Diagnosing nontuberculous mycobacterial cervicofacial lymphadenitis in children: An updated systematic review | ||
| Microbes and Infectious Diseases | ||
| Volume 6, Issue 3, August 2025, Pages 3086-4004 PDF (931.08 K) | ||
| Document Type: Systematic review or meta-analysis | ||
| DOI: 10.21608/mid.2025.324731.2256 | ||
| Authors | ||
| Mohammad Mohammadi1; Narges Norouzkhani2; Motahare Rouhparvarzamin3; Shaghayegh Afshari4; Atena Rahmanifar5; Ata Akhtari kohnehshahri6; Ali Ghadam7; Aida Mehrani8; Sepide Mohit9; Hadiyeh Dadras10; Nasrin Mohammadi11; Farzad Sheikhzadeh12; Alireza Ghajary13; Kourosh Mousazadeh14; Yaser Khakpour15; Mahta Malek16; Parisa Behshood17; Mohadeseh Poudineh* 18; Niloofar Deravi* 19 | ||
| 1School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| 2Department of Medical Informatics, faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran. | ||
| 3Student research committee, school of nursing and midwifery, Shahid sadoughi University of medical sciences, Yazd, Iran. | ||
| 4Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran | ||
| 5Student Research committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. | ||
| 6Student Research Committee, Faculty of medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran | ||
| 7Medical student, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Iran | ||
| 8Faculty of medicine, Isfahan University of Medical Sciences, Isfahan, Iran. | ||
| 9Student Research Committee, School of Medicine, Shiraz University of Medical Science, Shiraz, Iran. | ||
| 10Department of Medical Informatics, faculty of medicine, Babol University of Medical Sciences, Babol, Iran. | ||
| 11Faculty of medicine, Iran University of Medical Sciences, Tehran, Iran. | ||
| 12School of medicine, Iran University of Medical Sciences, Tehran, Iran | ||
| 13School of pharmacy, Mashhad University of medical science, Mashhad, Iran | ||
| 14Medical doctor, school of medicine, Islamic Azad university, Tehran medical branch, Tehran, Iran | ||
| 15Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran | ||
| 16Faculty of Dentistry, Tehran Medical Science, Islamic Azad University, Tehran, Iran | ||
| 17Department of Microbiology, Young Researchers and Elite Club, Islamic Azad University, Shahrekord, Iran | ||
| 18School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. | ||
| 19School of medicine, Shahid beheshti universityof medical sciences | ||
| Abstract | ||
| Background: Nontuberculous mycobacterial (NTM) cervicofacial lymphadenitis is an emerging infectious disease that affects children. Regarding the correct diagnosis of NTM cervicofacial lymphadenitis, there is widespread controversy. This updated systematic review aimed to reevaluate the efficacy and safety of diagnostic methods for NTM cervicofacial lymphadenitis. Methods: We systematically searched the databases PubMed, Web of Science, Embase, and Google Scholar (from March 3, 2017, through January 11, 2023) to detect relevant studies, using Mesh keywords. Inclusion criteria were i) NTM cervicofacial lymphadenitis studies, ii) Reports on patients under 18 years old, iii) Reports on diagnostic methods. Immuno-incompetent patients, studies that reported adults, and non-clinical studies (laboratory studies, technical notes, letters to editors, reviews) or case reports/series were excluded. Results: 512 patients between the ages of 0 and 18 are included in eight research studies. Diagnostic accuracy of acid-fast bacilli (AFB) staining, histology, culture, polymerase chain reaction (PCR), tuberculin skin test (TST), immunodiagnostic assays, enzyme-linked immunosorbent spot assays, and radiomic features were studied. Culture sensitivity was 67.2%, while PCR sensitivity was 92%, AFB staining specificity was between 80 and 100%, and sensitivity was between 46 and 85%. Using radiomic markers to differentiate benign from malignant lymphadenopathy has a specificity of 93% and sensitivity of 91%. Conclusion: This review indicates that isolation of the specimen by PCR or culture is still required for the precise identification of mycobacterial infections. While TST can not distinguish between tuberculosis (TB) and NTM, interferon-gamma release assays (IGRAs) and radiomic analyses, show promising sensitivity and specificity and reduce the need for invasive procedures. | ||
| Keywords | ||
| Cervicofacial lymphadenitis; Children; Diagnosis; Nontuberculous mycobacteria; Systematic review | ||
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