Role of surgery and chemotherapy for peripheral lymph node tuberculosis

A total of 105 patients with peripheral lymph node tuberculosis were treated by either surgical excision and chemotherapy or chemotherapy alone. The cervical nodes were affected in 98 patients, axillary nodes in four and inguinal nodes in three. Biopsy of the lymph nodes confirmed the diagnosis in all cases. Thirty-five patients who had sinus, ulcer or abscess underwent excision of the lymph nodes with drainage of the abscess, or resection of the sinus or ulcer. The remaining 70 patients received only chemotherapy. Chemotherapy in all patients consisted of isoniazid and ethambutol for 18 months. Of the 35 patients treated with surgery and chemotherapy, two had gaping wounds, one infection and one cellulitis of the face and neck. After 3 months, one patient had recurrence of the lymph node mass and one recurrence of a sinus; these were excised. Of the 70 patients treated only with chemotherapy, 13 were lost to follow-up. Four had non-healing wounds at the biopsy site, six wound infection and two sinus formation. Five of these patients had persistent lymph node masses, which were excised after 3 months. The remaining 52 patients had no recurrence.