학술논문

Surgical treatment for chronic cervical lymphadenitis in children. Experience from a tertiary care paediatric centre on non-tuberculous mycobacterial infections.
Document Type
Article
Source
International Journal of Pediatric Otorhinolaryngology. May2018, Vol. 108, p137-142. 6p.
Subject
*LYMPHADENITIS
*MYCOBACTERIAL diseases
*TERTIARY care
*DIFFERENTIAL diagnosis
*SURGICAL indications
*JUVENILE diseases
*THERAPEUTICS
Language
ISSN
0165-5876
Abstract
Objectives Non-tuberculous mycobacteria are the most frequent cause of chronic lymphadenitis in children. We reviewed treatment and outcomes of paediatric patients with chronic cervical lymphadenitis, to better understand their differential diagnosis, surgical indication, complication and recover. Methods A retrospective study was carried out on children who underwent surgery from 2013 to 2016 at Meyer Children's University Hospital, Florence, Italy. Time to cure, type of surgery, and complications rate were determined and etiologic agents were identified and correlated to their clinical presentation. Results 275 children were evaluated. Nearly 98% of the patients were cured regardless of which therapeutic option was used and surgery was necessary in 38.2% of children. Complete excisional biopsy ensured recover in 97.7% of patients compared with the non-excisional surgical group 88.2% (p = 0.06). Re-interventions were needed in the 2.3% of complete excision group and in two cases of the incision and drainage group; all of them developed fistula and were caused by Mycobacterium avium complex . Excision followed by adjunctive antibiotic therapy was favoured in the majority of the patients (80.1%, n = 71). Conclusion In cases of non-tuberculous mycobacteria lymphadenitis, surgery is the treatment of choice and it is closely related to a favourable prognosis. [ABSTRACT FROM AUTHOR]