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Case Reports: Unusual presentation of more common disease/injury
Massive generalised lymphadenopathy: a rare presentation of tuberculosis with a favourable outcome
  1. Tushar Ramesh Sahasrabudhe,
  2. Kurinji Ramachandran Senthamizh and
  3. Shailesh Bhanudas Meshram
  1. Department of Respiratory Medicine, Dr D Y Patil Medical College, Hospital and Research center, Dr D Y Patil Vidyapeeth, Pimpri, Pune (Deemed University), Pune, Maharashtra, India
  1. Correspondence to Professor Tushar Ramesh Sahasrabudhe; dr_tushar_s{at}yahoo.co.in

Abstract

We present a case of massive generalised necrotic lymphadenopathy due to tuberculosis (TB) without any solid organ involvement. An immunocompetent man in his early 30s presented 1 year ago with weight loss, cough and a solitary cervical node. Contrast-enhanced CT scan thorax showed massive enlargement of almost all groups of mediastinal nodes with large areas of necrosis. Ultrasound examination revealed multiple necrotic abdominal nodes. Core biopsy of the supraclavicular node confirmed TB by histopathology and molecular testing. His Mantoux test was negative suggesting tuberculin anergy. Biopsy of deep nodes was avoided. He responded well to standard antitubercular treatment in weight-corrected doses along with systemic steroids which were prescribed to prevent further breakdown/rupture of nodes. After the extended TB treatment for 12 months, he is asymptomatic and has gained weight, with complete resolution of cervical node and near complete resolution of all deep nodes.

  • TB and other respiratory infections
  • radiology
  • tuberculosis

https://doi.org/10.1136/bcr-2022-252558

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    Footnotes

    • Contributors TRS has contributed to writing and revising the manuscript, literature review, patient diagnosis and management and obtaining consent. KRS has contributed to writing and revising the manuscript and literature review. SBM has contributed to writing and revising the manuscript and literature review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.