Surgical treatment of atypical mycobacterial cervicofacial adenitis in children

Background: Atypical mycobacteria have long been recognized as a cause of cervicofacial adenitis in otherwise healthy children. The disease is nearly always localized but if left untreated the involved lymph nodes caseate and discharge. The management of this condition has been considered to be surgical with techniques including aspiration, incision and drainage, curettage and excision. Methods: Cases of atypical mycobacterial cervicofacial adenitis treated by curettage at the Canberra Hospital, ACT, Australia, are reviewed. Results: Ten cases successfully treated with curettage are reported. Two patients experienced delayed healing of their wounds and one required a second curettage 7 months after primary excision for recurrent disease. Conclusion: Curettage is a safe and effective means of treating atypical mycobacterial cervicofacial adenitis in children. The primary cure rate of 70% is less than that for excision of the involved nodes (92% cure rate), which is the standard treatment for this disease.