Legionella-associated Granulomatous Cervical Lymphadenitis in Three Pediatric Patients: Utility of Broad-range Polymerase Chain Reaction

Cervical lymphadenitis is a common infection in the pediatric population and can be caused by bacteria, viruses, fungi and mycobacteria. In addition to traditional culture methods, we recently began sending fresh frozen tissue for broad-range polymerase chain reaction, which identified Legionella species as the pathogen in 3 clinically unsuspected cases that would not have been detected otherwise, given that recovery in culture requires specialized media. Furthermore, all 3 cases were associated with granulomatous inflammation, a pattern that is typically associated with fungal or mycobacterial infection and has not been associated with Legionella .