BACKGROUND: Nontuberculous mycobacteria (NTM) are a common cause of chronic cervicofacial lymphadenitis in young children. The differential diagnosis includes other infections, lymphoepithelial cysts and malignancies. OBJECTIVE: To assess the sonographic findings of NTM cervicofacial lymphadenitis in children. MATERIALS AND METHODS: We analysed the sonograms of cervicofacial lymph nodes of 145 children with microbiologically proven NTM lymphadenitis. RESULTS: The size of the involved lymph nodes ranged from 1.9 cm to 4.4 cm. Most of the NTM patients (85%) presented in a stage of lymph node fluctuation with violaceous skin discoloration. On sonography, marked decreased echogenicity was seen in all cases. In 133 of the patients (92%) liquefaction with intranodal cystic necrosis, nodal matting and adjacent soft-tissue oedema were present. 66 children received antibiotic treatment, and the other children underwent surgical excision of the involved lymph nodes. In 69% of the patients successfully treated with antibiotics, multiple intranodal calcifications were present on sonography after 1 year. CONCLUSIONS: Sonographic findings can provide additional diagnostic clues for NTM lymphadenitis in childhood. A marked decrease of echogenicity in the early stages, with intranodal liquefaction in the advanced stages, are universal features, albeit not entirely specific. Multiple intranodal calcifications are rather characteristic of end-stage mycobacterial infection.
BACKGROUND:Nontuberculous mycobacteria (NTM) are a common cause of chronic cervicofacial lymphadenitis in young children. The differential diagnosis includes other infections, lymphoepithelial cysts and malignancies. OBJECTIVE: To assess the sonographic findings of NTM cervicofacial lymphadenitis in children. MATERIALS AND METHODS: We analysed the sonograms of cervicofacial lymph nodes of 145 children with microbiologically proven NTM lymphadenitis. RESULTS: The size of the involved lymph nodes ranged from 1.9 cm to 4.4 cm. Most of the NTM patients (85%) presented in a stage of lymph node fluctuation with violaceous skin discoloration. On sonography, marked decreased echogenicity was seen in all cases. In 133 of the patients (92%) liquefaction with intranodal cystic necrosis, nodal matting and adjacent soft-tissue oedema were present. 66 children received antibiotic treatment, and the other children underwent surgical excision of the involved lymph nodes. In 69% of the patients successfully treated with antibiotics, multiple intranodal calcifications were present on sonography after 1 year. CONCLUSIONS: Sonographic findings can provide additional diagnostic clues for NTM lymphadenitis in childhood. A marked decrease of echogenicity in the early stages, with intranodal liquefaction in the advanced stages, are universal features, albeit not entirely specific. Multiple intranodal calcifications are rather characteristic of end-stage mycobacterial infection.
Authors: Jerome A Lindeboom; Jan M Prins; Elisabeth S Bruijnesteijn van Coppenraet; Robert Lindeboom; Ed J Kuijper Journal: Clin Infect Dis Date: 2005-10-28 Impact factor: 9.079
Authors: E S Bruijnesteijn Van Coppenraet; J A Lindeboom; J M Prins; M F Peeters; E C J Claas; E J Kuijper Journal: J Clin Microbiol Date: 2004-06 Impact factor: 5.948
Authors: Lesla E S Bruijnesteijn van Coppenraet; Edward J Kuijper; Jerome A Lindeboom; Jan M Prins; Eric C J Claas Journal: Emerg Infect Dis Date: 2005-01 Impact factor: 6.883
Authors: Maria Grazia Caprio; Marco Di Serafino; Giuseppe Pontillo; Norberto Vezzali; Eugenio Rossi; Francesco Esposito; Massimo Zeccolini; Gianfranco Vallone Journal: J Ultrasound Date: 2018-09-05
Authors: Kelly M Pennington; Ann Vu; Douglas Challener; Christina G Rivera; F N U Shweta; John D Zeuli; Zelalem Temesgen Journal: J Clin Tuberc Other Mycobact Dis Date: 2021-05-08