Role of Add-on Prednisolone in the Management of Peripheral Lymph Node Tuberculosis

Abstract

© 2018 Gupta PR. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. Peripheral lymph node tuberculosis (PLNTB) is the commonest form of extra-pulmonary tuberculosis (EPTB), both in HIV infected and non-infected patients1,2. Cervical region is most frequently affected site3-5. Mycobacterium tuberculosis is the most common cause. Females and economically productive young adults are more commonly affected6,7. Tubercular lymphadenitis is mainly a medical disease as surgical excision is associated with slightly worse outcome as compared to medical treatment alone, but repeated aspiration of the affected node is sometimes required to avoid scar formation. But in spite of medical treatment, many of these patients show appearance of new lymph node or new disease, increase in the size of existing lesions and/ or sinus formation while on treatment. This becomes more problematic, while managing PLNTB in cosmosensitive area i.e. cervical lymph node tuberculosis (CLNTB). Several studies have also shown better outcomes, when oral steroids are added to anti tubercular drugs (ATT), in EPTB cases i.e. pleural effusion8, pericardial effusion9, tubercular meningitis, mediastinal lymphadenitis causing pressure on vital structure10. But studies defining the role of add on steroids in management of PLNTB are sparse11-13.