Concluded Case

A discharging sinus neck - Excised - Post Op ATT?

A 42 years old male with a a draiming sinus track on right aspect of neck . The sinus track was excised 12 day back and primary suturing of wound was done .After excision the tissue was sent for histopathology. Sutures were removed 2 days back and wound have healed completely. BIOPSY REPORT - COMMENTS WELCOMED WHETHER HE NEEDS ATT OR NOT .

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Concluded answer
Discharging sinus is most commonly seen in Tuberculosis Histopathology show Granulomatous tissue - commonly seen in tuberculosis Epithelioid Giant cells commonly seen in tuberculosis All these finding are pointing to tuberculosis as diagnosis I would have sent biopsy specimens for TB culture and started this patient on empirical antitubercular treatment
All Answers
Discharging sinus is most commonly seen in Tuberculosis Histopathology show Granulomatous tissue - commonly seen in tuberculosis Epithelioid Giant cells commonly seen in tuberculosis All these finding are pointing to tuberculosis as diagnosis I would have sent biopsy specimens for TB culture and started this patient on empirical antitubercular treatment
Case of tb Start with akt According to lft report See for triple h n other blood report
Case is complete , I don't find need of ATT
Valuable opinion
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History of having sinus on ant aspect neck related to neck gland mostly due to tuberculous Biopsy sings inflammatory granulomatous tissue and epithloud giant cell all suggestive of tuberculosis The it can be taken up as tuberculous sinus and post operative healing with stich removal uneventful. Now the question is to continue ATT or not to me it is better to give a full course ATT. because biopsy inflammatory granulation tissue may reactive signs of the surrounding normal tissue later on giving rise to infection again may lead to another Tuberculous abscess followed by sinus
Now a days as I have seen pathologists would not give the report as tuberculosis, the report will be granulomatous lesion, and since the common chronic granulomatous lesion is Kocks ,it is better to give anti TB treatment and Watch the results.
Sinus from a TB cervical lymph node , Ultrasound of neck. ATT can be started if the sinus opens up again, or ultrasound shows underlying cold abscess.
Hiv test See for Caesiating granuloma . Send sample for AFB culture including atypical mycobacterium species. Can consider AKT.
Granulomatous inflammation may be infection Fungal Neoplastic do pets can
Should pit under ATT cat1