Tuberculous lymphadenitis in children

Abstract

Objective: Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis in childhood. The aim of this study is to evaluate the epidemiological and clinical signs and treatment results of patients with tuberculous lymphadenitis.Material and Method: Epidemiological properties, clinical signs, treatment regimens of 19 patients with tuberculous lymphadenitis proven by histopathological and/or microbiological evaluation in Uludag University Medical Faculty, Pediatric Infectious Disease Department between years 2005-2010 were evaluated.Results: Of patients, 68.4% were girls with a mean age of 7.45 +/- 4.59 years (12 months-16 years). The patients < 5 years were 31.5%. The most frequent complaint was swelling in 94.7% of patients. Three patients (15.8%) had a member with active tuberculosis in his/her family. One patient (5.3%) had been treated for pulmonary tuberculosis 2 years earlier. One patient (5.3%) had miliary and meningeal tuberculosis at the same time due to interferon gamma receptor deficiency. The tuberculin skin test (TST) was applied to all patients and resulted in > 15 mm enduration in 78.9%, 10-14 mm enduration in 21.1%, BCG vaccine scarring was present in 94.7% of patients while 57.9% had one scarring, 57.8% had two scarrings. The most frequent localization of disease was the cervical lymph nodes in 47.4%. In 94.7% of patients, diagnosis depended on revealing granulomatous inflammation and caseification necrosis of lymph nodes by excisional biopsy. Acid-alcohol-resistant bacillus (AARB) was seen and grew Mycobacterium tuberculosis complex in lymph node specimens of two of the patients who were diagnosed by lymph node biopsy. Side effects of antituberculous drug treatment were seen in 10.6% of patients. Of all patients, 94.7% recovered while one patient who had interferon gamma receptor deficiency died.Coclusion: Because tuberculous lymphadenitis is not a rare entity in children in our country, it must be considered in the differential diagnosis of lymphadenopathies.