Tuberculosis lymphadenitis (TL) occurs when lymph nodes are infected by tuberculous mycobacteria, such as Mycobacterium tuberculosis or Mycobacterium bovis. Mycobacterium tuberculosis poses a serious global health challenge, infecting approximately one-third of the world’s population. In the United States, TL accounts for about 10% of tuberculosis (TB) cases and is frequently the sole manifestation of extrapulmonary disease. The highest disease rates are observed among individuals aged 30–40 years. An initial surgical excision offers optimal diagnostic sensitivity and should be considered as an adjunct to standard antibiotic treatment to improve the slow response to treatment. This case report described a 24-year-old female patient with a painless neck swelling, diagnosed with TL based on histopathology results. She was subsequently treated with first-line anti-TB medication and remains in remission. Despite the surgery intended to reduce the swelling and evacuate the pus from the infected lymph nodes, pus continued to discharge from the surgical wound. Therefore, the treating physician decided to administer streptomycin monotherapy injections, totaling 56 injections.