Incidence of Tuberculosis in Cervical Lymphadenopathy. A Clinico- Epidemiological Study
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 6
Abstract
Introduction: Tuberculosis, one of the oldest diseases known to mankind is even today a leading cause of human suffering & loss of life in developing country like India. Tubercular lymphadenitis is the commonest form of extra-pulmonary tuberculosis and most commonly cervical lymph nodes are affected. It mimics other pathological processes & yields inconsistent physical & laboratory results. Study aimed to analyse the incidence of tuberculosis in the cases of cervical lymphnode adenopathy. Material and methods: This hospital based prospective study was conducted in the Department of ENT, FAA Medical College and Hospital, Barpeta, Assam for a period of 1 year from May 2016 to April 2017. All cases of swelling in the neck or cervical lymphadenitis selected for the study were initially given conservative treatment in the form of antibiotics and were reviewed after 2 weeks. If neck swelling persists FNAC, USG and in some cases biopsy were performed. Results: Out of 120 cases chosen for the study, infectious or inflammatory etiology was seen in 47.5%, tubercular lymphadenopathy in 33.33%, metastatic nodes in 13.335, lymphoma in 1.67% and non-specific lymphadenitis in 4.17% cases. Clinco-epidemiological study of the 40 cases of tubercular lymphadenopathy revealed that 15-24 age group was most commonly affected. 68% cases were female while 32% cases were male. Out of 28 cases which were more than 15 years of age, 15 cases were illiterate. Cervical lymph node level V was most commonly involved. Ultrasonography of the tubercular lymph nodes showed hypoechogenicity and necrosis in 100% cases, matted lymph nodes in 40% cases, calcifications in 27.5% cases and sharp margins in 67.5% cases. Tuberculin test was positive in only 73% cases. Conclusion: There is very high incidence of tubercular cervical lymphadenitis in patients with enlarged neck nodes in developing countries like India. Cervical lymph node adenopathy constitutes the most common presentation of extra pulmonary form of tuberculosis. However, it mimics other pathological conditions like metastasis from other primary sites, reactive lymphadenitis, chronic non-specific lymphadenitis, lymphoma etc. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region which can aid in early diagnosis with the help of simple investigations and subsequently patients can be managed promptly without delay.
Authors and Affiliations
Bibhuti Das, Surajeet Basumatari
Keywords
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