Six-month combination chemotherapy for cervical tuberculous lymphadenitis.

A prospective study was undertaken to determine the effectiveness of a 6-month four-drug regimen in the treatment of 123 patients with cervical tuberculous lymphadenitis. The results showed that the disease was satisfactorily controlled with residual lymph nodes which did not necessitate further chemotherapy in 14.6% of patients at 3 years follow-up. Recurrence requiring further chemotherapy occurred in 3.3% of patients between 9 and 28 months. Wound sinuses occurred in 3.3% of patients and all healed with conservative treatment. The culture results and numbers of lymph nodes at presentation had no effect on outcome at 3 years. An excisional procedure was associated with a lower incidence of residual lymph nodes than an incisional biopsy. Minor gastrointestinal upset from drug treatment was common, but only 2.4% of patients needed a change of regimen. Six months of combination chemotherapy is adequate for the treatment of the disease.