Welcome to HCM.
Tuberculous lympahadenitis is one of the difficult conditions to treat.
It might take just 3 weeks in few people for the clinical response and in some people it might take months.
Severe and unbearable pain is suggestive of suppuration ( lymph nodes fill with pus) and the pain must be like some one stabbing in her neck.
As you have mentioned that your wife has no improvement, here are the two possible options that should help your wife.
of the lymph nodes( abscess
drainage non dependant) will help her in relieving the pain and the mass effect. Though the pain is relieved the wound might take long to heal( which should not be a major concern).
Adding Streptomycin injection
to the existing AKT4 regimen will also help her.
My suggestion would be to see a general surgeon
and get the abscess drained if possible and add streptomycin to your regimen.
Hope this works for your wife. meanwhile use Tramadol
for the pain relief.
Wish your wife a speedy recovery.
Dr K. Sai Rajesh