Abstract
Objective:Tuberculosis (TB) is a major public health problem in Bangladesh since long. The present incidence and prevalence rates of all forms of TB are 227 and 404/100,000 population respectively. The aim of this study was to find out the clinical characteristics of involved cervical lymph nodes, demographic characteristics of the patients and response to treatment of Cervical Tuberculous Lymphadenitis (CTL) cases.Methods:A prospective study was performed in Shaheed Shamsuddin Ahmed Hospital, Sylhet, Bangladesh from June 2012 to June 2014. Total 65 patients having CTL attending outpatient department of the hospital were enrolled.Results:Age of the patients ranged from 5 to 60 years with a mean of 25.6 years. Two third (67.7%) of the patients were female. Male: Female ratio was 1:2.1. More than half of the patients came from rural areas (53.8%) and from low socio-economic conditions (58.5%). Most of the patients presented with unilateral (87.7%), multiple (82.3%), matted (68.6%) lymph nodes, <3cm diameter (54%), commonly in right side (57.9%). Abscess was found in 21.5% cases. Discharging sinus was found in 9.2% cases. Most commonly involved lymph node group was level V (59.4%) followed by level II (42.2%). Systemic features were found in 63.07% patients. Associated lung lesion was found in 3.1% cases. FNAC was found positive for tuberculosis in 83.9% cases. Most of the patients (78.46%) were cured with six months anti-tubercular chemotherapy.Conclusions:Early diagnosis and treatment is critical in reducing the overall prevalence. It is essential to have awareness regarding common presentations of cervical tuberculous lymphadenitis among the general population as well as healthcare professionals working in the resource poor primary and secondary level hospitals.
Highlights
Tuberculosis (TB) is a major public health problem in Bangladesh since long
Lymph node characteristics: For describing lymph nodes in the neck we used the system which originates from Memorial Sloan- Kettering Hospital, New York and adopted by the American Academy of Otolaryngology Head and Neck Surgery: Level I, Sub-mental and Sub-mandibular lymph nodes; Level II, Cervical jugular chain nodes above the level of hyoid; Level III, Cervical jugular chain nodes from the level of hyoid to the level of Cricoid; Level IV, Cervical jugular chain nodes from the level of Cricoid to the supra-sternal notch; Cervical Tuberculous Lymphadenitis
Cervical tuberculous lymphadenitis usually presents with unilateral, multiple, matted neck swelling in young adults
Summary
Tuberculosis (TB) is a major public health problem in Bangladesh since long. In 2014, the incidence of all forms of TB for all age groups was 227/100,000 population, while the prevalence rate was 404/100,000 population.
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