Brief Answer:
Need ultrasound and biopsy

Detailed Answer:
Hi,

Most lymphadenitis take 3-4 weeks after start of antibiotics to settle down. Its management depends on the cause like tooth decay, sore throat, tonsils, etc. It doesnt seem to be an emergency as you do not have any symptoms of its flaring up.

Ideally its management will include ENT specialist or surgeons visit if the lump does not resolve in 3 weeks time. An ultrasound of the swelling and biopsy sent to pathology (if service is available).

Maybe you can visit emergency or surgeons office if there is spread of the lump or fever, weight loss, severe sore throat, headache, pain abdomen and other signs of toxicity appear. Till then you can manage it symptomatically with Ibuprofen, prebiotics, cold compressions, etc. If you see pus or abscess then it will require incision and drainage by a doctor asap.

Hope this helps. Let me know if I can assist you further.
Thanks
Dr Vaishalee

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Brief Answer:
Biopsy does not require hospitalisation

Detailed Answer:
Hi again

How big does the lymph node become? If you can measure its diameter with a scale, please let me know.
Biopsy involves insertion of a thick needle into lymphnode and taking out some tissue to examine under microscope. You will need to do it when your surgeon thinks appropriate. Mostly small lymph node enlargements are best ignored. Lymph nodes do take many weeks to resolve even after infection has been cured.
If the lymph node has been there for long time or shows signs of some particular disease like cancer, tuberculosis etc then surgeon may order it to confirm diagnosis. Or they may do something else like incision and drainage or lymph node removal and send it for pathology.
First step would be to get to the root of the problem.

Yes you can increase frequency of warm compresses to every hour or 2 hrs.

This is most probably an infection. If there is a focus of infection that didnt get treated with antibiotics, then some surgical approach will be needed. Your ENT or surgery specialist doctor will be able to find it.

I dont think its serious till now. Having pain also indicates infection or past infection. If it is some other diagnosis or it spreads quickly then you will need urgent help. Chances of lymph node becoming serious are low. Lynph nodes are like policemen that help fight infection and may become enlarged and painful as a result.
If you take general precautions like drinking cleaner water, hygienic food, wash hands, prebiotics use, etc might help resolve the issues. Regular exercise helps build immunity.

Dr Vaishalee

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Brief Answer:
It does not lead to cancer at all

Detailed Answer:
Hi
Thanks for reverting back with details. You could have sent me approximate diameter of node.

Its not cancer and will not grow into cancer as its some ordinary infection. Lymph node is only trying to clean the infection. That is its job. It can increase in size for this purpose. It will decrease in size when infection is cleared. We need to find the infection and other focus will be on finding it.

Cancers definitely have alarming symptoms like weight loss, fatiguability, excess sweats, swollen abdomen , rock hard feel of lymph nodes, no pain at lymph nodes etc.

You are worrying unnecessarily.

Dr Vaishalee

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Brief Answer:
I would confirm it with a second test

Detailed Answer:
Hi again
And sorry to know that you are being detected with TB lymphadenopathy.

I will definitely run atleast 2 tests to confirm the diagnosis. The test will include tuberculin skin test and biopsy of lymphnode. Biopsies are done to confirm the diagnosis. Since you are scared of biopsy and in many countries its not done in routine, you can simply go for tuberculin skin test and chest XRay PA view. Chest Xray will exclude any lung involvement. If you get sputum then it can be sent for culture.

No, ultrasound of neck will not serve the purpose in your situation. If we were suspecting some benign lump like lipoma etc, it would have helped.

Dr Vaishalee

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Brief Answer:
Biopsy does not require hospitalisation or rest

Detailed Answer:
Hi

Biopsy is a minor procedure and does not require hospitalisation or bed rest. There will be slight discomfort at the site of injection.

One reason that can bring you back to XXXXXXX is weakness from the antitubercular medicines. After start of therapy, if you will not be able to handle your daily chores like cooking etc for yourself, then you may come back to your family. As an alternative you can get someone from your family there to help you. Otherwise, most people do survive by themselves while on medicines.

Another reason could be company or country laws. Every country has different laws for tuberculosis. In some places they isolate the patient and not allow him/her to work or come close to others during the infectious (contagious) period. So do check your country laws. Though I think that it should not be contagious as its in lymphnodes only.

It is good that chest X ray is normal.

Dr Vaishalee

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Brief Answer:
No stitches after biopsy

Detailed Answer:
Hi

Stitches are required if the whole lymph node is removed surgically and sent for pathology analysis. When a small quantity of tissue is removed with a thick needle and syringe for biopsy, then stitches are not needed.

MDR TB means that many antibiotics are not able to kill TB bacteria.

MDR-TB in new case of tubercular lymphadenopathy, its prevalence in XXXXXXX population is around 2%. It's risk is very less. Since you are a new case , you will require treatment that is same as pulmonary TB only. MDR TB requires injectable antibiotics that can have more side effects and their efficacy is also less. Such injectables are not required in your case. MDR treatment is given only after confirming antibiotic resistance in culture and sensitivity tests.

Hope it answers your question.
Dr Vaishalee

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