Childhood nontuberculous mycobacterial lymphadenitis –observation alone is a good alternative to surgery

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Lyly , A , Kontturi , A , Salo , E , Nieminen , T & Nokso-Koivisto , J 2020 , ' Childhood nontuberculous mycobacterial lymphadenitis –observation alone is a good alternative to surgery ' , International Journal of Pediatric Otorhinolaryngology , vol. 129 , 109778 .

Title: Childhood nontuberculous mycobacterial lymphadenitis –observation alone is a good alternative to surgery
Author: Lyly, Annina; Kontturi, Antti; Salo, Eeva; Nieminen, Tea; Nokso-Koivisto, Johanna
Contributor organization: Clinicum
Department of Ophthalmology and Otorhinolaryngology
HUS Head and Neck Center
University of Helsinki
Children's Hospital
HUS Children and Adolescents
University Management
Korva-, nenä- ja kurkkutautien klinikka
Date: 2020-02
Language: eng
Number of pages: 5
Belongs to series: International Journal of Pediatric Otorhinolaryngology
ISSN: 0165-5876
Abstract: Objective Cervicofacial lymphadenitis caused by nontuberculous mycobacteria (NTM) is commonly treated with surgery or antimicrobial therapy. The aim of this study was to analyze the utility of our new blood-based diagnostic method and the treatment protocol, surgery or observation alone, in NTM lymphadenitis in children. Methods All patients under 16 years of age with cervicofacial NTM lymphadenitis diagnosed and treated at Children’s Hospital or at the Department of Otorhinolaryngology, Helsinki University Hospital (Helsinki, Finland) in 2007-2017 were retrospectively reviewed. Results Fifty-two patients, 33 (63%) of whom were girls, were included in the study. The median age at initial presentation of the NTM lymphadenitis was 2.9 years. The novel blood-test had been performed on 49 (94%) of the patients and in all of them it was indicative of NTM infection. A sample for mycobacterial culture was available from 34 patients, and Mycobacterium avium was the most common species detected. Most patients (n=33, 63%) were treated conservatively with observation alone. Of these, nine patients (27%) did not develop a skin fistula, and the lymphadenitis resolved without drainage. Conclusions The novel blood test is clinically feasible method for diagnosing childhood cervicofacial NTM lymphadenitis noninvasively. Observation alone is a good alternative to surgery, without the risk of complications.
Subject: Non-tuberculous mycobacteria
3125 Otorhinolaryngology, ophthalmology
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: acceptedVersion

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