Role of surgery and chemotherapy for peripheral lymph node tuberculosis

Area of Science:

• Medicine
• Infectious Diseases
• Surgery

Background:

• Peripheral lymph node tuberculosis (PLNTB) is a significant extrapulmonary manifestation of Mycobacterium tuberculosis.
• Treatment strategies for PLNTB often involve a combination of chemotherapy and, in certain cases, surgical intervention.

Purpose of the Study:

• To compare the efficacy and safety of surgical excision plus chemotherapy versus chemotherapy alone in treating peripheral lymph node tuberculosis.
• To evaluate recurrence rates and complication profiles associated with each treatment modality.

Main Methods:

• A cohort of 105 patients with peripheral lymph node tuberculosis was retrospectively analyzed.
• Patients were divided into two groups: surgical excision with chemotherapy (n=35) and chemotherapy alone (n=70).
• Chemotherapy regimen included isoniazid and ethambutol for 18 months.

Main Results:

• Both treatment groups demonstrated comparable recurrence rates for lymph node masses and sinus formation.
• The surgical excision group experienced localized wound complications (infection, cellulitis), while the chemotherapy-only group had a higher incidence of non-healing biopsy sites and sinus formation.
• 13 patients in the chemotherapy-only group were lost to follow-up.

Conclusions:

• Surgical excision combined with chemotherapy is a viable option for managing peripheral lymph node tuberculosis, particularly for patients with sinus, ulcer, or abscess.
• Chemotherapy alone can be effective, but requires careful monitoring for wound complications and persistent disease.
• Both approaches show similar long-term efficacy in preventing recurrence when managed appropriately.