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Mycobacterial lymphadenitis in eastern Sydney

P Wark1, H Goldberg, M Ferson

  • 1Prince of Wales Hospital, Sydney, NSW.

Australian and New Zealand Journal of Medicine
|October 20, 1998
PubMed
Summary

Mycobacterial lymphadenitis in Sydney primarily affects immigrants with Mycobacterium tuberculosis (MTB) or HIV-positive individuals with atypical mycobacteria. Outcomes varied, with high mortality in HIV-positive patients and poor follow-up documentation.

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Microbiology

Background:

  • Tuberculosis (TB) resurgence noted globally, particularly extrapulmonary forms.
  • Lymphadenitis is the most common extrapulmonary manifestation of TB.
  • Review focuses on mycobacterial lymphadenitis in Sydney.

Purpose of the Study:

  • To review all cases of mycobacterial lymphadenitis in eastern Sydney.
  • To identify patient demographics and clinical characteristics.
  • To assess treatment outcomes and identify risk factors.

Main Methods:

  • Retrospective review of medical records (1989-1996).
  • Inclusion of 54 patients with TB presenting as lymphadenitis.
  • Data collection from Prince of Wales, Sydney Children's, and St Vincent's Hospitals.

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Main Results:

  • Two groups identified: Mycobacterium tuberculosis (MTB) (68.5%) and atypical mycobacteria (31.5%).
  • MTB group: predominantly foreign-born, 18.9% HIV-positive, 73% single node involvement, 73.1% complete resolution.
  • Atypical mycobacteria group: Australian-born children (HIV-negative) and adults (HIV-positive); high mortality (83.3%) in HIV-positive adults.

Conclusions:

  • MTB lymphadenitis in HIV-negative individuals often linked to immigration.
  • HIV-positive patients experienced diffuse disease and high mortality.
  • Significant issues with outcome reporting and follow-up documentation were identified.