Question: iam a 25 yr old male, i am working in XXXXXXX (a state in India).it’s all started 6 weeks ago,i found a swollen lymph node on left side of the neck little below the jaw line curve, i think its on the tonsilar side(cervical lymphadenopathy).it is painless, hard and XXXXXXX I don’t have any symptoms or weight loss, am completely normal. And don’t have any other swollen lymph node throughout the body. i went to see a ENT specialist after one week. He gave me some antibiotic and told me to come and visit again if the lymph node not srink or reduced. I had the antibiotic for one week, but its did not reduced, i waited one more week to see if it reduced or not, but it remain the same.
one 3rd week,i visited the doctor again, he said may be it because of tuberculosic.but need to perform FNAC and start the treatment. And If the FNAC is not clear, will do the excision biopsy. We dont have any TB history on my family and don’t know how this affected me.but i have a doubt, i am staying in a appartment,am new there,i think the previous guy stayed there was have pulmonary TB.i found lots of tablets and chest x-ray from my room. I remember, i found the swollen lymph node after 2 weeks i stayed there.
i told doctor, i need to go to my home town to perform FNAC,because my parents are there, so it will be convenience for me to do treatment there. On the very next day, i go to my home town and take a appointment with a physician. He refer a surgeon to do the FNAC.When i see the Surgeon .he said don’t do FNAC, it’s not accurate. Excision biopsy is best.so we finally decide to do excision biopsy without FNAC.i don’t know that is foolishness or not. Anyway my result came after 1 week and they told me i have lymph node TB.
(After surgery surgeon said, the surgery didn’t harm any vein, they did the surgery that way)
The excision biopsy the result is
MICROSCOPY: "show sections of lymphnodes with multiple caseating epithelioid cell granulomas"
DIAGNOSIS: "caseating epithelioid cell granulomatous lymphadenitis,tuberculous aetiolgy may be considered"
other test results
*skin test for tb(mantoux) is negative
*chest x-ray test is negative
*pus collected from lymph node culture result is negative. The result is "No growth after 48 hrs of incubation at 37 deg c"
*hiv test not performed yet.i didn’t do any type of sexual activity in my life, and not did anything that cause HIV,like blood transfer or use others needle etc. That am sure.
*also am too skinny only have 54 kg with 6 feet height.my weight is same for almost 5 years
am coming to my main point, i take the result and take an appointment to my physician again, he said need to go through 6 month treatment with AKT4,AKT3 and AKT2
But the treatment is not started yet becoz my SGPT value is high 224.he gave me another tablets to reduce the value and told me to come on next week.

i check on the internet and found that i have scrofula. I don’t know what type of scrofula i have, mycobacterium TB or NTM.i read that surgery is not recommended for scrofula. If it caused due to mycobacterium Tb.
This is the story so far.so my question is.
1, is there any problem in my case if i have scrofula? am asking this bcoz i did surgery first.with out starting the antibiotic.
2, is this spread to other organs?
3, any other suggestions in my case.