Tuberculosis of peripheral lymph nodes

Most often affects the cervical lymph nodes (deep), somewhat less - underarm, sometimes amazed at the same time, many groups of lymph nodes (generalized lymphadenitis).
Often the outer tuberculous lymphadenitis occurs as a complication of primary TB lymphogenous or hematogenous route of primary pulmonary complex. These lymphadenitis in 75% of cases are related to a primary infection. However, they also occur in the secondary period of tuberculosis as a flash of the old hearth. On the classification of N. A. Shmelev, allocate lymphadenitis primary and secondary, and morphological picture - infiltrative, caseous-purulent and indurativnyy. There are transitional forms.
Primary lymphadenitis have a greater tendency to cheesy disintegration, fusion and fistula formation.
Begins peripheral lymphadenitis with the appearance of puffiness, which gradually increases. At a palpation find a lumpy mass education, consisting of soldered between the lymph nodes. In the future, the skin over it thin, red and breaks with the formation of a fistula. Outward facing liquid cheesy mass, and fistula long time does not heal. The General condition changed little, but the temperature for a long time remains low; the blood - accelerated ROHE and neutrophilia. Long: from several months to several years, with occasional outbreaks and relapses. Healing comes close fistula education inverted scars. Primary lymphadenitis can be a source of generalization process. This raises the lesions in other organs, bones, skin, eyes, etc.
Secondary lymphadenitis occur in adolescents and adults; proceed as more limited process. Lymph nodes reach the significant value (of a chicken egg and more), but usually without softening and fistula formation. In the treatment gradually decrease, compacted.
Differential diagnosis of tuberculous lymphadenitis is usually done with acute infectious lymphadenitis. In favor of the latter say a strong pain, rapid melting, no peradenia. With chlamydia usually increase the lymph nodes in the front cervical triangle in the form of dense conglomerate and without inflammation around. Biopsy.
When tularemia swelling occurs without sharp separation, quickly grow painful perident and melting. In the discharge of fistula prevails pus over caseosa.
Treatment of external lymphadenitis: antibacterial therapy of stimulating and desensitizing funds. In the initial period prescribed streptomycin, PAS and ftivazid with the addition of corticosteroids; then move on to two drugs (PAS and ftivazid). The course of treatment 6-9 months. depending on the severity and extent of the process. When relapse courses repeated. The outcome is usually favorable, but possible relapses.
Tuberculosis separate bodies - see about the authorities.