Hostname: page-component-669899f699-7tmb6 Total loading time: 0 Render date: 2025-04-25T06:03:30.482Z Has data issue: false hasContentIssue false

The management of non-tuberculous mycobacteria cervicofacial lymphadenitis: a survey of UK paediatric tertiary hospitals

Published online by Cambridge University Press:  29 October 2024

Timothy Williams*
Affiliation:
Department of ENT, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough, UK
Craig McCaffer
Affiliation:
Department of Paediatric Otolaryngology, Starship Children’s Hospital, Te Whatu Ora Te Toka Tumai Auckland, Grafton, AL, New Zealand
Kate Blackmore
Affiliation:
Department of ENT, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough, UK
*
Corresponding author: Timothy Williams; Email: [email protected]

Abstract

Objectives

Management of paediatric non-tuberculous mycobacteria cervicofacial lymphadenitis (NTMCL) is variable without standard practice in the U.K. We undertook a survey to evaluate current U.K. practice in tertiary paediatric units.

Methods

A survey of twenty-one tertiary paediatric centres to evaluate NTMCL management.

Results

We received over 90% response rate. Only 21% have local guidelines, with the majority believing that written national guidance would improve management. Surgery is the most common management choice (69%), with a more limited procedure if skin is involved and/or in proximity to important structures. Observation alone is favoured (32%) when there is no skin involvement but in close proximity to the facial nerve. When treated medically, rifampicin and clarithromycin for 3 months was the commonest choice. Over 25% of respondents state their management has changed following previous adverse outcomes within their own practice or department.

Conclusion

This survey consolidates the current management of NTMCL in U.K. tertiary paediatric units.

Type
Main Article
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Timothy Williams takes responsibility for the integrity of the content of the paper.This work was presented, through oral presentation, at the European Society of Pediatric Otorhinolaryngology congress, 21 May 2023, Liverpool, UK.

References

Spinelli, G, Mannelli, G, Arcuri, F, Venturini, E, Chiappini, E, Galli, L. Surgical treatment for chronic cervical lymphadenitis in children. Experience from a tertiary care paediatric centre on non-tuberculous mycobacterial infections. Int J Pediatr Otorhinolaryngol 2018;108:137–42Google Scholar
Moe, J, Rajan, R, Caltharp, S, Abramowicz, S. Diagnosis and management of children with mycobacterium abscessus infections in the head and neck. J Oral Maxillofac Surg 2018;76:1902–11Google Scholar
Loizos, A, Soteriades, ES, Pieridou, D, Koliou, MG. Lymphadenitis by non-tuberculous mycobacteria in children. Pediatr Int 2018;60:1062–7Google Scholar
Meoli, A, Deolmi, M, Iannarella, R, Esposito, S. Non-tuberculous mycobacterial diseases in children. Pathogens 2020;9:553–65Google Scholar
Gallois, Y, Cogo, H, Debuisson, C, Guet-Revillet, H, Brehin, C, Baladi, B, et al. Nontuberculous lymphadenitis in children: what management strategy? Int J Pediatr Otorhinolaryngol 2019;122:196202Google Scholar
Willemse, SH, Karssemakers, LHE, Oomens, MAEM, Schreuder, WH, Lindeboom, JA, van Wijk, AJ, et al. Cervicofacial non-tuberculous mycobacterial lymphadenitis: clinical determinants of incomplete surgical removal. J Oral Maxillofac Surg 2020;49:1392–6Google Scholar
Lyly, A, Kontturi, A, Salo, E, Neiminen, T, Nokso-Koivisto, J. Childhood nontuberculous mycobacterial lymphadenitis-observation alone is a good alternative to surgery. Int J Pediatr Otorhinolaryngol 2020;129:109778Google Scholar
Koo, EY, Maksimoski, MT, Herron, MH, Bhushan, B, Reynolds, MA, Kats, BZ, et al. Surgical management of parotid non-tuberculous mycobacteria lymphadenitis in children: a pediatric tertiary-care hospital’s experience. Int J Pediatr Otorhinolaryngol 2020;151:110960Google Scholar
Ford, TJ, Silcock, RA, Holland, SM. Overview of nontuberculous mycobacterial disease in children. J Paediatr Child Health 2021;57:1518Google Scholar
Lindeboom, JA, Kuijper, EJ, van Coppenrat ESB, , Lindeboom, R. Surgical excision versus antibiotic treatment for nontuberculous mycobacterial cervicofacial lymphadenitis in children: a multicenter, randomized, controlled trial. Clin Infect Dis 2007;44:1057–64Google Scholar
Lindeboom, JA. Conservative wait-and-see therapy versus antibiotic treatment for nontuberculous mycobacterial cervicofacial lymphadenitis in children. Clin Infect Dis 2011;52:180–4Google Scholar
Lindeboom, JA. Surgical treatment for nontuberculous mycobacterial (NTM) cervicofacial lymphadentitis in children. J Oral Maxillofac Surg 2012;70:345–8Google Scholar
Zimmerman, P, Tebruegge, M, Curtis, N, Ritz, N. The management of non-tuberculous cervicofacial lymphadenitis in children. J Infect 2015;71:918Google Scholar
Roy, CF, Balakrishnan, K, Boudewyns, A, Cheng, A, Chun, RH, Daniel, SJ, et al. International Pediatric Otolaryngology Group: consensus guidelines on the diagnosis and management of non-tuberculous mycobacteria cervicofacial lymphadenitis. Int J Pediatr Otorhinolaryngol 2023;166:111469Google Scholar
British Association for Paediatric Otolaryngology. Non-tuberculous mycobacterial cervical lymphadenitis (NTMCL): guideline for investigation and management. In: https://www.bapo.co.uk/wp-content/uploads/2024/05/NTMCL-guideline-BAPO-May-2024-final.pdfGoogle Scholar
Neven, Q, Van der Linden, D, Hainaut, M, Schmitz, S. Long-term outcome of surgical excision for treatment of cervicofacial granulomatous lymphadenitis in children. Eur Arch Otorhinolaryngol 2020;277:1785–92Google Scholar