Nontuberculous mycobacterial infections of the head and neck

Abstract

Objective: To review the treatment and outcome of patients with nontuberculous mycobacterial infections of the head and neck.

Design: Retrospective examination of the medical records of patients treated by several surgeons during a 5-year period with a minimum 6-month follow-up.

Setting: Large teaching children's hospital.

Patients: Twenty-six children hospitalized for treatment of nontuberculous mycobacterial infections of the head and neck.

Main outcome measures: Resolution of infection, recurrence, and need for additional surgical intervention for cure.

Results: Eleven patients initially were treated by incisional biopsy or incision and drainage procedures; eight patients developed recurrence or a draining sinus tract, necessitating a second surgical procedure. In contrast, 15 patients initially underwent complete excision; only one developed a recurrence (P < .01). Thus, eight (31%) of 26 patients required at least two surgical procedures owing to inadequate initial treatment.

Conclusions: Excisional biopsy is both the diagnostic procedure and treatment of choice for nontuberculous mycobacterial adenitis.