PT  - JOURNAL ARTICLE
AU  - Chandimani Undugodage
AU  - Wathsala Gunasinghe
AU  - Suharshi De Silva
AU  - Kirthi Gunasekera
AU  - Amitha Fernando
TI  - Diagnostic modalities and treatment outcome of tuberculous cervical lymphadenitis (TCL) - Retrospective study in a resource poor setting
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P2799
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P2799.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P2799.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - BackgroundSri Lanka has a moderate prevalence for TB and TCL is the commonest form of extra pulmonary tuberculosis. There is a paucity of local data in management of TCL.ObjectivesTo describe the diagnostic modalities and treatment outcomes of patients with TCL who presented to the main state referral center in Colombo, Sri Lanka.MethodsIncident cases of non HIV TCL, during a period of 3 months were analyzed using past records. The diagnosis of TCL was made based on the FNAC (Fine needle aspiration cytology) or EB (excision biopsy). FNAC, EB, Mantoux, culture and treatment outcome at the end of 6 months were assessed. WHO category 1 treatment was given.ResultsWe collected 70 records. Majority (46%) was between 20 – 40 year age group with 51 females (73%).In the sample, 41 (58.5%) had FNAC, 37 (53.1%) had EB. 29 (41%) patients had an EB without a prior FNAC.TCL was diagnosed in 85% of those with FNAC. 100% of EB were TCL.Nearly 50% had Mantoux. This was of more than 15mm in 88% (n=31).7 patients had TB culture reports and all were Mycobacterium tuberculosis. All had completed 6 months treatment. At the end of 6 months 94% had complete resolution, 6% had persistent nodes. Treatment was extended for more than 6 months in 3%, while 1 patient needed steroids. None had sinus formation.ConclusionsSeveral diagnostic methods have been used to diagnose TCL in this sample leading to resource wastage and patient morbidity; this could be averted by setting guidelines on managing TCL in TB prevalent countries.This data suggests that FNAC can be used as a preliminary investigation in the diagnosis of TCL. A Mantoux test can further support the diagnosis.