Atypical mycobacterial lymphadenopathy in children--is it underdiagnosed?

Lymphadenitis due to atypical mycobacteria occurs primarily in the neck region of children, the most common organisms isolated are the Mycobacterium avium intracellulare (MAIS) group and M. malmoense. The nodes are unilateral and may be hot or cold. The infection is benign. There is little or no systemic upset and it is usually the preschool child who is affected. Routine haematological investigations are unhelpful, chest X-ray is clear and the Mantoux test may be positive or negative. Cultures are necessary to prove the diagnosis. The ideal treatment is total excision of the affected nodes and antituberculosis chemotherapy is not indicated.