A 28-Year Multicenter Cohort Study of Nontuberculous Mycobacterial Lymphadenitis in Children, Spain

Martínez-Planas, A. and Baquero-Artigao, F. and Méndez-Echevarría, A. and Del Rosal, T. and Rodríguez-Molino, P. and Toro-Rueda, C. and Bustillo-Alonso, M. and Lafuente, M. and Canet, A. and Manzanares, Á. and Tagarro, A. and Sanz-Santaeufemia, F.J. and Guillén-Martín, S. and Cilleruelo, M.J. and Falcón-Neyra, L. and Santiago, B. and Rincón, E. and Lillo, M. and Soriano-Arandes, A. and Sedda, L. and Fortuny, C. and Monsonís, M. and González-Martín, J. and Tebruegge, M. and Noguera-Julian, A. and Gutiérrez-Abad, C. and Gavilán, C. and Valmanya, T. and Minguell-Domingo, L. and Mellado, M.J. and Álvarez, J. and Villalobos-Pinto, E. and Pérez-Gorricho, B. and Rodríguez, S. and Torres, D. and Blázquez-Gamero, D. and Prieto, L. and Ruiz, B. and Santos, M. and Hernández-Sanpelayo, T. and Blanco, I.R. and Roa, M. and Gómez, A.B. and Morales, A. and Rueda, S. and Galé, I. and Guerrero-Laleona, C. and Terraza, S.M. and Viñuelas, J. and Álvarez, R. and Ruiz, M. and Calvo, J.C. and Neth, O. and Cepillo, A. and Martín-Nalda, A. and Espiau, M. and Soler-Palacín, P. and Moreno, D. and Núñez, E. and Menasalvas-Ruiz, A. and Martinón-Torres, F. and Dacosta-Urbieta, A. and Calavia, O. and Lahoz, R. and Murua, J.J.K. and Alonso, M. and Arroyo, M. and Pomar, I. and Herrero, S. and Pérez-Tamarit, A. and Piqueras, A. and Otero, C. and Carreras, M. and Álvarez, C. and Lobato, Z. and Garcia, L. and Rius, N. and Guarch, B. and Couceiro, J. and van Ingen, J. (2025) A 28-Year Multicenter Cohort Study of Nontuberculous Mycobacterial Lymphadenitis in Children, Spain. Emerging Infectious Diseases, 31 (3). pp. 536-546. ISSN 1080-6040 (In Press)

Abstract

We describe the epidemiology, diagnosis, and management of nontuberculous mycobacterial lymphadenitis cases detailed in a 28-year (1996–2023) multicenter cohort from Spain. The case numbers remained stable during the initial prospective phase (2013–2020), but a sharp decline was observed during 2021–2022. Disease onset occurred during spring or June in 45.9% of cases. Mycobacterium avium complex (43.1%) and M. lentiflavum (39.9%) were the most common species detected. M. lentiflavum affected mostly younger children from central Spain. The most common treatment strategy was complete surgical resection with (n = 80) or without (n = 88) antimicrobial drug treatment, followed by antimicrobial drugs alone (n = 76). Facial palsy developed in 10.4% of surgical cases. Adverse events because of antimicrobial drugs were uncommon. New fistula formation during follow-up occurred more in children managed with observation alone than in those treated with antimicrobial drugs alone (relative risk 2.7 [95% CI 1.3–5.3]; p = 0.014).