Title: Multiple Cold Abscesses

Authors: Sunil Kumar Agrawalla, Sumant Kumar Panigrahy, Bijayalaxmi Mallick, Jatadhari Mahar, Sasmita Patra, Sonali Pradhan

 DOI: https://dx.doi.org/10.18535/jmscr/v10i4.11

Abstract

Study has been shown that Tubercular lymphadenitis represents 30-40% extra pulmonary tuberculosis in word wide. And it is also most common extra pulmonary manifestation of tuberculosis. This condition is more prominent in children. It is also known as scrofula or cervical tuberculous lymphadenitis. All tuberculosis in body caused by an organism Mycobacterium tuberculosis, a genus of acinetobacteria. They are characteristically Acid fast, aerobic.

Tubercular lymphadenitis being the most common form with most common lymph node involved are cervical group of LN but multiple node can be involved. Study has been shown that even after advancement of diagnostic tool for tuberculosis at all levels it is still difficult to diagnose the disease because of its insidious onset and unusual pattern of presentation and so as treatment and if neglected they may progress to form an abscess and if not treated there occurs formation of sinus.

It has been seen that extra pulmonary Tuberculosis are mostly presents with solitary cold abscess but we presents a case here with multiple cold abscess , initially suspected for bacterial abscess but found to be  tubercular lymphadenitis.

This case was undertaken for study, a 8yr old male child who was presented to us with multiple cold abscess which was for prolonged period for over 4-6 months and only associated symptoms were intermittent low grade fever. We performed lymph node fine needle aspiration cytology (FNAC) of both left cervical LN and abscess and diagnosed as tubercular lymphadenitis on evidenced by  FNAC lymph node cytology finding  granulomatous lesion .Recently role of aspiration cytology has been recognized as initial screening procedure. According to WHO, ATT for 6 month regimen is enough for tubercular lymphadenitis.

Keywords: cold abscess, extrapulmonary, lymphadenitis, scrofula, tuberculosis, cervical lymph node

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Corresponding Author

Sonali Pradhan

Junior Resident, Department of Pediatrics, SVPPGIP, SCB Medical College, Cuttack, Odisha