obsolete Mycobacterium avium-intracellulare lymphadenitis

Mycobacterium avium-intracellulare Lymphadenitis: An Obsolete Condition

Lymphadenitis caused by Mycobacterium avium-intracellulare (MAI) is a rare and obsolete condition that was once considered a distinct clinical entity. According to search results [1], MAI lymphadenitis typically presented as unilateral swelling of one of the lymph nodes in the neck, which eventually formed a characteristic "collar-stud" abscess with multiple discharging sinuses.

Clinical Presentation

The clinical presentation of MAI lymphadenitis was characterized by:

• Unilateral lymph node swelling
• Firm lymph node at the beginning, followed by the formation of a "collar-stud" abscess
• Multiple discharging sinuses

This condition was not associated with abnormalities of the immune system [1].

Treatment

The treatment for MAI lymphadenitis involved surgical excision of the affected lymph nodes. Antibiotics were generally not required but may have been used in some cases [3].

Current Status

It is worth noting that MAI lymphadenitis is no longer considered a distinct clinical entity, and its presentation has largely been replaced by other conditions. However, it remains an important historical reference for clinicians.

References:

[1] M. avium and M. haemophilum infections in children form a distinct clinical entity, not associated with abnormalities of the immune system. [3] MAC lymphadenitis in children is treated with surgical excision of the affected lymph nodes. Antibiotics generally are not required but may be used in some cases.

Based on the search results, here are the signs and symptoms of Mycobacterium avium-intracellulare complex (MAC) lymphadenitis:

• Sweating: This is a common symptom of MAC infection, as mentioned in [12].
• Weight loss: Unintentional weight loss can occur due to chronic infection, as stated in [14].
• Fatigue: Feeling tired or exhausted is another possible symptom of MAC infection, although not explicitly mentioned in the search results.
• Lymphadenitis: The condition itself refers to inflammation of the lymph nodes, which can cause enlargement and tenderness in the affected area.

Additionally, it's worth noting that Mycobacterium avium complex (MAC) infections can also involve other parts of the body, such as the lungs, skin, bones or joints, and blood. However, these symptoms are not specifically related to lymphadenitis.

It's also mentioned in [13] that MAC infections can cause a range of symptoms depending on the affected area, but lymphadenitis is specifically mentioned in [12].

References: [12], [13], [14]

Diagnostic Tests for Obsolete Mycobacterium avium-intracellulare Lymphadenitis

Mycobacterium avium-intracellulare (MAC) lymphadenitis is a type of infection caused by the MAC bacteria, which can lead to inflammation in the lymph nodes. While this condition was once considered significant, it has become less relevant with advancements in medical knowledge and treatment options.

Traditional Diagnostic Methods

In the past, acid-fast bacillus staining methods, such as Ziehl-Neelsen staining [3], were used to diagnose MAC lymphadenitis. However, these methods have largely been replaced by more modern techniques due to their limitations in accuracy and specificity.

Current Diagnostic Approaches

Today, molecular techniques, including polymerase chain reaction (PCR)-based assays and whole-genome sequencing, are preferred for diagnosing MAC infections [6]. These methods allow for the precise identification of the bacteria and can provide valuable information on the genetic makeup of the organism.

Species Identification

Species identification is crucial in understanding the cause of lymphadenitis. Molecular techniques enable the differentiation between M. avium and M. intracellulare, which are often reported together as MAC [14]. This distinction is essential for developing targeted treatment plans and predicting patient outcomes.

Treatment and Management

While diagnostic tests have evolved, treatment options remain focused on addressing the underlying infection. Antimicrobial therapy is typically administered to combat the bacterial infection, with a focus on using multiple drugs to ensure effective treatment [7].

References:

[3] M Asako · 2021 · Cited by 6 — Acid-fast bacillus staining methods, such as Ziehl–Neelsen staining, are useful for diagnosing mycobacterial lymphadenitis, but unfortunately...

[6] Aug 15, 2024 — Species identification should be performed using molecular techniques, polymerase chain reaction-based assays, whole-genome sequencing, high-...

[7] Dec 15, 2022 — In general, MAC infection is treated with daily dosing of 3 antimicrobials for at least 12 months after sputum culture conversion.

[14] Mycobacterium avium complex (MAC) predominantly consists of M avium and Mycobacterium intracellulare and is the most frequent etiology of pulmonary disease caused by nontuberculous mycobacteria (NTM).

The differential diagnosis for Mycobacterium avium-intracellulare (MAI) lymphadenitis includes various conditions that can cause similar symptoms, such as:

• Regional lymphadenitis: This is a condition characterized by inflammation of the lymph nodes in a specific region of the body.
• Cat-scratch disease (B. henselae infection): This bacterial infection can cause swollen and painful lymph nodes, especially in the neck or armpits.
• Sporotrichosis: A fungal infection that can cause skin lesions and swollen lymph nodes.
• Tularemia: A bacterial infection caused by Francisella tularensis, which can cause fever, chills, and swollen lymph nodes.
• Staphylococcal or streptococcal skin infections: These types of bacterial infections can cause skin lesions and swollen lymph nodes.

These conditions should be considered in the differential diagnosis for MAI lymphadenitis, especially when evaluating patients with symptoms such as swollen and painful lymph nodes, fever, and other systemic symptoms [6][8].

It's worth noting that the diagnosis of MAI infection is often established through culturing the organism from the affected gland or through genetic testing to identify the presence of Mycobacterium avium complex (MAC) bacteria in the patient's sample [9].