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The management of non-tuberculous mycobacteria cervicofacial lymphadenitis: a survey of UK paediatric tertiary hospitals

Published online by Cambridge University Press:  29 October 2024

Timothy Williams Open the ORCID record for Timothy Williams [Opens in a new window] ,
Craig McCaffer  and
Kate Blackmore
Timothy Williams*
Affiliation:
Department of ENT, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough, UK
Craig McCaffer
Affiliation:
Department of Paediatric Otolaryngology, Starship Children’s Hospital, Te Whatu Ora Te Toka Tumai Auckland, Grafton, AL, New Zealand
Kate Blackmore
Affiliation:
Department of ENT, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough, UK
*
Corresponding author: Timothy Williams; Email: Tim.williams5@nhs.net
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Abstract

Objectives

Management of paediatric non-tuberculous mycobacteria cervicofacial lymphadenitis (NTMCL) is variable without standard practice in the U.K. We undertook a survey to evaluate current U.K. practice in tertiary paediatric units.

Methods

A survey of twenty-one tertiary paediatric centres to evaluate NTMCL management.

Results

We received over 90% response rate. Only 21% have local guidelines, with the majority believing that written national guidance would improve management. Surgery is the most common management choice (69%), with a more limited procedure if skin is involved and/or in proximity to important structures. Observation alone is favoured (32%) when there is no skin involvement but in close proximity to the facial nerve. When treated medically, rifampicin and clarithromycin for 3 months was the commonest choice. Over 25% of respondents state their management has changed following previous adverse outcomes within their own practice or department.

Conclusion

This survey consolidates the current management of NTMCL in U.K. tertiary paediatric units.

Keywords

Infectious diseasesHead and neckNeck lumpImmunology

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 5 , May 2025 , pp. 368 - 372
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Timothy Williams takes responsibility for the integrity of the content of the paper.This work was presented, through oral presentation, at the European Society of Pediatric Otorhinolaryngology congress, 21 May 2023, Liverpool, UK.

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