Diagnostic Evaluation for Tuberculous Lymphadenitis Re-visited in the Era of Molecular Techniques: A Review of Literature Satpathi S, Mahajan S, Aggarwal S, Arora S*, Sen R Department of Pathology, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India *Corresponding author email id: jugs.arora915@gmail.com
Online Published on 04 August, 2023. Abstract Tuberculosis is caused by Mycobacterium Tuberculosis bacteria and affects mainly the pulmonary system but also affects the extra-pulmonary system of which lymph node is most involved. Although it is a curable and preventable disease, still as per WHO it is the 13th leading cause of death globally. Burden of Tuberculosis is still very high in India with an estimate of more than 2 million patients annually, which is approximately one-fifth of total global incidence. In developing countries like India, low socio-economic status and overcrowded societies leads to increased incidence of tuberculosis. In developed countries, increased prevalence of human immunodeficiency virus (HIV) has given rise to re-emergence of tuberculosis. Tubercular Lymphadenitis is a paucibacillary disease due to which microbiological confirmation which is essential for diagnosis is very challenging. In this study we have done Literature review of studies based upon various diagnostic modalities to analyse and identify the utility, accuracy of various diagnostic modalities used in present era for early and appropriate diagnosis of Tuberculous lymphadenitis. Detailed study done and data obtained from the published literatures are critically evaluated. Conventional method of diagnosis had many short comings like high rate of errors and very time consuming. Modern methods like Cartridge based Nuclei Acid Amplification Test (CBNAAT) were introduced to overcome the challenges faced by traditional methods. CBNAAT can detect as low as bacterial load of 100-130 bacilli per ml of sample and the turnaround time is only 2 hours. It can detect Rifampicin resistance which is beneficial in selecting treatment regime. CBNAAT is now the first mode of investigation for tubercular lymphadenitis in key population groups like patients who are HIV positive, children. A combination of conventional techniques with newer modalities such as molecular methods gives more accurate results than any single method. Top Keywords Tubercular lymphadenitis, Extra-pulmonary tuberculosis, CBNAAT, Ziehl-neelsen staining, AFB culture. Top |