Relapse of cervical tuberculous lymphadenitis immediately after completion of effective anti‐tuberculosis treatments

Most cases of lymph node enlargement after completing tuberculosis (TB) treatment are due to paradoxical reaction (PR), not relapse, and therefore, do not require re‐treatment. We herein report a case of a 28‐year‐old man who had developed cervical TB lymphadenitis and exhibited re‐enlargement of the same lymph nodes one month after completing effective TB chemotherapy, which was microbiologically proven as relapse. The patient noticed painful cervical lymphadenopathy one month after completion of chemotherapy for TB lymphadenitis. Combination chemotherapy with multiple anti‐TB drugs was resumed with suspicion of relapse. But, with his symptoms having worsened, surgical excision was performed. Mycobacterium tuberculosis was cultured from the dissected lymph nodes. Early regrowth of the lymph nodes after completing treatment can derive from microbiological relapse, in addition to PR. Surgical excision was useful for the microbiological diagnosis of the relapse. We must take care of lymph node re‐enlargement in consideration of TB relapse.