Cervical lymphadenitis caused by nontuberculous mycobacteria in immunocompetent children: Clinical and therapeutic experience

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Abstract
Background Cervical lymphadenitis is a frequent manifestation of nontuberculous mycobacteria (NTM) infection in immunocompetent children. Surgical excision, the treatment of choice, is often incomplete and may be difficult. A medical approach could reduce treatment morbidity. Methods Systemic antibiotic therapy was administered to seven children for at least 6 months as treatment for cervical lymphadenitis due to NTM: rifabutin and clarithromycin in 4 cases; rifabutin, clarithromicyn, and ethambutol in 2 cases; rifabutin, amikacin, and cycloserine in 1 case. Results All patients, six followed for a mean of 3 years and one for 6 months, were initially seen with regression of local signs of infection without relapse. Toxicity, likely due to rifabutin, was represented by neutropenia in three patients and yellow skin pigmentation in one patient. Conclusions Systemic antibiotic therapy was safe and effective in children with lymphadenitis due to NTM. This approach could represent a sound alternative or adjunct to surgery. © 1998 John Wiley & Sons, Inc. Head Neck 20:245–249, 1998.