scholarly journals Comparison of PCR with standard culture of fine needle aspiration samples in the diagnosis of tuberculosis lymphadenitis

2011 ◽  
Vol 6 (01) ◽  
pp. 53-57 ◽  
Author(s):  
Yohannes Derese ◽  
Elena Hailu ◽  
Tekalign Assefa ◽  
Yonas Bekele ◽  
Adane Mihret ◽  
...  
Keyword(s):  
Bacterial Culture ◽  
Extrapulmonary Tuberculosis ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Pcr Diagnosis ◽  
Suspected Tuberculosis ◽  
Standard Culture ◽  
Safety Procedures ◽  
Culture Positive ◽  
Culture Negative

Introduction: Lymphadenopathy is the commonest form of extrapulmonary tuberculosis (TB) Clinical diagnosis of TB in lymph nodes requires aspiration of the material and isolation of mycobacteria.  Bacterial culture is the gold standard for detection of tubercle bacilli, but it is time-consuming and requires specialized safety procedures and a BSL3 laboratory. However, PCR is a rapid method which requires small volumes of samples and can also be performed on killed bacilli to ensure safety. This project was designed to compare direct fine needle aspirate (FNA) PCR with culture in the diagnosis of tuberculosis lymphadenitis. Methodology: Direct examination of samples with EZN staining, culture, cytology and PCR was performed on previously collected FNA from the patients with suspected tuberculosis lymphadenitis Results: In total, 38% of the samples were positive for TB by culture, 11.8% by EZN staining, 23.4% by PCR, and 59.8% by cytology. Cytology had the highest sensitivity (81%) and EZN stain the least (22.9%). The specificity of EZN stain was the highest (92.4%) while cytology was the lowest (50%). In this study, out of 50 culture-positive samples, 21 (42%) were positive by PCR while 8 (10.8%) out of 74 culture-negative samples were positive by PCR. Conclusions: Although PCR is a sensitive diagnostic method, its sensitivity was shown to be low in this study. Therefore, we recommend that further studies should be conducted on fresh aspirate samples to investigate for possible PCR inhibitors which may limit the sensitivity of PCR diagnosis.

Cervical lymphadenopathy: scrofula revisited

2008 ◽  
Vol 123 (7) ◽  
pp. 764-767 ◽  
Author(s):  
R Khan ◽  
S H Harris ◽  
A K Verma ◽  
A Syed
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Extrapulmonary Tuberculosis ◽  
Cervical Lymphadenopathy ◽  
Polymerase Chain Reaction Analysis ◽  
Needle Aspiration ◽  
Cervical Lymphadenitis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

AbstractBackground:The commonest form of extrapulmonary tuberculosis is tubercular cervical lymphadenitis, or scrofula.Methods and results:A total of 1827 patients with cervical lymphadenopathy who presented to various out-patients clinics of our institution were studied over a three-year period. Eight hundred and ninety-three (48.87 per cent) of these patients had lesions of tubercular origin. The most common observation was unilateral, matted adenopathy in female patients aged between 11 and 20 years and without constitutional symptoms of tuberculosis. Posterior triangle nodes were affected in 43.8 per cent of cases, followed by upper deep cervical nodes in 33.9 per cent. Fine needle aspiration cytology constituted the main diagnostic tool, with a positive yield in 90 per cent of patients. Polymerase chain reaction analysis was performed in 126 patients, with a sensitivity of 63 per cent. Only 18 per cent of patients had associated pulmonary tuberculosis, the rest having isolated involvement of cervical nodes. Medical treatment with anti-tubercular drugs for a period of six months formed the mainstay of treatment and cure. Surgical management was reserved for selected refractory patients.Conclusion:Tubercular cervical lymphadenitis can readily be diagnosed by fine needle aspiration cytology, a simple and cost-effective test. The disease can be cured completely by a short course of anti-tubercular chemotherapy, without surgical intervention.

Diagnosis of Clinically Unsuspected Extrapulmonary Tuberculosis by Fine Needle Aspiration

2001 ◽  
Vol 45 (6) ◽  
pp. 1032-1036 ◽  
Author(s):  
Heather M. Brown ◽  
Patricia L. Abbitt ◽  
Edward J. Wilkinson
Keyword(s):  
Fine Needle Aspiration ◽  
Extrapulmonary Tuberculosis ◽  
Needle Aspiration ◽  
Fine Needle

scholarly journals MON-482 Thyroid Tuberculosis - An Unlikely Diagnosis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Alexandra Novais Araújo ◽  
Tânia Matos ◽  
Ema Nobre ◽  
Maria Joao Bugalho
Keyword(s):  
Lymph Node ◽  
Fine Needle Aspiration ◽  
Histopathological Examination ◽  
Extrapulmonary Tuberculosis ◽  
Needle Aspiration ◽  
Tuberculous Infection ◽  
Rare Presentation ◽  
Adequate Treatment ◽  
Fine Needle ◽  
The Right

Abstract Background: Mycobacterium tuberculosis (MTB) is an aerobic bacillus responsible for the most cases of tuberculous infection. Approximately one-third of the world’s population is infected. Tuberculosis (TB) of the thyroid gland is an unusual diagnosis with an estimated prevalence of 0.1 to 0.6%. The thyroid TB can mimic different pathologies (thyroid neoplasms, lymphoma, infectious or granulomatous thyroiditis, Graves’ disease or bacterial abscess) and the diagnosis can be easily disregarded, especially in non-endemic countries and if the patient doesn’t have systemic symptoms. The fine needle aspiration and histopathological examination, with acid-fast bacilli staining and TB culture, are the gold standard exams. Clinical Case: A 71-year-old female was referred to our Endocrinology department after a diagnosis of nodular thyroid disease. She had complaints of slight cervical discomfort, with 6 months of duration. She hadn’t personal or familiar relevant antecedents. At observation, a movable, elastic and non-tender nodule of 15mm at the right superior thyroid lobe was identified. Blood tests including a thyroid profile were normal. The neck ultrasound showed, at the right lobe of the thyroid, multiple solid nodules; the dominant had 18mm, was heterogeneous and had multiple calcifications. Moreover, lymph nodes with suspicious ultrasonographic features along the right internal jugular chain were reported. The patient underwent fine-needle aspiration (FNA) of the suspicious thyroid nodule and one lymph node. Results were respectively: non-diagnostic (Bethesda I) and reactive pattern. FNA was repeated on a different occasion and results were similar. Due to ultrasound suspicious of malignancy, a total thyroidectomy was performed and a lymph node from level IV was sampled for extemporaneous examination. Necrotizing granulomas were documented; the Ziehl-Neelson staining (ZNS) was negative; material was sent to microbiology. Following this finding, ganglion emptying was not performed. The thyroid histology showed tuberculoid type granulomas with lymphoid border and central necrosis. However, the ZNS was negative. The diagnosis was definitely established by a positive culture of the lymph node tissue and molecular detection, by polymerase chain reaction (PCR), of MTB. Pulmonary involvement was excluded and she started antituberculous agents planned for 9 months (rifampicin and isoniazid during 9 months and ethambutol and pyrazinamide for 2 months). Conclusion: Thyroid TB is a rare presentation of extrapulmonary tuberculosis. In presence of systemic or specific complaints or history of exposition the diagnosis may be suspected and confirmatory tests requested in order to ensure an adequate treatment. However, sometimes, histopathology remains a key step and the use of cultures improves the sensitivity and specificity of TB tests.

scholarly journals Associations Between Procalcitonin and Markers of Bacterial Sepsis

Medicina ◽  
2012 ◽  
Vol 48 (8) ◽  
pp. 57 ◽  
Author(s):  
Veeresh Patil ◽  
Jaymin Morjaria ◽  
Francois De Villers ◽  
Suresh Babu
Keyword(s):  
Bacterial Culture ◽  
White Cell Count ◽  
Bacterial Sepsis ◽  
Reactive Protein ◽  
Paired Samples ◽  
Positive Bacterial Culture ◽  
Specificity And Sensitivity ◽  
Significant Difference ◽  
Culture Positive ◽  
Culture Negative

Background. Bacterial sepsis with no bacterial isolates can be a difficult clinical conundrum, where other markers like C-reactive protein (CRP), white cell count (WCC), and neutrophilia are helpful to arrive at a diagnosis. Procalcitonin (PCT) has been shown to be a useful biomarker in bacterial sepsis. The aim of the study was to look at the association of PCT with bacterial cultures and compare this to currently used markers of bacterial sepsis. Material and Methods. WCC, neutrophil count, and CRP with PCT were compared in patients with a positive bacterial culture from blood/body fluid. The specificity and sensitivity of PCT were compared with those of CRP. Results. Of the 99 paired samples obtained, 25 cultures were positive for bacteria. There was a significant difference in CRP (P=0.04) and PCT (P<0.001) levels between culture-positive and culture-negative samples. PCT had a better sensitivity and specificity than CRP (84% and 64.9% vs. 69.6% and 52.9%, respectively), with a combined specificity (CRP and PCT) of 83.5%. Conclusions. PCT has a better association with bacterial sepsis and is superior to currently available biomarkers in the clinical setting. The rapid pharmacodynamics of PCT can serve as an early predictor of the diagnosis of bacterial sepsis while awaiting the bacterial culture results avoiding undue delay in the institution of antibiotics, hence, potentially improving the prognosis of patients with bacterial sepsis.

Role of Fine Needle Aspiration Cytology in Extrapulmonary Tuberculosis

2021 ◽  
Vol 18 (2) ◽  
pp. 31-34
Author(s):  
Subarna Acharya ◽  
Sharmila Gupta
Keyword(s):  
Pulmonary Tuberculosis ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Extrapulmonary Tuberculosis ◽  
Needle Aspiration ◽  
Age Group ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Introduction: Extrapulmonary tuberculosis is equally important as that of pulmonary tuberculosis. Fine needle aspiration cytology (FNAC) is accurate, cost effective, minimal invasive outpatient procedure and aids in prompt diagnosis of extrapulmonary tuberculosis. Aims: To determine the role of fine needle aspiration cytology for diagnosis of extra pulmonary tuberculosis. Methods: This is a hospital based descriptive study done over a period of one and half year April 2019 to October 2020 at Nepalgunj Medical College Teaching Hospital, Nepalgunj, Nepal. All the 80 patients who were clinically suspected for tuberculosis had undergone fine needle aspiration cytology and diagnosed as tuberculosis in cytology were included in study. Cytological diagnosis was made with microscopic features and positive acid fast bacilli staining. Microscopy showed epithelioid histiocytes, granulomas, multinucleated giant cells, caseous necrosis, neutrophils and mature lymphocytes. Results: Out of 930 cases received, 80 cases were diagnosed as tuberculosis in cytology. 33 cases were diagnosed with acid fast bacilli positive. Rest was diagnosed with cytological features. Among 80 aspirated samples, a portion of purulent specimen was evaluated with Genexpert test in 11 cases for Mycobacterium Tuberculosis detection and rifampicin sensitivity/ resistant. Out of 11 positive patients in Genexpert tests; 10 were rifampicin sensitive and one was rifampicin resistant. Conclusion: Common presentation of extrapulmonary tuberculosis is in lymph nodes with increased frequency in age group of 21 to 30 years. Therefore, lymph nodes in this age group should be prioritized more for investigation of extrapulmonary tuberculosis.

scholarly journals A Case of DisseminatedMycobacterium aviumInfection in a Dog in Greece

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
V. Kontos ◽  
E. I. Papadogiannakis ◽  
G. Mantziaras ◽  
M. Styliara ◽  
S. Kanavaki
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Mycobacterium Avium ◽  
Fine Needle Aspiration ◽  
Bacterial Culture ◽  
Pcr Amplification ◽  
Needle Aspiration ◽  
Molecular Techniques ◽  
Fine Needle ◽  
Pcr Products

A Basset Hound dog was presented with anorexia, fever, diarrhea, significant level of splenomegaly, and enlargement of mesenteric and superficial lymph nodes. Cytology of fine-needle-aspiration material, obtained from popliteal lymph node, revealed macrophages with intracytoplasmic, nonstaining, slender, rod-like structures, indicative of mycobacteria. Bacterial culture of lymph node aspirated material produced a colony which by means of molecular techniques (PCR amplification and hybridization of PCR products) was subsequently identified asMycobacterium avium. This is the first report of disseminatedM. aviuminfection in a dog in Greece.

scholarly journals Evaluation of the Xpert MTB/RIF Ultra Assay for Direct Detection ofMycobacterium tuberculosisComplex in Smear-Negative Extrapulmonary Samples

2018 ◽  
Vol 56 (9) ◽  
Author(s):  
Daniel Perez-Risco ◽  
David Rodriguez-Temporal ◽  
Ivan Valledor-Sanchez ◽  
Fernando Alcaide
Keyword(s):  
Nontuberculous Mycobacteria ◽  
Direct Detection ◽  
Extrapulmonary Tuberculosis ◽  
High Sensitivity ◽  
Rapid Diagnosis ◽  
Clinical Samples ◽  
Content Type ◽  
Smear Negative ◽  
Culture Positive ◽  
Culture Negative

ABSTRACTThe rapid detection ofMycobacterium tuberculosiscomplex (MTUBC) in clinical samples is essential for successful treatment. New techniques such as real-time PCR have been developed in order to facilitate rapid diagnosis, but their sensitivity is low in extrapulmonary specimens, due to the low bacillary load in such samples. A next-generation assay has recently been developed to try to overcome this limitation. The aim of this study was to analyze the effectiveness of the Xpert MTB/RIF Ultra (GX-Ultra) for the detection of MTUBC DNA in 108 smear-negative extrapulmonary specimens that were MTUBC culture positive. In addition, 40 extrapulmonary culture-negative samples and 20 samples with nontuberculous mycobacteria were tested to evaluate the specificity of the assay. All samples were collected between May 1999 and May 2017. The GX-Ultra detected DNA of MTUBC in 82 extrapulmonary specimens that were MTUBC culture positive (75.9% sensitivity; 95% confidence interval [CI], 66.6 to 83.4%). The assay was negative for all clinical specimens that were MTUBC culture negative and the samples with nontuberculous mycobacteria (100% specificity). Furthermore, two (1.8%) samples presented mutations related to rifampin resistance. The highest sensitivity was obtained in samples of lymph nodes (94.1%) and nonsterile fluids (93.7%), followed by tissue specimens (86.6%), stool material (80%), abscess aspirates (64.7%), and sterile fluids (60.5%). Pleural fluids, one of the least optimal samples for detecting DNA of MTUBC, were GX-Ultra positive in 10/21 (47.6%) of cases. In summary, GX-Ultra showed excellent specificity and high sensitivity in paubacillary specimens, making it a useful tool for rapid diagnosis of extrapulmonary tuberculosis.

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