Abstract
Purpose
We aim to compare the different treatment modalities of non-tuberculous cervicofacial lymphadenitis in children, by means of a retrospective study conducted in the University Hospitals of Leuven of patients treated between 2012 and 2022.
Methods
For this retrospective cohort study, data were collected and pseudonimised from 52 patients with non-tuberculous cervicofacial lymphadenitis, who were treated in our hospital between January 2012 and December 2022, either conservatively, antibiotically, surgically, or with a combination of these options.
We only included patients who were considered immunocompetent. All of the included patients were below 10 years at time of treatment. We collected data regarding time to resolution and adverse effects, i.e., skin discoloration, excessive scar formation, fistula formation, persistence of adenopathies after treatment, need for additional treatment, facial nerve paresis/paralysis, or systemic side-effects due to antibiotic treatment.
Results
The mean time to resolution (in days) when looking at primary treatments, was shortest in partial excisions (16), followed by complete excisions (19), antibiotic therapy (129), incision and drainage (153), curettage (240), and finally conservative management (280). Taking into account isolated treatments (i.e., both primary and adjuvant), we also observed consistently faster time to resolution in surgical and antibiotic treatments when compared to conservative treatment. Antibiotic therapy (p = 0.003), incision and drainage (p = 0,004) were associated with a significantly higher need for adjuvant treatment. Curettage was associated with a higher incidence of fistula formation (p = 0,006) and higher number of adjuvant treatments (p = 0,002).
Conclusions
This study shows a faster resolution of nontuberculous mycobacterial cervicofacial lymphadenitis in children when treated surgically, more specifically when treated with partial or complete lymph node excision. Antibiotic treatment also leads to faster resolution than conservative management. There was a low rate of complications, and no permanent facial nerve damage was reported.
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References
Wolinsky E (1995) Mycobacterial lymphadenitis in children: a prospective study of 105 Nontuberculous cases with long-term follow-up. Clin Infect Dis 20(4):954–963
To K, Cao R, Yegiazaryan A, Owens J, Venketaraman V (2020) General overview of nontuberculous mycobacteria opportunistic pathogens: Mycobacterium avium and Mycobacterium abscessus. J Clin Med 9(8):2541
Loizos A, Soteriades ES, Pieridou D, Koliou MG (2018) Lymphadenitis by non-tuberculous mycobacteria in children. Pediatr Int 60(12):1062–1067
Repositorio UC | Dirección de Bibliotecas UC. [cited 2023 Feb 18]. https://repositorio.uc.cl/handle/11534/58368
Cuschieri S (2019) The STROBE guidelines. Saudi J Anaesth 13(Suppl 1):S31–S34
Zimmermann P, Tebruegge M, Curtis N, Ritz N (2015) The management of non-tuberculous cervicofacial lymphadenitis in children: a systematic review and meta-analysis. J Infect 71(1):9–18
Lindeboom JA (2011) Conservative wait-and-see therapy versus antibiotic treatment for nontuberculous mycobacterial cervicofacial lymphadenitis in children. Clin Infect Dis 52(2):180–184
Lyly A, Kontturi A, Salo E, Nieminen T, Nokso-Koivisto J (2020) Childhood nontuberculous mycobacterial lymphadenitis-observation alone is a good alternative to surgery. Int J Pediatr Otorhinolaryngol 129:109778
Willemse SH, Lindeboom JA, Karssemakers LHE, Oomens MAEM, Schreuder WH, de Lange J. Long-term esthetic outcome of different treatment modalities for nontuberculous mycobacterial cervicofacial lymphadenitis. Journal of Pediatric Surgery. 2023; S0022346823000726.
Willemse SH, Oomens MAEM, De Lange J, Karssemakers LHE (2018) Diagnosing nontuberculous mycobacterial cervicofacial lymphadenitis in children: a systematic review. Int J Pediatr Otorhinolaryngol 112:48–54
Hermansen TS, Thomsen VØ, Lillebaek T, Ravn P (2014) Non-tuberculous mycobacteria and the performance of interferon gamma release assays in Denmark. PLoS ONE 9(4):e93986
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Compliance with ethical standards was maintained. The Ethical Committee of KU Leuven granted favorable advice to conduct this study (Reference number: S67584). No studies with human participants or animals were performed by any of the authors.
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Mennes, T., Vander Poorten, V., Vermeulen, F. et al. Comparison of treatment modalities for non-tuberculous mycobacterial cervicofacial lymphadenitis in children. Eur Arch Otorhinolaryngol 281, 1463–1471 (2024). https://doi.org/10.1007/s00405-023-08376-0
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DOI: https://doi.org/10.1007/s00405-023-08376-0