A case of dacryocystitis due to M. haemophilum

Cervical lymphadenitis is common in childhood and is a frequent reason for consultation at the pediatric ENT clinic. It is usually caused by a viral upper respiratory tract infection and is a self-limiting condition. In children with subacute or chronic cervical lymphadenitis that fails to respond to conventional antibiotics, infection due to nontuberculous mycobacteria (NTM) should always be considered. This condition occurs predominantly in an otherwise healthy child of 1–5 years of age. Early diagnosis is essential as the treatment of choice is early surgical excision before skin necrosis and fistula occur. To the best of our knowledge, dacryocystitis due to Mycobacterium (M.) haemophilum has never been reported before. We present the case of a 9-year-old girl with fistulous dacryocystitis and cervicofacial lymphadenitis due to M. haemophilum. Its treatment proved to be difficult because complete excision of the nasolacrimal duct was deemed inappropriate, and a combination of medical and surgical treatment became necessary. This article reviews the specific clinical features, diagnostic tools and treatment of lymphadenitis due to NTM and presents a new clinical manifestation of infection due to NTM.