title: Diagnosis of tuberculosis lymphadenitis using a polymerase chain reaction on peripheral blood mononuclear cells.
abstract: Providing prompt and precise laboratory confirmation of a clinical diagnosis of tuberculous lymphadenitis is difficult given the paucibacillary nature of lymph node specimens. In this study carried out in Karachi, Pakistan, a polymerase chain reaction (PCR) assay aimed at detecting Mycobacterium tuberculosis DNA in peripheral blood mononuclear cells (PBMC-PCR) was standardized and compared with standard M. tuberculosis diagnostic techniques or a lymph node PCR (LN-PCR) for the diagnosis of tuberculosis lymphadenitis. Thirty-seven (77%) specimens from 48 patients with clinical or diagnosis of tuberculosis lymphadenitis were positive by cytology [17/48 (35%) with no acid fast bacilli (AFB) (suggestive), and 20/48 (42%) with AFB (positive) in direct smears], 30 (63%) by PBMC-PCR, 16 (33%) by LN-PCR, and 13 (27%) by culture. All controls were negative, with the exception of one false-positive LN-PCR. These data suggest the PBMC-PCR may be helpful in the diagnosis of tuberculous lymphadenitis.
authors.affiliation: Department of Pathology, Aga Khan Hospital, Karachi, Pakistan.
authors.forename: Shaper
authors.initials: S
authors.lastname: Mirza
authors.forename: Blanca I
authors.initials: BI
authors.lastname: Restrepo
authors.forename: Joseph B
authors.initials: JB
authors.lastname: McCormick
authors.forename: Susan P
authors.initials: SP
authors.lastname: Fisher-Hoch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004269:DNA, Bacterial / Q000097:blood*; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000382:microbiology; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D010154:Pakistan / Q000453:epidemiology; D016133:Polymerase Chain Reaction / Q000592:standards*; D011237:Predictive Value of Tests; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology
chemical_list: D004269:DNA, Bacterial