Clinical Features and Treatment of Cervical Tuberculous Lymphadenitis / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Cervical tuberculous lymphadenitis is the most common form of peripheral tuberculous lymphadenitis. The American Thoracic Society recommends 6 months of isoniazid, rifampin, ethambutol and pyrazinamide for treatment of peripheral tuberculous lymphadenitis, but even with this recommended treatment, frequent relapse occurs in actual clinical situations. MATERIAL AND METHOD: The medical records of 38 patients diagnosed and treated for cervical tuberculous lymphadenitis between February 1997 and February 2007 were retrospectively reviewed. RESULT: The study included 14 males (36.8%) and 24 females (63.2%), with a mean age of 36.9+/-16.3 years. The most frequent symptom was palpable neck mass in 24 patients (63.2%); 10 patients (26.3%) complained of fever or chills. Only nine patients (23.7%) had radiologic abnormalities. All patients received anti-tuberculous medications for at least 7 months, with isoniazid, rifampin, ethambutol and pyrazinamide for the first 2 months, and then isoniazid, rifampin and ethambutol given for more than 5 months. Relapse occurred in 7 patients (21.2%). CONCLUSION: Since many patients with cervical tuberculous lymphadenitis have no symptoms and show no radiologic abnormalities, diagnosis and treatment tend to be delayed. Considering the high relapse rate, the anti-tuberculous medication period should be longer than 6 months and this is recommended by the American Thoracic Society.