HIV-associated tuberculous lymphadenitis: the importance of polymerase chain reaction (PCR) as a complementary tool for the diagnosis of tuberculosis - a study of 104 patients

Bibliographic Details
Title: HIV-associated tuberculous lymphadenitis: the importance of polymerase chain reaction (PCR) as a complementary tool for the diagnosis of tuberculosis - a study of 104 patients
Authors: Cortez, Marcio Valle, Oliveira, Cintia Mara Costa de, Monte, Rossicléia Lins, Araújo, José Ribamar de, Braga, Bruna Backsmann, Reis, Débora Zotteli dos, Ferreira, Luis Carlos de Lima, Moraes, Milton Ozório, Talhari, Sinésio
Source: Anais Brasileiros de Dermatologia. October 2011 86(5)
Publisher Information: Sociedade Brasileira de Dermatologia, 2011.
Publication Year: 2011
Subject Terms: AIDS-related opportunistic infections, HIV, Tuberculosis, Tuberculosis, lymph node
More Details: BACKGROUND: Lymphadenitis is common in HIV-positive patients. Diagnosis of the infections associated with this condition is complex, particularly in the case of tuberculosis. Rapid and specific detection of Mycobacterium tuberculosis (M. tuberculosis) is fundamental in ensuring adequate treatment. In addition, frequent causes of lymphadenitis such as those associated with lymphoma and histoplasmosis, among others, must be eliminated as possible causes. OBJECTIVES: To evaluate the accuracy of polymerase chain reaction as a tool for the diagnosis of lymphadenitis resulting from M. tuberculosis. METHODS: In this study, a protocol was developed using the following procedures: direct microscopy using Ziehl-Neelsen staining, culture in Lowenstein-Jensen medium, histology and polymerase chain reaction. RESULTS: A total of 104 patients were included in the study. According to histopathology, 38 patients (36%) were found to have nonspecific chronic lymphadenitis, 27 (26%) had tuberculous lymphadenitis, 11 patients (10.5%) had lymphoma and 9 (8.7%) had histoplasmosis. When Lowenstein-Jensen culture was performed, positive tests for tuberculous lymphadenitis increased by 30%. With polymerase chain reaction, M. tuberculosis DNA was detected in 6 out of 38 samples of non-specific chronic lymphadenitis. Three of these patients were followed up, developed symptoms of tuberculosis and were cured following specific treatment. CONCLUSION: The data obtained in this study suggest that all cases of lymphadenopathies should be submitted to histopathology, Lowenstein-Jensen or Ogawa culture and polymerase chain reaction. Polymerase chain reaction may prove to be useful in providing an early and accurate detection of cases of extrapulmonary tuberculosis in HIV-positive patients with lymphadenopathies, avoiding empirical treatment and the possible development of resistant strains.
Document Type: article
File Description: text/html
Language: English
ISSN: 0365-0596
DOI: 10.1590/S0365-05962011000500010
Access URL: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962011000500010
Rights: info:eu-repo/semantics/openAccess
Accession Number: edssci.S0365.05962011000500010
Database: SciELO
More Details
ISSN:03650596
DOI:10.1590/S0365-05962011000500010
Published in:Anais Brasileiros de Dermatologia
Language:English