1. Lymph node tuberculosis in patients from regions with varying burdens of tuberculosis and human immunodeficiency virus (HIV) infection.
- Author
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Clevenbergh P, Maitrepierre I, Simoneau G, Raskine L, Magnier JD, Sanson-Le-Pors MJ, Bergmann JF, and Sellier P
- Subjects
- AIDS-Related Opportunistic Infections complications, AIDS-Related Opportunistic Infections diagnosis, AIDS-Related Opportunistic Infections drug therapy, Adult, Africa ethnology, Biopsy, Chi-Square Distribution, Comorbidity, Cost of Illness, Diagnosis, Differential, Endemic Diseases statistics & numerical data, Europe ethnology, Female, Humans, Incidence, India ethnology, Lymph Node Excision, Male, Pakistan ethnology, Paris epidemiology, Population Surveillance, Prevalence, Retrospective Studies, Sex Distribution, Tuberculosis, Lymph Node complications, Tuberculosis, Lymph Node drug therapy, AIDS-Related Opportunistic Infections ethnology, Residence Characteristics statistics & numerical data, Tuberculosis, Lymph Node diagnosis, Tuberculosis, Lymph Node ethnology
- Abstract
Background: Few large cohorts of patients with lymph node tuberculosis (LNTB) have been reported in developed countries., Objective: To describe the epidemiological and clinical characteristics of LNTB in patients living in France but born and raised in geographic areas with varying burdens of tuberculosis and human immunodeficiency virus (HIV) infection., Design: A retrospective study of all patients with bacteriologically-proven LNTB assessed in a French hospital from March 1996 through April 2005., Results: The analysis included 92 patients. HIV coinfected patients had a higher risk than those without HIV of presenting with disseminated TB and systemic symptoms and of hospitalization. Lymph node diagnostic procedures had a high yield when samples were cultured. About 25% of patients had an abnormal chest radiograph, and most of them were positive for acid-fast bacilli on sputum smears or for Mycobacterium tuberculosis culture. Treatment was generally prescribed for a longer duration than that recommended by international guidelines. One quarter of the patients developed a paradoxical reaction. A high proportion of our patients were classified as nonadherent and 20% defaulted or were lost to follow-up., Conclusion: Most of the differences in the clinical presentation among patients from various geographic areas were driven by the epidemiology of TB and HIV in the countries of origin. LNTB is frequently a clinical sign of disseminated disease, and culture for M. tuberculosis from LN or other sites is crucial for diagnosis. Adopting the strategy of Directly Observed Treatment, Short course (DOTS) might reduce the rates of nonadherence and default., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)
- Published
- 2010
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