This is an automatically translated article.
Question
Hello doctor,
My father often has a fever, fever for more than a month at the hospital, the doctor diagnosed tuberculosis of the mediastinal lymph nodes. Three children had endoscopy and blood and sputum tests. My father is also very weak, always has a fever. So the doctor asked me how to treat fever with mediastinal tuberculosis? Thank you doctor.
Anonymous customer
Answer
Answered by Doctor, Doctor Le Thi Huong - Department of Examination, Vinmec Times City International General Hospital.
Hello,
With the question “How is fever with TB lymph nodes in the mediastinum treated? ", the doctor would like to answer as follows:
The duration of treatment for lymph node tuberculosis is 12 months, the patient should be monitored for TB drug tolerance and TB drug side effects in the first weeks of treatment.
Patients are re-examined monthly to review the status of lymph nodes, if the lymph nodes are enlarged or abscessed with pus (after 2-3 months of treatment), then the patient will have surgical intervention, lymph node dissection or surgery. pus drainage. A pathologic examination or AFB should be performed and cultured as an antibiogram to confirm the diagnosis.
Note: Paradoxical creactions (23 - 30% in HIV-negative patients with nodal TB) occurring during treatment for nodal TB usually appear in the first 2 months and sometimes in the last months or have been Stopping treatment, lymph node enlargement and metabolism and pus leak, caused by the body's immune response to the dead TB germ, but biopsies or microbiological tests did not find evidence of TB. This is the differential diagnosis of lymph node tuberculosis recurrence or treatment failure. For HIV-infected nodal TB patients who are not on ART, adverse reactions occur at a rate of 7% compared with 36% in people on ART. Do not use corticosteroids to treat adverse reactions, lymph node dissection or lymph node drainage can be performed.
After 8 months of TB treatment, lymph nodes do not grow or shrink or are not palpable, clinical improvement, then the treatment is considered complete.
Treatment failure is based on the duration of prolongation or return of clinical and laboratory signs occurring during treatment that has been at least 6 months.
Relapse is based on the time when the reappearance of clinical and laboratory signs occurred after completion of treatment. It should be noted that the antibiotic test should be done to evaluate the drug sensitivity of bacteria, identify multi-drug resistant TB. New formulations for the treatment of these conditions rely on bacterial drug sensitivities.
If you still have questions about TB mediastinal lymph nodes, you can go to a hospital under Vinmec Health System for further examination and advice. Thank you for trusting and sending questions to Vinmec. Wish you a lot of health.
Best regards!
Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
