Martínez-Planas Aina, Baquero-Artigao Fernando, Méndez-Echevarría Ana, Del Rosal Teresa, Rodríguez-Molino Paula, Toro-Rueda Carlos, Bustillo-Alonso Matilde, Lafuente Miguel, Canet Anna, Manzanares Ángela, Tagarro Alfredo, Sanz-Santaeufemia Francisco José, Guillén-Martín Sara, Cilleruelo María José, Falcón-Neyra Lola, Santiago Begoña, Rincón Elena, Lillo Miguel, Soriano-Arandes Antoni, Sedda Luigi, Fortuny Clàudia, Monsonís Manuel, González-Martín Julián, Tebruegge Marc, Noguera-Julian Antoni
Emerg Infect Dis. 2025 Mar;31(3):536-546. doi: 10.3201/eid3103.241254.
We describe the epidemiology, diagnosis, and management of nontuberculous mycobacterial lymphadenitis cases detailed in a 28-year (1996-2023) multicenter cohort from Spain. The case numbers remained stable during the initial prospective phase (2013-2020), but a sharp decline was observed during 2021-2022. Disease onset occurred during spring or June in 45.9% of cases. Mycobacterium avium complex (43.1%) and M. lentiflavum (39.9%) were the most common species detected. M. lentiflavum affected mostly younger children from central Spain. The most common treatment strategy was complete surgical resection with (n = 80) or without (n = 88) antimicrobial drug treatment, followed by antimicrobial drugs alone (n = 76). Facial palsy developed in 10.4% of surgical cases. Adverse events because of antimicrobial drugs were uncommon. New fistula formation during follow-up occurred more in children managed with observation alone than in those treated with antimicrobial drugs alone (relative risk 2.7 [95% CI 1.3-5.3]; p = 0.014).
我们描述了西班牙一个为期28年（1996 - 2023年）的多中心队列中详细记录的非结核分枝杆菌淋巴结炎病例的流行病学、诊断和管理情况。在最初的前瞻性阶段（2013 - 2020年）病例数保持稳定，但在2021 - 2022年期间观察到急剧下降。45.9%的病例发病于春季或6月。鸟分枝杆菌复合群（43.1%）和缓黄分枝杆菌（39.9%）是检测到的最常见菌种。缓黄分枝杆菌主要影响西班牙中部的年幼儿童。最常见的治疗策略是完全手术切除，其中80例接受了抗菌药物治疗，88例未接受抗菌药物治疗，其次是单纯使用抗菌药物治疗（76例）。10.4%的手术病例出现面神经麻痹。抗菌药物引起的不良事件并不常见。随访期间新瘘管形成在仅接受观察的儿童中比仅接受抗菌药物治疗的儿童中更常见（相对风险2.7 [95%置信区间1.3 - 5.3]；p = 0.014）。
