Lymph node tuberculosis

Introduction Lymphatic tuberculosis, known as sputum in Chinese medicine, is a toxic block tissue embodied in the muscle surface, which is formed by the condensation of scorpion venom and heat in both liver and lung. Western medicine means that the human body has a lymphatic system that specializes in clearing poison and poisoning to protect vascular tissues, encountering germs that cannot be removed from the body and in the body, and condense and accumulate tumors formed by muscle tissue. The main source of infection of tuberculosis is tuberculosis patients, especially those with positive tuberculosis, who receive reasonable chemotherapy in the early stage. The tuberculosis in the tuberculosis is reduced in the short term, and even disappears, almost 100% can be cured, so early detection of patients, especially bacteria positive And timely giving reasonable chemotherapy is the central link of modern flood control work.

Cause

There are two causes of lymph node tuberculosis: one is the infection of the primary tumor caused by tuberculosis through the upper respiratory tract or with food in the mouth and nasopharynx, especially the tonsil gland. The posterior lymphatic vessels reach the shallow deep lymph nodes of the neck. Most of the sites are unilateral lymph nodes. Affected throat. Lymphatic tuberculosis continues to develop after the onset of severe disease, and forms a cold abscess or ulcer.

The other is that the tuberculosis in the blood after the original tuberculosis infection enters the medial cervical lymph node with the blood, causing cervical lymph node tuberculosis; it can also be infected from the lumbar and abdominal lymph nodes, and then the infection of the deep lymph nodes, which is more common in the pathogenesis of cervical lymph node tuberculosis. common.

an examination

Related inspection

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(1) The lateral lymph nodes of the neck are nodular and painless. More common in children and youth.

(2) The initial stage is isolated nodules, which are smooth and movable. Later, the nodules merge into blocks, irregular, and the activity is poor. The mass can form an abscess, which has a sense of fluctuating. After the rupture, it can form a sinus tract, and sneak along with the lower part of the skin, and it will not heal for a long time.

(3) The secretions are thin, often containing cheese-like substances, and the wound granulation is unhealthy.

(4) There may be systemic symptoms such as low fever, night sweats, fatigue, and weight loss.

(5) Some patients may have a history of tuberculosis or lesions such as the lungs.

(6) Taking the diseased tissue for PCR detection, it may be a positive result.

(7) Pathological biopsy can confirm the diagnosis.

Differential diagnosis

Tuberculosis is generally named after parts and organs. According to the location of the lymphatic tuberculosis, there are mainly the following:

1. Cervical lymphatic tuberculosis: This is the most common type of lymphatic tuberculosis, more women than men. According to Japanese statistics, men are the most in the 30-year-old age group and women are the 50-year-old age group. The location of the disease is more common on the right side. Western medicine believes that this disease is caused by the invasion of tubercle bacillus through the mouth (caries or tonsils), from the lymphatic vessels to the submandibular or axillary lymph nodes, but also due to the spread of blood in the lungs and intestinal tuberculosis. Chinese medicine believes that this disease is caused by emotional stagnation, liver qi stagnation, spleen deficiency and phlegm. Liver stagnation heats up, fights heat, and respects the veins of the neck. Also the factors are weak, lung and kidney yin deficiency, causing yin deficiency and anger, bonfire condensed into sputum.

2. Axillary lymphatic tuberculosis: This disease is rare in clinical practice. Patients often complain of swollen lymph nodes in the axillary fossa, and pain is seen. There are also calcifications in the axillary or upper chest wall during chest X-ray examination.

3. Inguinal lymphatic tuberculosis: swollen lymph nodes in the inguinal region, mostly from the lower extremities or genital trauma. However, tuberculosis spreads throughout the body and can occasionally occur. It can start with swelling that is only accompanied by mild pain. If it is not actively treated, it can self-destruct.

4. Abdominal lymphatic tuberculosis: Generally, due to systemic dissemination or on the basis of intestinal tuberculosis, abdominal lymphadenopathy appears successively. In the main complaint, there may have been no digestive symptoms in the past, and no lesions were found in the lungs. There are also those who have had symptoms of intestinal tuberculosis in the past, or because they have been treated for tuberculosis.

5. Hilar lymphatic tuberculosis: When the body has not yet developed an allergic reaction, the tuberculosis in the primary infection of the lung is invaded into the lymph node by the lymphatic flow. There are many lymph nodes from the hilar to the mediastinum. When the disease progresses, the mediastinal lymph nodes also become diseased, forming various degrees of cheeseification, from the lung lymph node flow through the hilar mediastinal lymph nodes, and finally from the right venous horn lymph into the pulmonary vein, so tuberculosis easily with it into the bloodstream. Therefore, hilar lymphatic tuberculosis is in a state prone to potential bacteremia.

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