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Clinical Features, Diagnosis, Histopathology, and Management

Andrew M. Margileth, MD; Roma Chandra, MD; R. Peter Altman, MD

Am J Dis Child. 1984;138(10):917-922.

Abstract
• This report provides clinical information, diagnostic criteria, management, and outcome of 153 cases of mycobacterial lymphadenitis; 22 patients (14%) had Mycobacterium tuberculosis (TB) and 131 patients (86%) had nontuberculous mycobacterial (NTM) disease. Correct diagnosis of TB v NTM disease is essential, since antituberculous chemotherapy was effective for TB adenitis, while excisional biopsy was the treatment of choice for NTM adenopathy. Dual (PPD-NTM, PPD-T) Mantoux tests discriminated between TB and NTM adenitis in 151 (99%) of 153 patients, while dual (PPD-Battey [B], PPD-T) tests differentiated between NTM and TB adenitis in 135 (88%) of 153 cases. A PPD-T reaction of 1 to 14 mm suggested either an NTM or TB infection, whereas a PPD-T of 15 mm or greater was strongly associated with TB disease. We recommend the use of PPD-B and PPD-T antigens as reliable diagnostic discriminators between TB and NTM adenitis.

(AJDC 1984;138:917-922)

Author Affiliations
From the Departments of Pathology (Dr Chandra) and Child Health and Development (Drs Margileth and Chandra), George Washington University School of Medicine, and the Children's Hospital National Medical Center (Drs Margileth and Chandra), Washington, DC; the Department of Surgery, College of Physicians and Surgeons, Columbia University (Dr Altman), and the Department of Pediatric Surgery, Babies Hospital Columbia Presbyterian Medical Center (Dr Altman), New York. Dr Margileth is now with the Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Md.

Footnotes
The opinions and assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Uniformed Services University of the Health Sciences or of the Department of Defense.

Reprint requests to Uniformed Services University, Department of Pediatrics, 4301 Jones Bridge Rd, Bethesda, MD 20814-4799 (Dr Margileth).

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