Tuberculosis lymphadenitis in a southeastern region in Tunisia: Epidemiology, clinical features, diagnosis and treatment

Int J Mycobacteriol. 2015 Sep;4(3):196-201. doi: 10.1016/j.ijmyco.2015.04.004. Epub 2015 May 14.

Abstract

Aim: To evaluate patients' profiles, demographics, clinical and therapeutic approaches and strategies in patients with tuberculous lymphadenitis (TBG).

Patients and methods: A retrospective study of all TBG-confirmed cases admitted in a tuberculosis-specific health care facility between 1 January 2009 and 16 June 2013.

Results: A total of 181 clinical files were examined. Mean age was 32years old; the female/male ratio was 1.78 to 1. Raw milk consumption was noted in 1/3 of patients. Most cases involved the head and neck region (83.4%), nodes involvement, including axillary (12 cases), and mediastinal (9 cases). Clinical symptoms were present in only 55.2%. Tuberculin skin test (TST) was conducted with 82.6% positive responses. Diagnostics confirmation was done with anatomical pathology in most of the patients; only 56 of them had any microbiology analysis done. Demonstration of acid-fast bacilli in microscopy from either fine-needle aspirates or biopsies was done in 17.5% of cases, and cultures yielded positive results in 27%. Treatment duration was varied. Paradoxical reactions were noted in 12% and persistent lymphadenopathy after treatment completion was noted in 10% of cases.

Conclusions: TBG remains a disease of interest. Today, its diagnosis and management is still a problem despite its increasing worldwide incidence, and especially in this study area. Disease control should be strengthened in this country.

Keywords: Epidemiology; Microbiology; Treatment; Tuberculous lymphadenitis; Tunisia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Axilla / pathology
  • Biopsy, Fine-Needle
  • Cattle
  • Child
  • Child, Preschool
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infant
  • Lymph Nodes / pathology
  • Lymphadenopathy / diagnosis
  • Lymphadenopathy / epidemiology
  • Lymphadenopathy / pathology
  • Lymphadenopathy / therapy
  • Male
  • Mediastinum / pathology
  • Middle Aged
  • Milk / adverse effects
  • Milk / microbiology
  • Neck / pathology
  • Pasteurization / statistics & numerical data
  • Raw Foods / adverse effects
  • Raw Foods / microbiology
  • Retrospective Studies
  • Tuberculin Test
  • Tuberculosis, Lymph Node* / diagnosis
  • Tuberculosis, Lymph Node* / epidemiology
  • Tuberculosis, Lymph Node* / pathology
  • Tuberculosis, Lymph Node* / therapy
  • Tunisia / epidemiology
  • Young Adult