Nancy Glory Davidson, Navaneethakrishnan Muthulakshmi
BACKGROUND Tuberculosis is one of the leading causes of mortality in India killing 2 persons every three minutes. The problem of drug resistance is now a major hindrance in our war against this disease. Much of the reported data worldwide is on pulmonary tuberculosis, hence this study to analyse the clinical and bacteriological characteristics in lymph node tuberculosis. Aims and Objectives- 1) To study the clinical data and histopathological correlates in clinical suspects of lymph node tuberculosis. 2) To study the pattern of drug resistance in microbiologically confirmed cases of lymph node tuberculosis. MATERIALS AND METHODS 84 cases of suspected lymph node TB were enrolled in the study. The clinical history regarding history of anti-tubercular treatment (ATT), contact history and associated disease was taken. Surgical specimens – biopsy and aspirates were obtained after informed consent and were processed. RESULTS 1. We observed that in 66/84 (79%) of clinical suspects of lymph node tuberculosis there is histopathological evidence of granulomatous response. 2. We found 18/84 (22%) of cases to be culture positive and identified as Mycobacterium tuberculosis. 3. Of the culture isolates 23% (4) showed non granulomatous response in histopathology, of these patients, 75% (3) are HIV reactive and 25% (1) diabetic. 4. We observed that 5/18 (27.77%) cases to be resistant to atleast one of first line anti-tuberculous drugs. CONCLUSION Prompt diagnosis of lymph node tuberculosis is hindered by lack of gold standard diagnostic tests. Prognostic indicators for drug resistance includes previously treated patients, diabetics and HIV seropositive patients.
