A Clinical study of tuberculous lymphadenitis

Park, Hye Jung; Ryoo, Hun Mo; Shin, Kyeong Cheol; Park, Jong Seon; Chung, Jin Hong; Lee, Kwan Ho; Kim, Chang Ho; Park, Jae Yong; Jung, Tae Hoon; Han, Sung Beom; Jeon, Young Jun; Hyun, Dae Sung; Lee, Sang Chae

Abstract

BACKGROUND
The aim of this study was to analyze the clinical manifestations and efficacy of treatment regimens in order to determine the adequate combination of anti-tuberculotic agent and duration of treatment for tuberculous lymphadenitis.
METHODS
We made a review of 373 patients with tuberculous lymphadenitis, who were admitted to four medical college hospitals in Taegu Korea from 1989 to 1998, and their diagnoses were confirmed histologically and bacteriologically.
RESULTS
The incidence of tuberculous lymphadenitis was 71.3% in women and 57.7% were between the ages of 20 and 39 years. The most common symptom was painless swelling. The most commonly involved lymph nodes were unilateral superficial cervical lymph node groups. Tuberculous lymphadenitis was accompanied with active pulmonary tuberculosis, commonly. The sensitivity of fine needle aspiration(FNA) in tuberculous lymphadenitis was 79.6% and 92.2% of the patients had a strong positive reaction to the tuberculin skin test. The most commonly prescribed anti-tuberculotic regimen was the combination of INF, RMP, EMB and PZA(62.6%). Eighty percent of patient were treated for 9-12 months. There was no significantly difference in the recurrence rate of tuberculous lymphadenitis between the combinations of anti-tuberculotic agent, including INF and RMP, and between the durations of treatment, for a period of 6 months of treatment, for a period of 6 months of more.
CONCLUSION
The combination of FNA cytologic examination and tuberculin skin test may be helpful in the diagnosis of tuberculous lymphadenitis. We propose that the combination of anti-tuberculotic agents, INH, RMP, EMB, and PZA, be prescribed to patients for 6 to 9 months.