Management pathways and the surgical diagnosis of tuberculous lymphadenitis: can they be improved? The Bradford experience.
OBJECTIVE
To study the diagnostic pathway for tuberculous lymphadenitis from initial referral to the commencement of antituberculous therapy with the object of identifying potentially avoidable delays.


METHODS
Retrospective case series study.


METHODS
District General Hospital, England, UK.


METHODS
Thirty-four patients with head and neck tuberculous lymphadenitis diagnosed by a positive histological specimen over the 3-year period 1998-2000.


RESULTS
There were no clear pathways for referral and management. There were substantial variations in the management between different specialties and even sometimes within the same specialty. There was evidence of poor communication between various teams.


CONCLUSIONS
The study shows that for the management of head and neck tuberculous lymphadenitis, there is a need for a 'hospital' or 'trust' approach. It also reinforces the arguments for a dedicated 'neck lump clinic' with easy access both from the general practitioners and from other specialties within the hospital and for a protocol for handling biopsy specimens from nodes.
Tsikoudas
A
A
Department of Otorhinolaryngology, Head and Neck Surgery, Bradford Royal Infirmary, Bradford, UK. atsikoudas@yahoo.co.uk
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy