STUDY OF CLINICAL PROFILE OF TUBERCULOUS LYMPHADENITIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 13
Abstract
BACKGROUND Tuberculous lymphadenitis is the commonest form of extra pulmonary tuberculosis and most commonly cervical lymph nodes are affected. A high index of suspicion is needed for diagnosis of tuberculous lymphadenitis which is known to mimic numerous pathological conditions. Availability of molecular technology has improved the ease of diagnosis. We wanted to study the clinical profile, diagnostic dilemmas and management of tubercular lymphadenitis METHODS This descriptive study was conducted in the Department of General surgery at Sri Aurobindo Medical College and Post Graduate Institute between September 2015 to February 2017. The work was started after the review & approval of protocol of study by Institutional Ethics and Research committees. We included all patients with provisional diagnosis of tubercular lymphadenitis and 52 patients were made part of this study. A detail clinical history was taken. Thorough local & systemic examination was done. After clinical diagnosis, further investigated to confirm the diagnosis. Appropriate treatment was instituted & follow up done. RESULTS Total 52 Patients, 29 Female and 23 Male, in 20-60 years age group were included in study with a confirmed diagnosis of tubercular lymphadenitis. 39 (75%) patients belonged to low socioeconomic status. 24 (46%) patients presented to hospital between 1-3 months of symptoms. 36 (69.2%) patients were diagnosed with tuberculosis for the first time (primary tuberculosis of lymph mode ) 17 (33%) patients presented with constitutional symptoms like, fever, cough, loss of weight & loss of appetite. 32 (63%) patients had multiple nodes affected. 44 (85%) patients had positive tuberculin test. FNAC was positive in 42 (81%) cases CBNAAT was performed in 10 cases who were negative on FNAC. All cases with primary tuberculosis were started on DOTs CAT I & patients who had previous history of tuberculosis were started on DOTs CAT II regimen. CONCLUSIONS Though anti-tuberculosis chemotherapy is the mainstay of treatment for tubercular lymphadenitis, surgical treatment is more useful in selected cases. In this regard, early diagnosis and treatment are critical in lowering the overall prevalence. Lymph node tuberculosis is different from pulmonary tuberculosis in terms of diagnosis & management. With the availability molecular diagnosis, the diagnostic scenario has changed in the last decade, though treatment has not changed much since the last decade. Paradoxical reactions occur in 10–15% of immune-competent and approximately 50% of human immunodeficiency virus positive patients and need appropriate management. Every effort should be made to know the drug sensitivity of the organism at the onset of treatment by using molecular tests
Authors and Affiliations
Kshitij Dhull, Kiran Somani, Rajesh Sharma, Akhilesh Patel, Rohan Chaphekar, Rishikant Varhistha
Keywords
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- EP ID EP555740
- DOI 10.14260/jemds/2019/227
- Views 83
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