Nontuberculous Mycobacterial Cervical Lymphadenitis: Tips and Pearls for Easy Management

Monday, October 13, 2025

8:00 AM - 8:50 AM EDT

Location: 233-234

Disclosure(s):

Mathieu Bergeron, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Joshua P. Wiedermann, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jennifer D. McLevy-Bazzanella, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: Nontuberculous mycobacterial lymphadenitis is a prevalent cause of subacute and chronic cervicofacial masses in children under the age of 5. The disease typically involves the gradual enlargement of lymph nodes in the cervicofacial region. Most patients do not experience any systemic symptoms, and the infection remains confined to a single area. Over time, the classic violaceous skin discoloration may occur as the infection spreads beyond the lymph node capsule. In the later stages, the infection may progress to a draining fistula.

There is no universally accepted work-up or treatment algorithm. Common work-up options involve lab tests, ultrasound, and biopsy. Current treatment options include observation, antibiotic therapy, curettage, and complete surgical excision. Each of these options comes with benefits and possible complications. The management decision is highly dependent on the medical center as no consensus exists. Several grey zones exist for this topic. What are, if any, are the highest yield tests? How can we predict spontaneous resolution? Who should undergo surgery and if indicated, does complete excision of involved nodes provide better outcomes than curettage? Should antibiotics be given at the same time? Should adjacent cervical nodes be addressed? This will be case-based and provide updated information.

This session will provide updated information on diagnosing and treating nontuberculous mycobacterial cervicofacial lymphadenitis. It will help clinicians decide which therapy is most suitable for their patients. The panel of experts will consist of three pediatric otolaryngologists who are highly skilled in managing such patients.

OUTCOME OBJECTIVE 1: Describe the presentation and workup of nontuberculous mycobacterial cervicofacial lymphadenitis

OUTCOME OBJECTIVE 2: Compare the current management options of nontuberculous mycobacterial cervicofacial lymphadenitis

OUTCOME OBJECTIVE 3: Explain the benefits and downsides of each treatment modality

BACKGROUND STATEMENT: This panel will discuss the treatment gaps for atypical mycobacteria and share updated findings from a large multi-institutional and international study.

Comprehensive Otolaryngology Track Statement : This panel consists of surgeons, each with a unique approach to treating patients with atypical mycobacteria. Their methods range from medical management to surgical interventions. Each panelist will share their personal strategies and the lessons they have learned throughout their career.

Moderator(s)

MB

Mathieu Bergeron, MD

Assosiate Professor
Sainte-Justine Hospital
Montréal, QC, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Panelist(s)

JW

Joshua P. Wiedermann, MD

Associate professor
Mayo Clinic
Rochester, Minnesota, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Jennifer D. McLevy-Bazzanella, MD

Program Director
Westchester Medical Center Program
Valhalla, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
CL

Christopher Liu, MD

University of Texas at Southwestern, United States

Disclosure information not submitted.