Diagnostic de la tuberculose ganglionnaire périphérique en Tunisie

Laboratoire d’hygiène, CHU Hédi Chaker, Sfax, Tunisie
Médecine et Maladies Infectieuses (Impact Factor: 1.24). 02/2010; DOI: 10.1016/j.medmal.2009.10.014


ObjectiveThe aim of the study was to evaluate the contribution of microbiology, cytology, and anatomopathology in 50 cases of peripheral tuberculous lymphadenitis.MethodologyOur patients underwent bacteriological tests and cytology and/or histopathology for lymphadenitis.ResultsZiehl-Neelsen stains and cultures were positive in only 29.7% and 10.8% of cases respectively. The diagnosis was confirmed by cytology in 31.3% of cases (10/32) and by histology in 58.6% of cases (27/46). Granulomas were observed in 46.8% (15/32) of needle aspirates and 76% (35/46) of surgical biopsies.ConclusionOur study reveals a weak contribution of conventional microbiological techniques. Cytology remains the procedure of choice in endemic countries. Excisional biopsy may be performed in case of doubt.

118 Reads
  • Source
    • "less effective than its counterpart reported in the same study [9]. Overall, the sensitivity of microbiological methods is considered mediocre and disparate. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate patients’ profiles, demographics, clinical and therapeutic approaches and strategies in patients with tuberculous lymphadenitis (TBG).Patients and methodsA retrospective study of all TBG-confirmed cases admitted in a tuberculosis specific health care facility between 1 January 2009 and 16 June 2013.ResultsA total of 181 clinical files were examined. Mean age was 32 years old; the female/male ratio was 1.78 to 1. Raw milk consumption was noted in 1/3 of patients. Most cases involved the head and neck region (83.4%), nodes involvement, including axillary (12 cases), and mediastinal (9 cases). Clinical symptoms were present in only 55.2%. TST was conducted with 82.6% positive responses. Diagnostics confirmation was done with anatomical pathology in most of the patients; only 56 of them had any microbiology analysis done. Demonstration of acid-fast bacilli in microscopy from either fine-needle aspirates or biopsies was done in 17.5%, and cultures yielded positive results in 27%. Treatment duration was varied. Paradoxical reactions were noted in 12% and persistent lymphadenopathy after treatment completion was noted in 10% of cases.ConclusionsTBG remains a disease of interest. Today, its diagnosis and management is still a problem despite its increasing worldwide incidence, and especially in this study area. Disease control should be strengthened in this country.
    International Journal of Mycobacteriology 11/2014; 4. DOI:10.1016/j.ijmyco.2014.10.022
  • Source
    Pan African Medical Journal 01/2014; 19:211. DOI:10.11604/pamj.2014.19.211.5213
  • [Show abstract] [Hide abstract]
    ABSTRACT: Each year, there are more than eight million new cases of tuberculosis and 1.3 million deaths. There is a renewed interest in extrapulmonary forms of tuberculosis as its relative frequency increases. Among extrapulmonary organs, pleura and lymph nodes are the most common. Their diagnosis is often difficult and is based on clinical, radiological, bacteriological and histological findings. Extrapulmonary lesions are paucibacillary and samplings, in most cases, difficult to obtain, so diagnosis is often simply presumptive. Nucleic acid amplification tests, which are fast and specific, have greatly facilitated the diagnosis of some forms of extrapulmonary tuberculosis. However, their sensitivity is poor and a negative test does not eliminate the diagnosis. Treatment is the same as for pulmonary forms, but its duration is nine to 12 months for central nervous system and for bone tuberculosis. Corticosteroids are indicated in meningeal and pericardial localizations. Complementary surgery is used for certain complicated forms.
    Revue de Pneumologie Clinique 08/2014; 71(2-3). DOI:10.1016/j.pneumo.2014.04.001 · 0.25 Impact Factor