Tuberculous lymphadenitis as a cause of persistent cervical lymphadenopathy in children from a tuberculosis-endemic area

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dc.contributor.authorMarais, B. J.
dc.contributor.authorWright, C. A.
dc.contributor.authorSchaaf, H. Simonen_ZA
dc.contributor.authorGie, R. P.
dc.contributor.authorHesseling, A. C.
dc.contributor.authorEnarson, D. A.
dc.contributor.authorBeyers, Nuldaen_ZA
dc.date.accessioned2011-05-15T16:17:38Z
dc.date.available2011-05-15T16:17:38Z
dc.date.issued2006
dc.description.abstractBackground: Cervical lymphadenitis is the most common form of extrapulmonary tuberculosis in children, although its relative contribution as a cause of persistent cervical adenopathy is not well-documented. The aim of this study was to determine the relative contribution of tuberculous lymphadenitis as a cause of persistent cervical adenopathy in a tuberculosis-endemic setting and to document its clinical presentation at the primary health care level. Methods: A prospective descriptive study was conducted from February 2003 through October 200 at 5 primary health care clinics in Cape Town, South Africa. The study included all children younger than 13 years presenting with persistent cervical adenopathy to the local primary health care clinic. Results: A total of 158 children were evaluated of whom 35 (22.2%) were diagnosed with tuberculous lymphadenitis. Bacteriologic confirmation was achieved in 27 of 35 (77.1%) children; all 35 responded to standard antituberculosis treatment. The majority of those without tuberculous lymphadenitis (105 of 123, 85.4%) had a visible superficial lesion in the area drained by the affected nodes. In children with persistent lymphadenopathy ≥2 x 2 cm, tuberculosis lymphadenitis was diagnosed in 31 of 33 (93.9%); specificity was 98.4%, sensitivity was 88.6% and the positive predictive value was 93.4%. Conclusion: Children commonly present with persistent cervical adenopathy to the primary health care clinic. The use of a simple clinical algorithm provided an accurate diagnosis of tuberculous lymphadenitis in the study setting. Fine needle aspirations provided a rapid and definitive diagnosis in the majority of children and will have added diagnostic value in settings where alternative diagnoses are more likely. Copyright © 2006 by Lippincott Williams & Wilkins.
dc.description.versionArticle
dc.identifier.citationPediatric Infectious Disease Journal
dc.identifier.citation25
dc.identifier.citation2
dc.identifier.issn08913668
dc.identifier.other10.1097/01.inf.0000199259.04970.d1
dc.identifier.urihttp://hdl.handle.net/10019.1/14301
dc.subjectamoxicillin
dc.subjectantibiotic agent
dc.subjecttuberculostatic agent
dc.subjectalgorithm
dc.subjectarticle
dc.subjectaspiration biopsy
dc.subjectcervical lymphadenopathy
dc.subjectchild
dc.subjectchildhood disease
dc.subjectclinical feature
dc.subjectcontrolled study
dc.subjectdescriptive research
dc.subjectdiagnostic accuracy
dc.subjectdiagnostic value
dc.subjectdisease activity
dc.subjectdisease association
dc.subjectdisease course
dc.subjectendemic disease
dc.subjectfemale
dc.subjecthuman
dc.subjecthuman tissue
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectprediction
dc.subjectprimary health care
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectsensitivity and specificity
dc.subjectSouth Africa
dc.subjecttuberculosis
dc.subjecttuberculous lymphadenitis
dc.subjectAlgorithms
dc.subjectBiopsy, Needle
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectChronic Disease
dc.subjectEndemic Diseases
dc.subjectFemale
dc.subjectHumans
dc.subjectLymphatic Diseases
dc.subjectMale
dc.subjectSouth Africa
dc.subjectTuberculosis
dc.subjectTuberculosis, Lymph Node
dc.titleTuberculous lymphadenitis as a cause of persistent cervical lymphadenopathy in children from a tuberculosis-endemic area
dc.typeArticle
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