Tuberculous lymphadenitis in Manitoba: incidence, clinical characteristics and treatment.
BACKGROUND
Tuberculous lymphadenitis (TBL) is an important form of extrapulmonary tuberculosis (TB). Recent studies have shown an increase in TBL in Canada.


OBJECTIVE
To determine the incidence of TBL in Manitoba and to identify the characteristics associated with its presentation, diagnosis and treatment


METHODS
Population data from the Manitoba Health Population Registry, the First Nations and Inuit Health Branch of Health Canada, and Statistics Canada were used to calculate incidence. Case characteristics and outcomes were determined by a systematic, retrospective review of all cases between January 1, 1990 and December 31, 2000.


RESULTS
One-hundred forty seven cases of TBL were identified during the study period; 77% confirmed by culture; 68% women. TBL was found in Canadian-born/nonstatus Aboriginal (12%), status Aboriginal (29%) and foreign-born (59%) populations. Incidence of TBL was 1.17 per 100,000 person years (95% CI 0.98 to 1.36). The highest incidence was in status Aboriginals over 65 years (16.85 per 100,000 person years; 95% CI 3.37 to 30.33). TBL is seen most often in Western Pacific women. The most common presentation was a single, enlarged cervical node (80%). No atypical mycobacterium was found. Drug resistance occurred in 13% of cases and only in the foreign-born. Cure rates (81%) were influenced by comorbidity and burden of TB disease. Relapse occurred in 8.1 per 1000 person years of follow-up (95% CI 1.7 to 23.7).


CONCLUSIONS
Respiratory physicians, who manage the majority of TB disease in Canada, need to remain aware that TB is an important and treatable cause of enlarged lymph nodes.
Cook
Victoria J
VJ
University of Manitoba, Health Sciences Centre, Winnipeg, Canada. victoria.cook@bccdc.ca
Manfreda
Jure
J
Hershfield
Earl S
ES
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology
D000995:Antitubercular Agents