Thitta Mohanty1 , Sonali Mallik2 , Manoranjan Pattnaik3 , Jeetendra Kumar Patra4 , Swetapadma Pradhan5 , Paresh Nath Mohanty6 , Rajesh Kumar Dora7 , Sushanta Mishra8
BACKGROUND Tubercular lymphadenitis is the most common extra-pulmonary manifestation of TB that represents 35% of EPTB and 15-20% of all cases of TB. GeneXpert MTB/RIF has the potential to diagnose active TB in non-respiratory specimens from patients suspected of having extra-pulmonary tuberculosis and multidrug resistant tuberculosis. METHODS This study was conducted in 100 patients on clinically suspected tubercular lymphadenitis admitted to the Department of Pulmonary Medicine, SCB Medical College, Cuttack (from July 2016 to Jan 2018) after obtaining ethical clearance from institutional ethical committee. Pus/aspirate/tissue from lymph node for CBNAAT and liquid culture by MGIT, tissue from lymph node for histopathology were done. RESULTS The commonest age group was 16-30 years (48%) followed by 31-45 years (33%). There were 55 females (55%) and 45 males (45%). Fever was the commonest symptom seen in 47 patients (47%) followed by loss of weight in 25 patients (25%). Cervical lymph node was the most common site detected (52%) followed by supraclavicular lymph nodes involvement (22%) and axillary lymphadenopathy (16%). Tissue sample was sent from 25 patients and fine needle aspirate from 45 patients and pus sent from 30 patients. Tuberculosis was evident in 19 cases (76%) either in the form of granuloma or necrosis or both. AFB culture was sent in all patients. Phenotypic detection through Liquid Culture (MGIT 960 BACTEC) was possible in lymph node samples from 60 patients (60%). CONCLUSIONS GeneXpert MTB/RIF when compared to traditional conventional methods to diagnose tubercular lymphadenitis, showed high sensitivity, specificity, positive predictive value and negative predictive value. In TB endemic settings, its implementation could significantly improve the rapid diagnosis of TB Lymphadenopathy and rule out MOTT.
