Distinct clinical parameters were associated with shorter spontaneous resolution in children with non-tuberculous mycobacterial lymphadenitis.

Autor: Jensen FN; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark., Nielsen AB; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark., Dungu KHS; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark., Poulsen A; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark., Schmidt G; Department of Plastic Surgery and Burns Treatment, University of Copenhagen, Copenhagen, Denmark., Hjuler T; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Otorhinolaryngology and Audiology, University of Copenhagen, Copenhagen, Denmark., Zhang H; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark., Vissing NH; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark., Nygaard U; Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark.; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2024 Sep; Vol. 113 (9), pp. 2091-2097. Date of Electronic Publication: 2024 Jan 16.
DOI: 10.1111/apa.17104
Abstrakt: Aim: Non-tuberculous mycobacteria (NTM) lymphadenitis typically resolves spontaneously, yet factors influencing the duration remain explored. We aimed to identify clinical parameters associated with shorter spontaneous resolution.
Methods: This cohort study included children with NTM lymphadenitis from 1 January 2015 to 1 March 2021 at Copenhagen University Hospital. Time-to-event analysis assessed clinical parameters associated with the duration of NTM lymphadenitis.
Results: Sixty children (57% boys) with a median age of 24 months (range 11-84) were included; 13 (22%) received primary surgery, 13 (22%) underwent surgery after a wait-and-see period and 34 (57%) received no intervention. In children without intervention, the median duration was 10 months (range 2-25). Faster resolution was associated with parental-reported lymph node enlargement within 2 weeks (HR 2.3, 95% CI 1.0-5.0; p = 0.044), abscess on ultrasound examination (HR 3.3, 95% CI 1.5-7.3; p = 0.003) and skin discoloration and/or perforation within 3 months of onset (HR 4.3, 95% CI 1.3-14.4; p = 0.017 and HR 3.7, 95% CI 1.5-9.1; p = 0.005).
Conclusion: Knowledge of predictors for shorter spontaneous resolution of NTM lymphadenitis, such as rapid initial lymph node enlargement, abscess on ultrasound examination, and skin discoloration and/or perforation within 3 months of disease onset, may guide clinical management decisions concerning surgery versus a conservative approach.
(© 2024 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)
Databáze: MEDLINE
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