Non-tuberculous mycobacterial adenitis refers to lymphadenopathy due to mycobacterial infection other than M. tuberculosis.
Most cases occur in immunocompetent children younger than 5 years of age.
Patients present with a firm, painless mass that enlarges over several weeks and develops overlying violaceous skin changes.
The most common microbiologic cause is Mycobacterium avium-intracellulare complex.
The cervicofacial nodes, especially in the submandibular and parotid region, are most commonly involved.
The involved lymph nodes show markedly decreased echogenicity consistent with intranodal liquefactive/cystic necrosis 1. Nodal matting and adjacent soft tissue edema are also present 1.
CT and MRI
Contrast-enhanced CT or MRI demonstrates an enlarged nodal mass with central necrosis (rim or heterogeneous enhancement) but characteristically minimal surrounding fat stranding 2-4.
Treatment and prognosis
Patients are treated with a combination of surgery (incision and drainage or excision) and antibiotics (for several months), with most achieving cure 4.
See separate differential articles:
- 1. Lindeboom JA, Smets AM, Kuijper EJ, van Rijn RR, Prins JM. The sonographic characteristics of nontuberculous mycobacterial cervicofacial lymphadenitis in children. (2006) Pediatric radiology. 36 (10): 1063-7. doi:10.1007/s00247-006-0271-6 - Pubmed
- 2. Robson CD, Hazra R, Barnes PD, Robertson RL, Jones D, Husson RN. Nontuberculous mycobacterial infection of the head and neck in immunocompetent children: CT and MR findings. (1999) AJNR. American journal of neuroradiology. 20 (10): 1829-35. Pubmed
- 3. Bagla S, Tunkel D, Kraut MA. Nontuberculous mycobacterial lymphadenitis of the head and neck: radiologic observations and clinical context. (2003) Pediatric radiology. 33 (6): 402-6. doi:10.1007/s00247-003-0884-y - Pubmed
- 4. Wei JL, Bond J, Sykes KJ, Selvarangan R, Jackson MA. Treatment outcomes for nontuberculous mycobacterial cervicofacial lymphadenitis in children based on the type of surgical intervention. (2008) Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 138 (5): 566-71. doi:10.1016/j.otohns.2008.01.022 - Pubmed