Tuberculous lymphadenitis | stages of cervical lymphadenitis | cold abscess | collar stud abscess

Summary

This video provides a comprehensive breakdown of tuberculosis lymphadenitis, the most common form of extra-pulmonary tuberculosis. It covers the basics of tuberculosis transmission, common sites of infection, and the stages of lymphadenitis—from the early formation of non-tender, firm lymph nodes to the development of cold abscesses, cholesterol abscesses, and finally, the formation of discharging sinuses. The video highlights clinical features, including swelling, fever, and malaise, and offers a detailed look at the pathological progression of the disease. This informative lecture concludes with a preview of further discussions on diagnosis and treatment.

Takeaways

• 😀 Tuberculosis is a bacterial infection caused mainly by Mycobacterium tuberculosis and, in some cases, Mycobacterium bovis or atypical mycobacteria.
• 😀 The primary mode of tuberculosis transmission is through droplet infection, typically via coughing and sneezing of an infected person.
• 😀 Extra-pulmonary tuberculosis occurs in about 15-20% of active tuberculosis cases, and tuberculosis lymphadenitis is the most common form, accounting for 20-40% of these cases.
• 😀 The cervical lymph nodes, particularly the upper deep cervical group, are the most common site of infection in tuberculosis lymphadenitis.
• 😀 The tuberculosis bacteria typically enter the lymph nodes via the tonsillar crypts of the palatine tonsil, and in some cases, it can spread from the apex of the lungs to the supraclavicular lymph nodes.
• 😀 Clinical features of tuberculosis lymphadenitis include painless swelling of lymph nodes, evening fever, cough (if pulmonary tuberculosis is involved), malaise, and failure to thrive in children.
• 😀 The stages of tuberculosis lymphadenitis include: 1) Firm, non-tender, mobile lymph nodes, 2) Maturation leading to fixed, firm swellings (matting), 3) Formation of a cold abscess with caseous necrosis, 4) Cholesterol abscess formation, and 5) Sinus formation as the abscess ruptures through the skin.
• 😀 The 'matting' of lymph nodes is a key sign of tuberculosis and is caused by the involvement of the capsule of the lymph nodes.
• 😀 A cold abscess is a characteristic feature of tuberculosis lymphadenitis, which does not show signs of acute inflammation such as redness or tenderness.
• 😀 The final stage involves the formation of persistent discharging sinuses, often surrounded by infected skin, leading to further complications.
• 😀 The video ends with a review of the stages of tuberculosis lymphadenitis, urging viewers to recall the clinical features and stages for better understanding.

Q & A

What is tuberculosis lymphadenitis?

Tuberculosis lymphadenitis is the most common form of extra-pulmonary tuberculosis, characterized by the infection of the lymph nodes, usually the cervical lymph nodes.

What are the main causes of tuberculosis?

Tuberculosis is primarily caused by Mycobacterium tuberculosis, though it can also be caused by Mycobacterium bovis and some atypical mycobacteria.

How is tuberculosis typically transmitted?

Tuberculosis is mainly transmitted through droplet infection, often when an infected individual coughs or sneezes.

What percentage of active tuberculosis cases result in extra-pulmonary tuberculosis?

Approximately 15 to 20 percent of active tuberculosis cases result in extra-pulmonary tuberculosis.

What are the common sites of infection for tuberculosis lymphadenitis?

The most common site of infection is the cervical lymph nodes, especially the upper deep cervical lymph nodes, such as the jugular digastric lymph node.

What is the role of the tonsils in tuberculosis lymphadenitis?

In most cases, the bacilli enter the lymph nodes through the tonsillar crypts of the palatine tonsil, leading to infection in the cervical lymph nodes.

What is the typical progression of tuberculosis lymphadenitis?

The progression of tuberculosis lymphadenitis involves several stages: 1) adenopathy (non-tender, firm, discrete lymph nodes), 2) matting (fixed lymph nodes), 3) cold abscess formation, 4) cholesterol abscess, and 5) sinus formation.

What distinguishes a cold abscess in tuberculosis lymphadenitis?

A cold abscess is characterized by a lack of acute inflammation signs like redness, tenderness, or local temperature rise, and it presents as soft and fluctuating.

What is a cholesterol abscess in the context of tuberculosis lymphadenitis?

A cholesterol abscess occurs when a cold abscess breaks through the deep fascia and forms a collection of pus, which communicates through a narrow opening under the skin.

What happens during the final stage of tuberculosis lymphadenitis?

In the final stage, the abscess ruptures through the skin to form a persistent discharging sinus, which may have multiple openings and can lead to extensive tuberculosis infection in surrounding areas.