Follow-up results of cervical tuberculous lymphadenitis

Abstract

Problem: To investigate the efficacy of medical antituberculous treatment in patients with tuberculous cervical lymphadenitis without pulmonary tuberculosis. Methods: We followed 46 patients with tuberculous cervical lymphadenitis who were treated at Dicle University, Diyarbakir, Turkey between 1996 and 2001. Mean age at presentation was 32.2 ± 14.9. Diagnosis was based on clinical findings, results of the PPD tests (Mantoux test) and histopathologic appearance of caseating granuloma, which was consistent with tuberculosis in all cases. The chief complaint was a cervical mass localized mostly to the posterior cervical and/or submandibular regions. Treatment included standard antituberculous medications including isoniasid, rifampisin, and etambutol. Treatment period was between 9 and 12 months with a mean of 7.8 months. During follow-up, excisional biopsy was performed when the lymphadenopathy was bigger than 1 cm in diameter. Results: After clinical and histopathological evaluation, recurrent disease was observed in 8 patients (17 %). Lymphadenopathy was detected in the cervical region (6 patients) mesentery (1 patient) and spleen (1 patient). Cervical excisional biopsy was consistent with tuberculosis in these 6 patients. Conclusion: Patients with tuberculous cervical lymphadenitis should have follow-ups regularly. When there is no cure, the treatment period should be extended to eradicate the disease and other treatment alternatives such as surgery should be kept in mind. Significance: Mycobacterial infections have been shown to be increasing in number worldwide. Standard anti-tuberculous drugs are used for medical treatment. Anti-tuberculous drug resistance is also becoming more frequent. Support: None reported.