Nontuberculous mycobacterial infections in children
Authors:
Nicol Koblásová 1
; Jan Mejzlík 1,2
; Lukáš Školoudík 1,2
; Hubert Vaníček 2,3; Jana Dědková 4; Jan Laco 2,5
; Petra Kašparová 2,5
; Lenka Ryšková 2,6
; Viktor Chrobok 1,2
Authors‘ workplace:
Univerzita Karlova, LF v Hradci Králové
2; Dětská klinika, FN Hradec Králové
3; Radiologická klinika, FN Hradec Králové
4; Fingerlandův ústav patologie, FN Hradec Králové
5; Ústav klinické mikrobio logie, FN Hradec Králové
6
Published in:
Otorinolaryngol Foniatr, 73, 2024, No. 1, pp. 8-15.
Category:
Original Article
doi:
https://doi.org/10.48095/ccorl20248
Overview
Introduction: Nontuberculous mycobacterial (NTM) infection of lymph nodes in young children is a rare disease. The increasing incidence has been observed after termination of vacciation in Czech Republic in November 2010. Aim of the study: To provide an overview of the clinical picture, diagnostic options and therapeutic approach in children with neck lymph nodes affected by non-tuberculous mycobacteria. Methods: Retrospective cohort study of patients with confirmed NTM infection treated at the Clinic of Otorhinolaryngology and Head and Neck Surgery of Faculty Hospital Hradec Kralove from 2010 to 2021. The inclusion criterion was proof of the causative agent of the disease (nontuberculous mycobacteria) by culture or molecular biological technique (PCR). Results: A total of 19 children with an average age of 26 months (range 12–42, SD 7.27) were enrolled. The most frequent pathogen was Mycobacterium avium (N = 16). Culture examination was positive in 84% (N = 16) of cases, PCR was positive in 47% of patients (N = 9). All children from the group underwent both surgical and antibiotic treatment. The most frequently used antibiotics were a combination of a macrolide antibiotic (clarithromycin) with an antituberculotic drug (rifampicin). In 6 children, an incision was made along with drainage of the lesion and for the duration of the inflammation a complete extirpation of the pathological tissue under general anaesthesia followed. A total of 15 children underwent probatory extirpation of the pathological neck lymph node. We performed block dissections of the infected tissue in 7 children for residual inflammation. Conclusion: The most effective treatment of the infection seems to be the exstirpation of all affected lymph nodes with surrounding tissue and combination of antibiotic (macrolide) with antituberculotic agent (rifampicin).
Keywords:
nontuberculous mycobacteria – children – mycobacterial infection – cervical lymphadenitis
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ORCID autorů
Přijato k recenzi: 14. 12. 2022
Přijato k tisku: 29. 12. 2022
MUDr. Nicol Koblásová
Klinika otorinolaryngologie a chirurgie hlavy a krku
FN Hradec Králové
Sokolská 581
500 05 Hradec Králové
nicol.koblasova@fnhk.cz
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
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