Journal Article

A 28-Year Multicenter Cohort Study of Nontuberculous Mycobacterial Lymphadenitis in Children, Spain

Fortuny, Clàudia, González-Martín, Julián, Del Rosal, Teresa, Baquero-Artigao, Fernando, Lillo, Miguel, Soriano-Arandes, Antoni, Toro-Rueda, Carlos, Noguera-Julian, Antoni, Rodríguez-Molino, Paula, Rincón, Elena, Guillén-Martín, Sara, Bustillo-Alonso, Matilde, Sanz-Santaeufemia, Francisco José, Sedda, Luigi, Manzanares, Ángela, Canet, Anna, Méndez-Echevarría, Ana, Falcón-Neyra, Lola, Cilleruelo, María José, Lafuente, Miguel, Martínez-Planas, Aina, Santiago, Begoña, Tagarro, Alfredo, Tebruegge, Marc, Monsonís, Manuel

2025

Overview

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).

• Publisher: U.S. National Center for Infectious Diseases,Centers for Disease Control and Prevention
• Subject: A 28-Year Multicenter Cohort Study of Nontuberculous Mycobacterial Lymphadenitis in Children, Spain / Adolescent / Anti-Bacterial Agents - therapeutic use / bacteria / BCG / BCG vaccines / Care and treatment / Child / Child, Preschool / Children & youth / Cohort analysis / Cohort Studies / Communicable diseases in children / Diagnosis / Epidemiology / Female / Health risks / Humans / Immunization / Infant / Infections / interferon-gamma release assay / Laboratories / Lymphadenitis / Lymphadenitis - diagnosis / Lymphadenitis - epidemiology / Lymphadenitis - microbiology / Lymphadenitis - therapy / Lymphatic system / Male / Mycobacterial infections / Mycobacterium avium complex / Mycobacterium Infections, Nontuberculous - diagnosis / Mycobacterium Infections, Nontuberculous - drug therapy / Mycobacterium Infections, Nontuberculous - epidemiology / Mycobacterium Infections, Nontuberculous - microbiology / Mycobacterium Infections, Nontuberculous - therapy / Mycobacterium lentiflavum / Neurological disorders / Nontuberculous Mycobacteria - classification / Patient outcomes / Patients / Pediatric research / Pediatrics / Prospective Studies / Rifabutin / Spain - epidemiology / Statistics / Tuberculosis / tuberculosis and other mycobacteria / Variables