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Cervicofacial lymphadenitis due to Mycobacterium mantenii: rapid and reliable identification by MALDI-TOF MS. New Microbes New Infect 2018; 22:1-3. [PMID: 29348923 PMCID: PMC5767568 DOI: 10.1016/j.nmni.2017.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 11/29/2017] [Accepted: 12/07/2017] [Indexed: 11/20/2022] Open
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2
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Naselli A, Losurdo G, Avanzini S, Tarantino V, Cristina E, Bondi E, Castagnola E. Management of nontuberculous mycobacterial lymphadenitis in a tertiary care children's hospital: A 20year experience. J Pediatr Surg 2017; 52:593-597. [PMID: 27614809 DOI: 10.1016/j.jpedsurg.2016.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/27/2016] [Accepted: 08/13/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE Nontuberculous mycobacteria are uncommon cause of chronic cervicofacial lymphadenitis in healthy children. We describe clinical features and management strategies of cervicofacial nontuberculous mycobacterium lymphadenitis in a tertiary pediatric hospital. METHODS Retrospective analysis of medical records of children discharged from 1992 to 2014 with a diagnosis of cervicofacial nontuberculous mycobacterium was made. Diagnosis certainty was based on microhistological investigations. Clinical stage was evaluated according to lymph node size and presence of fistulas. Successful therapy was defined by the regression of the lymph node enlargement (>75%) or complete surgical excision without relapse. RESULTS Cervicofacial nontuberculous mycobacterium was diagnosed in 33 patients. Complete excision was performed in 73% of cases primarily observed in our hospital, while 83% of those referred from other hospitals required further surgical treatment. No case of relapse was observed after one year of follow-up. CONCLUSIONS We recommend surgical approach as the first therapeutic option in the management of cervicofacial nontuberculous mycobacterium lymphadenitis. LEVELS OF EVIDENCE Prognosis and Retrospective Study - Level II.
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Affiliation(s)
- Aldo Naselli
- Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy
| | - Giuseppe Losurdo
- Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy
| | - Stefano Avanzini
- Pediatric Surgery Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy
| | - Vincenzo Tarantino
- Otorhinolaryngology Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy
| | - Emilio Cristina
- Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy
| | - Elisabetta Bondi
- Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy
| | - Elio Castagnola
- Infectious Diseases Unit, Istituto Giannina Gaslini, Ospedale Pediatrico IRCCS, Genova, Italy.
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Ruiz del Olmo Izuzquiza I, Bustillo Alonso M, Monforte Cirac ML, Burgués Prades P, Guerrero Laleona C. Lymphadenitis due to non-tuberculous mycobacteria: Experience over 15 years. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.anpede.2016.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ruiz Del Olmo Izuzquiza I, Bustillo Alonso M, Monforte Cirac ML, Burgués Prades P, Guerrero Laleona C. [Lymphadenitis due to non-tuberculous mycobacteria: Experience over 15 years]. An Pediatr (Barc) 2016; 86:115-121. [PMID: 27052399 DOI: 10.1016/j.anpedi.2016.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/29/2016] [Accepted: 03/03/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To study the epidemiology, clinical features, diagnosis, therapeutic management, and outcome of non-tuberculous mycobacterial lymphadenitis in a paediatric population of Aragón (Spain). MATERIAL AND METHODS A retrospective study was conducted on patients under 15 years-old diagnosed with non-tuberculous mycobacterial lymphadenitis between the years 2000 and 2015. INCLUSION CRITERIA patients with lymphadenitis and positive culture. Quantitative values are shown as mean, rank, and standard deviation, and qualitative data as frequencies. RESULTS Twenty-seven cases were registered, with a mean age of presentation of 39.9 months (range 10 months-8 years). The mean time between the symptoms onset and first consultation was 1.7±1.1 months. The most frequent location was sub-maxilar in 17/27 cases (63%), on the right side in 59.3%, and size 2.96±1.26cm. Fistulae were observed in 16/27 cases. Tuberculin test was greater than 10mm in 7/24 (29.1%). Microbiological cultures were positive for Mycobacterium avium in 14/27 (51.9%), Mycobacterium intracellulare 3/27 (11.1%), and Mycobacterium lentiflavum 3/27 (11.1%). Combined treatment of antibiotics and surgery was given in 16/27 cases (59.8%), medical treatment only in7/27 (25.9%), and surgical exeresis alone in 4/27 (14.8%). Two patients required a new surgery, and one showed severe neutropenia secondary to rifabutin. Only one case (3.7%) suffered from temporary facial palsy as sequel. CONCLUSIONS The most frequent treatment was the combination of antibiotics and surgery. Delay in diagnosis seemed to be responsible for the limited number of exeresis as first option, only one for every seven patients.
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Affiliation(s)
| | - Matilde Bustillo Alonso
- Unidad de Infectología, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España
| | | | - Pedro Burgués Prades
- Servicio de Cirugía Pediátrica, Hospital Infantil Universitario Miguel Servet, Zaragoza, España
| | - Carmelo Guerrero Laleona
- Unidad de Infectología, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España
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Elispot Igra With Purified Protein Derivative Stimulation For Diagnosing Nontuberculous Mycobacterial Cervical Lympadenitis. Pediatr Infect Dis J 2016; 35:349-51. [PMID: 26584055 DOI: 10.1097/inf.0000000000000998] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Childhood cervical lymphadenitis caused by nontuberculous mycobacteria is a diagnostic challenge for the clinician. We present a new promising diagnostic method for childhood nontuberculous mycobacterial lymphadenitis. The modified T-SPOT.TB test with purified protein derivative as an additional antigen is noninvasive with estimated sensitivity and specificity of 1.00 and 0.81, respectively.
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6
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Recomendaciones de la Sociedad Española de Infectología Pediátrica sobre el diagnóstico y tratamiento de las adenitis por micobacterias no tuberculosas. An Pediatr (Barc) 2012; 77:208.e1-208.e12. [DOI: 10.1016/j.anpedi.2012.02.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 02/22/2012] [Indexed: 12/28/2022] Open
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Scott CA, Atkinson SH, Sodha A, Tate C, Sadiq J, Lakhoo K, Pollard AJ. Management of lymphadenitis due to non-tuberculous mycobacterial infection in children. Pediatr Surg Int 2012; 28:461-6. [PMID: 22438045 DOI: 10.1007/s00383-012-3068-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE Non-tuberculous mycobacterial (NTM) infection is an important cause of cervico-facial lymph node enlargement in young children. The optimal treatment is thought to be early complete excision without chemotherapy. We compared management of patients referred to our centre to this "gold standard" and determined clinical outcomes by type of primary surgical intervention (complete excision vs. incomplete excision). METHODS Retrospective study of management and clinical outcomes of all children (<12 years) with NTM lymphadenitis referred to a single UK centre between May 1998 and May 2008. RESULTS We identified 43 children. Median time from onset of swelling to operation was 6 weeks. Management was: no operation (n = 1, 2 %), complete excision (n = 20, 47 %), incision and drainage (n = 17, 40 %) and fine needle aspirate (n = 5, 12 %). Children not treated by primary complete excision were more likely to have: re-operation (91 vs. 30 %; χ(2) = 16.48; p < 0.0001); persistent lymphadenitis (77 vs. 30 %; χ(2) = 9.45; p = 0.002); sinus formation (26 vs. 5 %; χ2 = 3.74; p = 0.05). CONCLUSION Failure to undertake primary complete excision leads to further morbidity. A high index of suspicion is required for timely appropriate management to avoid unnecessary morbidity and further intervention.
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Affiliation(s)
- Catherine A Scott
- Department of Paediatrics, Childrens Hospital, University of Oxford, Oxford, OX3 9DU, UK
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Penn R, Steehler MK, Sokohl A, Harley EH. Nontuberculous mycobacterial cervicofacial lymphadenitis--a review and proposed classification system. Int J Pediatr Otorhinolaryngol 2011; 75:1599-603. [PMID: 22014500 DOI: 10.1016/j.ijporl.2011.09.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 09/15/2011] [Accepted: 09/19/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe a clinical staging system for nontuberculous mycobacterial (NTM) cervicofacial lymphadenitis that has both diagnostic and therapeutic implications. METHODS A Medline database search was performed using key words "nontuberculous mycobacteria". All articles pertaining to nontuberculous mycobacterial cervicofacial lymphadenitis were reviewed for data evaluation regarding diagnosis and treatment methodologies. RESULTS Nontuberculous cervicofacial lymphadenitis infections pass through distinctly segmented clinical phases. In Stage I, a painless mass presents with notable increase in vascularity. Stage II is characterized by liquefaction of the affected lymph node, causing the mass to appear fluctuant. Significant skin changes characterize Stage III, whereby overlying skin may develop violaceous discoloration and become notably thinner, or parchment-like, with a "shiny" appearance. During Stage IV, the lesion fistulizes to the skin surface causing a draining wound. CONCLUSIONS While nontuberculous mycobacterial cervicofacial lymphadenitis has typically been thought of as a surgical disease, further characterization is warranted. We present a new classification system for appraising the clinical stages of nontuberculous mycobacterial cervicofacial lymphadenitis that may be used as part of a greater approach to disease management: (1) after other causes have been ruled out, the possibility of a tuberculous scrofula must be eliminated, and the degree of diagnostic suspicion must be categorized; (2) the clinical stage of the infection can be determined using the classification system described; and (3) a stage-specific treatment may be chosen based on the individual patient.
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Affiliation(s)
- Renee Penn
- Department of Otolaryngology - Head and Neck Surgery, South Pasadena Cancer Center, 209 Fair Oaks Avenue, South Pasadena, CA 91030, United States
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Syed SS, Aderinboye O, Hanson KE, Spitzer ED. Acute cervical lymphadenitis caused by Mycobacterium florentinum. Emerg Infect Dis 2010; 16:1486-7. [PMID: 20735941 PMCID: PMC3294984 DOI: 10.3201/eid1609.100433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Timmerman M, Morley A, Buwalda J. Treatment of non-tuberculous mycobacterial cervicofacial lymphadenitis in children: critical appraisal of the literature. Clin Otolaryngol 2008; 33:546-52. [DOI: 10.1111/j.1749-4486.2008.01821.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Nontuberculous mycobacteria can cause a chronic localized cervicofacial lymphadenitis in immunocompetent children. The recommended treatment is total excision of the affected lymph node. The aim of this study was to describe our experience with an observational approach. METHODS Children with chronic nontuberculous mycobacterial (NTM) cervical lymphadenitis, whose parents opted for conservative treatment, were followed at our center from 1990 to 2004. The diagnosis of NTM was based on mycobacterial culture of lymph node specimens obtained by fine needle aspiration. The clinical laboratory and follow-up data were documented. RESULTS Ninety-two children with lymph node positive cultures of nontuberculous mycobacterium were included in the study. Mycobacterium avium complex and Mycobacterium hemophilum were isolated in 90% of the cultures. In most cases, the affected lymph nodes underwent violaceous changes with discharge of purulent material for 3-8 weeks. Total resolution was achieved within 6 months in 71% of patients and within 9-12 months in the remainder. At the 2-year follow-up, a skin-colored, flat scar in the region of the drainage was noted. There were no complications. CONCLUSIONS We suggest that the observational approach can be effective for managing NTM lymphadenitis in immunocompetent children.
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Méndez Echevarría A, Baquero Artigao F, García Miguel MJ, Romero Gómez MP, Alves Ferreira F, Del Castillo Martín F. Adenitis por micobacterias no tuberculosas. An Pediatr (Barc) 2007; 66:254-9. [PMID: 17349251 DOI: 10.1157/13099687] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To study the clinical features, epidemiology and outcome of nontuberculous mycobacterial lymphadenitis (NTML). METHODS A retrospective study was performed on 54 patients under 14 years old diagnosed with atypical mycobacterial lymphadenitis between 1987 and 2004. Inclusion criteria were: (i) positive polymerase chain reaction (PCR) test or culture; (ii) positive sensitin skin test 6 mm above Mantoux; (iii) histopathologic features compatible with mycobacterial infection and/or positive direct smear for acid-fast bacilli, Mantoux reaction less than 15 mm, a normal chest radiograph, absence of exposure to an adult with tuberculosis, negative Mantoux test reactions in family members, and exclusion of other causes of granulomatous adenitis. RESULTS Fifty-four patients were included in the study. The number of NTML cases increased notably from 1996, coinciding with a decrease in cases of tuberculous adenitis. The mean age was 35 months (range: 14 months-6 years). Submandibular nodes were involved in 22 of 63 cases of adenitis (34.9%) and cervical nodes were involved in 21 (33.3%). In 8/42 patients (19%) the tuberculin skin test was larger than 10 mm. Cultures were positive in 52.9% of the cases (18/34) and PCR in 53.3% (8/15). The most frequently isolated mycobacteria was Mycobacterium avium (61%). Therapy failed in 8/21 patients receiving antibiotics (38%), in 10/13 patients with drainage alone (77%) and in none of the patients who underwent surgery (8/8). CONCLUSIONS Nontuberculous mycobacterial adenitis has become more frequent in our hospital since 1996. Cultures do not always allow isolation of mycobacteria and the Mantoux test frequently yields false positive results, thus hampering diagnosis. The most effective treatment was surgical excision. Nevertheless, when the surgical approach is difficult or there is postoperative recurrence, pharmacological treatment can be useful.
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Affiliation(s)
- A Méndez Echevarría
- Unidad de Infectología Pediátrica, Hospital Infantil La Paz, Madrid, España.
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Muszlak M, Chapgier A, Barry Harivelo R, Castella C, Crémades F, Goulois E, Laporte R, Casanova JL, Ranaivoarivony V, Hebert JC, Santiago J, Picard C. [Multifocal infection due to Mycobacterium intracellulare: first case of interferon gamma receptor partial dominant deficiency in tropical French territory]. Arch Pediatr 2007; 14:270-2. [PMID: 17223023 DOI: 10.1016/j.arcped.2006.11.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2006] [Accepted: 11/30/2006] [Indexed: 11/23/2022]
Abstract
Nontuberculous mycobacterial infections are rare in immunocompetent children, and usually present as adenitis. We report a case of a 6-year-old girl with a multifocal chronic osteomyelitis and pulmonary localisation due to Mycobacterium intracellulare associated with an autosomal dominant mutation of interferon gamma receptor 1 gene (INFGR1) leading to a syndrome of mendelian predisposition to mycobacteria infections by partial deficiency of intracellular signalisation of gamma interferon. This child has been cured with anti-mycobacteria drugs and gamma interferon. This report focus on the importance of looking for a susceptibility of the host to infectious diseases, which can lead to a specific treatment. As far as we know, this is the first case described in a tropical area.
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Affiliation(s)
- M Muszlak
- Service de pédiatrie et néonatologie, centre hospitalier de Mayotte, Mamoudzou, Mayotte, France.
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Chang JT, Huang YF, Lin YT, Liu YC, Chiu LH, Tu HZ, Hsieh KS. Mycobacterium abscessus Cervical Lymphadenitis: An Immunocompetent Child. Kaohsiung J Med Sci 2006; 22:415-9. [PMID: 16911925 DOI: 10.1016/s1607-551x(09)70332-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Nontuberculous mycobacterium (NTM) is one of the well-known causes of cervicofacial lymphadenopathy in children under 5 years of age. Children often present with a painless cervical mass that fails to respond to conventional antibiotics. They are often referred under the suspicion of a neoplasm or bacterial adenitis rather than NTM cervical lymphadenitis. The lack of systemic symptoms, modest or negative purified protein derivative test and absence of exposure to active tuberculosis are characteristics of NTM lymphadenitis. The diagnosis usually requires the isolation of pathogen or pathologic proof. Complete excision is the choice of treatment by the majority of authors in the literature. This not only enables rapid diagnosis but ensures the lowest recurrence rate. Medical management is sometimes successful when complete resection is impossible or refused. To our knowledge, the incidence of NTM cervical lymphadenitis in children is increasing throughout the world. However, such reports of children in Taiwan is lacking. Clinicians should suspect a possible nontuberculous mycobacterial infection when a cervical lump is found in a child.
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Affiliation(s)
- Jenn-Tzong Chang
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Coulter JBS, Lloyd DA, Jones M, Cooper JC, McCormick MS, Clarke RW, Tawil MI. Nontuberculous mycobacterial adenitis: effectiveness of chemotherapy following incomplete excision. Acta Paediatr 2006; 95:182-8. [PMID: 16449024 DOI: 10.1080/08035250500331056] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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.
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Alvez González F. Tratamiento de la linfadenitis. An Pediatr (Barc) 2005; 63:266-7; author reply 267. [PMID: 16219284 DOI: 10.1157/13078494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hogan M, Price D, Burrage K, Pushpanathan C. Atypical mycobacterial cervical lymphadenitis with extensive local spread: a surgical disease. Pediatr Surg Int 2005; 21:758-60. [PMID: 16133519 DOI: 10.1007/s00383-005-1491-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2005] [Indexed: 10/25/2022]
Abstract
Atypical (nontuberculous) mycobacterium is an uncommon cause of cervical lymphadenitis in immunocompetent children. Rarely, this disease progresses to locoregional destruction of the deep structures of the neck including salivary glands. Recent reports suggest medical monotherapy as an effective treatment of this disease. We report three cases of children who experienced progression to locoregional disease while on appropriate antibiotics. We suggest that the patient population to benefit from medical monotherapy has yet to be adequately defined. In our experience, surgical therapy is the only effective treatment for locoregional disease.
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Affiliation(s)
- M Hogan
- Discipline of Surgery, Faculty of Medicine, The Health Sciences Center, Memorial University of Newfoundland, St. John's, NF A1B 3V6, Canada.
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Ellis EN, Schutze GE, Wheeler JG. Nontuberculous mycobacterial exit-site infection and abscess in a peritoneal dialysis patient. A case report and review of the literature. Pediatr Nephrol 2005; 20:1016-8. [PMID: 15880270 DOI: 10.1007/s00467-005-1870-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2004] [Revised: 01/10/2005] [Accepted: 01/10/2005] [Indexed: 12/27/2022]
Abstract
Nontuberculous mycobacterial infections of peritoneal dialysis catheter exit sites have rarely been reported in patients on peritoneal dialysis. We report here a case of Mycobacterium abscessus exit site infection with abdominal wall abscess formation in an adolescent on peritoneal dialysis, which required long-term antibiotic therapy, peritoneal dialysis catheter removal, and surgical debridement of the abscess. Nontuberculous mycobacteria should be considered as a possible causative organism for an exit site infection that fails to respond to usual antibiotic therapy. Nontuberculous mycobacterial exit site infections may require peritoneal dialysis catheter removal and surgical debridement.
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Affiliation(s)
- Eileen N Ellis
- Department of Pediatrics, Arkansas Children's Hospital, 800 Marshall, Little Rock, AR 72202, USA.
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