scholarly journals Role of CB-NAAT in diagnosing extra pulmonary tuberculosis in correlation with FNA in a tertiary care center

Author(s):  
Sunil Kumar Komanapalli ◽  
Uma Prasad ◽  
Bhagyalakshmi Atla ◽  
Vasundhara Nammi ◽  
Divya Yendluri

Background: The diagnosis of extra-pulmonary tuberculosis (EPTB) is challenging due to the pauci-bacillary nature of disease. Recently, WHO recommends GeneXpert/CBNAAT to be used as the initial diagnostic test in patients suspected extra-pulmonary tuberculosis (EPTB). The study was done to assess the role of Cartridge Based Nucleic Acid Amplification Test (CB-NAAT) in the diagnosis of EPTB. Aims and objectives was to study the role of FNAC, CBNAAT and Fluorescent LED in diagnosing extra-pulmonary tuberculosis (EPTB).Methods: This is a descriptive observational study carried out over a period of 12 months (April 2017 to March 2018) at department of Pathology, Andhra Medical College. All presumptive cases of extrapulmonary tuberculosis and purulent aspirates from the various sites between the age group of <10yrs to 60 years of age were included in the study. FNA was done and material sent to CBNAAT and fluorescent LED (Light-emitting Diode) microscopy in all the cases and results tabulated.Results: The total number of cases with presumptive extra pulmonary Tb were 289. Majority of the aspirates are from lymph nodal and cervical swellings 94.1% (272/289). CBNAAT has detected 6.5 % of cases (19/289) which were not detected by FNA and 9.3% of cases (27/289) LED negative cases. Resistant to rifampicin was identified in 2.1% (3/142 cases) of CBNAAT positive cases.Conclusions: FNA still remains the cheapest test to diagnose TB. In cases with Granulomatous lymphadenitis and purulent aspirates CBNAAT has an important role in diagnosing EPTB. In addition it offered rapid detection of rifampicin-resistant M. tuberculosis strains which is an added advantage.

2021 ◽  
pp. 25-26
Author(s):  
Chhotala Yagnik ◽  
Vishal Oza ◽  
Chetal Suva

Background:Extra-pulmonary tuberculosis can affect the lymph nodes, pleura, bones, joints, genito-urinary tract, nervous system (meningitis, tuberculoma), abdominal tuberculosis (intestines, mesentery, solid organs), skin. Materials and Methods: It is a record based, observational prospective study which assesses the presentation and evaluation of the site of distribution of extrapulmonary tuberculosis and management of it in a tertiary care hospital. Result:In present study, 26% of cases from lymph node TB, 20% cases from CNS and pleural TB, 18% cases from GIT, 8% cases from skeletal TB, 4% cases from GUT, 2% cases from ocular and 2% cases from pericardial TB Conclusion:The frequency of extrapulmonary TB in this study was highest in lymph node followed by pleural, CNS, GIT, skeletal and others respectively


2021 ◽  
pp. 3-4
Author(s):  
Chhotala Yagnik ◽  
Chetal Suva ◽  
Vishal Oza

Background:Extra-pulmonary tuberculosis can affect the lymph nodes, pleura, bones, joints, genitourinary tract, nervous system (meningitis, tuberculoma), abdominal tuberculosis (intestines, mesentery, solid organs), skin. Materials and Methods: It is a record based, observational prospective study which assesses the presentation and evaluation of the socio-economic distribution of extrapulmonary tuberculosis and management of it in a tertiary care hospital. Result: In present study, out of 50 cases 52% patients were from low socio-economic class, 44% patients were from middle socioeconomic class and 4% were from high socio-economic class. Conclusion:The frequency of extrapulmonary TB in this study was highest in low socio-economic class followed by middle and high socio-economic class.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S808-S808
Author(s):  
Anchal Sharma ◽  
Kusum Sharma ◽  
Manish Modi ◽  
Aman Sharma

Abstract Background Rapid and accurate diagnosis of extra-pulmonary tuberculosis (EPTB) is imperative for early treatment and better patient outcome. Loop-mediated Isothermal Amplification (LAMP) is a promising nucleic-acid amplification assay. LAMP assay could be carried out in simple water bath under isothermal conditions in 60 minutes, and can be performed in any laboratory even in rural setting in resource poor endemic countries. We evaluated LAMP assay using two different target regions LAMP primers specific for Mycobacterium tuberculosis complex for the diagnosis of EPTB. Methods LAMP assay using 6 primers (each for IS6110 and IS1081) specific for Mycobacterium tuberculosis complex were performed on patients suspected of EPTB on various EPTB samples(CSF, Synovial fluid, Lymaphnode and tissue biopsies and various other samples) of 150 patients (50 confirmed, 100 suspected) Clinically suspected of EPTB and 100 non-TB control subjects. Results Overall LAMP test (using any of the two targets) had sensitivity and specificity of 96% and 100% for confirmed (50 culture positive) EPTB cases. In 100 clinically suspected but unconfirmed EPTB cases, LAMP was positive in 87 out of 100 cases (87%). Sensitivity of IS6110 LAMP, 1S1081 LAMP and IS6110 PCR for clinically suspected cases was 78 (78%), 84 (84%) and 70 (70%), respectively. In total 150 EPTB patients, the overall sensitivity of microscopy, culture, IS6110 PCR, IS6110 LAMP, 1081 LAMP and the LAMP test (if any of the two targets were used) were 4%, 33.3%, 74.6%, 82.66%, 87% and 92%, respectively. Specificity of all the tests was 100%. There were 8 cases which were missed by IS6110 LAMP and 2 cases by 1081 LAMP. Conclusion LAMP assay using two targets is a promising technique for rapid diagnosis of EPTB in 60 minutes especially in a resource poor setting who are still battling with this deadly disease. Disclosures All Authors: No reported disclosures


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