Nontuberculous mycobacterial adenitis: effectiveness of chemotherapy following incomplete excision.

Abstract

BACKGROUND:

Management of lymphadenopathy caused by nontuberculous mycobacteria (NTM) is primarily surgical. Where this cannot achieve sufficient clearance of infected nodes, chemotherapy is often given.

AIM:

This study compared results of surgery alone with surgery followed by chemotherapy in instances where there was incomplete surgical removal of diseased tissue.

METHODS:

Chemotherapy comprised azithromycin 10 mg/kg and rifabutin 6 mg/kg both given once daily for 6 mo. Ninety-eight children with NTM infection were seen in the period 1990-2004. Sixty-eight cases with adenopathy where "time to healing" (discharge stopped and inflammation settled) was known were available to compare response to treatment.

RESULTS:

The median (range) "time to healing" in weeks for 43 patients who had surgery alone was: incision and drainage (I&D)/curettage 6 (1-72) (n = 10); excision 3 (1-28) (n = 22); and from the last operation of multiple (repeat) surgery 3 (1-40) (n = 11). For 25 patients who required chemotherapy in addition to surgery, the median (range) "time to healing" in weeks was I&D/curettage 10 (1-40) (n = 17), excision 14 (8-20) (n = 2) and multiple surgery 29 (2-88) (n = 6).

CONCLUSION:

In children with adenitis due to NTM, where surgical resection is followed by continued discharge and inflammation, chemotherapy should be considered before further surgery is undertaken.

• Authors: J Brian S Coulter, David A Lloyd, Matthew Jones, John C Cooper, Maxwell S McCormick, Raymond W Clarke, Mohommed I Tawil
• Journal: Acta paediatrica (Oslo, Norway : 1992) (Acta Paediatr) Vol. 95 Issue 2 Pg. 182-8 (Feb 2006) ISSN: 0803-5253 [Print] Norway
• PMID: 16449024 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Rifabutin
• Azithromycin

Topics

• Anti-Bacterial Agents (therapeutic use)
• Azithromycin (therapeutic use)
• Child
• Child, Preschool
• Combined Modality Therapy
• Extremities
• Face
• Female
• Humans
• Knee
• Lymphadenitis (drug therapy, microbiology, surgery)
• Male
• Mycobacterium (isolation & purification)
• Neck
• Parotid Gland
• Postoperative Care
• Rifabutin (therapeutic use)
• Time Factors
• Wound Healing