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What Causes Recurrent Lump In Neck Post Antibiotic Treatment?
Question: In mar 2014 I dignossed with lymph node tb. There was a lymp node is right of my neck. I took forcox for 6 months. At that time my weight was 88 and ESR was 38. Again lump is formed but this time it become red. I checked my ESR..its 2. Weight 96 KGS. Wbc is also ok. I did fnac .its showing tb. Now I am planning to do genexpert butblab Dr is suggesting not to do needle aspiration it may form sinus after doing sonography which shows cold absess. Please suggest what should I do next since no one is aware about genexpert properly.
Brief Answer:
You can absolutely go for GeneXpert now.
Detailed Answer:
Hello Sir,
I understand your query and concern.
You seem to have Multidrug resistant Tuberculosis of the neck-This is called Scrofula.
Fnac is absolutely indicated in your case to document the organisms and nature of lesion.
FNAC will not lead to sinus formation.
Its the biopsy-excisional/incisional that will lead to potential sinus formation and is avoided at all cost in your case.
You can absolutely go for GeneXpert testing at the moment.
This is sputum based test with can accurately detect resistant TB DNA molecules.
It also has high propensity to detect Rifampicin resistance with results being given in less than 2 hours.
All you currently need is another course of FORCOX along with 3 another added drugs -Amikacin+Levofloxacin+Para amino salicylic acid/Ethionamide
Consider substitution of Rifabutin for Rifampicin in the FORCOX KIT.
These drugs changes will be very effective against the organisms concerned.
please not that these drug changes have to be made only after detailed consultation with your doctor.
I hope i have answered your query .
Post your further queries if any.
Thank you.
You can absolutely go for GeneXpert now.
Detailed Answer:
Hello Sir,
I understand your query and concern.
You seem to have Multidrug resistant Tuberculosis of the neck-This is called Scrofula.
Fnac is absolutely indicated in your case to document the organisms and nature of lesion.
FNAC will not lead to sinus formation.
Its the biopsy-excisional/incisional that will lead to potential sinus formation and is avoided at all cost in your case.
You can absolutely go for GeneXpert testing at the moment.
This is sputum based test with can accurately detect resistant TB DNA molecules.
It also has high propensity to detect Rifampicin resistance with results being given in less than 2 hours.
All you currently need is another course of FORCOX along with 3 another added drugs -Amikacin+Levofloxacin+Para amino salicylic acid/Ethionamide
Consider substitution of Rifabutin for Rifampicin in the FORCOX KIT.
These drugs changes will be very effective against the organisms concerned.
please not that these drug changes have to be made only after detailed consultation with your doctor.
I hope i have answered your query .
Post your further queries if any.
Thank you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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