European Journal of Pediatrics

, Volume 176, Issue 5, pp 607–613 | Cite as

Risk factors of non-tuberculous mycobacterial lymphadenitis in children: a case–control study

  • Patricia W. Garcia-Marcos
  • Mercedes Plaza-Fornieles
  • Ana Menasalvas-Ruiz
  • Ramon Ruiz-Pruneda
  • Pedro Paredes-Reyes
  • Santiago Alfayate Miguelez
Original Article


The aim of the present study is to clarify the association between environmental exposures and non-tuberculous mycobacterial (NTM) lymphadenitis, during the last decade, in a population of children. In children up to 14 years of age in a pediatric tertiary hospital, all cases of NTM lymphadenopathy with a specific microbiological diagnosis, from January 2004 to January 2015, were reviewed. This is a case–control study (1:5 proportion), in which the prevalence of environmental factors between cases and controls was compared by means of a multivariate logistic regression analysis. A total of 24 cases were diagnosed in the aforementioned period, and 18 of them included in the case–control study. Mycobacterium avium-intracellulare was the predominant mycobacterium species isolated (83.3%). Exposure to hens showed a clear trend to be significantly associated with the disease (OR = 4.33; IC95% 0.97–19.41, p = 0.055), with no significant differences for the rest of the risk factors studied.

Conclusion: M. avium is still the predominant bacteria causing NTM lymphadenitis in children of our region. Contact with hens has been the only risk factor for NTM lymphadenitis detected in the present study.

What is Known:

M. avium is the predominant bacteria causing NTM lymphadenitis in children of our region.

There is no consensus on which environmental factors are associated with NTM lymphadenitis in children.

What is New:

The only risk factor for NTM lymphadenitis found in the present study was regular contact with hens. Contact with other farm animals was not associated to NTM lymphadenitis.


Non-tuberculous Lymphadenitis Children Risk factors Birds Hens 



Adjusted ORs


Emergency department


Fine-needle aspiration biopsy


Mycobacterium intracellular complex


Non-tuberculous mycobacterial



We are grateful to Mr. Anthony Carlson for his assistance with the English language.

Authors’ contributions

All coauthors have contributed to the study: Dr. Alfayate and Dr. Menasalvas (pediatricians) diagnosed the cases, with the cooperation of Dr. Paredes (microbiologist). Dr. Ruiz Pruneda (pediatric surgeon) was in charge of the surgical therapy. Dr. Plaza and Dr. García-Marcos (pediatricians) interviewed about the risk factors and contributed to the follow-up. They also recruited and interviewed the control group. Dr. Garcia-Marcos wrote the paper, which was corrected and approved in the last version by the rest of the authors.

Compliance with ethical standards

Informed consent was obtained before interviewing all cases and controls.

This article does not contain any studies with human participants performed by any of the authors.


This work was not supported by any funding source.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Patricia W. Garcia-Marcos
    • 1
    • 2
  • Mercedes Plaza-Fornieles
    • 1
  • Ana Menasalvas-Ruiz
    • 3
  • Ramon Ruiz-Pruneda
    • 4
  • Pedro Paredes-Reyes
    • 5
  • Santiago Alfayate Miguelez
    • 3
  1. 1.Deparment of General Pediatrics, Arrixaca University Children’s HospitalUniversity of MurciaMurciaSpain
  2. 2.Secretaría de Pediatría, 3a planta Hospital Materno-InfantilMurciaSpain
  3. 3.Pediatrics Infectious Diseases Unit, Arrixaca University Children’s HospitalUniversity of MurciaMurciaSpain
  4. 4.Department of Pediatric Surgery, Arrixaca University Children’s HospitalUniversity of MurciaMurciaSpain
  5. 5.Department of Microbiology, Arrixaca University Children’s HospitalUniversity of Murcia and IMIB-Arrixaca Research InstituteMurciaSpain

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