T. Del Rosal1, A. Méndez-Echevarría1, F. Baquero-Artigao1, A. Martínez-Planas2, ... 3Hospital Universitario Miguel Servet, Zaragoza; 4Hospital Universitario 12 ...
MYCOBACTERIUM LENTIFLAVUM AND MYCOBACTERIUM AVIUM CERVICOFACIAL LYMPHADENITIS IN SPAIN: A COMPARATIVE MULTICENTER STUDY T. Del Rosal1, A. Méndez-Echevarría1, F. Baquero-Artigao1, A. Martínez-Planas2, M. Bustillo3, P. Rojo-Conejo4, C. Guerrero3, D. Blázquez4, B. Santiago5, L. Prieto6, P. Soler-Palacín7, S. Rueda8, M. Arroyo9, T.Valmanya10, Z. Lobato11, L. García12, C. Alvarez13, I. Pomar14, C. Gutiérrez15, A. Morales16, O. Calavia17, M.J. Mellado1, A. Noguera-Julian2 1Hospital
Universitario La Paz, Madrid; 2Hospital Sant Joan de Déu, Barcelona; 3Hospital Universitario Miguel Servet, Zaragoza; 4Hospital Universitario 12 de Octubre, Madrid; 5Hospital Universitario Gregorio Marañón, Madrid; 6Hospital Universitario de Getafe, Madrid; 7Hospital Universitari Vall d’Hebron, Bardelona; 8Hospital Clínico San Carlos, Madrid; 9Hospital Universitario San Agustín, Avilés; 10Hospital Universitari Arnau Vilanova, Lleida; 11Hospital de Manresa; 12Hospital de Mataró; 13Hospital Universitario Marqués de Valdecilla, Santander; 14Hospital Son Llàtzer, Palma de Mallorca; 15Centro de Salud Las Huelgas, Burgos; 16Hospital de Möstoles; 17Hospital Universitari Joan XXIIII, Tarragona
Background
Methods
Mycobacterium avium and Mycobacterium lentiflavum are frequently isolated in previously healthy children with nontuberculous mycobacterial lymphadenitis in Spain. We compared the clinical features, outcome and geographical distribution of cervicofacial lymphadenitis caused by both species of mycobacteria.
Ongoing retrospective-prospective, multi-center observational study including Institutions within Red Española de Tuberculosis Pediátrica (pTBred, Spain). Patients aged 0-18 years with culture- or PCR-confirmed M.avium and M. lentiflavum cervicofacial lymphadenitis were eligible. Epidemiological, clinical and treatment data were collected through REDCap software (http://www.project-redcap.org/).
Results A total of 86 patients were included (45 M. lentiflavum, 41 M. avium) M. lentiflavum (n=45)
M. avium (n=41)
p
47% (21/45)
44% (18/41)
>0.05
26.7 (15.6) months
38.7 (18.7) months
0.002
3.6 (3.3) weeks
4.9 (3.9) weeks
>0.05
5.1 (4.6) mm
6.5 (5.5) mm
>0.05
29% (13/45)
12% (5/41)
0.057
Bilateral involvement
9% (4/45)
7% (3/41)
>0.05
Recurrence
4% (2/45)
14% (6/41)
>0.05
Fistula formation
13% (6/45)
22% (9/41)
>0.05
Need of surgery
76% (31/41)
65% (24/37)
>0.05
14.8 (8.1) weeks
12.4 (11.4) weeks
>0.05
Male sex Age, mean (SD) Time from symptom onset to diagnosis, mean (SD) Mean (SD) TST induration Preauricular lymph nodes involvement
Length of antibiotic treatment, mean (SD) Geographical distribution of microbiological isolates: Madrid: 40 cases (89%) M. lentiflavum Other regions: 5 cases (11%)
n=62
p=0.013 Madrid: 22 cases (54%) M. avium Other regions: 19 cases (46%)
M. avium M. lentiflavum
Conclusions Ø Compared to M. avium, children with M. lentiflavum cervicofacial lymphadenitis were younger and more often showed preauricular node involvement Ø Clinical course was similar for both species of mycobacteria Ø M. lentiflavum was more frequently identified in Madrid, suggesting endemicity in this region
