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Non-tuberculous mycobacterial infections presenting as salivary gland masses in children: investigation and conservative management

Published online by Cambridge University Press:  29 June 2007

H. J. Cox ,
A. P. Brightwell  and
T. Riordan
H. J. Cox*
Affiliation:
Department of Otolaryngology, Royal Devon and Exeter Health Care NHS Trust, Barrack Road, Exeter, Devon.
A. P. Brightwell
Affiliation:
Department of Otolaryngology, Royal Devon and Exeter Health Care NHS Trust, Barrack Road, Exeter, Devon.
T. Riordan
Affiliation:
Public Health Laboratory, Royal Devon and Exeter Health Care NHS Trust, Barrack Road, Exeter, Devon.
*
Address for correspondence: Mr H. J. Cox, ENT Department, Royal Naval Hospital, Haslar, Gosport, Hants. Fax: 01705 762403
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Abstract

Non-tuberculous mycobacterial (NTM) infections in children commonly present as cervicofacial masses. The importance of early diagnosis is in the exclusion of infection requiring treatment, particularly tuberculosis and the rare case of malignancy. Five children with NTM presenting with salivary gland masses illustrate the value of skin testing with new tuberculins and the place of fine-needle aspiration cytology in the investigation of these infections.

Four children who were skin tested reacted specifically to one of the new tuberculins, two indicating infection with Mycobacterium malmoense, confirmed by culture, the others responding to tuberculins from M. scrofulaceum and M. avium-intracellulare, neither having a positive culture. The one case not skin tested produced M. avium-intracellulare on culture.

All five patients were managed conservatively. The place for conservative management when the facial nerve is at risk and extensive skin excision is indicated are discussed.

Keywords

Mycobacterium, atypicalSalivary glandBiopsy, needleSkin testsChild
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 6 , June 1995 , pp. 525 - 530
Copyright
Copyright © JLO (1984) Limited 1995

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