Diagnostic Yield of Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) In Lymph Node Tuberculosis at Institute of Respiratory Disease, SMS Medical College, Jaipur
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Introduction: Lymph Node Tuberculosis (LNTB) is considered to be the local manifestation of a systemic disease. LNTB often affects children and young adults. Mycobacterial lymphadenitis most frequently affects patients in their second decade but may affect patients of any age. Some patients with LNTB may manifest systemic symptoms and these include fever, weight loss, fatigue, and night sweats. There are many methods for detecting LNTB in patients, but recently focus has been shifted to Molecular diagnosis or nucleic acid amplification (NAA). The purpose of the study was to evaluate the diagnostic yield of CBNAAT in LNTB. Materials And Methods: This study was conducted at Institute of Respiratory diseases, SMS Medical college, Jaipur, Rajasthan, India from June 2017, to June 2018. In total, 51 consecutive patients, with suspicion of LNTB were subjected fine needle aspiration (FNA) and the specimens were processed simultaneously for ZiehlNeelsen, Cytopathology, liquid culture via ‘NAP test’ or ‘TB Ag MPT4 Rapid’ immunochromatographic assay and CBNAAT. Results: Among 51 samples tested, CBNAAT detected DNA of MTBC in 37 samples (72.5%). Highest yield was found with cytopathology, with detecting caseous necrosis and AFB in 38 samples (86.4%). Standard biological assays, including AFB microscopy and culture, were positive, respectively, in 20 (39.2%) and 25 (49%). FNA CBNAAT sensitivity and specificity were assessed according to smear and culture results, clinical and cytopathological findings. The sensitivity and specificity of CBNAAT were 77.27% and 57.1% respectively. Conclusion: Combining FNAC and rapid genotypic diagnosis using automated systems (CBNAAT) should greatly improve access to appropriate diagnosis and treatment for patients with tuberculous lymphadenitis.
Authors and Affiliations
Vishnu Kumar Goyal, R. K. Jenaw
Keywords
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- EP ID EP573262
- DOI 10.9790/0853-1804096367.
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