Chronic lymphadenopathy due to mycobacterial infection. Clinical features, diagnosis, histopathology, and management
Margileth, A.M.; Chandra, R.; Altman, R.P.
American Journal of Diseases of Children 138(10): 917-922
1984
ISSN/ISBN: 0002-922X PMID: 6475852 Document Number: 227419
This report provides clinical information, diagnostic criteria, management and outcome of 153 cases of myocobacterial lymphadenitis; 22 patients (14%) had Mycobacterium tuberculosis (TB) and 131 patients (86%) had nontuberculous mycobacterial (NTM) disease. Correct diagnosis of TB vs. NTM disease is essential, since antituberculous chemotherapy was effective for TB adenitis, while excisional biopsy was the treatment of choice for NTM adenopathy. Dual purified protein derivative (PPD-NTM, PPD-T) Mantoux tests discriminated between TB and NTM adenitis in 151 (99%) of 153 patients; dual (PPD-Battey [B], PPD-T) tests differentiated between NTM and TB adenitis in 135 (88%) of 153 cases. A PPD-T reaction of 1-14 mm suggested either an NTM or TB infection; a PPD-T of .gtoreq. 15 mm was strongly associated with TB disease. The use of PPD-B and PPD-T antigens is recommended for reliable diagnostic discrimination between TB and NTM adenitis.