caa a22 4500 606183302 CHVBK 20210128100820.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00405-014-3160-x doi (NATIONALLICENCE)springer-10.1007/s00405-014-3160-x Atypical mycobacteriosis in children: a diagnostic and therapeutic challenge [Elektronische Daten] [C. Deichmueller, K. Emmanouil, H.-J. Welkoborsky] Atypical mycobacteriosis (AM) is a rare disease, which is caused by an infection with mycobacteria other than tuberculosis (MOTT). In children, the cervical lymph nodes are frequently affected. MOTT are a pathogen or facultative pathogen environmental germs, which can affect otherwise healthy individuals. The diagnostic and therapeutic management is often challenging. Currently, there are only few data published about the systematic investigation and therapy of children with AM. In a retrospective study, 29 children with AM were evaluated. The clinical records of these patients were reviewed and analyzed along with the results of histopathological and microbiological findings. The clinical parameters were correlated to patients' therapy and clinical follow-up. 29 otherwise healthy and immunocompetent children (18 girls, 11 boys, average age of 3.5years, range 1.5-9.5years) with AM of the head and neck region have been evaluated. Clinically, all patients were admitted with a swelling of cervical lymph nodes and discoloration of the overlaying skin. In five patients, an abscess formation of the lymph nodes occurred. Ultrasound examinations typically revealed a hypoechoic mass with central necrosis and intralesional septa. Histologically, epithelioid granuloma with caseating necrosis was described in any case. Germ identification by either microbiological culture or PCR was successful in 20 cases, with Mycobacterium avium and Mycobacterium intercellulare being the most frequent germs. In all patients, lymph nodes were surgically removed. In a clinical follow-up of at least 18months, a recurrence occurred in five cases. Diagnosis of atypical mycobacteriosis is often difficult and challenging, since clinical appearance is unspecific and MOTT can only be identified microbiologically or by PCR in about two-thirds of cases. Therefore, a close cooperation between clinician, pathologist, and microbiologist is required. Therapeutically excision of all affected lymph nodes is recommended. Alternative or concomitant medical treatment with tuberculostatics is indicated in particular cases, i.e., recurrence, persistence or systemically lymph node involvement. Springer-Verlag Berlin Heidelberg, 2014 Atypical mycobacteriosis nationallicence Children nationallicence MOTT nationallicence NTM nationallicence Cervical lymphadenitis nationallicence Mycobacterium avium complex nationallicence Deichmueller C. Department of Otorhinolaryngology, Children's Hospital auf der Bult, Hannover, Germany aut Emmanouil K. Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Region Hannover, Nordstadt Clinic, Academic Hospital, Haltenhoffstr. 41, 30167, Hannover, Germany aut Welkoborsky H.-J Department of Otorhinolaryngology, Children's Hospital auf der Bult, Hannover, Germany aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/9(2015-09-01), 2425-2431 0937-4477 272:9<2425 2015 272 405 https://doi.org/10.1007/s00405-014-3160-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3160-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Deichmueller C. Department of Otorhinolaryngology, Children's Hospital auf der Bult, Hannover, Germany aut NATIONALLICENCE 700 1- Emmanouil K. Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Region Hannover, Nordstadt Clinic, Academic Hospital, Haltenhoffstr. 41, 30167, Hannover, Germany aut NATIONALLICENCE 700 1- Welkoborsky H.-J Department of Otorhinolaryngology, Children's Hospital auf der Bult, Hannover, Germany aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/9(2015-09-01), 2425-2431 0937-4477 272:9<2425 2015 272 405