Fine-needle extrathoracic lymph-node aspiration in HIV-associated sputum-negative tuberculosis

Area of Science:

• Infectious Diseases
• Public Health
• Microbiology

Background:

• HIV-associated tuberculosis presents atypical clinical and radiological features, complicating diagnosis.
• Diagnostic challenges are exacerbated by negative sputum smear results in many patients.
• Extrathoracic lymphadenopathy is a common finding in suspected intrathoracic tuberculosis cases.

Purpose of the Study:

• To evaluate the utility of extrathoracic lymph node aspirate analysis for diagnosing tuberculosis.
• To assess the effectiveness of Ziehl-Neelsen staining in resource-limited settings.

Main Methods:

• Fine-needle aspiration of palpable extrathoracic lymph nodes was performed.
• Aspirates were analyzed using Ziehl-Neelsen staining for acid-fast bacilli.
• Diagnostic yield was compared with final tuberculosis diagnoses.

Main Results:

• Ziehl-Neelsen staining identified acid-fast bacilli in 71% (20/28) of suspected tuberculosis cases.
• The diagnostic yield reached 87% (20/23) in patients with a confirmed tuberculosis diagnosis.
• Aspiration provided a definitive diagnosis in a significant proportion of patients.

Conclusions:

• Lymph node aspiration with Ziehl-Neelsen staining is a valuable diagnostic tool for tuberculosis.
• This simple, rapid, and inexpensive method is particularly beneficial in developing countries with limited resources.
• It offers a crucial alternative for diagnosing tuberculosis when conventional methods fail.