Clinical characteristics and treatment outcome in Tubercular lymphadenitis patients- A prospective observational...

Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis. This study was primarily designed to assess clinical characteristics of Peripheral tubercular lymphadenitis and incidence of Paradoxical reaction.

It is a prospective observational study for 130 peripheral Lymph node tuberculosis patients diagnosed and treated between 1st Jan 2018 to 31st Dec 2019. All statistical analyses were performed using statistical software SPSS version 20 (SPSS Inc, Chicago, USA). A P value of <0.05 is considered significant.

Out of 130 study patients, 54 were male, and 76 were female, with a sex ratio of 1:1.4. The mean age of the patients was 28.01 years (±12.41). Almost one-fourth of study patients (25.38%) had symptoms for more than one years before the diagnosis of tubercular lymphadenitis. Of the 130 patients, 62 (47.69%) were classified as having confirmed TB based on AFB positivity in FNAC sample. More than half of study patients (55.38%) received homoeopathic treatment before initiation of anti-tubercular treatment. The most common Lymph node involved was cervical (66.15%). Forty-six (35.38%) patients developed Paradoxical reaction, and most of this occurred in the first two months of the initiation of Anti-tubercular treatment. Fifty-eight patients (44.61%) had a residual Lymph node of size more than one centimetre after six months of treatment. Only 9 patients out of 54 patients had significant reduction in the size of the lymph node with 9 months of treatment.

Significant number of patients had residual lymph node at the end of 6 months of treatment, but extending the treatment to 9 months was not beneficial. More than half of patients had history of homoeopathic treatment that could lead to delayed presentation. The paradoxical reaction is very common but most of it subsided spontaneously.