Evaluation of Diagnostic Modalities and Clinical Profiles of Cervical Tuberculous Lymphadenitis in a Medical College in Jharkhand

Pinki Kumari; Jiwesh Kumar Thakur; Aditya Kumar Jha; Satyendra Prasad Yadav

Pinki Kumari Associate Professor, Microbiology, PJMC, Dumka, Jharkhand, India
Jiwesh Kumar Thakur Professor Surgery, GIMSH, Durgapur, India
Aditya Kumar Jha Specialist Medical Officer, Sadar Hospital, Chaibasa, Jharkhand, India
Satyendra Prasad Yadav

Keywords: Extrapulmonary Tuberculosis, Fnac, Xpert/ Rif

Abstract

Introduction: Tuberculosis (TB) is a major global health issue, with extrapulmonary TB (EPTB) making up 15–20% of cases, and tuberculous lymphadenopathy being the most common form. Diagnosing cervical lymphadenitis, often presenting as painless neck lumps, is difficult due to its paucibacillary nature. Traditional methods like smear microscopy and culture have low sensitivity, so advanced diagnostics like PCR, histopathology, FNAC, and Xpert MTB/ RIF are needed. This study aimed to assess the clinical features and diagnostic accuracy of these methods in smear-negative cervical tuberculous lymphadenitis.

Materials and Method: A total of 100 individuals with 10–80 years of age with cervical lymphadenopathy were included in the study in the Department of Microbiology of a medical college in Dumka, Jharkhand. Samples from FNAC or incision biopsy were obtained and prepared for Ziehl-Neelsen (ZN) staining, culture using the MGIT 960 system, Xpert MTB/ RIF, and PCR. A histopathological examination was also conducted. The diagnostic performance of each modality was assessed against a composite reference standard including culture, histopathology, radiological findings, or treatment response. SPSS version 25 was used to examine the data.

Results: The study population’s mean age was 59.55 years, and the male-to-female ratio was 1:1.17. Xpert MTB/ RIF identified 26% of cases, PCR detected 21%, and MGIT 960 identified 18%. The combined use of these modalities improved diagnostic accuracy. Sensitivity and specificity were highest for PCR compared to the composite reference standard.

Conclusion: The enhanced diagnosis of Mycobacterium TB in neck tuberculous lymphadenitis is possible when a multimodal diagnosis strategy combining conventional and molecular methods is used.

How to cite this article:
Kumari P, Thakur J K, Jha A K, Yadav S P. Evaluation of Diagnostic Modalities and Clinical Profiles of Cervical Tuberculous Lymphadenitis in a Medical College in Jharkhand. J Commun Dis. 2024;56(4):31-36.

DOI: https://doi.org/10.24321/0019.5138.202467