphadenitis in immunocompetent children is best treated with complete excision, whereas antituberculous drugs are required in tuberculous lymphadenitis. (9) As opposed to tuberculous lymphadenitis, NTM lymphadenitis is not infectious, hence notification with contact tracing is not required. However, differentiation between these two forms of lymphadenitis is difficult in practice because:…”

Section: Introductionmentioning

confidence: 99%

“…(9,(10)(11)16) Several authors have adopted and modified Starke's recommendations and guidelines provided by the American Thoracic Society for the management of NTM lymphadenitis, but are not aware of any local series of granulomatous cervicofacial lymphadenitis (GCL) previously. (11,17) Hence, this study aimed to describe the clinical and microbiological epidemiology of patients in our institution with GCL, and identify any features that may impact patient outcome.…”

Section: Introductionmentioning

confidence: 99%

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