Nontuberculous Mycobacterial Cervical Lymphadenitis: Tips and Pearls for Easy Management

PROGRAM DESCRIPTION: Nontuberculous mycobacterial lymphadenitis is a prevalent cause of subacute and chronic cervicofacial masses in children under the age of 5. The disease typically involves the gradual enlargement of lymph nodes in the cervicofacial region. Most patients do not experience any systemic symptoms, and the infection remains confined to a single area. Over time, the classic violaceous skin discoloration may occur as the infection spreads beyond the lymph node capsule. In the later stages, the infection may progress to a draining fistula.

There is no universally accepted work-up or treatment algorithm. Common work-up options involve lab tests, ultrasound, and biopsy. Current treatment options include observation, antibiotic therapy, curettage, and complete surgical excision. Each of these options comes with benefits and possible complications. The management decision is highly medical center dependent as no consensus exists. Several grey zones exist for this topic. What are, if any, are the highest yield tests? How can we predict spontaneous resolution? Who should undergo surgery and if indicated, does complete excision of involved nodes provide better outcomes than curettage? Should antibiotics be given at the same time? Should adjacent cervical nodes be addressed?
Nontuberculous mycobacterial lymphadenitis (NTML)
is a common cause of subacute and chronic cervicofacial
masses in children under 5 years of age

This session will provide updated information on the diagnosis and treatment of nontuberculous mycobacterial cervicofacial lymphadenitis. It will help clinicians make informed decisions about which therapy is most suitable for their patients. The panel of experts will consist of three pediatric otolaryngologists who are highly skilled in managing such patients.