title: Tuberculosis of superficial lymph nodes, a not so rare event to consider in diagnosis. A case in an elderly male.
abstract: Tuberculosis (TB) is still one of the most frequent infectious diseases worldwide. Until the 1990s, Western European countries showed a low frequency of TB infection, but the rise of immigration has led to a rapid increase in its occurrence. In the elderly, TB is emerging as a significant health problem (age-related decline of the cell-mediated immunity, associated illnesses, use of immunosuppressive drugs, malnutrition, poor life conditions), although its detection and diagnosis is not easy also considering its subclinical presentation. Almost 70% of all TB infections in Italy are found in the lungs; 50% of the extrapulmonary infections affect lymph nodes. Due to the low incidence of superficial tuberculous lymphadenitis without pulmonary manifestations, the possibility of a TB aetiology is often not taken into consideration in the differential diagnosis of lymphadenopathy, resulting in significant delay of appropriate treatment. Herein, we describe the case of a 78-year-old male with nocturnal fever, weakness, night sweats, loss of weight and decay in general condition. The patient had a past medical history of prostate adenocarcinoma treated with hormone therapy. The past medical history in association with clinical findings and laboratory data (anaemia, high titers of fibrinogen and reactive C-protein) led to the suspect of metastatic adenocarcinoma. Only histological and molecular biology findings allowed us to make a correct diagnosis of TB.
authors.affiliation: Geriatric Unit, "Pugliese-Ciaccio" Hospital, Catanzaro, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Merante
authors.forename: M R
authors.initials: MR
authors.lastname: Ambrosio
authors.forename: B J
authors.initials: BJ
authors.lastname: Rocca
authors.forename: A M
authors.initials: AM
authors.lastname: Condito
authors.forename: A
authors.initials: A
authors.lastname: Ambrosio
authors.forename: M
authors.initials: M
authors.lastname: Arvaniti
authors.forename: G
authors.initials: G
authors.lastname: Ruotolo
mesh_terms: D000230:Adenocarcinoma / Q000150:complications; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000473:pathology; D011471:Prostatic Neoplasms / Q000150:complications; D014388:Tuberculosis, Lymph Node / Q000150:complications / Q000473:pathology* / Q000503:physiopathology
chemical_list: D000995:Antitubercular Agents