title: Rapid culture diagnosis of tuberculous lymphadenitis from a tertiary care centre in an endemic nation: potential and pitfalls.
abstract: In spite of low sensitivity and specificity, standard diagnostic algorithm recommends fine needle aspiration cytology (FNAC) and direct microscopic screening for acid-fast bacilli (AFB) for the routine diagnosis of tuberculous lymphadenopathy (LNTB). In this study, the diagnostic utility of liquid broth based automated culture (BacT/ALERT 3D) technique was assessed in comparison with conventional techniques in 89 clinically suspected tubercular lymphadenitis patients. 60% (n = 53) were positive by FNAC and 38.4% (n = 34) demonstrated AFB in smear examination. BacT/ALERT yielded isolation in 43.1% (n = 38) aspirates, confirming tubercular aetiology. We also found six paediatric culture-positive cases which showed negative outcome by both FNAC and smear. Thus, we conclude that culture by BacT/ALERT, may be used for faster yield of Mycobacteria in LNTB, especially in children. Additionally, this could also be used as a platform for further differentiation of Mycobacterium tuberculosis from non-tuberculous mycobacteria (NTM) infection and for testing of anti-tubercular chemotherapeutic agents whenever drug resistance is suspected.
authors.affiliation: Department of Microbiology, VMMC and Safdarjung Hospital, India.
authors.forename: J S
authors.initials: JS
authors.lastname: Verma
authors.forename: I
authors.initials: I
authors.lastname: Dhavan
authors.forename: D
authors.initials: D
authors.lastname: Nair
authors.forename: N
authors.initials: N
authors.lastname: Manzoor
authors.forename: D
authors.initials: D
authors.lastname: Kasana
mesh_terms: D000293:Adolescent; D000328:Adult; D057205:Automation, Laboratory / Q000379:methods; D001431:Bacteriological Techniques / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009169:Mycobacterium tuberculosis / Q000254:growth & development / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers; D013997:Time Factors; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis*