Necrotising granulomatous lymphadenitis.
Extrapulmonary tuberculosis (EPTB) is defined as Mycobacterium TB through Ziehl-Neelsen acid-fast stain and culture in Loewenstein-Jensen in a tissue from a site other than lung parenchyma, in association with clinical or imaging findings compatible with infection locally. The authors report a case of a patient who presented with asthenia, anorexia and weight loss. He complained of fever, chills and night sweats of 1-week duration. The thoracic scan reveals lymph node enlargement in the left axilla and pleural effusion and the histological study revealed a necrotising granulomatous lymphadenitis. It was decided to initiate antituberculous drugs with a good response. EPTB is a difficult diagnostic because lymph nodes contain few tubercle bacilli, leading to a low sensitivity of smear microscopy detection. The introduction of antituberculous agents is the cornerstone of management of such infections and, occasionally, it is the only way to make a diagnosis.
Department of Internal Medicine, Faro's Hospital, Rua leao penedo, Faro, Portugal. jeanfrancoisalves@sapo.pt
François
F
Alves
Ana
A
Baptista
Helena
H
Brito
Idálio
I
Mendonça
D000369:Aged, 80 and over; D006099:Granuloma; D006801:Humans; D008297:Male; D009336:Necrosis; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000473:pathology