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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Lump On Ankle. Have Diffuse Goiter. And Have Lump On Neck. Taking Medication And All Test Done. What To Do?

Hi doctor Mintz, I am 26 year old, female, married, with one child. I was diagnosed with diffuse goiter. Its been 6 months when i noticed a strange swollen lump on my right ankle. Its painful and as time goes by. From 1 lump there's now plenty of them. I went to a surgeon and it was diagnosed as lymphodinities. He prescribed me sultamicillin 3x a day for 1 week. However, after a week of treatment there was no improvement and still more lumps appeared. A week after i noticed big lumps on my right neck. I visited an I.M. And told her about the medication the surgeon gave me. She then increased the dosage of sultamicillin 2x a day still for 7 days. After the treatment no improvement was seen. So she decided for a chest xray. The xray result is negative. So she refered me to a surgeon for biopsy. However, the surgeon refused for an immediate biopsy, instead he wanted me for another antibiotic treatment of clindamycin for 14days since i still have tonsilitis and requested for a sputum culture. Unfortunately the lumps are still there and now it becomes bigger and the sputum is negative. I also had thyroid and neck ultrasound the result was thyromegaly with Diffuse Nodular parenchymal disease (nodular goiter), Diffuse bilateral cervical lymphanedophaties right>left, sonographically normal submandibular glands. I went to an EENT for a second opinion, he prefer not to have a biopsy instead he treated me with anti tb drugs. He said its a lymphatic TB and he suggested that i should keep myself away from my daughter and husband to avoid spreading the disease to them. Lately i have sinusitis, cold, and sligt coug.My questions are:
1. Is there a connection with my swollen ankles to the my lymph nodes on my neck?
2. Is lymphatic TB contagious? Is it transmittable thru kissing and sex? My daughter is sleeping beside me...
3. What are the precautions we should take?
4. Should I undergo any other test?

Please help, i am really worried about my child health with me around her...

Thanks.

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Mon, 17 Jun 2013
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Radiologist,  's  Response
Hello,
Lets answer your questions one by one,

1. Is there a connection with my swollen ankles to the my lymph nodes on my neck?
Yes, if both lumps have appeared around the same time, have same features and with suspected diagnosis of TB, they can be connected.

2. Is lymphatic TB contagious? Is it transmittable thru kissing and sex? My daughter is sleeping beside me...
TB is a multisystem disease and even if first found in lymphatics, it can affect other systems in the body. Your cough may need observation and investigation.
Transmission through sex is not common but still documented in medical literature. Wet kissing with exchange of saliva also can transmit infection. Transmission generally stops after 2 months of intensive treatment.
As long you remain infective, avoiding close contact with your daughter can prevent transmission of infection.

3. What are the precautions we should take?
Getting confirmatory diagnosis and taking proper treatment will help. After 2 months of treatment infection is no longer transmitted but you must take medicines till your doctors tells you, may be 9 months to a year.

4. Should I undergo any other test?
FNAC test from lumps and PCR test are confirmatory in most patients.

TB is a curable disease but requires proper treatment.
Hope this helps.
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Have Lump On Ankle. Have Diffuse Goiter. And Have Lump On Neck. Taking Medication And All Test Done. What To Do?

Hello, Lets answer your questions one by one, 1. Is there a connection with my swollen ankles to the my lymph nodes on my neck? Yes, if both lumps have appeared around the same time, have same features and with suspected diagnosis of TB, they can be connected. 2. Is lymphatic TB contagious? Is it transmittable thru kissing and sex? My daughter is sleeping beside me... TB is a multisystem disease and even if first found in lymphatics, it can affect other systems in the body. Your cough may need observation and investigation. Transmission through sex is not common but still documented in medical literature. Wet kissing with exchange of saliva also can transmit infection. Transmission generally stops after 2 months of intensive treatment. As long you remain infective, avoiding close contact with your daughter can prevent transmission of infection. 3. What are the precautions we should take? Getting confirmatory diagnosis and taking proper treatment will help. After 2 months of treatment infection is no longer transmitted but you must take medicines till your doctors tells you, may be 9 months to a year. 4. Should I undergo any other test? FNAC test from lumps and PCR test are confirmatory in most patients. TB is a curable disease but requires proper treatment. Hope this helps.