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Reminder of important clinical lesson
Case report
Submandibular lymphadenitis due to Mycobacterium malmoense: first reported case from Greece
  1. Elpis Mantadakis1,
  2. Chrysostomos Soultanidis2,
  3. Athanasia Christidou3 and
  4. Sofia Maraki3
  1. 1Department of Pediatrics, Democritus University of Thrace, Alexandroupolis, Greece
  2. 2Department of Pediatric Surgery, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
  3. 3Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Crete, Greece, Heraklion, Greece
  1. Correspondence to Professor Elpis Mantadakis; emantada{at}med.duth.gr

Abstract

An 8-year-old girl with subacute submandibular lymphadenitis and no other complaints is described. After failure of parenteral antistaphylococcal therapy, she underwent incision and drainage of the involved lymph node. The responsible pathogen was identified as Mycobacterium malmoense by GenoType CM assay and sequencing of the 16S ribosomalRNA (rRNA) gene. The patient remains healthy, 11 months after surgery, even though it took approximately 4 months for the surgical incision to heal completely. While M. malmoense is a relatively common cause of non-tuberculous mycobacteria (NTM) lymphadenitis in Northern Europe, this is the first reported case from Greece. We conclude that in a young child with lymphadenitis without systemic symptoms, the microbiology laboratory should be notified in advance in order to extend the duration of mycobacterial cultures. Application of molecular methods will increase the number of reported cases of rare NTM in the future.

  • otolaryngology / ENT
  • infections

https://doi.org/10.1136/bcr-2020-234657

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    Footnotes

    • Contributors EM had the idea of writing the case report, performed the literature search, wrote the manuscript and provided medical care for the patient. CS operated on the patient and helped with literature search. AC and SM performed the microbiological investigations and helped revise the manuscript prior to its submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.