Clinical features of tuberculous lymphadenitis in a low-incidence country
Background: Tuberculous lymphadenitis (TBLA) is the most common extrapulmonary manifestation of tuberculosis (TB) in Denmark. However, the clinical features of patients with TBLA have never been systematically studied in this setting. Methods: Patients treated for TBLA in Central Region Denmark from...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220305543 |
| _version_ | 1818317658771161088 |
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| author | Victor Dahl Mathiasen Peter Henrik Andersen Isik Somuncu Johansen Troels Lillebaek Christian Wejse |
| author_facet | Victor Dahl Mathiasen Peter Henrik Andersen Isik Somuncu Johansen Troels Lillebaek Christian Wejse |
| author_sort | Victor Dahl Mathiasen |
| collection | DOAJ |
| description | Background: Tuberculous lymphadenitis (TBLA) is the most common extrapulmonary manifestation of tuberculosis (TB) in Denmark. However, the clinical features of patients with TBLA have never been systematically studied in this setting. Methods: Patients treated for TBLA in Central Region Denmark from 2007 to 2016 were identified using the national TB surveillance register and The Danish Hospital Patient Registry. Data of clinical characteristics and treatment were extracted from hospital records. Results: Eighty-three TBLA patients were identified. The median age was 32 years (IQR 23–42); 71 (85.5%) were migrants; 58 (69.9%) presented with cervical lymphadenopathy; and 45 (54.2%) had one or more systemic TB symptom such as fever, chills, night sweats, fatigue, and weight loss. Sixty-five patients had no comorbidities (78.3%). HIV co-infection was seen in five (7.2%) of the 69 who were tested for HIV. Abscesses and/or draining sinuses were noted in 13 (15.7%) patients and 15 (18.1%) had concurrent pulmonary infection. The median time from first hospital contact to treatment initiation was 42 days (IQR 16–82) and admitted patients were hospitalised for a median of 7 days (IQR 3–13.5). For 24 patients (28.9%), lymph node material was not sent for mycobacterial culture and 52 (62.7%) had microbiologically confirmed TB. Treatment outcome was successful for 70 patients (84.3%). Conclusion: In Denmark, TBLA is mainly seen among young and previously healthy migrants presenting with cervical lymphadenopathy and sparse systemic symptoms. The diagnosis is often considerably delayed and not microbiologically verified, implying diagnostic difficulties. Treatment outcome needs to be improved. |
| first_indexed | 2024-12-13T09:40:50Z |
| format | Article |
| id | doaj.art-410ffc10241d4803944d2de7e42e116d |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-13T09:40:50Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-410ffc10241d4803944d2de7e42e116d2022-12-21T23:52:12ZengElsevierInternational Journal of Infectious Diseases1201-97122020-09-0198366371Clinical features of tuberculous lymphadenitis in a low-incidence countryVictor Dahl Mathiasen0Peter Henrik Andersen1Isik Somuncu Johansen2Troels Lillebaek3Christian Wejse4Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; Centre for Global Health (GloHAU), Department of Public Health, Aarhus University, Aarhus, Denmark; International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark; Corresponding author at: Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensens Blvd 99, Aarhus N, 8200 Denmark.Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, DenmarkDepartment of Infectious Diseases, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Mycobacterial Centre for Research Southern Denmark – MyCRESD, Odense, DenmarkInternational Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark; School of Global Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; Centre for Global Health (GloHAU), Department of Public Health, Aarhus University, Aarhus, DenmarkBackground: Tuberculous lymphadenitis (TBLA) is the most common extrapulmonary manifestation of tuberculosis (TB) in Denmark. However, the clinical features of patients with TBLA have never been systematically studied in this setting. Methods: Patients treated for TBLA in Central Region Denmark from 2007 to 2016 were identified using the national TB surveillance register and The Danish Hospital Patient Registry. Data of clinical characteristics and treatment were extracted from hospital records. Results: Eighty-three TBLA patients were identified. The median age was 32 years (IQR 23–42); 71 (85.5%) were migrants; 58 (69.9%) presented with cervical lymphadenopathy; and 45 (54.2%) had one or more systemic TB symptom such as fever, chills, night sweats, fatigue, and weight loss. Sixty-five patients had no comorbidities (78.3%). HIV co-infection was seen in five (7.2%) of the 69 who were tested for HIV. Abscesses and/or draining sinuses were noted in 13 (15.7%) patients and 15 (18.1%) had concurrent pulmonary infection. The median time from first hospital contact to treatment initiation was 42 days (IQR 16–82) and admitted patients were hospitalised for a median of 7 days (IQR 3–13.5). For 24 patients (28.9%), lymph node material was not sent for mycobacterial culture and 52 (62.7%) had microbiologically confirmed TB. Treatment outcome was successful for 70 patients (84.3%). Conclusion: In Denmark, TBLA is mainly seen among young and previously healthy migrants presenting with cervical lymphadenopathy and sparse systemic symptoms. The diagnosis is often considerably delayed and not microbiologically verified, implying diagnostic difficulties. Treatment outcome needs to be improved.http://www.sciencedirect.com/science/article/pii/S1201971220305543TuberculosisExtrapulmonary tuberculosisLymphadenopathyEpidemiology |
| spellingShingle | Victor Dahl Mathiasen Peter Henrik Andersen Isik Somuncu Johansen Troels Lillebaek Christian Wejse Clinical features of tuberculous lymphadenitis in a low-incidence country International Journal of Infectious Diseases Tuberculosis Extrapulmonary tuberculosis Lymphadenopathy Epidemiology |
| title | Clinical features of tuberculous lymphadenitis in a low-incidence country |
| title_full | Clinical features of tuberculous lymphadenitis in a low-incidence country |
| title_fullStr | Clinical features of tuberculous lymphadenitis in a low-incidence country |
| title_full_unstemmed | Clinical features of tuberculous lymphadenitis in a low-incidence country |
| title_short | Clinical features of tuberculous lymphadenitis in a low-incidence country |
| title_sort | clinical features of tuberculous lymphadenitis in a low incidence country |
| topic | Tuberculosis Extrapulmonary tuberculosis Lymphadenopathy Epidemiology |
| url | http://www.sciencedirect.com/science/article/pii/S1201971220305543 |
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