Why does my wife gets recurring nodes in the neck?

Q: My 36 years old wife has three nodes in her neck. An ENT specialist prescribed some antibiotics and the problem got solved but it re-appeared again after sometime. This was the third time the nodes reappeared at the same place. Five months back the doctor said that the infection was severe (ESR was 46). Now three days back the ESR was 86. The doctor advised for Mantoux test (TB test), which was negative. He also advised a chest x-ray and to consult a chest specialist. Is the treatment in the right direction? Why do the nodes in the neck re-appear even after taking antibiotics? Is it related to TB? She is suffering from skin allergy too for the last 8-10 years. She gets itching and rashes on the skin. She has used many medicines earlier and now itching is not much. Please advise.

A:Your 36-year-old wife has three neck nodes, which have become larger thrice in the past seven months. These episodes of enlargement are associated with pain. The significant point is that they do become smaller with some medicines (antibiotics) given by your doctors. Such enlargement is usually due to infection by bacteria. One of the bacteria is the tuberculosis bacterium. Hence, the correct way to proceed is to look for any infection in the throat. Because you had already seen an ENT specialist, he would have excluded this possibility.
The next step will be to see a chest specialist to find out whether there is any TB in the chest and in the neck nodes. Whatever it is, it needs to be investigated. Occasionally, the lymph nodes themselves may become larger due to other reasons. Hence, a definitive step will be to give some more antibiotics, take a test called fine needle aspiration cytology (FNAC). This is a simple test, which can be done as an office visit to a pathologist, in minutes. If a diagnosis is still not reachable, we can remove one of the nodes and test the same.
Such investigations do take some time. You need not despair because of the delay. For every such illness, very good treatment methods are now available.