Cervical lymphadenitis from Mycobacterium avium complex

BMJ Case Rep. 2024 Mar 15;17(3):e256726. doi: 10.1136/bcr-2023-256726.

Abstract

We present an instructive case of cervical lymphadenitis in a young man without a history of HIV infection. The patient developed spontaneous left-sided neck swelling that progressed over 4 months. CT imaging demonstrated a necrotic left-sided neck mass within the cervical lymph node chain. He was initially prescribed azithromycin and rifampin for presumed cat scratch disease with improvement but incomplete resolution of symptoms. Blood cultures ordered 2 months later grew Mycobacterium avium complex (MAC) and the patient had an excellent clinical response to MAC therapy. Here, we review the case, including presentation and management, and describe the implications for the immune status of the host and long-term considerations for treatment.

Keywords: Immunology; Infectious diseases.

Publication types

  • Case Reports

MeSH terms

  • HIV Infections* / drug therapy
  • Humans
  • Lymphadenitis* / diagnosis
  • Lymphadenitis* / drug therapy
  • Lymphadenitis* / microbiology
  • Male
  • Mycobacterium avium Complex
  • Mycobacterium avium-intracellulare Infection* / diagnosis
  • Mycobacterium avium-intracellulare Infection* / drug therapy
  • Rifampin / therapeutic use

Substances

  • Rifampin