Background: Tuberculosis remains a significant public health issue in Tunisia. This study aimed to describe the epidemiological, clinical, and therapeutic characteristics of cervical lymph node tuberculosis and identify factors influencing outcomes.
Methods: A retrospective study was conducted over a 3-year period in the ENT department at La Rabta Hospital, Tunis. Diagnosis was based on histopathological evidence, and disease progression was categorized as favorable (treatment <9 months, no additional surgery) or unfavorable (treatment >9 months and/or supplementary surgery).The study population was divided into two groups based on the outcome nature, and analytical analysis was performed to assess factors influencing outcomes.
Results: The study included 102 patients (32 men and 70 women), with a median age of 34.5 years (range: 8-83 years). Most patients (78.4%) had no significant medical history or known HIV infection. Thirty-nine patients (38.2%) had a history of consuming raw milk. In 65 cases (63.7%), lymph node size exceeded 3 cm. Hypoechogenicity (53.9%) and necrosis (40.1%) were the most common findings on ultrasound and CT scan, respectively. The initial diagnostic approach included adenectomy (56.8%), lymph node dissection (8.9%), and drainage of cold abscesses (34.3%). All patients received an initial four-drug antituberculosis regimen. Ethambutol treatment was extended beyond 2 months in 65 cases (63.7%). Fifty-six patients (54.9%) had a favorable outcome.Factors associated with a favorable outcome included intact skin, complete initial lymph node dissection, favorable progress at 2 months, and prolonged ethambutol therapy.
Conclusions: The management of lymph node tuberculosis remains challenging, especially with insufficient bacteriological confirmation. Regional epidemiological factors should be considered. The role of surgery is crucial; however, further standardization is needed to optimize patient outcomes.
Keywords: Mycobacterium Bovis; lymphadenopathy; outcome.; tuberculosis; tuberculous lymphadenitis.
Copyright: © 2025 Lajhouri M et al.