title: Comparison of the modified fluorescent method and conventional Ziehl-Neelsen method in the detection of acidfast bacilli in lymphnode aspirates.
abstract: OBJECTIVE
  The objectives were to correlate the modified fluorescent method with the conventional Ziehl-Neelsen (ZN) method for the detection of acid-fast bacilli (AFB) and, also to study the efficacy and advantages of using the auramine-rhodamine stain on lymph node aspirates under fluorescent microscopy.
  
  
  METHODS
  In 108 consecutive patients with a clinical suspicion of tuberculosis (TB) presenting with lymphadenopathy, fine needle aspirations were performed. Smears from the aspirates were processed for routine cytology, the conventional ZN method, and the modified fluorescent method. The significance of the modified fluorescent method over the conventional ZN method was analyzed using the chi-square test.
  
  
  RESULTS
  Out of 108 aspirates, 102 were studied and remaining 6 were excluded from the study due to diagnosis of malignancy in 4.04% (4/6) and inadequate aspiration in 2.02% (2/6). Among the 102 aspirates, 44.11% (45/102) were positive for AFB on the conventional ZN method, 58.9% (60/102) were indicative of TB on cytology, while the smear positive increased to 81.37% (83/102) on the modified fluorescent method.
  
  
  CONCLUSIONS
  Fluorescent microscopy has the advantage of speed and ease of screening, and reduces observer fatigue. The modified fluorescent method was found to be more advantageous than routine cytology and conventional ZN method, particularly in paucibacillary cases. The bacillary positivity rates were higher in the modified fluorescent method than in the ZN method. Hence, the modified fluorescent method can be an adjuvant when used with routine cytology for the identification of AFB.
authors.affiliation: Department of Pathology, Sree Siddhartha Medical College & Research Center, Tumkur, India. vamseedhar_a@yahoo.com
authors.forename: Vamseedhar
authors.initials: V
authors.lastname: Annam
authors.forename: Mohan H
authors.initials: MH
authors.lastname: Kulkarni
authors.forename: Rekha B
authors.initials: RB
authors.lastname: Puranik
references.citation: Indian Pediatr. 1999 Sep;36(9):921-3
references.pmid: 10744873
references.citation: East Afr Med J. 1993 May;70(5):263-6
references.pmid: 8306899
references.citation: Acta Cytol. 1987 Jan-Feb;31(1):8-13
references.pmid: 3468720
references.citation: J Laryngol Otol. 1991 Jul;105(7):558-61
references.pmid: 1908506
references.citation: Br J Surg. 1990 Aug;77(8):911-2
references.pmid: 2118407
references.citation: Rev Infect Dis. 1989 Mar-Apr;11 Suppl 2:S471-8
references.pmid: 2652258
references.citation: J Infect Dis. 1992 Nov;166(5):1177-80
references.pmid: 1402031
references.citation: Mikrobiyol Bul. 2003 Apr-Jun;37(2-3):131-6
references.pmid: 14593894
references.citation: Southeast Asian J Trop Med Public Health. 1998 Dec;29(4):860-3
references.pmid: 10772577
references.citation: Indian J Med Res. 1959 Sep;47:495-9
references.pmid: 14402832
references.citation: Indian J Med Res. 1974 Nov;62(11):1631-46
references.pmid: 4448509
references.citation: Am Rev Respir Dis. 1990 Sep;142(3):725-35
references.pmid: 2389921