Tuberculous lymphadenitis, also known as scrofula, is a form of tuberculosis (TB) that affects the lymph nodes. It is the most common form of extrapulmonary tuberculosis, meaning TB that occurs outside the lungs. The condition primarily affects the lymph nodes in the neck but can also appear in other parts of the body. Since tuberculosis is known for its contagious nature, many people wonder: Can tuberculous lymphadenitis spread?
Understanding Tuberculous Lymphadenitis
Tuberculous lymphadenitis is caused by the Mycobacterium tuberculosis bacteria, the same bacteria responsible for pulmonary tuberculosis (TB of the lungs). The infection leads to swollen, painful, or sometimes painless lymph nodes, often in the cervical (neck) region.
How Does It Develop?
- The bacteria usually enter the body through the respiratory system when a person inhales droplets from someone with active pulmonary TB.
- In some cases, TB bacteria travel through the bloodstream or lymphatic system and infect the lymph nodes, leading to tuberculous lymphadenitis.
- The disease may also develop due to reactivation of a past TB infection, especially in people with weakened immune systems.
Is Tuberculous Lymphadenitis Contagious?
The lymph node form of TB itself is not highly contagious. Unlike pulmonary TB, which spreads through airborne droplets when an infected person coughs, sneezes, or speaks, tuberculous lymphadenitis does not usually transmit from person to person.
However, the ability of the infection to spread depends on whether the lungs or airways are involved:
- If the patient has pulmonary TB along with tuberculous lymphadenitis, they can spread TB bacteria through coughing or sneezing.
- If the patient has only lymph node TB without lung involvement, they are generally not contagious because the bacteria are not expelled into the air.
Can Tuberculous Lymphadenitis Spread Within the Body?
Although it does not easily spread from person to person, tuberculous lymphadenitis can spread within the body if left untreated. The infection may:
- Extend to nearby lymph nodes, causing multiple swollen glands.
- Spread through the bloodstream (miliary TB), affecting organs like the liver, spleen, and bones.
- Cause cold abscesses, leading to the formation of pus and draining sinuses.
- Lead to chronic inflammation, scarring, and tissue damage.
Who Is at Risk?
Certain individuals are at a higher risk of developing tuberculous lymphadenitis, including:
- People with weakened immune systems (e.g., HIV/AIDS, diabetes, or malnutrition).
- Those who have had close contact with TB-infected individuals.
- Individuals living in TB-endemic regions.
- Patients undergoing immunosuppressive therapy (e.g., chemotherapy or organ transplant recipients).
Diagnosis and Treatment
Diagnosis
To confirm tuberculous lymphadenitis, doctors may perform:
- Physical examination to check for swollen lymph nodes.
- TB skin test (Mantoux test) or TB blood test.
- Fine-needle aspiration biopsy or excisional biopsy to test lymph node tissue.
- Chest X-ray or CT scan to check for pulmonary TB.
Treatment
Tuberculous lymphadenitis is treated with antibiotics over a period of 6 to 9 months. The standard treatment involves a combination of:
- Isoniazid (INH)
- Rifampicin (RIF)
- Ethambutol (EMB)
- Pyrazinamide (PZA)
In some cases, surgery may be needed to drain abscesses or remove heavily infected lymph nodes.
Conclusion
Tuberculous lymphadenitis does not spread easily from person to person like pulmonary TB. However, it can spread within the body if left untreated, leading to complications. Early diagnosis and proper TB treatment are crucial to preventing the progression of the disease. If you or someone you know has symptoms of TB or swollen lymph nodes, seeking medical attention promptly is essential.
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