Adenitis is inflammation of the lymph nodes or a gland.

Tuberculous adenitis is caused by Mycobacterium tuberculosis. The infection spreads from the infected site in the lungs to the hilar nodes. Other lymph nodes may also become involved.

The signs and symptoms of tuberculous adenitis may include a mildly tender, slowly progressive swelling of the involved nodes. The nodes may be painless, and matted into an irregular mass.

Tests used to diagnosis the condition are the same as those used for pulmonary tuberculosis (see Diagnostic Code: 6730 Tuberculosis, pulmonary, chronic, active). The tuberculin skin test is an important tool for diagnosis as is the chest x-ray. Tests may also include the following:

• computed tomography (CT) scan of the chest

• sputum cultures obtained on three consecutive days

• identification of the organism by DNA probe 

Culture reports may take as long as 3 to 6 weeks, whereas DNA probes are able to identify the organism in six hours. If the sputum is negative for organisms, then a fiberoptic bronchoscopy is performed to collect bronchial washings, or the stomach contents may be aspirated after an all-night fast. A biopsy of nodes may be done to establish the diagnosis.

Treatment with drugs is very effective if taken in the prescribed full-course manner. Principles of drug therapy include use of multiple drugs to prevent drug-resistant organisms, and prolonged chemotherapy (6 to 9 months). In tuberculous adenitis, therapy must be continued for at least 9 to 12 months. Rarely may the condition require excision.

The condition may respond slowly to medication, thereby requiring long-term drug therapy. The causative organism may be dormant and viable for years or decades, and can again multiply and produce an active disease.

• Consider service connection for tuberculosis, in its active form, on a presumptive basis as a chronic condition (38 CFR 3.307; §3.309(a)), if the condition manifests to a degree of 10 percent or more within three years from the date of separation.

• Rate under 38 CFR 4.88c or §4.89 of this part, whichever is appropriate

• None.