COMPARISON OF AURAMINE-O STAIN AND ZIEHL-NEELSEN STAIN IN THE DETECTION OF TUBERCULOUS BACILLI IN FINE NEEDLE ASPIRATION OF LYMPH NODES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 49
Abstract
BACKGROUND Tuberculosis is one of the major public health problems and has two types of clinical manifestations, pulmonary and extrapulmonary tuberculosis (EPTB). However, diagnosing EPTB remains challenging because clinical samples obtained from relatively inaccessible sites are paucibacillary, decreasing the sensitivity of diagnostic tests. The role of Fine Needle Aspiration Cytology (FNAC) of the lymph node in the diagnosis of tuberculous lymphadenitis is well documented. Also, Auramine-O staining technique plays a significant role in the detection of Mycobacteria in the present days. The objectives of this study are 1. To compare the efficiency between Auramine-O staining method and Ziehl-Neelsen method in the detection of tuberculous bacilli, along with conventional smears especially in patients with low bacillary load. 2. To prove the diagnostic value and to emphasize the use of Auramine-O stain in all the hospitals where fluorescent microscopy is available. MATERIALS AND METHODS This analytical cross-sectional study was conducted in the FNAC clinic, Department of Pathology. Study was done on 50 patients with high clinical suspicion of tuberculosis presenting with peripheral lymphadenopathy. Fine needle aspirations were performed. Three smears were made from each aspirate, one was alcohol fixed for Haematoxylin & Eosin (H&E) staining and the other two were air dried for ZN and Auramine-O staining. The significance was analysed using chi-square test. RESULTS Out of 50 lymph node aspirates, the smear positivity for acid-fast bacilli (AFB) on the Ziehl-Neelsen method was 44% [22/50] while the positivity increased to 80% [40/50] on the Auramine-O staining method. CONCLUSION Auramine-O staining was found to be more efficient & advantageous than conventional ZN staining, particularly in paucibacillary cases. The speed and ease of screening makes the procedure less time consuming & reduces observer fatigue. Hence, it can be used as an adjuvant along with routine cytology for the early diagnosis of tuberculous lymphadenitis.
Authors and Affiliations
Lokeshwaran R. S. , Lavanya K. B. , Dhanalakshmi A, Keerthivasan S, Yogalakshmi S
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