The pathogenesis of mycobacterial lymphadenitis is not completely understood despite the association of Mycobacterium tuberculosis with scrofula for centuries1 and of the "atypical" mycobacteria, or mycobacteria other than tuberculosis (MOTT), with cervical adenitis for more than 20 years.2 Because of the present day rarity of mycobacterial disease, the role of these microorganisms in childhood lymphadenitis is frequently overlooked. This report describes a patient whose unique site of infection and rapid progression of symptoms prompted an evaluation for lymphoma. Although the role of primary oral infections have been implicated in the pathogenesis of MOTT cervical adenitis,3 this patient represents the first case in which the relationship has been confirmed histologically and microbiologically.
Report of a Case.—A 7-year-old girl was admitted to the University of Virginia Hospital with a five-week history of fever, malaise, sore throat, and painless, cervical lymphadenopathy. Her medical history was unremarkable except for a