DIAGNOSIS OF TUBERCULOSIS LYMPHADENITIS IN CHILDREN

Abstract

INTRODUCTION: Tuberculosis represents a major health problem, and the most frequent cause of extrapulmonary tuberculosis is tuberculous lymphadenitis. OBJECTIVE: The aim of this study was to determine the relative contribution of tuberculous lymphadenitis as a cause of persistent cervical lymphadenopathy. METHODS: Our study included 87 children (aged 6 months to 18 years) suffering from tuberculous lymphadenitis who were admitted to our tuberculosis center during a period of 10 years. RESULTS: Our 10-year study of 1112 children with lymphadenopathy showed that tuberculous adenitis was encountered in 87 children (7.8%). The disease was present at all ages but was found more frequently between the ages of 10 and 18 years (39.1%). The most common location was the anterior cervical space in 43 children (49.4%), followed by the axillary and supraclavicular areas. Systemic clinical signs (fever, weight loss, tiredness, night sweats) were encountered by 69 children (79.3%). Granulomatous infection was confirmed in 19 children (21.8%) who had abnormal chest radiograph findings. The diagnosis of tuberculous lymphadenitis was based on histological demonstration of caseating epithelioid cell granulomas in the specimen obtained by excision biopsy in 56 cases (64.3%). Tuberculin skin-test results were positive in 76 cases (87.3%). Positive family history of tuberculosis was discovered in 72 cases (82.7%). CONCLUSIONS: In most cases, the diagnosis was established on the basis of the specific histopathological aspect, tuberculin skin-test result, positive family history of tuberculosis, and the abnormal chest radiograph findings.