A review of 23 patients with tuberculosis of the head and neck.

OBJECTIVE

to review the clinical features and management of tuberculosis of the head and neck and to identify those features which may aid diagnosis.

DESIGN

retrospective study.

SETTING

teaching hospital, England, UK.

SUBJECTS

Twenty-three patients with tuberculosis of the head and neck diagnosed by culture of specimens obtained by fine needle biopsy (n = 8) or by open biopsy of the lumps in the neck (n = 15) who presented between 1990 and 1993.

MAIN OUTCOME MEASURES

methods of diagnosis and management.

RESULTS

thirteen of the 23 patients (57%) presented with either a fluctuant mass or a discharging sinus in the neck. Nine (39%) had uncomplicated enlarged lymph nodes and 12 (55%) had systemic symptoms. The supraclavicular region was the most common site (n = 11) and 8 of these 11 had abnormalities in the chest radiograph. In 3 patients the disease was resistant to treatment with standard antituberculous treatment.

CONCLUSIONS

atypical mycobacterial lymphadenitis is usually resistant to standard antituberculous treatment, so it is essential to obtain a microbiological diagnosis. Excision is usually the treatment of choice for such patients.