Nontuberculous mycobacterial sinusitis in children with cystic fibrosis☆

Summary 

Objective

Only 13 cases of nontuberculous mycobacterial (NTM) sinusitis have been reported in the literature, the majority in patients with AIDS. We report three pediatric patients routinely followed at our cystic fibrosis (CF) center with sinus cultures positive for NTM.

Methods

Case report and review of the literature.

Results

One patient had positive NTM sinus cultures after a sinus procedure and was then noted to have NTM on sputum cultures. The second patient was noted to have NTM on bronchoscopy and then underwent sinus cultures demonstrating the same organism. The third patient had NTM in the sinuses on routine endoscopic sinus surgery and is still undergoing further evaluation.

Conclusions

Questions arise as to whether disease in the lungs is affected by a reservoir in the sinuses and should sinus cultures and debridement be performed in all cases of NTM lung disease in CF patients. Since NTM has been increasing in prevalence in sputum cultures in the CF population, its existence in the sinuses should be considered when these patients present with sinus disease.

Keywords: Nontuberculous mycobacterium, Acid-fast bacilli, Atypical sinusitis, Mycobacterium abscessus, Cystic fibrosis, Pediatric sinusitis