Gene Xpert Assay for the Diagnosis of Tuberculous Lymphadenitis on Concentrated Fine Needle Aspirates in a Tertiary Care Hospital in Chamba District
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Introduction: The diagnosis of tuberculous lymphadenitis remains challenging.The routinely used methods have sub-optimal sensitivity.Recently,WHO recommends GeneXpert to be used as the initial diagnostic test in patients suspected of having extra-pulmonary tuberculosis.However,this was a conditional recommendation.In this study we evaluated the performance of Xpert for the diagnosis of TBL on concentrated fine needle aspirates (FNA) in Chamba. Methods: FNA was collected from presumptive TBL cases. Two smears were prepared from each aspirate and processed for cytology and conventional microscopy The concentrated sediment was used for culture and Xpert test.Composite bacteriological methods (culture and/or smear microscopy) were considered as a reference standard. Result: Out of 143 enrolled suspects, 64.3% (92/143) were confirmed TBL cases. Xpert detected M. tuberculosis complex (MTBC) in 60.1% (86/143) of the presumptive TBL cases. The sensitivity of Xpert compared to CRS was 87.8% and specificity 91.1% . The sensitivity was 27.8% for smear microscopy and 80% for cytology compared to CRS. Xpert was positive in 4 out of 45 culture- and smear-negative cases. Among 47 cytomorphologically non-TBL cases, 15 were positive on Xpert Resistance to rifampicin was identified in 4.7% of Xpert-positive cases. Conclusion: Xpert test showed a high sensitivity and specificity for the diagnosis of TBL on concentrated FNA samples.
Authors and Affiliations
Nidhi Gupta, Kamna Singh, Mamta Gupta
Keywords
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- EP ID EP556584
- DOI 10.9790/0853-1803107682.
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