International Pediatric Otolaryngology Group: Consensus guidelines on the diagnosis and management of non-tuberculous mycobacterial cervicofacial lymphadenitis

Catherine F. Roy, Department of Otolaryngology Head & Neck Surgery, McGill University Health Center, Montreal, QC, Canada.
Karthik Balakrishnan, Department of Otolaryngology-Head & Neck Surgery, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, USA.
An Boudewyns, Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Belgium.
Alan Cheng, Department of Pediatric Otolaryngology, The Sydney Children's Hospital Network-Westmead Campus, The University of Sydney, Sydney, NSW, Australia.
Robert H. Chun, Department of Otolaryngology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
Sam J. Daniel, Department of Otolaryngology Head & Neck Surgery, McGill University Health Center, Montreal, QC, Canada.
Pierre Fayoux, Department of Pediatric Otolaryngology-Head and Neck Surgery, CHU Lille, F-59000, Lille, France.
Catherine Hart, Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Ann Hemansson, Department of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, Lund, Sweden.
Richard Hewitt, Department of Ear, Nose and Throat Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Wei-Chung Hsu, Division of Pediatric Otolaryngology, National Taiwan University College of Medicine and Children's Hospital, Taipei, Taiwan.
Michael Kuo, Department of Pediatric Otolaryngology, Birmingham Children's Hospital, Birmingham, United Kingdom.
Christopher Liu, Division of Pediatric Otolaryngology, UT Southwestern Medical Center, Dallas, TX, USA.
John Maddalozzo, Department of Otolaryngology/Head and Neck Surgery, Lurie Children's Hospital, Chicago, IL, USA.
Anna H. Messner, Department of Otolaryngology/Head & Neck Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Seth Pransky, Department of Pediatric Otolaryngology, Rady Children's Hospital, San Diego, CA, USA.
Reza Rahbar, Department of Pediatric Otolaryngology and Communication Enhancement, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Scott Rickert, Division of Pediatric Otolaryngology, Hassenfeld Children's Hospital, New York University Langone Health, New York, NY, USA.
Soham Roy, Department of Otolaryngology-Head and Neck Surgery, Children's Hospital Colorado, Aurora, CO, USA.
John Russell, Department of Pediatric Otorhinolaryngology, Children's Health Ireland (Crumlin), Dublin, Ireland.
Michael J. Rutter, Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Kathleen C. Sie, Department of Otolaryngology Head and Neck Surgery, Seattle Children's Hospital, University of Washington, Seattle, USA.
Douglas Sidell, Department of Otolaryngology-Head & Neck Surgery, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, USA.
Richard Smith, Department of Otolaryngology-Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Marlene Soma, Department of Paediatric Otolaryngology, Sydney Children's Hospital, Randwick, NSW, Australia.
Jorge Spratley, Pediatric Otorhinolaryngology, University of Porto Faculty of Medicine, S. Joao Hospital Center, CINTESIS, Porto, Portugal.
Karen Watters, Department of Pediatric Otolaryngology, Rady Children's Hospital, San Diego, CA, USA.
David R. White, Division of Pediatric Otolaryngology, MUSC Shawn Jenkins Children's Hospital, Charleston, SC, USA.
Nikolaus Wolter, Department of Otolaryngology - Head and Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
George Zalzal, Division of Otolaryngology, Children's National Medical Center, George Washington University, Washington, DC, USA.
Jeffrey C. Yeung, Department of Otolaryngology Head & Neck Surgery, McGill University Health Center, Montreal, QC, Canada. Electronic address: Jeffrey.yeung@mcgill.ca.

Document Type

Journal Article

Publication Date

3-1-2023

Journal

International journal of pediatric otorhinolaryngology

Volume

166

DOI

10.1016/j.ijporl.2023.111469

Keywords

Atypical mycobacteria; Cervical lymphadenitis; Consensus recommendations; Non-tuberculous mycobacteria

Abstract

INTRODUCTION: Non-tuberculous mycobacterial (NTM) infection commonly manifests as subacute or chronic cervicofacial lymphadenitis in immunocompetent children. The optimal management of this pathology remains controversial. OBJECTIVES: This international consensus guideline aims to understand the practice patterns for NTM cervicofacial lymphadenitis and to address the primary diagnostic and management challenges. METHODS: A modified three-iterative Delphi method was used to establish expert recommendations on the diagnostic considerations, expectant or medical management, and operative considerations. The recommendations herein are derived from current expert consensus and critical review of the literature. SETTING: Multinational, multi-institutional, tertiary pediatric hospitals. RESULTS: Consensus recommendations include diagnostic work-up, goals of treatment and management options including surgery, prolonged antibiotic therapy and observation. CONCLUSION: The recommendations formulated in this International Pediatric Otolaryngology Group (IPOG) consensus statement on the diagnosis and management of patients with NTM lymphadenitis are aimed at improving patient care and promoting future hypothesis generation.

Department

Surgery

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