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The sonographic characteristics of nontuberculous mycobacterial cervicofacial lymphadenitis in children

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Abstract

Background

Nontuberculous mycobacteria (NTM) are a common cause of chronic cervicofacial lymphadenitis in young children. The differential diagnosis includes other infections, lymphoepithelial cysts and malignancies.

Objective

To assess the sonographic findings of NTM cervicofacial lymphadenitis in children.

Materials and methods

We analysed the sonograms of cervicofacial lymph nodes of 145 children with microbiologically proven NTM lymphadenitis.

Results

The size of the involved lymph nodes ranged from 1.9 cm to 4.4 cm. Most of the NTM patients (85%) presented in a stage of lymph node fluctuation with violaceous skin discoloration. On sonography, marked decreased echogenicity was seen in all cases. In 133 of the patients (92%) liquefaction with intranodal cystic necrosis, nodal matting and adjacent soft-tissue oedema were present. 66 children received antibiotic treatment, and the other children underwent surgical excision of the involved lymph nodes. In 69% of the patients successfully treated with antibiotics, multiple intranodal calcifications were present on sonography after 1 year.

Conclusions

Sonographic findings can provide additional diagnostic clues for NTM lymphadenitis in childhood. A marked decrease of echogenicity in the early stages, with intranodal liquefaction in the advanced stages, are universal features, albeit not entirely specific. Multiple intranodal calcifications are rather characteristic of end-stage mycobacterial infection.

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References

  1. Wolinsky E (1995) Mycobacterial lymphadenitis in children: a prospective study of 105 nontuberculous cases with long-term follow-up. Clin Infect Dis 20:954–963

    PubMed  CAS  Google Scholar 

  2. Ahuja A, Ying M, Yuen YH, et al (2001) Power Doppler sonography to differentiate tuberculous cervical lymphadenopathy from nasopharyngeal carcinoma. AJNR 22:735–740

    PubMed  CAS  Google Scholar 

  3. Ahuja AT, Ying M (2005) Sonographic evaluation of cervical lymph nodes. AJR 184:1691–1699

    PubMed  Google Scholar 

  4. Bruijnesteijn van Coppenraet ES, Lindeboom JA, Prins JM, et al (2004) Real-time PCR assay using fine-needle aspirates and tissue biopsy specimens for rapid diagnosis of mycobacterial lymphadenitis in children. J Clin Microbiol 42:2644–2650

    Article  PubMed  CAS  Google Scholar 

  5. Bruijnesteijn van Coppenraet ES, Kuijper EJ, Lindeboom JA, et al (2005) Mycobacterium haemophilum and lymphadenitis in children. Emerg Infect Dis 11:62–68

    PubMed  CAS  Google Scholar 

  6. Lindeboom JA, Prins JM, Bruijnesteijn van Coppenraet ES, et al (2005) Cervicofacial lymphadenitis in children caused by Mycobacterium haemophilum. Clin Infect Dis 41:1569–1575

    Article  PubMed  Google Scholar 

  7. Hajek PC, Salomonowitz E, Turk R, et al (1986) Lymph nodes of the neck: evaluation with US. Radiology 158:739–742

    PubMed  CAS  Google Scholar 

  8. Ridder GJ, Richter B, Disko U, et al (2001) Gray-scale sonographic evaluation of cervical lymphadenopathy in cat-scratch disease. J Clin Ultrasound 29:140–145

    Article  PubMed  CAS  Google Scholar 

  9. Robson CD, Hazra R, Barnes PD, et al (1999) Nontuberculous mycobacterial infection of the head and neck in immunocompetent children: CT and MR findings. AJNR 20:1829–1835

    PubMed  CAS  Google Scholar 

  10. Görges R, Eising EG, Fotescu D, et al (2003) Diagnostic value of high resolution B-mode and power mode sonography in the follow up of thyroid cancer. Eur J Ultrasound 16:191–206

    Article  PubMed  Google Scholar 

  11. Schulte-Altedorneburg G, Demharter J, Linne R, et al (2003) Does ultrasound contrast agent improve the diagnostic value of colour and power Doppler sonography in superficial lymph node enlargement? Eur J Radiol 48:252–257

    Article  PubMed  Google Scholar 

  12. Ahuja AT, Ying M (2004) Evaluation of cervical lymph node vascularity: a comparison of colour Doppler, power Doppler and 3-D power Doppler sonography. Ultrasound Med Biol 12:1557–1564

    Article  Google Scholar 

  13. Solbiati L, Osti V, Cova L, et al (2001) Ultrasound of thyroid, parathyroid gland and neck nodes. Eur Radiol 11:2411–2424

    Article  PubMed  CAS  Google Scholar 

  14. Bagla S, Tunkel D, Kraut MA (2003) Nontuberculous mycobacterial lymphadenitis of the head and neck: radiologic observations and clinical context. Pediatr Radiol 33:402–406

    PubMed  Google Scholar 

  15. Danielides V, Patrikakos G, Moerman M, et al (2003) Diagnosis, management and surgical treatment of non-tuberculous mycobacterial head and neck infection in children. ORL J Otorhinolaryngol Relat Spec 64:284–289

    Google Scholar 

  16. Schaad UB, Votteler TP, McCracken GH Jr, et al (1979) Management of atypical mycobacterial lymphadenitis in childhood: a review based on 380 cases. J Pediatr 95:356–360

    Article  PubMed  CAS  Google Scholar 

  17. Margileth AM, Chandra R, Altman RP (1984) Chronic lymphadenopathy due to mycobacterial infection. Am J Dis Child 138:917–922

    PubMed  CAS  Google Scholar 

  18. Rahal A, Abela A, Arcand PH, et al (2001) Nontuberculous mycobacterial adenitis of the head and neck in children: experience from a tertiary care pediatric center. Laryngoscope 111:1791–1796

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The study was supported by grants from the Netherlands Organization for Scientific Research (ZonMw), grant no. 945-02-019, and from the Leiden Foundation Microbiology. We thank all the children who took part in the study, and their parents.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Jerome A. Lindeboom

  2. Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Jan M. Prins

  3. Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Jan M. Prins

  4. Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Anne M. J. B. Smets & Rick R. van Rijn

  5. Academic Center for Dentistry (ACTA), University of Amsterdam, Amsterdam, The Netherlands

    Jerome A. Lindeboom

  6. Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands

    Ed J. Kuijper

Authors
  1. Jerome A. Lindeboom
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  2. Anne M. J. B. Smets
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  3. Ed J. Kuijper
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  4. Rick R. van Rijn
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  5. Jan M. Prins
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Corresponding author

Correspondence to Jerome A. Lindeboom.

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Lindeboom, J.A., Smets, A.M.J.B., Kuijper, E.J. et al. The sonographic characteristics of nontuberculous mycobacterial cervicofacial lymphadenitis in children. Pediatr Radiol 36, 1063–1067 (2006). https://doi.org/10.1007/s00247-006-0271-6

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  • DOI: https://doi.org/10.1007/s00247-006-0271-6

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