Related Experiment Video
Updated: Feb 19, 2026
Optimized Protocols for Mycobacterium leprae Strain Management: Frozen Stock Preservation and Maintenance in Athymic Nude Mice
Published on: March 23, 2014
Comparison of Conventional Ziehl-Neelsen Method of Acid Fast Bacilli with Modified Bleach Method in Tuberculous
Mani Krishna1, Sheetal G Gole2
1Department of Pathology, UP University of Medical Sciences, Saifai Etawah, Uttar Pradesh, India.
Insights
The bleach concentration method significantly improves acid-fast bacilli detection in tuberculous lymphadenitis compared to the Ziehl-Neelsen stain. This enhanced sensitivity aids in diagnosing tuberculosis, especially in challenging cases.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Cytopathology
Background:
- Tuberculosis (TB) remains a significant global health challenge, particularly in developing nations.
- Lymphadenopathy is the most frequent manifestation of TB.
- Fine needle aspiration cytology (FNAC) is a key diagnostic tool for tuberculous lymphadenitis.
Purpose of the Study:
- To evaluate the efficacy of the bleach concentration method for detecting acid-fast bacilli (AFB) in FNAC samples.
- To compare the diagnostic yield of the bleach method with the conventional Ziehl-Neelsen (ZN) staining technique.
Main Methods:
- A study involving 75 patients with suspected tuberculous lymphadenopathy.
- Collection and cytomorphological analysis of lymph node aspirates.
- Direct smear microscopy using conventional Ziehl-Neelsen and bleach concentration methods.
Main Results:
- The bleach concentration method identified AFB in 49 out of 75 cases (65.33%).
- It revealed an additional 34 positive cases not detected by the conventional Ziehl-Neelsen method.
- The bleach method demonstrated a higher case detection rate for AFB.
Conclusions:
- The bleach concentration method offers superior sensitivity for AFB detection in tuberculous lymphadenitis compared to the Ziehl-Neelsen method.
- This improved sensitivity can aid in diagnosing challenging cases where conventional methods are inconclusive.
- The bleach method is a valuable adjunct for diagnosing tuberculosis in lymph node aspirates.
Introduction:
Tuberculosis caused by Mycobacterium tuberculosis is a chronic infectious disease and a major health problem in developing countries, with lymphadenopathy being the most common presentation. Tuberculous lymphadenitis can be diagnosed on fine needle aspiration cytology of lymph node. Conventional Ziehl-Neelsen method for acid fast bacilli plays a key role in the diagnosis and monitoring of treatment for tuberculosis, however, with low sensitivity. Present study emphasizes the role of bleach concentration method in fine needle aspiration cytology of lymph nodes over conventional direct smear microscopy.
Materials And Methods:
The study included 75 patients with clinically suspected tuberculous lymphadenopathy who were referred to the Department of Pathology in a tertiary care hospital, Faridabad. Data regarding age, sex, duration and site of swelling, nature of aspirate, and cytomorphological diagnosis were documented for each patient.
Results:
Of the total 75 cases, 15 were positive both in conventional Ziehl-Neelsen method and bleach concentration method. By bleach concentration method, additional 34 cases showed positivity that were not revealed by conventional Ziehl-Neelsen method. Thus, a total 49 cases were positive for acid fast bacilli.
Conclusion:
There are problems in arriving at an absolute diagnosis in certain cases of tuberculous lymphadenitis when the aspirate shows polymorphous picture with occasional epithelioid cells and absence of typical Langhans giant cell or caseous necrosis. In the present study, acid fast bacilli positivity was established in 65.33% of the cases with the bleach method. Bleach method for detection of tubercle bacilli has a high case detection rate than that of the conventional Ziehl-Neelsen method.
More Related Videos
06:26Author Spotlight: Optimizing CFU Determination for Efficient Assessment of TB Vaccine Efficacy and Antigen Presentation Analysis
Published on: July 28, 2023
06:52Optimized Workflow for Iterative Bleaching Extends Multiplexity Imaging of Highly Autofluorescent Clinical Samples
Published on: July 11, 2025
Related Concept Videos
01:26Differential Staining Technique
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:13Special Staining Techniques