Host susceptibility spectrum and diagnostic challenges in pediatric nontuberculous mycobacterial disease: a case series of five patients with literature review
Abstract
Objective: Pediatric nontuberculous mycobacterial (NTM) infections are frequently misdiagnosed due to their heterogeneous clinical presentations, which can mimic pulmonary tuberculosis, common respiratory diseases, or other infectious conditions depending on the site of involvement. This case series aimed to characterize the host susceptibility spectrum underlying pediatric NTM infection across both pulmonary and extrapulmonary sites, with emphasis on the diagnostic role of targeted next-generation sequencing (tNGS).
Methods: We conducted a retrospective analysis of five pediatric patients with confirmed NTM infection diagnosed at Fujian Provincial Fuzhou Pulmonary Hospital between January and December 2025. Clinical characteristics, predisposing factors, therapeutic regimens, and clinical outcomes were systematically reviewed and discussed in the context of relevant literature.
Results: The cohort included 5 children aged 7 months to 12 years. Pathogenic species were Mycobacterium abscessus (n = 4) and Mycobacterium paragordonae (n = 1). Infection sites included the lungs (n = 3), cervical lymph nodes (n = 1), and parotid gland (n = 1). Predisposing factors ranged from localized infection in immunocompetent children to congenital airway anomalies, DiGeorge syndrome, and cystic fibrosis with bronchiectasis. All patients improved after individualized multidrug therapy and were discharged.
Conclusions: Pediatric NTM infection is associated with a broad spectrum of predisposing…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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