Lymph Node Tuberculosis

Lymph node TB is called luoli (scrofula) in TCM, viewed as toxic phlegm-heat condensed from liver and lung. In Western medicine, it is a toxic mass formed when the lymphatic system cannot clear pathogens. It usually presents as lumps on one or both sides of the neck, gradually enlarging, painless, movable, without marked tenderness. Rupture yields watery pus then yellow turbid caseous pus. Systemic toxic symptoms include low fever, night sweats, anorexia, and weight loss.

Common Symptoms

Progressive cervical mass; lymph node TB; tuberculous toxicity; anorexia; night sweats; low fever; weight loss

Causes and Pathogenesis

Two causes: (1) Bacilli enter via the upper respiratory tract or food, forming primary foci in the mouth/nasopharynx (especially tonsils), then travel along lymphatics to superficial/deep cervical nodes, usually unilateral with pharyngeal involvement; after absorption, involved nodes continue to develop into cold abscesses or ulcers. (2) Hematogenous spread after primary infection to medial cervical nodes; or from abdominal lymph infection spreading to deep node groups; this is more common in cervical TB.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Control the source: Early chemotherapy for sputum-positive TB rapidly reduces bacilli (~100% cure); early detection and treatment is the core of modern TB control. Screen: (1) chronic cough/hemoptysis unresponsive to antibiotics; (2) close contacts of open pulmonary TB; (3) family members of strongly Mantoux-positive children; (4) industrial workers, especially silicosis patients; (5) periodic chest X-rays in endemic areas. Cut transmission: TB is airborne; do not spit. Disinfect sputum, utensils, and surroundings with UV (2 h daily/every other day); boil utensils 10-15 min; sun bedding 4-6 h; soak sputum cups/bedpans in 5-10% cresol for 2 h; best to burn sputum on paper or soak in 20% bleach for 6-8 h. BCG vaccination: An avirulent live vaccine giving ~80% protection lasting 5-10 years; booster doses are needed for those who revert to Mantoux-negative. Vaccinate infants (ideally within 3 months), schoolchildren, and new urban residents from ethnic regions; intradermal injection is preferred. BCG reduces miliary TB and tuberculous meningitis in children, but immunity is relative and other measures remain important.

Department to Visit

It is recommended to visit the Infectious Diseases 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.