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What is the cause and treatment for TB of the cervical glands?

Tuesday, 20 September 2005
Answered by: Dr. Sandeep Saluja
Senior Consultant in Medicine,
Pushpawati Singhania Research Institute,
New Delhi
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Q. I noticed a swelling on the right side of the lower neck 4 months ago. It pained for the first few days, but ceased after taking antibiotics. I underwent scanning and FNAC, which showed development of multiple lymph nodes. The FNAC indicated only bacteria of streptococcal and staphylococcal types. My doctor told me that I am suffering from lymphadenitis. Since then I have been on antibiotics but the swelling has not decreased. I visited another doctor and underwent another FNAC, which indicates that I have TB of the cervical gland. When can I start treatment? How can I know that I am cured from TB & the dose is effective? Is surgical removal of the infected glands necessary? What diet should I take during chemotherapy? What is the cause of TB of the cervical gland? Is it possible for the mycobacteria to spread to other organs like lungs and liver?

A.  TB of cervical glands is caused by TB bacteria - Mycobacterium tuberculosis. It needs prompt anti TB medication. It may be useful to attempt culture of TB bacteria by BACTEC so that drug sensitivity may be done if culture is positive. There is unfortunately no simple test available which may give an indication of extent of response. Some parameters are useful like ESR and clinical follow up. The duration of treatment will have to be decided on follow up. Surgical removal may be necessary in some cases but surgical removal does not mean end of the disease and drugs are essential. At a microscopic level, the bacteria may have already spread to various organs even though it may not be possible to demonstrate that clinically.

A.  TB of cervical glands is caused by TB bacteria - Mycobacterium tuberculosis. It needs prompt anti TB medication. It may be useful to attempt culture of TB bacteria by BACTEC so that drug sensitivity may be done if culture is positive. There is unfortunately no simple test available which may give an indication of extent of response. Some parameters are useful like ESR and clinical follow up. The duration of treatment will have to be decided on follow up. Surgical removal may be necessary in some cases but surgical removal does not mean end of the disease and drugs are essential. At a microscopic level, the bacteria may have already spread to various organs even though it may not be possible to demonstrate that clinically.

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