RESUMO
BACKGROUND: Nontuberculous mycobacteria (NTM) lymphadenitis is an under-recognized entity, and data of the true burden in children are limited. Without a high index of suspicion, diagnosis may be delayed and microbiological detection is challenging. Here, we report a cluster of NTM lymphadenitis experienced in Korean children. METHODS: Subjects under 19 years of age diagnosed with NTM lymphadenitis during November 2016–April 2017 and April 2018 were included. Electronic medical records were reviewed for clinical, laboratory and pathological findings. Information regarding underlying health conditions and environmental exposure factors was obtained through interview and questionnaires. RESULTS: A total of ten subjects were diagnosed during 18 months. All subjects were 8–15 years of age, previously healthy, male and had unilateral, nontender, cervicofacial lymphadenitis for more than 3 weeks with no significant systemic symptoms and no response to empirical antibiotics. Lymph nodes involved were submandibular (n = 8), preauricular (n = 6) and submental (n = 1). Five patients had two infected nodes and violaceous discoloration was seen in seven subjects. Biopsy specimens revealed chronic granulomatous inflammation and acid-fast bacteria culture identified Mycobacterium haemophilum in two cases and NTM polymerase chain reaction was positive in two cases. Survey revealed various common exposure sources. CONCLUSION: NTM lymphadenitis is rare but increasing in detection and it may occur in children and adolescents. Diagnosis requires high index of suspicion and communication between clinicians and the laboratory is essential for identification of NTM.
Assuntos
Adolescente , Criança , Humanos , Masculino , Antibacterianos , Bactérias , Biópsia , Diagnóstico , Registros Eletrônicos de Saúde , Exposição Ambiental , Inflamação , Linfonodos , Linfadenite , Mycobacterium , Mycobacterium haemophilum , Micobactérias não Tuberculosas , Reação em Cadeia da Polimerase , Tuberculose dos LinfonodosRESUMO
No abstract available.
Assuntos
Humanos , Histiocitose , Mycobacterium haemophilum , MycobacteriumRESUMO
Atypical mycobacteria may cause many different types of infections such as septic arthritis, abscesses and skin and bone infection. Mycobacteria are classified according to their rate of growth and ability to produce yellow pigment in the dark or in the light. The varied and diverse group of cutaneous mycobacterial infections arise from a combination of the low innate pathogenicity of the organisms and opportune exposures of the hosts. Mycobacteria may pose an infectious risk for pedicure and manicure customers. Physicians should suspect this cause in patients with persistent furunculosis after exposure to whirlpool footbaths or pedicure procedures. Also an outbreak of M. abscessus was reported in a haemodialysis clinic in many clinics. All physicians should be alert to the current cluster of M. abscessus infections after injections for cosmetic purposes by nonmedical practitioners