A case of cervical lymphadenitis due to a difficult-to-diagnose nontuberculous mycobacterial infection

Abstract

We report a case of cervical lymphadenitis caused by a rare nontuberculous mycobacterial infection (NTM infection), which was suspected to be tuberculosis by rapid intraoperative diagnosis. The patient, a 69-year-old man, was referred to our department for a thorough examination of a left-sided submandibular mass measuring 35 × 20 mm, which was pointed out by a local dentist. A needle biopsy was performed, however a diagnosis could not be made. We performed a left-sided submandibular gland tumor resection under general anesthesia. An intraoperative rapid diagnosis of tuberculosis was performed to help determine the extent of the resection. However, Mycobacterium intracellulare was detected in the postoperative bronchial lavage fluid, and cervical lymphadenitis caused by NTM was diagnosed. More than two years have passed since the surgery, and no recurrence has been observed.