Emerging Infectious Diseases (Mar 2025)

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

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

DOI
https://doi.org/10.3201/eid3103.241254
Journal volume & issue
Vol. 31, no. 3
pp. 536 – 546

Abstract

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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).

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