Mycobacterium abscessus Cervical Lymphadenitis Mimicking Tuberculosis in China: A Case Report.

Mycobacterium abscessus (Mab) is recognized as the most pathogenic mycobacterium affecting humans, comprising three phylogenetic subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. bolletii, and M. abscessus subsp. massiliense. Its clinical manifestations are varied and frequently subject to misdiagnosis. Mab exhibits both intrinsic and acquired resistance to numerous antibiotics, which results in limited therapeutic options and poor clinical outcomes. This report details a case of cervical lymphadenitis caused by Mab, initially misdiagnosed as tuberculosis. During anti-tuberculosis therapy, the patient's symptoms initially improved but subsequently deteriorated. Diagnosis of Mab infection was confirmed through high-throughput sequencing. However, due to the delay in accurate diagnosis and treatment missteps, the patient ultimately succumbed to a central nervous system (CNS) Mab infection. Consequently, early and precise diagnosis is imperative for the effective management of Mab infections.