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Dual infection with atypical mycobacteria and Mycobacterium tuberculosis causing cervical lymphadenopathy in a child

Published online by Cambridge University Press:  08 March 2006

S. Ganesan
Affiliation:
Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, Gray’s Inn Road, London
A. Thirlwall
Affiliation:
Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, Gray’s Inn Road, London
C. Brewis
Affiliation:
Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, Gray’s Inn Road, London
H. R. Grant
Affiliation:
Department of Otolaryngology, Royal National Throat, Nose and Ear Hospital, Gray’s Inn Road, London
V. M. Novelli
Affiliation:
Department of Infectious Diseases, Great Ormond Street Hospital for Children NHS Trust London, UK.
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Abstract

The most common presentation of mycobacterial infection encountered in otolaryngological practice is cervical lymphadenitis. We report a child with an unusual cause of cervical lymphadenopathy, i.e. dual tuberculous infections. This had clinical ramifications as, initially Mycobacterium avium-intracellulare was grown in culture and was resistant to standard anti-tuberculous agents, and hence treated with excision of the lymph node. However, the cultures from the excised lymph node grew out Mycobacterium tuberculosis that was sensitive to standard anti-tuberculous drugs. To our knowledge, no such presentation has been reported previously. We also review the literature on cervical lymphadenitis due to atypical mycobacteria and Mycobacterium tuberculosis , with particular emphasis on clinical presentation, diagnosis and management.

Type
Research Article
Copyright
Royal Society of Medicine Press Limited 2000

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