Download FREE Practo app
Get ₹200 HealthCash
Suppurative lymph node in neck
Suffering from lymph node swelling on 25th November,I visit to doctor and advice to me 1st tab cetil cv 500 and give test...I have do some of test as trucut biopsy histopathological shows suppurative lymph node ,mantoux test negative,TB PCR not detected,Genexpert shows Not detected,USG neck shows reactive lymph node,CBC shows increase total count ,and increase crp level,I have already use antibiotics as piperacillin tezobactum injection for 12 days,levofloxacine 750 for 10 days,Ciprofloxacin ornidazole for 5 days
And lastly Tidezolid 200 once daily for 12 days ,but lymph node can't subside and form abscess draining,What I will do for next
Answers (17)
Get your queries answered instantly with Care AI FREE
20000+ health queries resolved in last month
You need to drain it...and do culture test...
Consult for better and further management
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Didn't find the answer you are looking for?
Talk to experienced doctor online and get your health questions answered in just 5 minutes.
+128
kindly consult me on practo
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
The fact this is going on for more than 6 weeks, would suggest either this is a ‘multiple- antibiotic resistant’ bacterial infection or an ‘atypical infection like TB or Fungal infection’.
Do the following,
1. Sample from abscess for Microscopy, culture and sensitivity
2. Sample from abscess for AFB smear and TB culture
3. Blood tests: D-glucan
4. Hold off all antibiotics and wait for results. If you develop high fever or signs of sepsis, then attend your local hospital.
All the best.
J G S R clinic
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
All your reports suggest Suppurative Lymph node of infective origin. Antibiotics is treatment of choice. As you have undergone full antibiotics course, without relief it suggests that the source of infection is persistent at site drained by lymph node. Most probably the source of infection is in and around mouth. Surgical treatment of lymph node and persistent source of infection is treatment of choice.
Next Steps
Consult a general surgeon or faciomaxillary surgeon. U need to undergo further investigation to rule out site of infection, like CT head and neck, complete oral examination also check for dental caries and hidden infection by OPG.
Health Tips
Maintain oral hygiene, do not manipulate abscess with non sterile methods, Consult General surgeon and dentist first.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Your reports suggest infective (suppurative) lymph node. Since it has formed an abscess and is not responding to antibiotics, surgical drainage and culture are needed. Please consult a surgeon/physician urgently for further management.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Please consult a gen surgeon physically.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Stop all the antibiotics and it requires a surgical procure call incision and drainage, followed by pus culture and tissue culture , then followed by appropriate antibiotics, if culture is inconclusive then we will have to excise the lymph node
Next Steps
Visit general surgeon for consultation
Health Tips
Stop empirical antibiotics
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Removal of lymphnode enlargement by general surgeon. As u had taken all treatment.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
You are dealing with a persistent suppurative (pus-forming) lymphadenitis that has now progressed to abscess formation with drainage despite multiple rounds of broad-spectrum antibiotics (oral + IV) over weeks. This is not resolving as expected, which is concerning and needs urgent re-evaluation.
Key points from your history & tests:
• Histopathology: suppurative (pus) lymphadenitis — indicates bacterial or atypical infection
• Negative Mantoux, TB PCR, GeneXpert → TB is extremely unlikely
• Reactive nodes on USG → no malignancy or deep structural issue
• High total WBC + high CRP → ongoing active infection/inflammation
• No response to Piperacillin-tazobactam (IV), Levofloxacin, Ciprofloxacin+Ornidazole, Linezolid → suggests either:
• Resistant bacteria (MRSA, atypical mycobacteria, anaerobes, or gram-negative)
• Inadequate drainage (antibiotics alone cannot cure an abscess)
• Possible fungal or non-infectious cause (rare but possible)
The abscess formation + drainage means antibiotics alone are not enough anymore — pus collection needs proper surgical intervention to heal.
Next Steps
1. Go to a hospital / ENT or General Surgeon TODAY or TOMORROW (do not wait) — preferably one with good infectious disease backup
• Take all previous reports (biopsy, GeneXpert, USG, culture if done, antibiotic list)
2. What the doctor will most likely do next:
• Repeat USG neck (to see current abscess size, location, collection)
• Incision & Drainage (I&D) of the abscess under local anesthesia (small procedure, same day) — this is the most important step now — removes pus, reduces infection load, and allows antibiotics to work
• Send pus for culture & sensitivity (aerobic + anaerobic + AFB + fungal if needed) — this will show the exact organism & which antibiotic will work
• Blood culture if systemic symptoms (fever, chills)
• Possibly FNAC or repeat biopsy if no pus drainage or atypical features
• Start IV antibiotics post-drainage (based on previous culture or empirical)
3. Do NOT continue self-antibiotics or old medicines — resistance is building, and abscess won’t heal without drainage.
Health Tips
• Keep the area clean — wash gently with soap & water, apply sterile gauze, change dressing 2–3 times/day
• Take paracetamol 650 mg for pain/fever
• Avoid squeezing/poking the node — can spread infection deeper
• Rest, high-protein diet (eggs, milk, dal, chicken if non-veg), plenty of water
• No hot fomentation on abscess — can increase spread
This is treatable — once proper drainage + correct antibiotic (based on culture) is done, most suppurative nodes heal completely in 2–6 weeks.
But delay in drainage can lead to chronic sinus, scarring, or deeper spread — so act fast.
For urgent guidance (which hospital/ENT surgeon is best in your city, how to prepare for I&D, what questions to ask the surgeon, or help understanding culture report later), please book an online consultation with me — I’ll give you clear, step-by-step direction so you get the right treatment quickly and safely.
Looking forward to helping your father get relief fast — book now and let’s resolve this properly
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Is it tender?! USG abd and pelvis?!
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Need few more details for proper understanding of your issue.
You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Go to a surgeon , check the drainge fluid PCR done.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Pls consult back your surgeon for physical examination
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Sajid Ali
General Practitioner
4 yrs exp
Kanpur
Consult to General Surgeon
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Need some more details kindly consult
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Articles you may like
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
The question asked on this page is a free question. You can ask a free health question by downloading the Practo app.
Articles you may like
Tell us what's troubling you
Tell us what's troubling you
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.