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Atypical mycobacteria-induced cervical adenitis. Treatment by needle aspiration.

Atypical mycobacteria are among the most frequent causes of cervical adenitis. These unilateral nodes seldom present a treatment problem since surgical excision is curative. Occasionally, however, the affected cervical node lies adjacent to the facial nerve and/or its marginal mandibular branch. There can be a substantial risk of damage to the facial nerve and its branches in excision of such an infected mass with surrounding edema and cellulitis. An alternative and safe method of treatment in these cases is needle aspiration of the contents of mass. Of 17 cases of atypical mycobacteria-induced cervical adenitis seen at UCLA from 1975 to 1985, nine were treated by aspiration alone. None of these required further surgery. All were treated with one or more antituberculous agents during and after aspiration. This method of needle decompression of cervical nodes provides a safe and effective way to treat atypical mycobacteria infection that overlies the facial nerve and its branches.