Raffaldi Irene, Scolfaro Carlo, Garazzino Silvia, Peradotto Federica, Calitri Carmelina, Tovo Pier Angelo
Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children Hospital; Department of Paediatric Otorhinolaryngology, Regina Margherita Children Hospital, Turin, Italy.
Infez Med. 2014 Jun;22(2):136-9.
Non-tuberculous mycobacteria are one of the major causes of lymphadenitis in children and seldom of deep neck infections. We reported the case of an immunocompetent two-year-old girl with adenitis and retropharyngeal abscess caused by an atypical mycobacterium. She had a positive tuberculin skin test, whereas the Quantiferon TB Gold test was negative. The child underwent a complete nodal excision. The search for acid fast bacilli was positive and Mycobacterium scrofulaceum was isolated from the surgically removed material. The retropharyngeal abscess was treated only with antimicrobial therapy, which resulted in an appreciable size reduction of the abscess. After two months antimicrobial treatment was interrupted, and complete resolution was achieved after twelve months. No relapse of disease or possible long-term complications were observed. The surgical wound healed completely, with normal overlying skin and a good aesthetic result. The clinical management of atypical mycobacteria lymphadenitis and retropharyngeal abscess in children is discussed.
非结核分枝杆菌是儿童淋巴结炎的主要病因之一，很少引起颈部深部感染。我们报告了一例免疫功能正常的两岁女童，其腺炎和咽后脓肿由非典型分枝杆菌引起。她结核菌素皮肤试验呈阳性，而结核感染T细胞检测呈阴性。该患儿接受了完整的淋巴结切除术。抗酸杆菌检查呈阳性，从手术切除的材料中分离出瘰疬分枝杆菌。咽后脓肿仅接受抗菌治疗，脓肿大小明显缩小。抗菌治疗两个月后中断，十二个月后完全消退。未观察到疾病复发或可能的长期并发症。手术伤口完全愈合，皮肤覆盖正常，美观效果良好。本文讨论了儿童非典型分枝杆菌淋巴结炎和咽后脓肿的临床管理。
