| Cervicofacial nontuberculous mycobacterial lymphadenitis in children. | |
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MedLine Citation:
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PMID: 22239836 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Nontuberculous mycobacteria are ubiquitous organisms readily isolated from natural waters, drinking water systems and soil. They form a continuous challenge to the human immune system which becomes apparent in patients with impaired immunity. However, most infections occur in seemingly healthy children. The clinical presentation consists of a unilateral, non-tender, persistent, cervical lymphadenopathy without systemic illness. Fistula formation may occur. MATERIAL AND METHODS: Patients were included if one or more of the following were positive; 1) mycobacterial culture, 2) acid-fast microscopy, 3) polymerase chain reaction and/or 4) granulomatous inflammation. RESULTS: On the basis of operative management, two distinct groups were established. Group 1 had an excision of all pathological tissue performed and Group 2 was treated with incision and drainage. There was a difference between the two groups in regard to the risk of developing a postoperative fistula. In Group 1, 50% developed a fistula compared with 91% in Group 2 (p = 0.06). CONCLUSION: Surgical treatment is generally advocated as the treatment of choice. Antibiotic treatment is associated with adverse effects and avoidance of surgery does not justify the inferior results related to antibiotics. A watch-and-wait strategy or antibiotic therapy may be considered when surgical excision carries a high risk of facial nerve injury. Although the lymph nodes may persist for months, spontaneous regression may occur and the children remain systemically well. FUNDING: not relevant. TRIAL REGISTRATION: not relevant. |
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Authors:
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Rikke Haahr Iversen; Peter Illum |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Danish medical journal Volume: 59 ISSN: 2245-1919 ISO Abbreviation: Dan Med J Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-01-13 Completed Date: 2012-05-08 Revised Date: 2012-09-06 |
Medline Journal Info:
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Nlm Unique ID: 101576205 Medline TA: Dan Med J Country: Denmark |
Other Details:
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Languages: eng Pagination: A4349 Citation Subset: IM |
Affiliation:
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Otorhinolaryngology, Aarhus University Hospital, Denmark. rikkehaahr@hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
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administration & dosage*,
adverse effects Child Child, Preschool Cutaneous Fistula / etiology*, prevention & control Denmark / epidemiology Drainage* / adverse effects, methods Facial Nerve Injuries / etiology*, prevention & control Female Humans Incidence Infant Lymph Node Excision* / adverse effects, methods Lymph Nodes* / microbiology, pathology, surgery Lymphadenitis* / epidemiology, microbiology, pathology, therapy Male Mycobacterium Infections, Nontuberculous* / epidemiology, pathology, therapy Neck Nontuberculous Mycobacteria / isolation & purification Postoperative Complications* Remission, Spontaneous Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
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