Ford Timothy J, Silcock Robyn A, Holland Steven M
Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.
Infection Management and Prevention Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2021 Jan;57(1):15-18. doi: 10.1111/jpc.15257. Epub 2021 Jan 6.
Nontuberculous mycobacteria (NTM) are ubiquitous organisms in our surrounding environment. Four distinct clinical syndromes associated with NTM infection have been described: skin and soft tissue disease, lymphadenitis, disseminated disease and pulmonary disease. In children, lymphadenitis is the most common NTM clinical entity, particularly affecting those aged 1-5 years who have no known risk factors for disease. Optimal management of NTM lymphadenitis is not entirely clear, although surgical intervention is likely a definitive therapy. Disseminated NTM disease is uncommon and only seen in the setting of immunocompromise. In previously well children, this presentation should always lead to consideration of an underlying immune defect, such as Mendelian susceptibility to mycobacterial disease. Identification of the underlying cause enables more targeted therapy and better prognostic understanding. Pulmonary NTM disease is fundamentally different to the other clinical syndromes, presenting in different hosts, who have different comorbidities, and follow a different clinical course.
非结核分枝杆菌（NTM）是我们周围环境中普遍存在的微生物。已描述了与NTM感染相关的四种不同临床综合征：皮肤和软组织疾病、淋巴结炎、播散性疾病和肺部疾病。在儿童中，淋巴结炎是最常见的NTM临床病症，尤其影响1至5岁且无已知疾病危险因素的儿童。尽管手术干预可能是一种确定性治疗方法，但NTM淋巴结炎的最佳管理尚不完全明确。播散性NTM疾病并不常见，仅在免疫功能低下的情况下出现。在先前健康的儿童中，这种表现应始终促使考虑潜在的免疫缺陷，如孟德尔式分枝杆菌病易感性。确定潜在病因有助于进行更有针对性的治疗并更好地了解预后。肺部NTM疾病与其他临床综合征有根本不同，在不同宿主中表现不同，有不同的合并症，且遵循不同的临床病程。
