Nontuberculous Mycobacterial Infections of the Head and Neck

OBJECTIVE: To review the treatment and outcome of patients with nontuberculous mycobacterial infections of the head and neck. DESIGN: Retrospective examination of the medical records of patients treated by several surgeons during a 5-year period with a minimum 6-month follow-up. SETTING: Large teaching children's hospital. PATIENTS: Twenty-six children hospitalized for treatment of nontuberculous mycobacterial infections of the head and neck. MAIN OUTCOME MEASURES: Resolution of infection, recurrence, and need for additional surgical intervention for cure. RESULTS: Eleven patients initially were treated by incisional biopsy or incision and drainage procedures; eight patients developed recurrence or a draining sinus tract, necessitating a second surgical procedure. In contrast, 15 patients initially underwent complete excision; only one developed a recurrence (P < .01). Thus, eight (31%) of 26 patients required at least two surgical procedures owing to inadequate initial treatment. CONCLUSIONS: Excisional biopsy is both the diagnostic procedure and treatment of choice for nontuberculous mycobacterial adenitis.