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Méndez, A.Autor o CoautorAlves Ferreira, F.Autor o Coautor
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Artículo

Adenitis por micobacterias no tuberculosas

Publicado en:ANALES DE PEDIATRIA. 66 (3): 254,259- - 2007-01-01 66(3), DOI:

Autores: Méndez, A; Baquero Artigao, Fernando; García Miguel, M J; Romero Gómez, María Pilar; Alves Ferreira, F

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Resumen

Objective: To study the clinical features, epidemiology and outcome of nontuberculous mycobacterial lymphadenitis (NTML). Methods: A retrospective study was performed on 54 patients under 14 years old diagnosed with atypical mycobacterial lymphadenitis between 1987 and 2004. Inclusion criteria were: (i) positive polymerase chain reaction (PCR) test or culture; (ii) positive sensitin skin test 6 mm above Mantoux; (iii) histopathologic features compatible with mycobacterial infection and/or positive direct smear for acid-fast bacilli, Mantoux reaction less than 15 mm, a normal chest radiograph, absence of exposure to an adult with tuberculosis, negative Mantoux test reactions in family members, and exclusion of other causes of granulomatous adenitis. Results: Fifty-four patients were included in the study. The number of NTML cases increased notably from 1996, coinciding with a decrease in cases of tuberculous adenitis. The mean age was 35 months (range: 14 months-6 years). Submandibular nodes were involved in 22 of 63 cases of adenitis (34.9 %) and cervical nodes were involved in 21 (33.3 %). In 8/42 patients (19%) the tuberculin skin test was larger than 10 mm. Cultures were positive in 52.9% of the cases (18/34) and PCR in 53.3% (8/15). The most frequently isolated mycobacteria was Mycobacterium avium (61 %). Therapy failed in 8/21 patients receiving antibiotics (38%), in 10/13 patients with drainage alone (77%) and in none of the patients who underwent surgery (8/8). Conclusions: Nontuberculous mycobacterial adenitis has become more frequent in our hospital since 1996. Cultures do not always allow isolation of mycobacteria and the Mantoux test frequently yields false positive results, thus hampering diagnosis. The most effective treatment was surgical excision. Nevertheless, when the surgical approach is difficult or there is postoperative recurrence, pharmacological treatment can be useful.

Palabras clave
General medicineMedicina iMedicina iiPediatricsPediatrics, perinatology and child health

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Impacto bibliométrico. Análisis de la aportación y canal de difusión

El trabajo ha sido publicado en la revista ANALES DE PEDIATRIA, Q3 Agencia Scopus (SJR), su enfoque regional y su especialización en Pediatrics, Perinatology and Child Health, le otorgan un reconocimiento lo suficientemente significativo en un nicho concreto del conocimiento científico a nivel internacional.

Análisis de liderazgo de los autores institucionales

Existe un liderazgo significativo ya que algunos de los autores pertenecientes a la institución aparecen como primer o último firmante, se puede apreciar en el detalle: Primer Autor (MENDEZ ECHEVARRIA, ANA MARIA) y Último Autor (ALVES FERREIRA, FRANCISCO JAVIER).