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In spite of low sensitivity and specificity, standard diagnostic algorithm recommends fine needle aspiration cytology (FNAC) and direct microscopic screening for acid-fast bacilli (AFB) for the routine diagnosis of tuberculous lymphadenopathy (LNTB). In this study, the diagnostic utility of liquid broth based automated culture (BacT/ALERT 3D) technique was assessed in comparison with conventional techniques in 89 clinically suspected tubercular lymphadenitis patients. 60% (n = 53) were positive by FNAC and 38.4% (n = 34) demonstrated AFB in smear examination. BacT/ALERT yielded isolation in 43.1% (n = 38) aspirates, confirming tubercular aetiology. We also found six paediatric culture-positive cases which showed negative outcome by both FNAC and smear. Thus, we conclude that culture by BacT/ALERT, may be used for faster yield of Mycobacteria in LNTB, especially in children. Additionally, this could also be used as a platform for further differentiation of Mycobacterium tuberculosis from non-tuberculous mycobacteria (NTM) infection and for testing of anti-tubercular chemotherapeutic agents whenever drug resistance is suspected.

Myocardial tuberculosis (TB) is an exceptionally rare form of extrapulmonary TB [(1)][1]. It is a serious illness with varied clinical manifestations (conduction blocks, ventricular failure, malignant ventricular arrhythmias, and sudden cardiac death) and has been occasionally documented in case

Resume Propos -Les tuberculoses ganglionnaires isolees sont des formes rares de tuberculose, surtout en l'absence d'infection par le VIH. Methodes -Nous decrivons les resultats d'une etude retrospective de 18 cas de forme ganglionnaire de tuberculose en dehors de toute infection par le VIH. L'etude incluait dix femmes et huit hommes, huit patients autochtones (âge moyen : 69 ans) et dix patients d'origine africaine (âge moyen : 32,5 ans). Resultats Sur les 18 cas de tuberculose ganglionnaire ainsi analyses, 14 touchaient exclusivement le systeme hematopoietique, dont deux atteintes medullaires, une hepatique et une splenique associee. Une biopsie ganglionnaire a ete realisee 14 fois : 12 formes granulomateuses avec necrose caseeuse ainsi que deux aspects folliculaires simples epithelioides et gigantocellulaires ont ete observes. Le syndrome inflammatoire etait inconstant, l'intradermoreaction (IDR) parfois negative. La guerison a ete obtenue dans tous les cas sans complication locale, que le traitement ait dure 6, 12 ou 18 mois selon l'appreciation clinique. Conclusion Les tuberculoses ganglionnaires chez les patients non infectes par le VIH peuvent evoluer sans syndrome inflammatoire, l'IDR peut etre negative, la necrose caseeuse est inconstante.

Summary We here report a case of mediastinal tuberculous lymphadenopathy presenting as superior cava vena syndrome (SCVS). It was a 68-year-old male patient, who had been admitted to hospital because of cough over 3 months. Chest computed tomography (CT) scan revealed a mass in the superior lobe of right lung, and the widening mediastinum that compressed the superior cava vena (SCV). Mediastinoscopy biopsy indicated that it was nonmalignant tuberculous lymphadenopathy. After successful anti-tuberculosis chemotherapy, the upper mediastinum diminished.

A retrospective radiographic comparison of two regimens, RHE2/RH10 (n = 32) and RHZ2/RH10 (n = 37), used in the treatment of tuberculous mediastinal lymphadenopathy is reported. The two groups did not differ in age, pretreatment or post-treatment values. The rate of improvement in serial radiographs was compared between the two groups, each patient acting as his own control. There was no difference in the incidence of initial gland enlargement at 1 month, but at 2 months RHZ2/RH10 had less enlargement (0.05 greater than P greater than 0.01). The rate of improvement was faster in the RHZ2/RH10 group from 2-7 months' treatment, being significantly better than RHE2/RH10 at 2 (P = 0.003), 5 (0.01 greater than P) and 7 months (0.02 greater than P). Pyrazinamide (25-40 mg/kg) appears to be superior to ethambutol 15 mg/kg for the initial 2 months of treatment of tuberculous mediastinal lymphadenopathy. The findings may be applicable to peripheral tuberculous lymphadenopathy.

A case of psoas abscess occurring during treatment of tuberculous lymphadenopathy is described. There was no evidence of a bony origin for this abscess. It appears likely that it arose from involved glands on the posterior abdominal wall.