Losurdo G, Castagnola E, Cristina E, Tasso L, Toma P, Buffa P, Giacchino R
Department of Infectious Diseases, G. Gaslini Children's Hospital, Genoa, Italy.
Head Neck. 1998 May;20(3):245-9. doi: 10.1002/(sici)1097-0347(199805)20:3<245::aid-hed10>3.0.co;2-j.
Cervical lymphadenitis is a frequent manifestation of nontuberculous mycobacteria (NTM) infection in immunocompetent children. Surgical excision, the treatment of choice, is often incomplete and may be difficult. A medical approach could reduce treatment morbidity.
Systemic antibiotic therapy was administered to seven children for at least 6 months as treatment for cervical lymphadenitis due to NTM: rifabutin and clarithromycin in 4 cases; rifabutin, clarithromicyn, and ethambutol in 2 cases; rifabutin, amikacin, and cycloserine in 1 case.
All patients, six followed for a mean of 3 years and one for 6 months, were initially seen with regression of local signs of infection without relapse. Toxicity, likely due to rifabutin, was represented by neutropenia in three patients and yellow skin pigmentation in one patient.
Systemic antibiotic therapy was safe and effective in children with lymphadenitis due to NTM. This approach could represent a sound alternative or adjunct to surgery.
颈部淋巴结炎是免疫功能正常儿童非结核分枝杆菌（NTM）感染的常见表现。手术切除作为首选治疗方法，往往不彻底且可能存在困难。药物治疗方法可能会降低治疗的发病率。
对7名儿童进行了至少6个月的全身抗生素治疗，以治疗NTM引起的颈部淋巴结炎：4例使用利福布汀和克拉霉素；2例使用利福布汀、克拉霉素和乙胺丁醇；1例使用利福布汀、阿米卡星和环丝氨酸。
所有患者，6例平均随访3年，1例随访6个月，最初均表现为局部感染体征消退且无复发。毒性反应可能归因于利福布汀，表现为3例患者出现中性粒细胞减少，1例患者出现皮肤黄染。
全身抗生素治疗对NTM引起的淋巴结炎患儿安全有效。这种方法可以作为手术的合理替代方案或辅助手段。
