Mycobacterial cervical lymphadenitis: role of surgery
Mani, R.; Belcadhi, M.; Harrathi, K.; Rejeb, A.B.; Benali, M.; Abdelkefi, M.; Bouzouita, K.; Bouzouita, H.
Revue de Laryngologie - Otologie - Rhinologie 126(2): 99-103
2005
ISSN/ISBN: 0035-1334 PMID: 16180349 Document Number: 587564
To discuss the place of surgery in the management of mycobacterial cervical lymphadenitis. It's a retrospective study (1982-2002) about 246 patients treated in the ENT department of Farhat Hached Sousse for cervical lymph node tuberculosis. Resolution was considered when neither symptoms nor lymphadenopathy in examination were noted. The mean age of our patients was 28 years. A light female prevalence was noted. In 5 patients diagnosis was established by lymph node punction. A medical treatment of first intention was then managed with a failure in 3 cases, after deadlines from 3 to 4 months. All other patients were operated: cellulolymphadenectomy (47%), adenectomy (47%) or drainage of a cervical abscess (4%). Recurrence and antituberculosis treatment resistance were noted respectively in 6% and 3% of cases. Two questions are still discussed in the management of mycobacterial cervical lymphadenitis: 1- Is surgery necessary for the diagnosis? 2- When is surgery indicated directly? Histological specimen established the diagnosis in all cases and excluded a mestastatic lymph node. In some situations surgery must be indicated at first: cold abscess, lymph node fistulation. Surgery still has an important place in the treatment of tuberculosis lymphadenopathy.