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June 17, 1968

Surgical Management of Cervical Adenitis Due to Atypical Mycobacteria in Children

Author Affiliations

From the General Surgery Service, Children's Medical Center and the Department of Surgery, University of Texas Southwestern Medical School at Dallas (Drs. Votteler and Dorman), and Parkland Memorial Hospital (Dr. Salyer), Dallas.

JAMA. 1968;204(12):1037-1040. doi:10.1001/jama.1968.03140250017004

Thirty-eight cases of cervical adenitis in children, with infection due to atypical mycobacteria, have been seen at Children's Medical Center, Dallas. The clinical picture of this infection can be established as a specific entity. This consists of unilateral submandibular lymphadenopathy in the submaxillary gland area usually associated with erythema of the overlying skin and abscess formation. The age group affected is characteristic. The children have minimal systemic symptoms and normal roentgenograms of the chest. Skin tests for atypical organisms are strongly positive; skin tests for Mycobacterium tuberculosis are usually weakly positive. Surgical management is advocated and consists of total excision of involved lymph nodes and skin, closure without drainage, and postoperative drug therapy with (para)aminosalicylic acid (PAS) and isoniazid (INH).