Clinical and Epidemiological Profile and Treatment Outcomes of Tuberculous Cervical Lymphadenitis: A Hospital-Based...

Tuberculosis (TB) continues to be the biggest health problem in developing countries with enormous social and economic implications. The commonest form of extrapulmonary TB (EPTB) is tubercular cervical lymphadenitis, or scrofula. The diagnosis and management of TB lymphadenitis is challenging, given the multiple differentials. Also, relapse and persistence of lymph nodes (LNs) despite treatment result in significant morbidity.

A hospital-based descriptive study was conducted among 35 newly diagnosed cervical tubercular lymphadenitis patients who were initiated on anti-tuberculous treatment (ATT). Patients were followed up till treatment completion and six months post-treatment to rule out relapse.  Results: The most common clinical presentation was painless neck swelling. The most common comorbidities noted were hypertension (n = 2) and hypothyroidism (n = 2). Chronic kidney disease and diabetes mellitus were observed in one patient each. Two patients also had pulmonary TB. Six months of ATT were advised for all the patients initially. Thirty-four patients completed treatment. One died during the fourth month of treatment. Eighteen patients had complete resolution of LNs, and three patients required extension of treatment. No paradoxical reactions or drug-induced hepatitis were observed.  Conclusions: Extrapulmonary TB (EPTB) contributes to one-third of cases of TB. Microbiological confirmation of TB is essential even when pathological confirmation exists. Patients with cervical adenitis show an excellent response to first-line ATT, and six months of treatment is sufficient. Post-treatment follow-up for six months revealed no relapse. The study results need to be confirmed in a larger sample size.