Current diagnosis and management of peripheral tuberculous Lymphadenitis

Jose Mario Fontanilla, Arti Barnes, C. Fordham Von Reyn

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Peripheral tuberculous lymphadenitis accounts for ∼10% of tuberculosis cases in the United States. Epidemiologic characteristics include a 1.4:1 female-to-male ratio, a peak age range of 30-40 years, and dominant foreign birth, especially East Asian. Patients present with a 1-2 month history of painless swelling of a single group of cervical lymph nodes. Definitive diagnosis is by culture or nucleic amplification of Mycobacterium tuberculosis; demonstration of acid fast bacilli and granulomatous inflammation may be helpful. Excisional biopsy has the highest sensitivity at 80%, but fine-needle aspiration is less invasive and may be useful, especially in immunocompromised hosts and in resource-limited settings. Antimycobacterial therapy remains the cornerstone of treatment, but response is slower than with pulmonary tuberculosis; persistent pain and swelling are common, and paradoxical upgrading reactions may occur in 20% of patients. The role of steroids is controversial. Initial excisional biopsy deserves consideration for both optimal diagnosis and management of the otherwise slow response to therapy.

Original languageEnglish (US)
Pages (from-to)555-562
Number of pages8
JournalClinical Infectious Diseases
Volume53
Issue number6
DOIs
StatePublished - Sep 15 2011

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Lymph Node Tuberculosis
Biopsy
Immunocompromised Host
Fine Needle Biopsy
Pulmonary Tuberculosis
Mycobacterium tuberculosis
Bacillus
Tuberculosis
Therapeutics
Lymph Nodes
Steroids
Parturition
Inflammation
Pain
Acids

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Current diagnosis and management of peripheral tuberculous Lymphadenitis. / Fontanilla, Jose Mario; Barnes, Arti; Von Reyn, C. Fordham.

In: Clinical Infectious Diseases, Vol. 53, No. 6, 15.09.2011, p. 555-562.

Research output: Contribution to journalArticle

Fontanilla, Jose Mario ; Barnes, Arti ; Von Reyn, C. Fordham. / Current diagnosis and management of peripheral tuberculous Lymphadenitis. In: Clinical Infectious Diseases. 2011 ; Vol. 53, No. 6. pp. 555-562.
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