Chronic lymphadenopathy due to mycobacterial infection. Clinical features, diagnosis, histopathology, and management
A. M. Margileth, R. Chandra and R. P. Altman
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.
