Montoux Test Research Articles

Comparative Study of Intravenous Methylprednisolone Pulse Therapy versus Oral Prednisolone Minipulse Therapy in Progressive Vitiligo

Abstract Background: Vitiligo is an idiopathic acquired illness characterized by limited depigmented macules and patches. We aim to compare intravenous (IV) methylprednisolone pulse therapy with oral prednisolone minipulse therapy in the treatment of progressive vitiligo. Objective: The assessment of the efficacy of both treatment methods in the arrest of the progression of vitiligo and repigmentation of the existing lesions. Materials and Methods: A total of 60 patients, 30 in each group, were enrolled for the study. Each patient underwent a detailed clinical, general physical, systemic, and thorough dermatological examination. A set of routine investigations, consisting of hemoglobin%, total leukocyte count, differential leukocyte count, urine routine examination, blood sugar (fasting and postprandial), liver function tests, renal function test, serum electrolytes, Montoux test, chest X-ray posteroanterior view, and thyroid profile were carried out before the analysis. Clinical photographs were taken before the start of therapy and after each month thereafter were used for the analysis after taking written consent. Results: The age of vitiligo patients considered for the study ranged from 13 to 70 years. The ratio of male-to-female patients considered for the study was 22:38 (36.6%: 63.3%). The duration of instability in vitiligo cases studied varied from 6 months to 2 years. In both Group A and Group B, the maximum number of patients (66.7% and 86.7%, respectively) had unstable vitiligo for 6 months to 1 year. Percentage repigmentation was better in Group A (IV) than Group B (OMP). In Group A, 17 out of 20 (85%) patients had shown different degrees of repigmentation, while 20 out of 30 (66.7%) patients of Group B had shown the same. This was statistically insignificant. Types of repigmentation observed in patients were of the following types: perifollicular, marginal, and combined. In both groups, all patients showed perifollicular regimentation. Conclusions: In progressive vitiligo, it was observed that oral mini pulse with prednisolone is superior to IV methylprednisolone pulse therapy for the arrest of progression. Considering the cost, mode of administration, hospital admission, loss of man-hours, and patients’ compliance, OMP was considered simpler and cost-effective.

Study of tuberculosis and other infections among children (age 2 to 18 years) with multitransfused thalassemia major

Background: In India, beta thalassemia is prevalent across the country, with an average frequency of carriers being 3-4%. Infection is the major cause of morbidity and mortality in thalassemia, so regular screening is required for this disease. Methods: Ethical clearance taken from institutional ethical committee. 150 thalassemia patients were enrolled in study after informed written consent. The medical histories were obtained from the patients and their files. Clinical examination was done including anthropometry, general examination, and systemic examination. MT and chest X-ray (CXR) were done for screening of tuberculosis infection. Blood samples were taken for S. ferritin, S. creatinine, serum glutamic pyruvic transaminase (SGPT), human immunodeficiency virus (HIV), and hepatitis B surface antigen (HBsAg) tests. Transfusion and other detail were taken like iron chelator, folic acid (FA) and calcium supplements. Results: In this study, out of 150 patients, 4 patients were RVD positive and 34 patients were HCV positive. No Patients found HBsAg positive. No patient had Montoux test reactive and chest X-ray positive finding. Conclusions: : Increase frequency of transfusion-related infection (hepatitis C, B, and HIV) in multi-transfused thalassemia. No correlation was found between tuberculosis infection and thalassemia patients in this screening study.

Reliability of mantoux in diagnosis of tuberculosis and factors affecting it

This study was conducted to determine the frequency of infected children cohabiting with sputum-positive and negative tuberculous adults for grounding the authenticity of the Montoux test in diagnosing tuberculosis among these groups. It was inferred from the study that a significant figure of the children with positive tuberculin skin test was not found to be diseased with tuberculosis and those with negative test results were diagnosed tuberculous based on chest X-ray, sputum examination, and FNAC of enlarged lymph nodes. Therefore, despite its widespread use, a large proportion of children remain undiagnosed yet are infected. Therefore, the Montoux test solely is not worth reliable for the diagnosis of tuberculosis and hence confirmation of the disease by more sophisticated tests is mandatory

Macrophage Activation Syndrome in Adult Onset Still’s Disease: A Life Threatening Complication

Adult onset Still’s disease (AOSD), a multi-systemic inflammatory disorder, is a rare disorder but an important differential to be considered in patients of Pyrexia of Unknown Origin, especially if patient presents with polyarthritis. Macrophage activation syndrome (MAS), a subset of Secondary Hemophagocytic Lymphohistiocytosis (HLH), considered as the most life threatening complication of AOSD, mostly develops around the onset of disease. Hence, in a previously undiagnosed case of AOSD, recognizing MAS as a presenting feature complicating underlying AOSD is essential for increased patient survival, as in our case.
 
 
 A 39 year old diabetic female presented with high grade fever with chills and multiple joint pains symmetrically involving proximal shoulder, knees and distal joints (involving MCP, PIP and DIP joints of hand) associated with swelling and early morning stiffness, relieved on activity, since past 6 months. No history of oral ulcers, rash, jaundice, weight loss, loss of appetite, foreign travel or close animal contact.
 
 On examination, Pallor was present, Blood Pressure was 120/70 mm Hg, pulse rate was 102/min and temperature was 100 F. On per abdomen, mild hepatomegaly was present and other system examination was unremarkable.
 
 Routine laboratory findings on day of presentation have been summarised (Table 1.1). Ultrasound Abdomen revealed hepatomegaly and Chest X-ray showed signs of old infective foci. Peripheral smear for Malarial parasite, Ns1Ag and dengue serology, Widal test and Montoux test were negative. Blood cultures and urine cultures were sterile. X-Ray of joints were normal. USG of B/L Knee joints showed mild joint effusion bilaterally with no internal echoes (non tappable). Trans-thoracic echo and Trans-esophageal echo were normal. CT chest, neck and abdomen showed old tubercular changes in lung. Tests for atypical bacterial infections which was normal (RK 39, Chickungunya, Brucella, Leptospirosis and Scrub typhus). Fever did not respond to Broad Spectrum Antibiotics, Antimalarials or Antitubercular therapy and patient continued to have persistent fever spikes.
 
 Autoimmune profile showed ANA and RA Factor negative but markers of inflammation were raised: CRP- 521, ESR -148, IL-6 – 84.0, Procalcitonin-6.9 and S.Ferritin >2000. During the work up for Anemia, Microcytic hypochromic anemia was found with Elevated NAP SCORE-165. Incidentally, her triglycerides were found to be elevated (356) and a reduced fibrinogen. With these results, we planned for a bone marrow aspirate and biopsy which showed increased myeloid preponderance (32:1), increased histiocytes and evidence of hemophagocytosis.
 
 The 2004 diagnostic criteria of HLH was fulfilled. After ruling out almost all infectious and malignant causes of secondary HLH, we searched for a rheumatologic cause. Thus diagnosis of AOSD (after fulfilling Yamaguchi’s criteria) with MAS (a subset of 2’ HLH) was made. Patient had dramatic improvement after receiving steroids with her fever episodes and joint pains settling completely thereafter.
 
 
 Prompt recognition of life threatening complications like MAS which pose diagnostic difficulty due to overlapping features in a patient of AOSD, should be done at the earliest to improve patient prognosis and survival. Serum Ferritin levels can be considered a useful marker to assess the disease activity and to predict MAS occurrence in such patients.

P383 ‘It's not Fungus, its Nocardia’—an elementary diagnostic challenge for draining sinus on abdominal wall (rare): a case report

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PMIntroductionA rare finding of abdominal wall clinical presentation of persistent progressive tumefaction with draining sinus with no granules caused by Nocardia brasiliensis.MethodsHistory: A 22-year-old presented to the Dermatology OPD with complaints of swelling and tenderness and discharging sinuses with no granules around the periumbilical region in the lower abdominal area for three years. His initial fine needle aspiration cytology specimen report was inconclusive. He received anti-Kochs treatment based on a positive Montoux test and family history from outside the hospital.Initially punch biopsy samples were sent for fungal processing to our laboratory which was inconclusive. Repeat pus aspirate and punch biopsy samples were subjected to conventional techniques. The sample was inoculated on Sabouraud's Dextrose agar, Brain heart Infusion agar, and Lowenstein-Jensen media. Direct Smear was subjected to Gram stain and Modified Zeihl Neelson stain with 1% Sulfuric acid as decoloriser.ResultsOn Gram stain, Gram-positive filamentous bacilli against a background of pus cells in pus aspirate only (not in punch biopsy specimens).Modified Zeihl Neelson stain with 1% Sulfuric acid decoloriser was performed on all three samples. Beaded acid-fast filamentous bacilli with plenty of pus cells in the background were seen in pus aspirate only (not in punch biopsy specimens).No fungal elements were observed on the 20% KOH mount.Clinicians were notified immediately with the provisional report of possible Actinomycetoma due to Nocardia sp.Growth was observed within 9 days on SDA as well as LJ. It was a chalky white, dry colony to begin with that turned orangish-yellow in another week's time. Smear from the colony showed Gram-positive filamentous bacilli which on Modified ZN Smear were acid-fast filamentous beaded bacilli. The isolate was identified as Nocardia species. This was further confirmed as Nocardia brasiliensis by MALDI-TOF.On admission, the patient was initially started on Inj. Amikacin and then changed to Modified Raman regime of double dose Cotrimoxazole and Gentamicin. His lesions started showing improvement over 2 weeks of in-patient treatment. He was discharged on oral treatment thereafter.ConclusionAbdominal wall clinical presentation of persistent progressive tumefaction with draining sinus with no granules caused by N. brasiliensis is a rare clinical entity as Mycetoma. The differential diagnosis would lead to either bacterial or fungal etiology or neoplasia.Delay in correct diagnosis led to the chronicity of the clinical presentation with inappropriate therapy.For a chronic destructive debilitating infective mycetoma presentation, appropriate microbiological diagnostics become essential to have early correct detection with proper sampling technique to guide the appropriate therapy as per the causative pathogen.

Chronic Recurrent Mastitis: Bangladesh Perspective-10 Years Study in a Tertiary Care Hospital

Introduction: Granulomatous mastitis is a very significant chronic breast infection poses a lot of challenge for diagnosis and management. Treatment options are ranging from various medical management to different surgical procedure. However, none of the treatment strategy is considered as standard so far. In this study, we showed some investigations and management options for chronic breast infections. Materials and methods: It is a randomized clinical trial done in BIRDEM (Bangladesh Institute of Research and Rehabilitation of Diabetic Endocrine and Metabolic Disorders) Hospital and Ibrahim Medical College from July 2013 to June 2020. We enrolled patients on basis of histopathological report of chronic breast infected patients. Gene X-pert for tuberculosis, MT (Montoux Test) and bacterial culture was done in all enrolled patients. Results: A total of 165 female patients were enrolled in this study. Patient’s age was between 13-68 years with mean age 31.5 years. Maximum 44.85% (76) cases were found in 20-30 yeas age group. Most common clinical presentation non healing discharging ulcer 51.52% (85) followed by mass with abscess 26.02% (43) and mass with sinus 22.42% (37). Diagnosis was confirmed by histopathologically. Idiopathic Granulomatous Mastitis was found in 58.79 %( 97) patients and Tubercular Mastitis in 41.21% (68) patients. Tubercular Mastitis was treated by standard Anti tubercular drugs in 23.72% (37) patients and by additional oral methyl prednisolone in 18.79% (31). 21.82% (36) Idiopathic Granulomatous Mastitis was treated with oral methyl prednisolone and sensitive antibiotic, whereas 36.97% (61) patients needed additional oral methotrexate. Different type of surgical procedures needed in both infections to achieve the goal. Conclusion: We want to share our experience regarding diagnosis and management of different chronic breast infections and final outcome of management Bioresearch Commu. 8(2): 1156-1159, 2022 (July)

Ocular Tuberculosis: Clinical Profile, Management and Outcome at Tertiary Hospital in South India

Aim: Aim is to study the various clinical manifestations in the cases of Ocular TB, management and outcome of these patients. Study design: Retrospective study. Duration of study: Two years duration from June 2017 to June 2019. Source of study: Sarojini Devi Eye Hospital, Hyderabad, Telangana State, India. Materials and methods: All patients presented to Vitreo Retina department with various complaints were studied. Data collected from medical records. Patients underwent detailed ocular and systemic examination, BCVA, Slit lamp examination, fundus examination, fundus florescence angiography, B scans, OCT. In systemic examination uveitic work up done like CBP, ESR, Montoux test, Chest X ray; HIV, VDRL and Rheumatological work up. Based upon clinical presentation patients were treated with ATT (Anti tuberculosis treatment) and steroids. Systemic steroids (oral and intra venous), peri bulbar steroids and intravitreal steroids were used based on severity, unilateral or bilateral involvement. Results: Patients who presented early showed good response to the treatment, few patients who lost follow up after initial examination developed secondary glaucoma, painful blind eye and few eyes became physical due to irregular management. Conclusion: Ocular TB is one of the causes of blindness in uveitis cases, delayed presentation can cause complications and blindness, early diagnosis and proper management is required.

A study to assess the clinico-radiological presentation and outcome predictors in cases of tubercular meningitis

IntroductionTubercular bacterial meningitis continues to be an important cause of morbidity (especially neurologic handicap) in children from resource-poor countries. The present study was planned to assess the clinical and radiological presentation in cases of tubercular meningitis as well as to study the factors associated with mortality. MethodologyThis study was done over a period of 12 months on children between 5 years and 13 years with suspected TBM. Staging of tubercular meningitis was done according to RNTCP Pediatric TB guideline 2019. ResultThe study was conducted on a total of 47 pediatric patients with TBM. Mean age of children in present study was 8.77 ± 2.5 years. Our study documented male preponderance for TBM. Severe thinness was observed in 38.3% patients with TBM. Only 59.6% patients were immunized against tuberculosis and history of contact was documented in 40.5% patients. Maximum children belonged to stage I of TBM (59.6%) followed by stage III and stage II in 34% and 6.4% patients respectively. Montoux test positivity was observed in 14.9% patients only. CSF CBNAAT was positive in 6.4% patients. The most common finding was meningeal enhancement seen in 27.7% of patients followed by tuberculomas in 10.6%.Chest X ray was abnormal in 44.7% patients. In present study mortality was observed in 11 (23.4%) cases. Out of various risk factors, mortality was significantly associated with nutritional status and stage of TBM (p < 0.01). ConclusionTBM is associated with high morbidity and mortality in children especially in India where Burden of TB is high. Our study emphasized on the risk factors associated with mortality in children with TBM and need for early diagnosis and appropriate treatment.

Prevalence of Positive Montoux Test in the Province of Sindh

Prevalence of Positive Montoux Test in the Province of Sindh

Tuberculosis of the parotid gland and the middle ear: a rare case report

Abstract Tuberculosis of parotid gland is a rare entity only about a hundred cases have been reported till date. An associated tubercular otitis media is very rare. The present case was diagnosed by montoux test and treated successfully by ATT. A 26-year old lady attended our OPD with complaints of swelling over rt. parotid area and discharge from rt. ear since 5 and 3 months respectively. clinical examination, revealed a, non tender, soft, fluctuant parotid swelling of 4×2 cm, with rt. level 1b lymphadenopathy and granulations at annulus and dull, lustureless retracted TM with discharge. FNAC of parotid and granulation biopsy revealed epitheloid and giant cells with no caseation. Z-N stain for AFB, chest radiograph, serum ACE levels were unremarkable. Montoux test was positive (20FNx0120mm) and ESR was 42 mm/hr. A CT scan showed isodense mass with hypodesne centre and rim enhancement in the rt. parotid gland and MRI on T2W images had mastoiditis and middle ear mucosal disease. The patient was advised ATT and had remarkable improvement. Parotid gland and middle ear tuberculosis is rare. FNAC and Z-N staining of the aspirate, should be routinely done. Further an AFB negative presumptive diagnosis by this method may prompt a trial of ATT which can be rewarding.

Elderly lady with renal limited vasculitis presenting as pyrexia of unknown origin and progressive renal dysfunction

and immune studies were negative. Chest x-ray showed right hilar enlargement. Serum ACE levels and serum calcium were normal. The biopsy from the purpura yielded a histological diagnosis of leukocytoclastic vasculitis and direct immunofluorescence (DIF) was negative. Computed tomography (CT) disclosed significant mediastinal lymphadenopathy and matted lymph nodes in the lesser sac. Montoux test was highly positive. In view of high ESR, lymphadenopathy and positive montoux test, antitubercular treatment (ATT) was started. After oneweek of starting ATT, the skin lesions and fever completely resolved. CT chest and abdomen repeated after 2 months showed significant regression of lymphadenopathy. ATT continued for 6 months. Complete resolution of the lymphadenopathy was noted on Magnetic Resonance Imaging of chest and abdomen done 1 year later. Conclusion: Although incidence is rare, tuberculosis should be considered the possible underlying cause of vasculitis.

Spina ventosa in an 18 year old

An 18 year old female presented with painless swelling and a chronic discharging sinus at the base of right thumb for last 6 months. The swelling was insidious in onset and progressively increasing in size. She was also suffering from pulmonary tuberculosis. Local examination revealed a spindle shaped swelling of 3 cm 2 cm over the right 1st metacarpal. This swelling was bony hard tender and was fixed to underlying bone with a pus discharging sinus (Fig. 1). X-ray showed a cystic expansile lesion of right 1st metacarpal (Fig. 2). There was an increase in ESR (24 mm at 1 h). Montoux test and sputum for AFB were positive. Histopathological examination revealed an epitheloid granuloma with Langhans' giant cells suggestive of tuberculosis (Fig. 3). She was given a course of antituberculosis treatment for 12 months. At 1 year follow up, the discharging sinus had healed and the ESR had returned to normal, but the bony swelling had persisted. Tubercular dactylitis (spina ventosa) is an uncommon presentation of tuberculosis. It is characterised radiologically by spindle shaped cystic swelling of the short tubular bones. About 80e85% of cases occur below the age group of 6 years

Resistant thyrotoxicosis: A case of sarcoidosis of thyroid

Autoimmune endocrinopathies and, less commonly, thyroid autoimmune disease have been reported in patients with sarcoidosis. Similarities exist in the pathogenesis of these two conditions. Concomitant sarcoidosis in the thyroid gland in patients with Graves’ disease may contribute to the resistance to antithyroid drugs and radioiodine therapy. We present the clinical, laboratory, imaging, and pathologic findings of a patient with Graves’ disease who was unresponsive to medical management. This 37-year-old man presented with thyrotoxicosis. Thyroid hormone assays and 99mTechnitium findings were consistent with Graves’ disease. He was also found to have hilar lymphadenopathy. Patient failed to achieve remission with high doses of antithyroid drugs and 2 sessions of radioiodine ablative therapy. Histopathology of lymph nodesdisclosed noncaseating granulomas, consistent with sarcoidosis. Patient's thyrotoxicosis subsided only following steroid administration. The histopathology of the thyroid gland on aspiration and the subsidence of symptoms with steroids reiterate the possibility of thyroid sarcoidosis. This diagnosis needs biopsy for confirmation, which our patient didn't consent for.

English

INTRODUCTION: Tuberculosis is major cause of morbidity and mortality in India as well in other parts of world. It is caused by mycobacterium tuberculosis which primarily affects lung and cause pulmonary tuberculosis. Diagnosis of tuberculosis rests upon a positive history of contact, clinical symptoms, x-ray chest, sputum positivity and AFB culture. Adenosine deaminase (ADA) is an enzyme which catalyzes the deamination of adenosine into inosine and ammonia. ADA level is found to be elevated in tuberculosis and typhoid fever where cell mediated immunity is elevated. The ADA level is significantly elevated in tuberculosis and helps to differentiate between tubercular and non tubercular diseases. The ADA level is also found to be elevated in serum and pleural fluid in patients of tubercular pleural effusion, tubercular ascitis and tubercular pericardial effusion. METHODS : Routine hemogram, Montoux test, X-ray chest, FNAC of lymph nodes, biopsy of lymph node whenever required, estimation of serum ADA level and T.B.IgG studies were performed in each case. RESULTS: In the present study a total of 45 cases were selected for the study. There are 30 cases of pulmonary tuberculosis and 15 controls. The values of serum ADA and tubercular IgG in pulmonary tubercular group are significantly higher as compared to those of controls. None of the control for ADA showed significant ratio of positivity (≥1.7). One of the 15 cases showed remarkable ratio of positivity (>1.2-1.6) and 14 (93.3%) cases showed insignificant ratio of positivity. Only 2 (13.33%) of the 15 cases showed positivity for TB IgG and rest 13 (86.66%) were regarded negative. CONCLUSIONS: Thus it can be concluded that determination of serum adenosine deaminase levels can effectively diagnose tuberculosis with sensitivity of 96.66% and specificity of 93.33% as compared to TBIgG showing sensitivity of 90% and specificity of 86.6%. Also cost of ADA estimation is remarkably less than that of tubercular IgG

Spectrum of breast tuberculosis.

To determine the presentation of breast tuberculosis, diagnostic methods and surgical treatments. A case series. This study was conducted at Dow University of Health Sciences and Tuberculosis Clinic at Bantwa Hospital, Kharadar, Karachi, from April 1999 to March 2007. Clinically diagnosed patients of breast tuberculosis, confirmed by laboratory work-up, were included in this study. Detailed history and examination of both breast and axillae were the primary diagnostic measures. Complete blood counts, ESR, Mantoux test, ultrasound, mammogram, fine needle aspiration cytology, staining for acid-fast bacilli both smear and culture were performed. Core biopsy for lumps more than 5 cm and wide excision biopsy for the lump less than 5 cm were the methods applied. Pre-designed research proforma was filled and descriptive statistics of age, site, side, clinical presentations, investigations were recorded and surgical treatment done. Anti-tuberculosis treatment was given to all patients. Thirty patients were studied with mean age of 28.4 years ranging from 16-48 years. Bilateral breast involvement was seen in 2 patients with 14 cases involving the right and left breast. Lymph node involvement was present in 7. Pulmonary tuberculosis was seen in 4 patients. Multifocal disease was present in 27 patients. The clinical presentation was with lump in 6, discharging sinuses in 14, cold abscess in 8, and non-healing ulcer in 2 patients. There were 5 lactating mothers. Montoux test was positive in 5, AFB smear and culture were positive in 3. Only AFB culture was positive in 4. Five patients required core biopsy for diagnosis of confirmation of lump more than 5 cm and wide excision biopsy was required in 7 patients with lump less than 5 cm. Despite antituberculous treatment, surgical management was required in 21 (70%) cases. Tuberculosis of the breast, simulating the carcinoma breast and granulomatous mastitis very closely and are difficult to be differentiated without tissue diagnosis. Surgical management is more often required.

Montoux test in BCG-vaccined children with asthma

Montoux test in BCG-vaccined children with asthma

Myelomatous pleural effusion

This report is based on cytologic analysis of pleural fluid of a 52 year old man who came to hospital with non specific complaints of weakness, lethargy and pleuritic chest pain on the right side. X-ray chest showed right sided pleural effusion. Montoux test was negative and so were the three consecutive sputum samples for AFB. Thoracocentesis was done, which showed blood-tinged fluid with elevated protein. Cytology showed abnormal plasma cells with multinucleated forms. Pleural biopsy was negative. Further examination revealed one very small supra-clavicular lymph node less than 0.5 cm in size. Biopsy of this lymph node was done and it showed abnormal plasmacytoid cells and the diagnosis of plasmacytoma was confirmed.

ROLE OF BCG VACCINATION IN THE DIAGNOSIS OF CHILDHOOD TUBERCULOSIS

Diagnosis of Tuberculosis in childhood is controversial usually. Diagnostic parameters which are taken under consideration are clinical routine laboratory and radiological culture antigen antibody test. As antigen antibody test are very costly and culture reports take 6 weeks usually these tests are not done frequently. In children commonly used tests are erythrocyte sedimentation rate (ESR) Montoux test and X-ray chest. (excerpt)

Incidence of tuberculosis in enlarged neck nodes, our experience

To determine the incidence of tuberculous lymphadenitis in enlarged neck nodes. Continuous prospective study is carried out in the department of otorhinolaryngology head & neck surgery, Kathmandu Medical College, Kathmandu, during two years, from January 2006 to January 2008. The study included a group of 155 patients with cervical lymphadenopathy. Each patient underwent a detail clinical Ear, Nose and Throat (ENT) examination and a battery of investigations which included Fine Needle Aspiration Cytology (FNAC) of the nodes, Montoux's test, blood Erythrocyte Sedimentation Rate (ESR) and chest X-ray. Those patients with tubercular lymphadenitis were referred to Directly Observed Therapy System (DOTS) clinic for anti-tubercular therapy. Others with reactive lymphadenitis were treated with antibiotic and those with metastatic neck nodes were treated accordingly. Of the 155 cases with enlarged neck nodes, 83 (54%) had tubercular lymphadenitis. Fifty two (33%) cases had reactive lymphadenitis and 17 (11%) cases were diagnosed with metastatic neck nodes. Fine needle aspiration cytology was found to be highly effective in the diagnosis of tubercular lymphadenitis with 94% accuracy. Majority of patients were otherwise healthy adults, aged between 8 - 71 years. No difference was observed between male and female in this study. Posterior triangle (PT) nodes were most commonly affected group of nodes accounting for 35 (42%) cases and preauricular region 1 (1%) case being the least commonly affected site. Fifteen (18%) cases presented with abscess formation. Only 42 (50%) cases had family history of tuberculosis but 8 (9%) patients had previous history of various forms of tuberculosis. Twelve (14%) patients had positive chest X-ray findings suggesting of concurrent pulmonary tuberculosis. All the patients were referred to DOTS clinic and were treated with category (CAT) - III anti tubercular therapy (ATT). Others with concurrent pulmonary tuberculosis were treated with CAT I regime. None of the patients required surgical treatment. There is high incidence of tubercular cervical lymphadenitis in patients with enlarged neck nodes in developing countries like Nepal. Involvement of cervical lymphnodes are the most commonly affected group of nodes. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region.