International Pediatric Otolaryngology Group: Consensus guidelines on the diagnosis and management of non-tuberculous mycobacterial cervicofacial lymphadenitis.
Karthik Balakrishnan
(1)
,
An Boudewyns
(2)
,
Alan Cheng
(3)
,
Robert H. Chun
(4)
,
Sam J. Daniel
(5)
,
Pierre Fayoux
(6, 7)
,
Catherine Hart
(8)
,
Ann Hemansson
(9)
,
Richard Hewitt
(10)
,
Wei-Chung Hsu
(11)
,
Michael Kuo
(12)
,
Christopher Liu
(13)
,
John Maddalozzo
(14)
,
Anna H. Messner
(15)
,
Seth Pransky
(16)
,
Reza Rahbar
(17)
,
Scott Rickert
(18)
,
Soham Roy
(19)
,
John Russell
(20)
,
Michael J. Rutter
(21)
,
Kathleen C. Y. Sie
(22)
,
Douglas Sidell
(1)
,
Richard Smith
(23)
,
Marlene Soma
(24)
,
Jorge Spratley
(25)
,
Karen Watters
(16)
,
David R. White
(26)
,
Nikolaus Wolter
(27)
,
George Zalzal
(28)
,
Jeffrey C. Yeung
(5)
1
Stanford University
2 UZA - Antwerp University Hospital [Edegem]
3 The University of Sydney
4 MCW - Medical College of Wisconsin [Milwaukee]
5 MUHC - McGill University Health Center [Montreal]
6 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
7 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
8 Cincinnati Children's Hospital Medical Center
9 Skane University Hospital [Lund]
10 GOSHC - Great Ormond Street Hospital for Children NHS Foundation Trust [London, UK]
11 NTU - National Taïwan University
12 Birmingham Children’s Hospital
13 University of Texas Southwestern Medical Center [Dallas]
14 Ann & Robert H. Lurie Children's Hospital of Chicago
15 Texas Children's Hospital [Houston, USA]
16 Rady Children's Hospital
17 HMS - Harvard Medical School [Boston]
18 NYU Langone Health [New York]
19 Children’s Hospital Colorado
20 Children's Health Ireland at Temple Street
21 University of Cincinnati College of Medicine
22 Seattle Children’s Hospital
23 University of Iowa [Iowa City]
24 Sydney Children's hospital
25 Hospital de São João [Porto]
26 MUSC - Medical University of South Carolina [Charleston]
27 University of Toronto
28 GW - The George Washington University
2 UZA - Antwerp University Hospital [Edegem]
3 The University of Sydney
4 MCW - Medical College of Wisconsin [Milwaukee]
5 MUHC - McGill University Health Center [Montreal]
6 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
7 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
8 Cincinnati Children's Hospital Medical Center
9 Skane University Hospital [Lund]
10 GOSHC - Great Ormond Street Hospital for Children NHS Foundation Trust [London, UK]
11 NTU - National Taïwan University
12 Birmingham Children’s Hospital
13 University of Texas Southwestern Medical Center [Dallas]
14 Ann & Robert H. Lurie Children's Hospital of Chicago
15 Texas Children's Hospital [Houston, USA]
16 Rady Children's Hospital
17 HMS - Harvard Medical School [Boston]
18 NYU Langone Health [New York]
19 Children’s Hospital Colorado
20 Children's Health Ireland at Temple Street
21 University of Cincinnati College of Medicine
22 Seattle Children’s Hospital
23 University of Iowa [Iowa City]
24 Sydney Children's hospital
25 Hospital de São João [Porto]
26 MUSC - Medical University of South Carolina [Charleston]
27 University of Toronto
28 GW - The George Washington University
Résumé
Introduction
Non-tuberculous mycobacterial (NTM) infection commonly manifests as subacute or chronic cervicofacial lymphadenitis in immunocompetent children. The optimal management of this pathology remains controversial.
Objectives
This international consensus guideline aims to understand the practice patterns for NTM cervicofacial lymphadenitis and to address the primary diagnostic and management challenges.
Methods
A modified three-iterative Delphi method was used to establish expert recommendations on the diagnostic considerations, expectant or medical management, and operative considerations. The recommendations herein are derived from current expert consensus and critical review of the literature.
Setting
Multinational, multi-institutional, tertiary pediatric hospitals.
Results
Consensus recommendations include diagnostic work-up, goals of treatment and management options including surgery, prolonged antibiotic therapy and observation.
Conclusion
The recommendations formulated in this International Pediatric Otolaryngology Group (IPOG) consensus statement on the diagnosis and management of patients with NTM lymphadenitis are aimed at improving patient care and promoting future hypothesis generation.