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Skin testing is usually the first step in the evaluation of chronic cervicofacial lymphadenitis (CCL) to assess the likelihood of tuberculosis (TB) or nontuberculous mycobacterial (NTM) infection. Investigators in the Netherlands compared the accuracy of different mycobacterial skin tests for identifying NTM infection in 174 immunocompetent children (age range, 4 months to 16 years) with CCL. None of the children had received the Mycobacterium bovis Bacille Calmette-Guérin (BCG) vaccine. The reference standard for NTM infection was a positive culture result on lymph-node biopsy.
A total of 112 children had a microbiologic diagnosis of NTM infection. Using an induration of 10 mm as the cutoff for a positive result, the skin test for M. avium …