Epidemiological, therapeutic and evolutionary profiles in patients with lymph node tuberculosis

Tuberculosis remains a public health concern worldwide particularly in Third World countries. Lymph node (LN) tuberculosis is the most frequent extra lung localization. Because of modern transport and mass migration from the developing to the developed world, it is important for all clinicians to keep this diagnostic possibility in mind. Evaluate demographic characteristics, diagnosis approaches, therapeutic strategies and evolutionary aspects while treatment in patients with confirmed LN tuberculosis. Data were retrospectively analyzed in 69 patients collected in 2 health centers in Rabat over a period of 4 years. There was a female (70%) and a young age predominance of patients (31.4 year +/-13.1). The median duration between the onset of symptoms and diagnosis was long: 115 days (interquartile range 34-150 days) explicated by low Socioeconomic conditions (p< 0.05). The cervical LN were most frequently involved (85.5%). The confirmation was histological in 98.5%, bacterial in the liquid from puncture LN in 1.5% of cases. 48% of patients had received treatment according to the national guide of tuberculosis. Half of the patients had received prolonged treatment on average of 7 months and a half (7.3 month +/-1.3) because of the paradoxical response (PR) (p< 0.05). At the end of treatment, LN had returned to their normal size in 80% of patients, we noted residual nodes in 11.6%, and a scrofula in 8.6%. The delay of diagnosis of LN tuberculosis is still important, and the treatment is prolonged because of PR.