Swellings in neck due to Cervical Tuberculosis Lymphadenitis are curable in 6 months
What is Cervical Tuberculosis Lymphadenitis?
The enlarged cervical lymph nodes in simple words are swellings in the neck due to lymph nodes, it is medically termed as cervical lymphadenopathy. There can be various reasons for enlarged cervical lymph nodes among which tuberculosis (TB) is also one of the causes. The tuberculosis of the lymph nodes of the neck is termed Cervical Tuberculosis Lymphadenitis.
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What are lymph nodes?
Before knowing about Cervical Tuberculosis Lymphadenitis, it is important to understand the lymphatic system of the body. The lymphatic system in our body protects us from germs, controls the body’s fluid system, and works to store some nutrients and remove waste materials from the body.
There are mainly 3 things that come under the lymphatic system:
- Lymph – It is a clear, water-like substance, that does not flow in the blood vessels but keeps flowing in a separate vessel system. White blood cells are also found in this liquid.
- Lymphatic vessels – Lymph fluid keeps flowing in this vessel system.
- Lymph node – In the path of lymphatic vessels, there are small knots (nodes) smaller in size than a pea, where white blood cells accumulate. Lymph nodes act like sieves and filter out lymph, bacteria and viruses, or other foreign particles. Bacteria and viruses that have entered the body are captured and destroyed by white blood cells.
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Causes of increase in size of Cervical lymph nodes in the neck
Lymph nodes are so small in normal conditions that they are not felt even by touching the neck. But the size of lymph nodes may increase due to various reasons, then they not only become visible but also a lump can be palpated in the neck by touching it.
Common causes of lumps in the neck due to enlarged cervical lymph nodes are:
- Mouth infections
- Oral Ulcers
- Throat infections such as cold, sore throat
- Tonsil infection
- Dental infection
- Ear infection, etc.
There are also some rare causes of an increase in the size of lymph nodes in the neck, such as cancer, autoimmune diseases, some rare viral diseases, AIDS, and tuberculosis of Lymph nodes.
How to know, whether the swelling in neck are due to a common or rare cause?
If the lymph nodes have enlarged due to common causes, then these lymph nodes will become smaller in a few days, after the underlying cause such as infection of the mouth, throat, ear, etc. is relieved. But if the size or number of cervical lymph nodes is continuously increasing, then the reason for this may be something unusual, and in such a situation, the exact reason for the enlargement of lymph nodes should be investigated.
TB of Lymph Nodes
Tuberculosis of lymph nodes is an extrapulmonary TB, i.e. TB occuring outside the lungs. TB of lymph nodes is the most common type of extrapulmonary TB (35%). It occurs in children up to the age of 14 years at the rate of 4.4 patients per 1000 population. This disease can occur in a person of any age.
Cervical Tuberculosis Lymphadenitis occurs mostly in the neck. Due to this, the size of lymph nodes normally found in the neck increases, and they become visible in the neck. These lumps can be on any side of the neck, on the right or left side, one or more in number, separate or matted.
Symptoms of TB of Lymph node
Cervical Tuberculosis Lymphadenitis patient has the following symptoms;
- Swollen neck lymph nodes
- Pus-filled neck lymph node
- This pus can burst and form a draining sinus
- Common TB symptoms such as fever, lack of appetite, weight loss, constant fatigue
How is the diagnosis of Cervical Tuberculosis Lymphadenitis made?
If you start seeing small lumps in your neck, you should consult a doctor. The enlarged neck nodes due to common causes will regress to normal after few days of treatment, but in Cervical Tuberculosis Lymphadenitis the swelling shall persist for few days.
Examination: A physical examination of these lumps is done by the doctor.
Ultrasound: A detailed examination of these lymph nodes is done through ultrasound examination of the neck. It is seen how many lumps there are, what is their size, where they are located in the neck, and whether pus is accumulating or not.
FNA test: Some large-sized lymph nodes are examined with a needle, and then the material taken out in this process is tested through various tests like cytology, CBNAAT, culture test, etc. to diagnose whether the cause is Tuberculosis.
Biopsy: A piece of the neck lump is removed through a minor operation and then this tissue is examined to confirm the presence of TB in it.
Treatment of the Tuberculosis of neck lymph nodes
TB disease occurring in lymph nodes is treatable. Cervical Tuberculosis Lymphadenitis can be completely cured by taking TB medicines for 6 months or more. On proper intake of first-line TB medicines; Rifampicin, Isoniazid, Ethambutol, and Pyrazinamide, these lymph nodes become smaller and get cured soon.
Under the National Tuberculosis Eradication Program, TB treatment is provided free of cost in India. The detailed guidelines about Treatment of Cervical Tuberculosis Lymphadenitis for the health care personal can be accessed from GOI ,ministry of health and family welfare website-https://tbcindia.mohfw.gov.in/
In the tuberculosis treatment by the DOTS system, the government provides TB medicines free of cost from the DOTS center nearby to the patient’s home.
The large sized neck node can also be surgically excised and so as the patient may feel cosmetically better.
Nutrition is of special importance in the treatment of any type of TB disease. All patients with Cervical Tuberculosis Lymphadenitis are also especially advised to eat a good nutritious diet.
When to seek Specialist's advice?
In the disease of lymph nodes TB, a consultation with a specialist providing treatment in TB disease is required if:
- There is any doubt in the diagnosis of Cervical Tuberculosis Lymphadenitis and the patient is in dilemma.
- If the expected results are not being achieved during the treatment, and these neck lumps are increasing, or are not getting cured.
- If the type of disease is found to be due to drug-resistant Mycobacterium Tuberculosis organism, then a specialist in managing MDR TB cases should be consulted.
Follow up visits
Patients who are cured of Cervical Tuberculosis lymphadenitis should be vigilant for any recurrence of lymph node tuberculosis. They should be watchful for any new swelling of lymph nodes in the neck region.
A regular follow-up visits to your doctor, every 2-3 months for the next 02 years after completion of treatment is advisable for the patients of Cervical Tuberculosis Lymphadenitis.
Disclaimer: This article is written only for the purpose of essential information and to increase health awareness, and does not replace expert medical advice under any circumstances. The readers may contact medical expert <Contact Us> in case wish to know further about the related health condition.
