Cervical lymphadenitis due to non-tuberculous mycobacteria: surgical treatment and review

A retrospective study was carried out on 57 children, presenting with non-tuberculous mycobacterial (NTM) lymphadenitis of the head and neck, over a 12 year period. Cultures recovered 56 Mycobacterium avium-intracellulare (MAI), and one Mycobacterium kansnsaii. Anti-mycobacterial agents were used in seven patients only. On the basis of the initial operation there were two groups. Group 1 (11 patients) had an excision, and Group 2 (46 patients) had incision and drainage (30 patients), incision and curettage (13 patients), or aspiration (three patients). There was no significant difference in the makeup of these two groups. However, Group 1 had significantly lower number of re-operations than Group 2, P < 0.01, and achieved a significantly greater healing rate than Group 2, P < 0.001. In Group 2 those who had an excision following failure of the first operation were significantly more likely to heal than those who did not, P < 0.005. Operative excision gives a lower rate of re-operation, and a higher rate of healing than other procedures. The treatment, natural history, clinical presentation, pathogenesis, and diagnosis of NTM cervical lymphadenitis are discussed. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.