title: Extrathoracic tuberculosis lymphadenitis in adult HIV seronegative patients: a population-based analysis in Houston, Texas, USA.
abstract: OBJECTIVE
  To evaluate the covariates associated with extrathoracic tuberculosis lymphadenitis (ETBL) among adult HIV-seronegative patients.
  
  
  METHODS
  Enrollees were interviewed for TB risk assessment, their medical records were reviewed, and their Mycobacterium tuberculosis isolates underwent molecular characterization. Between 1 October 1995 and 30 September 1999, HIV-negative patients with ETBL were compared with other HIV-negative TB patients.
  
  
  RESULTS
  We identified 73 ETBL cases (5%) out of a total of 1371 adult HIV-negative enrollees. Significant variables predicting ETBL in the univariate analysis included age < 45 years, female sex, Asian ethnicity, foreign birth, BCG vaccination, and infection with a M. tuberculosis isolate identified in major genetic group 1. Further analysis by birth country revealed increased ETBL risk for persons from countries other than the Americas and with a TB incidence > 25 per 100 000 per year. The multivariate model demonstrated increased risk for ETBL for patients of female sex (OR = 2.6, P < 0.01) and birth in Africa or South-east Asia (OR = 4.8; P = 0.03 and OR = 33.6; P = 0.01, respectively).
  
  
  CONCLUSIONS
  In adult HIV-negative patients, ETBL occurs more frequently in females and in immigrants from countries other than the Americas; persons from India, South-east Asia and the Eastern Mediterranean exhibited the highest risk among these regions.
authors.affiliation: Department of Medicine, Infectious Disease Section, Baylor College of Medicine, Houston, Texas 77030, USA. oygl@excite.com
authors.forename: O Y
authors.initials: OY
authors.lastname: Gonzalez
authors.forename: L D
authors.initials: LD
authors.lastname: Teeter
authors.forename: B T
authors.initials: BT
authors.lastname: Thanh
authors.forename: J M
authors.initials: JM
authors.lastname: Musser
authors.forename: E A
authors.initials: EA
authors.lastname: Graviss
mesh_terms: D000328:Adult; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013781:Texas / Q000453:epidemiology; D014388:Tuberculosis, Lymph Node / Q000453:epidemiology* / Q000382:microbiology