OVERVIEW

What is lymph node tuberculosis?

Lymph node tuberculosis, also known as tuberculous lymphadenitis, can occur in almost all lymph nodes of the human body, most commonly in hilar lymph nodes and cervical lymph nodes. It is caused by Mycobacterium tuberculosis, the pathogen that causes pulmonary tuberculosis, and is the most common extrapulmonary mycobacterial infection.

SYMPTOMS

What are the manifestations of lymph node tuberculosis?

Lymph node enlargement is the most common manifestation of lymph node tuberculosis, especially in the neck, which is one of the most frequently affected areas. Other common sites include the supraclavicular and inguinal regions. Patients often seek medical attention after noticing lumps in these areas.

Infected and enlarged lymph nodes may be tender or form fistulas, discharging caseous pus. Nearby lymph nodes may also merge to form large, irregular masses. In addition to lymph node enlargement, some patients may experience low-grade fever, night sweats, weight loss, and loss of appetite.

CAUSES

Who is commonly affected by lymph node tuberculosis?

Previously, lymph node tuberculosis was thought to occur frequently in children. However, it is now found to be more common among young and middle-aged individuals with a history of tuberculosis.

Is lymph node tuberculosis contagious?

Lymph node tuberculosis is generally not contagious. However, if pulmonary tuberculosis is also present, it can be contagious.

DIAGNOSIS

What tests are needed to diagnose lymph node tuberculosis?

• If swollen lymph nodes are suspected to be caused by tuberculosis, first, it is necessary to rule out pulmonary tuberculosis. A chest X-ray or chest CT scan can be performed;

• Second, if there are no signs of pulmonary tuberculosis, routine tests such as complete blood count (CBC), erythrocyte sedimentation rate (ESR), tuberculin skin test (also called PPD test), and T-SPOT should be conducted;

• Finally, a lymph node biopsy and acid-fast staining smear test can confirm whether it is lymph node tuberculosis, while also ruling out conditions such as lymphoma or metastatic cancer.

TREATMENT

Which department should I go to for lymph node tuberculosis?

It is recommended to visit the Infectious Diseases Department or General Surgery Department for treatment.

How is lymph node tuberculosis treated?

After diagnosis, anti-tuberculosis drug therapy is required.

Currently, first-line anti-tuberculosis drugs include rifampicin, isoniazid, ethambutol, and pyrazinamide. In cases of drug resistance, second-line options include fluoroquinolones, amikacin, streptomycin, capreomycin, ethionamide, cycloserine, and para-aminosalicylic acid.

For patients with ruptured lymph nodes, local drainage, debridement, and irrigation are necessary.

How long does lymph node tuberculosis treatment last?

The most crucial aspect of anti-tuberculosis therapy is completing the full course with adequate dosage to prevent drug-resistant tuberculosis. The treatment duration is typically 6–9 months but may extend to 12–18 months.

Can lymph node tuberculosis recur?

Recurrence is possible. Completing the full course of anti-tuberculosis medication is essential to reduce the risk of recurrence and drug-resistant tuberculosis.

DIET & LIFESTYLE

What should be noted in daily life and diet for lymph node tuberculosis?

• Ensure adequate nutrition in your diet, eat more protein-rich foods such as eggs and fish to boost immunity.

• Try to avoid or minimize spicy and irritating foods, and consume more fresh vegetables and fruits.

• Engage in regular physical exercise. It is recommended to exercise for about 30 minutes daily, following the principle of not overexerting yourself.

• While taking anti-tuberculosis medications, adhere to the doctor's instructions and regularly undergo chest X-rays and tuberculin tests to monitor the condition.

PREVENTION

How to Prevent Lymph Node Tuberculosis?

• Follow the immunization plan to receive the BCG vaccine, enhancing the body's resistance to Mycobacterium tuberculosis.

• Improve nutrition, balance work and rest, and ensure adequate sleep.

• Strengthen personal protection and avoid direct contact with tuberculosis patients.