- Abscessed Lymph Node
- Atypical TB
Abscessed Lymph Node
There are chains of lymph nodes that are throughout the head and neck region. Many times, the nodes enlarge due to some type of systemic infection, and then eventually disappear. Less commonly, the lymph node may increase in size and develop into an abscess. They appear as a red, swollen, tense, tender swelling underneath the skin. Imaging through a CT scan of the area with contrast may be ordered to further assess the area of swelling.
The treatment for an abscess of the lymph node requires drainage of the pus within the node. This does require a general anesthetic, and involves draining the abscess and either packing the wound or placement of a drain. Either one is removed 1-3 days after the procedure in the office.
Atypical TB
Atypical TB (tuberculosis) is a term for several bacteria that are similar to tuberculosis, but does not have the lung symptoms and the contagiousness of TB. These bacteria are found everywhere in the environment. Atypical TB can present as a painless mass of the head and neck region, most commonly seen underneath the jaw. They invade the lymph nodes in that region through the mouth. These masses are seen in toddlers, who tend to place various objects in their mouth.
Atypical TB infections may produce a purplish hue to the overlying skin. The natural progression of the infection is for the mass to increase in size and drain out the skin. If left untreated, the infection would most likely resolve on its own, but may take many months for this to occur. There are various antibiotic therapies that may help in slowing the infection, but many times the infection slowly progresses into a painless abscess that drains.
Surgical treatment is a treatment option, but many times the infection is in an area where nerves that control facial function reside, so that total removal of the infected lymph node would put these nerves at risk for permanent injury. If the infection is in an area away from vital structures, complete excision may be possible. If near vital nerves, then removing a portion of the infection by scraping the infection away under a general anesthetic would aid in the resolution of the infection.