Surgery remains the treatment of choice.
Cervical lymphadenitis caused by atypical mycobacteria is a fairly common pediatric infection that traditionally has been treated by surgical excision of the infected nodes. Several antibiotics with good activity against these organisms prompted Dutch investigators to conduct the first prospective, head-to-head trial of medical versus surgical treatment.
Investigators randomized 100 immunocompetent children (age range, 9 months to 14 years) with nontuberculous mycobacterial cervical lymphadenitis, confirmed by smear and/or PCR of fine-needle aspirate, to surgical excision or treatment with oral clarithromycin and rifabutin. Significantly more children in the surgery group than in the antibiotic group (96% vs. 44%) were pronounced cured at th…