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Profile of Tuberculous Cervical Lymphadenopathy in Children

Ira Shah1, Samruddhi Dani1

  • 1Pediatric TB Clinic, B J Wadia Hospital for Children, Mumbai, India.

Journal of Tropical Pediatrics
|February 4, 2017
PubMed

Insights

Tuberculous cervical lymphadenopathy is uncommon in children, often presenting bilaterally around age 7. A significant proportion of these cases exhibit drug-resistant tuberculosis (TB), highlighting a critical clinical challenge.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Mycobacteriology

Background:

  • Tuberculous cervical lymphadenopathy (TCL) is a significant extrapulmonary manifestation of tuberculosis (TB).
  • Understanding the clinical characteristics of TCL in pediatric populations is crucial for timely diagnosis and effective management.
  • Pediatric TB often presents with atypical symptoms, necessitating focused research on specific clinical forms like TCL.

Purpose of the Study:

  • To analyze the clinical profile of children diagnosed with tuberculous cervical lymphadenopathy.
  • To determine the prevalence, demographic features, and microbiological characteristics of pediatric TCL.
  • To investigate the incidence of drug resistance and prior TB history in children with TCL.

Main Methods:

  • Retrospective analysis of clinical data from 1582 children with tuberculosis (TB).
  • Identification of a subgroup (63 children) with confirmed tuberculous cervical lymphadenopathy.
  • Microbiological evaluation including Mycobacterium tuberculosis culture and drug resistance testing.

Main Results:

  • Tuberculous cervical lymphadenopathy (TCL) was identified in 4% (63/1582) of pediatric TB cases.
  • The mean age of presentation was 7.4 years, with bilateral lymphadenopathy observed in 46% of cases.
  • Mycobacterium tuberculosis was cultured in 59.1% of cases, with a high prevalence of drug resistance, including pre-XDR and XDR strains.

Conclusions:

  • Tuberculous cervical lymphadenopathy is relatively uncommon in children but frequently involves bilateral lymph nodes.
  • Pediatric TCL cases present a significant challenge due to a high prevalence of drug-resistant Mycobacterium tuberculosis strains.
  • Early recognition and appropriate diagnostic workup are essential for managing pediatric TCL, especially in regions with high TB and drug resistance burdens.
Abstract

Keywords:
cervical lymphadenopathychildrentuberculosis

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