Positive Lymph node for Mycobacteria

[Philip615]

I am female 43 yo, with a histpory of positive ppd,  last april  I found a Lymph node over my left clavicula . CAt scann  show that I have several lymph node in my left side.   Last october biopsy was made , and  It was found a mycobacteria but they did not know the type because the laboratory did not cultivated the sample.
Broncoscopy negative
Blood culture is negative
Sputum negative
Chest x ray normal
No symptoms
  I am not receiving any kind of treatment because the doctor wants to do a biopsy again to find out what type of mycobacteria is.

I won't recieve any treatment until biposy is done,  and I do not want go through this again.
Don't you think I should  receieve something????
Why wait until you has the last name of the mycobacteria????
So, I am with a mycobacterium infection for aroud 10 mo and still no treatment ,what do you think???
  
thank you so much for your time.
I want to apologize , english is my second language.

[National Jewish Health]

Your English is actually very good.  The only change to be made in your message is to substitute the word culture, which means to attempt to grow, in the laboratory, for the word cultivate, which means to improve or prepare land for growing a crop, such as corn or wheat.

The key question here is, with what degree of certainty were the mycobacteria identified in your biopsied lymph node?  Were they actually visualized or was their presence inferred on the basis of the presence of granulomas.  Tuberculous granulomas usually have a feature called caseation, which means cheese-like.  Granulomas without caseation may also be seen with tuberculosis (TB), but occur with 2 other major diseases, sarcoidosis and berylliosis, the latter caused by the element beryllium.

Also, when TB is limited to lymph nodes, not in the lung itself, as can be seen on x-ray, it may be caused by Mycobacterium tuberculosis or by nontuberculous mycobacterium.  This is the reason why it is important to know the type of TB with which you are infected, only then can the best therapy be determined.

The most common cause of lymph node TB in the world is caused by infected un-pasteurized cow’s milk.

If your positive PPD was documented as a recent conversion and coincident with the lymph node enlargement, that would strengthen the case for the diagnosis of TB.

The best advice I can give you is that you request a second opinion from an infectious disease specialist, preferably one with experience in the treatment of tuberculosis.  Since accurate diagnosis and treatment are so important, you might want to seek consultation at an institution in Denver, Colorado noted for its treatment of TB, National Jewish Health.  Whatever you decide, do not agree to another biopsy until an expert has had the chance to evaluate you and review the biopsied tissue.

Good luck.

[Sunshine223]

First, you did great with your English :o)  
I am a student in Respiratory Therapy and have been dealing with vague and mysterious symptoms for over 1 year...So I completely empathize with you!  But, now you have an answer that hasn't been explained.  My advice to you (due to my experiences with my own problems as well as what I've witnessed in the medical field) is to BE A FUROCIOUS ADVOCATE for yourself.  I'm not implying to be unkind or beligerent, just be persistent and do your research!  Prepare a list of concerns and questions beforehand (before your doctor appointments).  If your doctor does not seem interested in your concerns then it's time to leave and research in your area for a new one.  Unfortunately, we have to do some/ if not ALL of the leg work (research) on our own and demand the doctor to do more testing.  Remember, be determined to find answers, research, prepare your concerns for your doctor, and demand action!!!  Just because he is wearing the white lab coat does not mean he knows your body better than you!!!  Tell him/ her that you are not willing to wait that long.  Also, make sure you keep a log of how your feeling from day to day and keep him/ her updated with that information.  Let them know if there is anything that you think may have caused this (i.e., you may have injured that area before and never thought anything of it- but over time the area became infected).  Anything is possible with our body!  Keep him/her informed.  
Doctors are magnificant human beings, but are not perfect.  They are overwhelmed and can only do so much with what little time they have available.  We must help them sometimes.  However, there are some doctors who only deal with the superficial problems that they can see themselves and forget to look deeper.  They forget your feelings so you must remind them!  
Good luck :o)