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Medical vs Surgical Management

Dan J. Castro, MD; Larry Hoover, MD; Donna J. Castro, CST; Lionel Zuckerbraun, MD

Arch Otolaryngol. 1985;111(12):816-819.

Abstract
• After years in its decrease, cervical mycobacterial adenitis is once again an increasing problem in Los Angeles County. We reviewed 54 cases of cervical lymphadenopathies treated over ten years. Twenty-five (46%) of these patients were found to have mycobacterial cervical lymphadenitis. Medical approaches often failed to conclusively diagnose this disease. In our series, none of the patients with cervical adenopathies (36%) treated only medically regressed, even after an average time of 18 months of antituberculosis drug treatment. The treatment of choice seems to be surgical excision and long-term antituberculosis drugs. Surgery provides a rapid tissue diagnosis and confirms the bacterial type, including atypical mycobacterium. This approach is simple, shortens hospitalization, is cost-effective, and carries a low morbidity.

(Arch Otolaryngol 1985;111:816-819)

Author Affiliations
From the UCLA Medical Center (Drs Castro, Hoover, and Zuckerbraun), the Olive View Medical Center, Van Nuys, Calif (Drs Hoover and Zuckerbraun), and the California Paramedical and Technical College, Long Beach (Ms Castro).

Footnotes
Accepted for publication April 8, 1985.

Read before the annual scientific meeting of the Southern California Chapter of the American College of Surgeons, Coronado, Calif, Jan 19, 1985.

Reprint requests to Head and Neck Surgery Department, UCLA Medical Center, 10833 LeConte Ave, Los Angeles, CA 90024 (Dr Hoover).

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