title: Management of peripheral lymph node tuberculosis in routine practice: an unselected 10-year cohort.
abstract: BACKGROUND
  The varied behaviour of tuberculous lymph nodes during TB chemotherapy can cause clinical uncertainty, resulting in prolonged courses of treatment.
  
  
  OBJECTIVE
  To investigate whether results in routine practice in Blackburn, a high-incidence tuberculosis (TB) area in England and Wales, replicated the results of the 6-month chemotherapy trial for lymph node TB conducted by the British Thoracic Society.
  
  
  METHODS
  All TB cases managed at the Blackburn Chest Clinic are recorded prospectively. Patients with lymph node TB were identified over a 10-year period.
  
  
  RESULTS
  A total of 100 patients with lymph node TB were listed in the database. Fine-needle aspiration was performed in 49 patients, while 66 underwent incisional lymph node biopsy. Culture confirmation was achieved in 60 cases. Sinus and new lymph node development was comparable between our study and the BTS trial. After cessation of treatment, 10 patients developed new/enlarged lymph nodes, but further investigations revealed that only three patients had relapsed TB.
  
  
  CONCLUSIONS
  The varied behaviour of lymph node TB during and after treatment causes clinical uncertainty. Six months of chemotherapy is effective for fully susceptible TB in routine clinical practice in England. Investigation of new signs is important in differentiating patients with relapsed TB from normal varied behaviour.
authors.affiliation: Chest Clinic, Royal Blackburn Hospital, Blackburn, UK. j.blaikley@yahoo.com
authors.forename: J F
authors.initials: JF
authors.lastname: Blaikley
authors.forename: S
authors.initials: S
authors.lastname: Khalid
authors.forename: L P
authors.initials: LP
authors.lastname: Ormerod
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001706:Biopsy; D044963:Biopsy, Fine-Needle; D016208:Databases, Factual; D004739:England; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000188:drug therapy*; D014852:Wales
chemical_list: D000995:Antitubercular Agents