A germ from the mycobacterium family, Mycobacterium tuberculosis, causes tuberculosis (TB). A related species of M tuberculosis, which doctors call non-TB mycobacteria (NTM), can cause other illnesses in children and adults.
Although there are many species of NTM (more than 80, according to the Centers for Disease Control and Prevention), the most common in childhood are M avium, M intracellulare, and M fortuitum. Many of these species are found in soil, food, and water. They enter the body through cuts in the skin, via the gums during teething, or through the respiratory tract during normal breathing. Even though many children are exposed to these germs, only a few ever develop a chronic infection or disease.
In youngsters, the most common NTM infection is called cervical lymphadenitis, an inflammation of the lymph nodes in the neck. Other infections occur much less commonly, including bone inflammation (osteomyelitis), ear infections, lung disease, and skin infections.
These NTM illnesses sometimes occur in children with human immunodeficiency virus (HIV) infections. In fact, children and adults with weakened immune systems may be at a higher risk for NTM diseases.
Signs and Symptoms
The signs and symptoms of NTM infections depend on factors such as the specific site involved and species of the bacteria. They may include
- Swollen lymph nodes
- Fever
- Weight loss
How Is the Diagnosis Made
Your pediatrician will take cultures from the lymph nodes, blood, or lungs to test for NTM.
Treatment
If your child has lymphadenitis, your pediatrician may recommend surgically removing the lymph nodes that have become infected. Antibacterials such as clarithromycin, azithromycin, and ciprofloxacin are often prescribed for other forms of NTM.
Choosing the best medicines for NTM infections depend on factors such as the specific species of germ causing a child’s illness and part of the body that has become infected. Some strains of NTM are resistant to most medicines. Your doctor will choose medicines carefully to make sure that they’ll be effective.
Prevention
For children 6 years or older with an HIV infection, pediatricians may prescribe preventive use of certain medicines such as azithromycin or clarithromycin to prevent M avium illnesses from developing.