[A toddler with a red swelling in the neck].

BACKGROUND

The differential diagnosis in a child with a swelling in the neck is broad. Chronic lymphadenopathy in children quite often leads to extensive blood tests. Cervicofacial non-tuberculous mycobacterial (NTM) lymphadenitis is, however, not revealed by blood tests. It is a rare condition, which is mostly seen in young children.

CASE DESCRIPTION

A 4-year-old girl had a 9-week history of a swelling in her neck; the skin covering the swelling had been red and flaking for the past week. Extensive blood tests did not provide a firm diagnosis and ultrasound revealed 3 heterogeneous abscessing lymph glands with fistulas to the subcutaneous layer, leading to a probable diagnosis of cervicofacial NTM lymphadenitis. The infected lymph node package was excised, and microbiological culture was positive for Mycobacterium haemophilum.

CONCLUSION

NTM infections in young children are persistent infections that should be treated surgically at an early stage for the best cosmetic and functional result.