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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0000000000000007
Original Studies

Comparison of Mycobacterium lentiflavum and Mycobacterium avium-intracellulare Complex Lymphadenitis

Jiménez-Montero, Beatriz MD*; Baquero-Artigao, Fernando MD; Saavedra-Lozano, Jesús MD, PhD; Tagarro-García, Alfredo MD, PhD*; Blázquez-Gamero, Daniel MD§; Cilleruelo-Ortega, María J. MD, PhD; Ramos-Amador, José T. MD, PhD; Galé-Ansó, Inés MD§; Marín, Natalia MD; Gómez-García, Raquel MD; Santiago-García, Begoña MD; Garrido, Jesus MD§; López, Goosen MD**

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Background: Mycobacterium lentiflavum is considered a rare pathogen causing nontuberculous mycobacterial (NTM) lymphadenitis.

Methods: A multicenter, retrospective study was performed in immunocompetent children <14 years of age with microbiologically confirmed NTM lymphadenitis treated at 6 hospitals in Madrid, Spain, during 2000–2010. We compared children with M. lentiflavum and Mycobacterium avium-intracellulare complex infection.

Results: Forty-five microbiologically confirmed NTM lymphadenitis patients were identified: 19 (45.2%) caused by M. avium-intracellulare complex, 17 (40.5%) by M. lentiflavum, 1 by both and 5 by other mycobacteria. Out of 17 M. lentiflavum cases, 14 were diagnosed in the past 5 years. Regarding M. lentiflavum cases, median age was 23 months. Submandibular nodes were the most frequently involved (76.5%), with multiple locations seen in 41% of the children and spontaneous drainage in 41% of them. Drug susceptibility tests were performed in 14 isolates and showed a complete susceptibility to clarithromycin and cycloserine, whereas 93% were resistant to rifampin, 33% to quinolones and full resistance to other tested antimycobacterial drugs was detected. All but 1 child required surgery and 11 were treated additionally with various drug combinations. Total resolution was achieved in 50% of children within 6 months.

Compared with M. avium-intracellulare complex cases, children were younger and laterocervical nodes were significantly less frequently involved. No statistically significant differences were found related to clinical characteristics, treatment and outcome.

Conclusions: M. lentiflavum is an emerging pathogen producing NTM lymphadenitis in Madrid.

© 2014 by Lippincott Williams & Wilkins, Inc.


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