Mediastinal Nontuberculous Mycobacterial Infection in Children: A Multidisciplinary Approach.

Autor:	Wiener J; From the Department of Paediatric Surgery, Sydney Children's Hospital., Wanaguru D; From the Department of Paediatric Surgery, Sydney Children's Hospital.; Faculty of Medicine, School of Women's and Children's Health, University of New South Wales., Currie B; From the Department of Paediatric Surgery, Sydney Children's Hospital., Grant P; Department of Cardiothoracic Surgery., Russell C; From the Department of Paediatric Surgery, Sydney Children's Hospital., Palasanthiran P; Faculty of Medicine, School of Women's and Children's Health, University of New South Wales.; Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, New South Wales, Australia., Williams P; Faculty of Medicine, School of Women's and Children's Health, University of New South Wales.; Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, New South Wales, Australia.; School of Public Health, Faculty of Medicine, University of Sydney., Belessis Y; Faculty of Medicine, School of Women's and Children's Health, University of New South Wales.; Department of Respiratory Medicine, Sydney Children's Hospital., Soma M; Faculty of Medicine, School of Women's and Children's Health, University of New South Wales.; Department of Paediatric Otolaryngology, Sydney Children's Hospital, Randwick, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	The Pediatric infectious disease journal [Pediatr Infect Dis J] 2024 Jul 01; Vol. 43 (7), pp. e225-e230. Date of Electronic Publication: 2024 Jun 14.
DOI:	10.1097/INF.0000000000004315
Abstrakt:	Background: Mediastinal infections due to nontuberculous mycobacteria remain an exceedingly rare entity. Most cases in the published literature do not include pediatric patients. Due to their clinical infrequency, poor response to antimicrobial therapy and often precarious anatomical location, the optimal management of these lesions can be challenging. Methods: Retrospective medical record review of 4 pediatric cases of mediastinal nontuberculous mycobacteria infection was undertaken. Each child presented with nonspecific respiratory symptoms, including significant acute airway obstruction and required a range of investigations to confirm the diagnosis. Nonresponsiveness to conservative measures and antimycobacterial therapy ultimately resulted in surgical intervention to obtain clinical improvement. Results: All 4 children had extensive evaluation and multidisciplinary involvement in otolaryngology, respiratory medicine, pediatric surgery, infectious diseases and cardiothoracic surgery. They all eventually had their disease debulked via thoracotomy in addition to prolonged antimycobacterial therapy, with successful clinical outcomes. Conclusions: Mediastinal nontuberculous mycobacteria infections in the pediatric population are rare and diagnostically challenging. A high clinical suspicion should be maintained, and multidisciplinary input sought. Targeted surgery with adjuvant medical therapy can reduce disease burden with minimal long-term morbidity. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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