[Tuberculous lymphadenitis in a general hospital]

All cases of tuberculous lymphadenitis admitted over a 43-year period (1951-1993) were surveyed. The diagnosis was validated in 188 cases. The incidence was 2.74 cases per year, but there was a cluster of 94 cases in the first 20 years. 50.8% had local signs alone, while 36.4% had both local and systemic signs. Nodes affected showed either painless or painful swelling, and sometimes there was drainage. Cervical nodes were affected most frequently, and the commonest general symptom was fever, followed by fatigue. In 28.8% there was pulmonary tuberculosis, in 14.4% other forms of extrapulmonary tuberculosis, and in 9.3% only active tuberculous lymphadenitis. Most of the patients had immigrated to Israel from eastern Europe and the Yemen. Though tuberculous lymphadenitis has become infrequent, it is still the commonest form of extrapulmonary tuberculosis. A high index of suspicion is needed to diagnose accurately and treat this potentially curable condition.