Medical Care

See Medication.

Surgical Care

Pediatric neck abscesses remain common problems that are sometimes difficult to manage.^[76]Surgical excision of infected nodes is recommended for immunocompetent children with suppurative adenitis secondary to M avium complex (MAC) and M scrofulaceum. The temptation is great to incise and drain the abscess cavity when fluctuant involvement is present. If this is done, a draining sinus usually persists until discharge of the involved lymph nodes beneath the skin has taken place over a period of months or years.^{[23, 7]}Careful attention should be paid to avoid any injury to the mandibular branch of the facial nerve because it is often adherent to the tract.^[23]

Consultations

Disseminated MAC disease is best treated in collaboration with a pediatric infectious disease specialist with experience in the treatment of pediatric HIV infection.

Diet

Diet should be individualized in the presence of gastrointestinal complications such as diarrhea and vomiting. Moderate and severe dehydration should be treated accordingly. Nutritional intervention such as nasogastric feeding and hyperalimentation through a central catheter, gastrostomy tube feeding, or jejunostomy tube feeding in the presence of gastroparesis should be considered. Oral feeding can be resumed when appropriate to improve the patient's quality of life.

Activity

Patients who are acutely or chronically ill may be weak and debilitated. Caloric loss and poor intake may restrict their daily activities. Pain relief treatment in the presence of recurrent abdominal pain is necessary to keep patients comfortable.

Medication

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