[Clinical, radiographic and ultrasonographic aspects of mediastinal nodular tuberculosis in the era of HIV infection].
OBJECTIVE
The purpose of this study was to determine the clinical, radiographic, and ultrasonographic aspects of mediastinal nodal tuberculosis and ascertain its clinical course in the era of HIV infection.


METHODS
We reviewed retrospectively 39 patients referred to the Ouédraogo Yalgado National Hospital Center and the National Anticancer Institute between February 1996 and December 1999 for mediastinal nodal tuberculosis. Endoscopic proof of tuberculosis was obtained in 30 cases (81.8%). HIV serology was positive in 26 of the 30 patients tested (86.6%).


RESULTS
Nodal mediastinal tuberculosis accounted for 1.7% of the cases of tuberculosis recorded over the same period at the Anticancer Institute. Mean age of the patients was 32.8 years and the sex ratio was 1.05 in favor of men. Clinically, a past medical history was found in 18 cases (46%) including a herpes zoster in 6 (15.4%), cough in 38 (97.5%). Weight loss (95%), fever (100%) and peripheral node enlargement (20%) were found frequently, probably related to HIV infection more than tuberculosis. Radiographically, standard x-rays evidenced associated lesions in 22 cases, with 59% having predominant parenchymatous lesions. Other localizations of tuberculosis were very frequent (42.5%).


CONCLUSIONS
Bronchial fibroscopy is most contributive to diagnosis of mediastinal nodal tuberculosis with an 81.8% yield in our series. HIV infection had a determining effect on the disease course since among the 16 patients who died, 14 were HIV-positive (52%).
Ouédraogo
M
M
Service de Pneumologie, Centre Hospitalier National Yalgado Ouédraogo (CHNYO).
Ouédraogo
S M
SM
Zoubga
Z A
ZA
Birba
E
E
Zigani
A
A
Ouédraogo
G
G
Ki
C
C
Bambara
M
M
Boncoungou
K
K
Ouédraogo
E
E
Auregan
G
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001999:Bronchoscopy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D012737:Sex Factors; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography