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Lymph node tuberculosis is the most frequent form of extrapulmonary tuberculosis, especially in immunocompromised patients. We have studied patients with proven lymph node tuberculosis in the Department of Infectious Diseases at Pitie´-Salpeˆtrie&grave;re Hospital, Paris, between January 1997 and January 2002. Clinical presentation, microbiological diagnosis and treatment were analyzed in 13 HIV infected and 19 non-HIV infected patients. A risk factor for tuberculosis was present in all cases (HIV infection, immigration, life in community, poverty, past history of tuberculosis and IVDU). The median duration between the onset of symptoms and diagnosis was longer for HIV infected (2 months) compared with non-HIV infected patients (1 month). At the time of the diagnosis, general symptoms were present in >50% of patients of both groups. In HIV infected patients, abdominal lymph node involvement was more frequent (P < 0.05). All the non-HIV infected and 85% of HIV infected patients had peripheral adenopathies. A pulmonary tuberculosis was noted in more than half of the cases (53% non-HIV and 69% HIV patients). Inflammatory parameters and liver function tests were frequently abnormal in both groups. Hyponatremia was more frequent in HIV patients (P < 0.05). TB skin testing was more frequently positive and phlyctenular in non-HIV infected patients (P < 0.05). In this study, direct examination of the needle aspirate from infected lymph nodes was rarely positive; cultures were more frequently positive after biopsy compared to needle-aspiration. The median duration of treatment was 9 months for the two groups (6–24 months). Three HIV infected patients were infected by mycobacteria resistant to at least one antibiotic (isoniazid, 1; rifampicin, 1; isoniazid, streptomycin, etambutool, 1). All the patients recovered. [Copyright &y& Elsevier]

Objective: To determine the main causes of lymphadenopathies and their clinical characteristics in Gabon., Material and Method: This retrospective study analyzed the records of patients hospitalized in the medical department at the Military Hospital of Libreville (Gabon) from January 2010 through December 2011 who presented one or more lymphadenopathies., Results: The study included 78 patients (45 men, 33 women), with a mean age of 42.2 ± 15.9 years. Lymphadenopathies were superficial in 67.9% of cases, abdominal in 42% of cases and mediastinal in 24% of cases. Both deep and superficial locations were noted in 26% (20 cases). Weight loss (63%), fever (56%), asthenia (54%), hepatomegaly (26%), and splenomegaly (20%) were the clinical signs most frequently associated with lymphadenopathy. The main diagnoses were tuberculosis (52%, 41 cases) and non-Hodgkin's lymphoma (11%, 9 cases). Infection with human immunodeficiency virus (HIV) was found in 47% of cases., Conclusion: Tuberculosis remains the most frequent cause of lymphadenopathy in our setting. HIV testing should be routinely performed in all patients with lymphadenopathy.