{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T06:07:00Z","timestamp":1794204420056,"version":"4.8.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>The therapeutic response of cervical tuberculous lymphadenitis (CTBL) may be delayed or paradoxical, with the frequent development of residual lymph nodes (LNs) during and after antituberculous treatment. We investigated the incidence of residual LNs and the clinical, radiological, microbiological, and pathologic responses of patients with CTBL after 6 months of antituberculous therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The medical records of HIV-negative adult patients with CTBL diagnosed between July 2009 and December 2017 were analyzed. After 6 months of first-line antituberculous treatment, computed tomography (CT) scans were conducted to evaluate for residual LNs. Fine-needle aspiration biopsy (FNAB) was carried out if a patient presented with residual LNs &gt;\u200910\u2009mm in diameter with central necrosis, peripheral rim enhancement, or perinodal inflammation on CT scan.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Residual LNs were detected in 35 of 157 patients who underwent follow-up CT scans and were more commonly observed in younger patients who completed the treatment (mean years \u00b1 standard deviation [SD]: 33\u2009\u00b1\u200913 vs. 44\u2009\u00b1\u200916, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The recurrence rate was approximately 5%, which was not significantly different in both groups. Among the 15 patients who underwent FNAB, 3 (30%) presented with granuloma, and 2 of 15 and 10 of 14 patients had positive AFB and TB PCR results, respectively. The TB culture results of 15 patients were negative.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Residual LNs may still be observed after 6 months of antituberculous treatment. Although the radiologic and pathologic findings after treatment are still indicative of TB, not all residual LNs indicate recurrence or treatment failure. A six-month therapy may be sufficient for cervical tuberculous lymphadenitis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-019-4507-0","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T16:20:27Z","timestamp":1571674827000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Characteristics of residual lymph nodes after six months of antituberculous therapy in HIV-negative individuals with cervical tuberculous lymphadenitis"],"prefix":"10.1186","volume":"19","author":[{"given":"Hyeri","family":"Seok","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hoon","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Ho","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Kyoung","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Suk","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Hen","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Suk","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soon Young","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-686X","authenticated-orcid":false,"given":"Dae Won","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,21]]},"reference":[{"key":"4507_CR1","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1093\/cid\/cir454","volume":"53","author":"JM Fontanilla","year":"2011","unstructured":"Fontanilla JM, Barnes A, von Reyn CF. Current diagnosis and management of peripheral tuberculous lymphadenitis. Clin Infect Dis. 2011;53:555\u201362.","journal-title":"Clin Infect Dis"},{"key":"4507_CR2","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1086\/605559","volume":"49","author":"HM Peto","year":"2009","unstructured":"Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis. 2009;49:1350\u20137.","journal-title":"Clin Infect Dis"},{"key":"4507_CR3","doi-asserted-by":"publisher","first-page":"e0186499","DOI":"10.1371\/journal.pone.0186499","volume":"12","author":"G Sotgiu","year":"2017","unstructured":"Sotgiu G, Falzon D, Hollo V, Kodmon C, Lefebvre N, Dadu A, et al. Determinants of site of tuberculosis disease: an analysis of European surveillance data from 2003 to 2014. PLoS One. 2017;12:e0186499.","journal-title":"PLoS One"},{"key":"4507_CR4","unstructured":"KCDC. 2017 Annual Report on the Notified Tuberculosis in Korea. Osong: Korea Centers for Disease Control and Prevention; 2018."},{"key":"4507_CR5","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1097\/01.md.0000189090.52626.7a","volume":"84","author":"A Polesky","year":"2005","unstructured":"Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore). 2005;84:350\u201362.","journal-title":"Medicine (Baltimore)"},{"key":"4507_CR6","first-page":"366","volume":"12","author":"HR Kim","year":"2019","unstructured":"Kim HR, Shin JY, Kim HA, Lee JE, Kim JH, Kong IS. Notified tuberculosis in the Republic of Korea, 2018. Public Health Wkly Rep. 2019;12:366\u201371.","journal-title":"Public Health Wkly Rep"},{"key":"4507_CR7","doi-asserted-by":"publisher","first-page":"e147","DOI":"10.1093\/cid\/ciw376","volume":"63","author":"P Nahid","year":"2016","unstructured":"Nahid P, Dorman SE, Alipanah N, Barry PM, Brozek JL, Cattamanchi A, et al. Official American Thoracic Society\/Centers for Disease Control and Prevention\/Infectious Diseases Society of America clinical practice guidelines: treatment of drug-susceptible tuberculosis. Clin Infect Dis. 2016;63:e147\u2013e95.","journal-title":"Clin Infect Dis"},{"key":"4507_CR8","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/S0954-6111(05)80265-3","volume":"87","author":"IA Campbell","year":"1993","unstructured":"Campbell IA, Ormerod LP, Friend JA, Jenkins PA, Prescott RJ. Six months versus nine months chemotherapy for tuberculosis of lymph nodes: final results. Respir Med. 1993;87:621\u20133.","journal-title":"Respir Med"},{"key":"4507_CR9","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1183\/09031936.00.15119200","volume":"15","author":"JH van Loenhout-Rooyackers","year":"2000","unstructured":"van Loenhout-Rooyackers JH, Laheij RJ, Richter C, Verbeek AL. Shortening the duration of treatment for cervical tuberculous lymphadenitis. Eur Respir J. 2000;15:192\u20135.","journal-title":"Eur Respir J"},{"key":"4507_CR10","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1017\/S002221510500277X","volume":"120","author":"MF Oktay","year":"2006","unstructured":"Oktay MF, Topcu I, Senyigit A, Bilici A, Arslan A, Cureoglu S, et al. Follow-up results in tuberculous cervical lymphadenitis. J Laryngol Otol. 2006;120:129\u201332.","journal-title":"J Laryngol Otol"},{"key":"4507_CR11","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.5588\/ijtld.15.0257","volume":"19","author":"SN Yu","year":"2015","unstructured":"Yu SN, Cho OH, Park KH, Jung J, Kim YK, Lee JY, et al. Late paradoxical lymph node enlargement during and after anti-tuberculosis treatment in non-HIV-infected patients. Int J Tuberc Lung Dis. 2015;19:1388\u201394.","journal-title":"Int J Tuberc Lung Dis"},{"key":"4507_CR12","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.ijid.2016.10.025","volume":"54","author":"H Chahed","year":"2017","unstructured":"Chahed H, Hachicha H, Berriche A, Abdelmalek R, Mediouni A, Kilani B, et al. Paradoxical reaction associated with cervical lymph node tuberculosis: predictive factors and therapeutic management. Int J Infect Dis. 2017;54:4\u20137.","journal-title":"Int J Infect Dis"},{"key":"4507_CR13","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1097\/01.rct.0000180192.46760.e5","volume":"29","author":"BK Je","year":"2005","unstructured":"Je BK, Kim MJ, Kim SB, Park DW, Kim TK, Lee NJ. Detailed nodal features of cervical tuberculous lymphadenitis on serial neck computed tomography before and after chemotherapy: focus on the relation between clinical outcomes and computed tomography features. J Comput Assist Tomogr. 2005;29:889\u201394.","journal-title":"J Comput Assist Tomogr"},{"key":"4507_CR14","first-page":"415","volume-title":"Tuberculosis and Infections by Nontuberculous Mycobacteria. Pathology of Infectious Diseases","author":"GW Procop","year":"2015","unstructured":"Procop GW. Tuberculosis and Infections by Nontuberculous Mycobacteria. Pathology of Infectious Diseases. Philadelphia: Elsevier Saunders; 2015. p. 415\u201324."},{"key":"4507_CR15","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.crad.2009.09.004","volume":"65","author":"S Vaid","year":"2010","unstructured":"Vaid S, Lee YY, Rawat S, Luthra A, Shah D, Ahuja AT. Tuberculosis in the head and neck--a forgotten differential diagnosis. Clin Radiol. 2010;65:73\u201381.","journal-title":"Clin Radiol"},{"key":"4507_CR16","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.1007\/s00259-012-2115-y","volume":"39","author":"M Sathekge","year":"2012","unstructured":"Sathekge M, Maes A, D'Asseler Y, Vorster M, Gongxeka H, Van de Wiele C. Tuberculous lymphadenitis: FDG PET and CT findings in responsive and nonresponsive disease. Eur J Nucl Med Mol Imaging. 2012;39:1184\u201390.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"4507_CR17","first-page":"408","volume":"67","author":"KH Park","year":"2013","unstructured":"Park KH, Lee MS, Lee SO, Choi SH, Kim YS, Woo JH, et al. Incidence and outcomes of paradoxical lymph node enlargement after anti-tuberculosis therapy in non-HIV patients. J Inf Secur. 2013;67:408\u201315.","journal-title":"J Inf Secur"},{"key":"4507_CR18","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1086\/429317","volume":"40","author":"CR Hawkey","year":"2005","unstructured":"Hawkey CR, Yap T, Pereira J, Moore DA, Davidson RN, Pasvol G, et al. Characterization and management of paradoxical upgrading reactions in HIV-uninfected patients with lymph node tuberculosis. Clin Infect Dis. 2005;40:1368\u201371.","journal-title":"Clin Infect Dis"},{"key":"4507_CR19","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s40336-016-0164-0","volume":"4","author":"AO Ankrah","year":"2016","unstructured":"Ankrah AO, van der Werf TS, de Vries EF, Dierckx RA, Sathekge MM, Glaudemans AW. PET\/CT imaging of mycobacterium tuberculosis infection. Clin Transl Imaging. 2016;4:131\u201344.","journal-title":"Clin Transl Imaging"},{"key":"4507_CR20","unstructured":"American Thoracic Society, CDC, Infectious Diseases Society of America. Treatment of tuberculosis. MMWR Recomm Rep. 2003;52:1\u201377."},{"key":"4507_CR21","doi-asserted-by":"publisher","first-page":"448","DOI":"10.4103\/ijmr.IJMR_1325_16","volume":"145","author":"SK Sharma","year":"2017","unstructured":"Sharma SK, Ryan H, Khaparde S, Sachdeva KS, Singh AD, Mohan A, et al. Index-TB guidelines: guidelines on extrapulmonary tuberculosis for India. Indian J Med Res. 2017;145:448\u201363.","journal-title":"Indian J Med Res"},{"key":"4507_CR22","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/S0194-5998(97)70323-1","volume":"116","author":"AP Yuen","year":"1997","unstructured":"Yuen AP, Wong SH, Tam CM, Chan SL, Wei WI, Lau SK. Prospective randomized study of thrice weekly six-month and nine-month chemotherapy for cervical tuberculous lymphadenopathy. Otolaryngol Head Neck Surg. 1997;116:189\u201392.","journal-title":"Otolaryngol Head Neck Surg"},{"key":"4507_CR23","doi-asserted-by":"crossref","unstructured":"Joint Tuberculosis Committee of the British Thoracic Society. Chemotherapy and management of tuberculosis in the United Kingdom: recommendations 1998. Thorax. 1998;53:536\u201348.","DOI":"10.1136\/thx.53.7.536"}],"updated-by":[{"DOI":"10.1186\/s12879-019-4640-9","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000}}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-4507-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12879-019-4507-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-4507-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T23:06:47Z","timestamp":1603148807000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-019-4507-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,21]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["4507"],"URL":"https:\/\/doi.org\/10.1186\/s12879-019-4507-0","relation":{"correction":[{"id-type":"doi","id":"10.1186\/s12879-019-4640-9","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,21]]},"assertion":[{"value":"17 May 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 October 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2019","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"After publication of the original article [1], we were notified that an author\u2019s name has been incorrectly spelled. Soon You Kwon\u2019s correct full name is Soon Young Kwon.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was approved by the institutional review board of Korea University Ansan Hospital (no. 2009AS0050). Written informed consent was obtained from each study participant.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"867"}}