Nontuberculous mycobacteria (NTM) are a miscellaneous collection of acid-fast bacteria that are widespread in the environment . They have been isolated from numerous environmental sources including water, soil, food products, and domestic and wild animals . Nosocomial transmission has occurred with medical equipment [3-5].
More than 130 species of have been identified, not all of which have been documented to cause disease in humans [6-9]. NTM pathogens are classified as rapidly growing or slowly growing (table 1). Rapidly growing species grow within seven days and include Mycobacterium fortuitum, M. abscessus, and M. chelonae. Slowly growing species require several weeks to grow and include M. avium complex (MAC), M. marinum, and M. kansasii. (See "Microbiology of nontuberculous mycobacteria", section on 'Classification'.)
NTM can cause a broad range of infections that vary depending on the particular NTM species and the host. In children, NTM cause four main clinical syndromes: lymphadenitis, skin and soft tissue infection (SSTI), pulmonary disease (predominantly in children with underlying pulmonary conditions), and disseminated disease (predominantly in children with immune compromise).
This topic will provide an overview of NTM lymphadenitis in children. NTM SSTI, pulmonary infections, disseminated infections, and bacteremia in children are discussed separately. (See "Overview of nontuberculous mycobacterial skin and soft tissue infections in children" and "Overview of nontuberculous mycobacterial pulmonary infections in children" and "Overview of disseminated nontuberculous mycobacterial (NTM) infections and NTM bacteremia in children".)
In case series of nontuberculous mycobacterial lymphadenitis among children in the United States, the majority of cases are caused by M. avium complex (MAC), which includes M. avium and M. intracellulare [2,10,11]. In series from other countries, MAC and M. haemophilum are frequently isolated [12-15].