Abstract
Study has been shown that Tubercular lymphadenitis represents 30-40% extra pulmonary tuberculosis in word wide. And it is also most common extra pulmonary manifestation of tuberculosis. This condition is more prominent in children. It is also known as scrofula or cervical tuberculous lymphadenitis. All tuberculosis in body caused by an organism Mycobacterium tuberculosis, a genus of acinetobacteria. They are characteristically Acid fast, aerobic.
Tubercular lymphadenitis being the most common form with most common lymph node involved are cervical group of LN but multiple node can be involved. Study has been shown that even after advancement of diagnostic tool for tuberculosis at all levels it is still difficult to diagnose the disease because of its insidious onset and unusual pattern of presentation and so as treatment and if neglected they may progress to form an abscess and if not treated there occurs formation of sinus.
It has been seen that extra pulmonary Tuberculosis are mostly presents with solitary cold abscess but we presents a case here with multiple cold abscess , initially suspected for bacterial abscess but found to be tubercular lymphadenitis.
This case was undertaken for study, a 8yr old male child who was presented to us with multiple cold abscess which was for prolonged period for over 4-6 months and only associated symptoms were intermittent low grade fever. We performed lymph node fine needle aspiration cytology (FNAC) of both left cervical LN and abscess and diagnosed as tubercular lymphadenitis on evidenced by FNAC lymph node cytology finding granulomatous lesion .Recently role of aspiration cytology has been recognized as initial screening procedure. According to WHO, ATT for 6 month regimen is enough for tubercular lymphadenitis.
Keywords: cold abscess, extrapulmonary, lymphadenitis, scrofula, tuberculosis, cervical lymph node
References
- Choudhury, N, Bruch, G, Kothari, P, Rao, G, Simo, R. 4 year's experience of head and neck tuberculosis in a south London hospital. J R Soc Med 2005;98:267– 9CrossRefGoogle Scholar
- Jha, BC, Dass, A, Nagarkar, NM, Gupta, R, Singhal, S. Cervical tuberculous lymphadenopathy: changing clinical pattern and concepts in management. Postgrad J Med 2001;77:185–7CrossRefGoogle Scholar PubMed
- Hussain, M, Rizvi, N. Clinical and morphological evaluation of tuberculous peripheral lymphadenopathy. J Coll Physicians Surg Pak 2003;13:694–6Google Scholar
- Ueda, T, Murayama, T, Hasegawa, Y, Bando, K. Tuberculous lymphadenitis: a clinical study of 23 cases [in Japanese]. Kekkaku 2004;79:349–54Google Scholar
- Kim, SS, Chung, SM, Kim, JN, Lee, MA, Ha, EH. Application of PCR from the fine needle aspirates for the diagnosis of cervical tuberculous lymphadenitis. J Korean Med Sci 1996;11:127–32 Cross Ref Google Scholar
- Lau, SK, Wei, WI, Hsu, C, Engzell, UC. Efficacy of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenopathy. J Laryngol Otol 1990;104:24–7CrossRefGoogle Scholar
- Narang, P, Narang, R, Narang, R, Mendiratta, DK, Sharma, SM, Tyagi, NK. Prevalence of tuberculous lymphadenitis in children in Wardha district, Maharashtra State, India. Int J Tuberc Lung Dis 2005;9:188–94Google Scholar PubMed
- Golden, MP, Vikram, HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician 2005;72:1761–8Google ScholarPubMed
- Sun, W, Liu, H, Liang, D. Clinical characteristics and management of primary cervical tuberculous lymphadenitis [in Chinese]. Lin Chuang Er Bi Yan Hou Ke Za Zhi 2006;20:552–3Google Scholar
- Tatar D, Senol G, Alptekin S, Gunes E. Assessment of lymph node tuberculosis in two provinces in Turkey. Jpn J Infect Dis. 2011;64:316–21. [PubMed] [Google Scholar]
- Kanlikama M, Mumbuç S, Bayazit Y, Sirikçi A. Management strategy of mycobacterial cervical lymphadenitis. J Laryngol Otol. 2000;114:274–8. [PubMed] [Google Scholar]
- Asano S. Granulomatous lymphadenitis. J Clin Exp Hematop. 2012;52:1–16. [PubMed] [Google Scholar]
- Kent DC. Tuberculous lymphadenitis: not a localized disease process. Am J Med Sci. 1967;254:866–74. [PubMed] [Google Scholar]
- Powell DA. Tuberculous lymphadenitis. In: Schlossberg D, editor. Tuberculosis and nontuberculous mycobacterial infections. 4th ed. Philadelphia: WB Saunders Company; 1999. pp. 186–94. [Google Scholar]
- Yew WW, Lee J. Pathogenesis of cervical tuberculous lymphadenitis: pathways to anatomic localization. Tuber Lung Dis. 1995;76:275–6. [PubMed] [Google Scholar]
Corresponding Author
Sonali Pradhan
Junior Resident, Department of Pediatrics, SVPPGIP, SCB Medical College, Cuttack, Odisha
DOI: https://dx.doi.org/10.18535/jmscr/v10i4.11
