Cervical Lymph Node Tuberculosis

Cervical lymph node TB (luoli in TCM). Bacilli usually enter from the mouth (carious teeth) or tonsils, with no visible lesion at the entry site; a few are secondary to pulmonary/bronchial TB. It mainly presents as local cold abscesses, with few systemic symptoms such as low fever, night sweats, or weight loss. Late nodes caseate and rupture into chronic sinuses discharging watery caseous pus. Comprehensive treatment combining standardized anti-TB therapy with surgical excision or curettage promotes recovery.

Common Symptoms

Acute nonsuppurative...; lymphadenopathy; abscess

Causes and Pathogenesis

(1) Etiology: The main pathogen is human-type M. tuberculosis; bovine infection from unpasteurized cow's milk is rare in China. Two routes: bacilli form primary foci in tonsils/carious teeth, then via rich submucosal lymphatics infect superficial/deep cervical nodes, especially nodes high beneath the mandible; the primary focus is usually clinically undetectable. Or pulmonary primary foci spread lymphohematogenously; mediastinal node TB ascends lymphatically, mainly involving supraclavicular or lower sternocleidomastoid deep nodes. (2) Pathogenesis: Lymph nodes filter and produce lymphocytes. Primary infection sensitizes immune-active lymphocytes, triggering cellular and humoral immunity with lymphokines and antibodies; macrophages are activated. With low bacillary load and small tissue damage, bacilli are eliminated and foci resolve or leave minimal fibrosis. With heavy aggregation, caseous necrosis occurs; small amounts are absorbed, large amounts form fibrous capsules that may partially calcify. With low resistance and heavy bacillary load, caseous tissue liquefies into abscesses that rupture node capsules, infect surrounding tissue, or drain to skin; recurrent improvement/deterioration forms scarred fistulas discharging pus.

Treatment

Anti-tuberculous therapy

Preventive Measures

1. BCG vaccination per immunization schedule to enhance resistance. 2. Exercise to improve fitness. 3. Nutrition, balanced work/rest, adequate sleep. 4. Personal protection, avoid direct contact with TB patients. 5. Oral hygiene, early treatment of caries and tonsillitis.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.