Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistry
Background: Tuberculosis (TB) continues to be a significant global health issue despite known causes and effective treatments. Factors such as virulent strains, drug resistance, and the human immunodeficiency virus pandemic, especially in India, contribute to its prevalence. Mycobacterium tuberculos...
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| Format: | Article |
| Language: | English |
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Manipal College of Medical Sciences, Pokhara
2024-01-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/56009 |
| _version_ | 1797369400720883712 |
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| author | Veera Raghavan Gurusamy Kanimozhi Sundararajan Gowri Prakasam Vincy TM |
| author_facet | Veera Raghavan Gurusamy Kanimozhi Sundararajan Gowri Prakasam Vincy TM |
| author_sort | Veera Raghavan Gurusamy |
| collection | DOAJ |
| description | Background: Tuberculosis (TB) continues to be a significant global health issue despite known causes and effective treatments. Factors such as virulent strains, drug resistance, and the human immunodeficiency virus pandemic, especially in India, contribute to its prevalence. Mycobacterium tuberculosis, the TB agent, can evade immune responses, persisting within host cells. A distinct feature of TB, granuloma formation, can also appear in diseases such as leprosy, histoplasmosis, and non-infectious conditions like Crohn’s disease. Proper diagnosis is vital, as in resource-limited countries, TB treatment often relies on presumptive diagnoses based on imaging and symptoms, leading to high false positive rates.
Aims and Objectives: This study aims to compare the utility of Ziehl-Neelsen (ZN) staining and immunohistochemistry (IHC) staining in suspected extrapulmonary TB lesions.
Materials and Methods: This is a retrospective cross-sectional study conducted at the Institute of Pathology, Rajiv Gandhi Government General Hospital, Chennai, over a 2-year period from August 2015 to July 2017. Fifty cases out of the 198 suspected extrapulmonary TB lesions were selected for the study.
Results: About 12% of cases were positive for acid-fast bacilli by ZN staining, whereas 82% of cases were positive for acid-fast bacilli by IHC staining. P value was found to be <0.001 by McNemar test which was statistically significant.
Conclusion: Diagnosing extrapulmonary TB can be challenging because the disease presents with various clinical manifestations and the bacterial load may be low. Immunohistochemistry is superior to ZN staining for localization of the tubercle bacilli and thus can serve as an effective ancillary technique in diagnoses of extrapulmonary TB in formalin-fixed paraffin embedded tissue sections. |
| first_indexed | 2024-03-08T17:46:12Z |
| format | Article |
| id | doaj.art-a431f71e208b4667808a81dd311c7f8e |
| institution | Directory Open Access Journal |
| issn | 2467-9100 2091-0576 |
| language | English |
| last_indexed | 2024-03-08T17:46:12Z |
| publishDate | 2024-01-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj.art-a431f71e208b4667808a81dd311c7f8e2024-01-02T10:29:11ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762024-01-01151142149https://doi.org/10.3126/ajms.v15i1.56009Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistryVeera Raghavan Gurusamy 0https://orcid.org/0009-0006-3418-8728Kanimozhi Sundararajan 1https://orcid.org/0009-0003-4882-9926Gowri Prakasam 2https://orcid.org/0009-0004-8999-2428Vincy TM3https://orcid.org/0009-0000-9755-9975Assistant Professor, Department of Pathology, Government Kilpauk Medical College, Chennai, Tamil Nadu, India Assistant Professor, Department of Pathology, Government Kilpauk Medical College, Chennai, Tamil Nadu, India Assistant Professor, Department of Pathology, Government Kilpauk Medical College, Chennai, Tamil Nadu, India Assistant Professor, Department of Pathology, Government Kilpauk Medical College, Chennai, Tamil Nadu, India Background: Tuberculosis (TB) continues to be a significant global health issue despite known causes and effective treatments. Factors such as virulent strains, drug resistance, and the human immunodeficiency virus pandemic, especially in India, contribute to its prevalence. Mycobacterium tuberculosis, the TB agent, can evade immune responses, persisting within host cells. A distinct feature of TB, granuloma formation, can also appear in diseases such as leprosy, histoplasmosis, and non-infectious conditions like Crohn’s disease. Proper diagnosis is vital, as in resource-limited countries, TB treatment often relies on presumptive diagnoses based on imaging and symptoms, leading to high false positive rates. Aims and Objectives: This study aims to compare the utility of Ziehl-Neelsen (ZN) staining and immunohistochemistry (IHC) staining in suspected extrapulmonary TB lesions. Materials and Methods: This is a retrospective cross-sectional study conducted at the Institute of Pathology, Rajiv Gandhi Government General Hospital, Chennai, over a 2-year period from August 2015 to July 2017. Fifty cases out of the 198 suspected extrapulmonary TB lesions were selected for the study. Results: About 12% of cases were positive for acid-fast bacilli by ZN staining, whereas 82% of cases were positive for acid-fast bacilli by IHC staining. P value was found to be <0.001 by McNemar test which was statistically significant. Conclusion: Diagnosing extrapulmonary TB can be challenging because the disease presents with various clinical manifestations and the bacterial load may be low. Immunohistochemistry is superior to ZN staining for localization of the tubercle bacilli and thus can serve as an effective ancillary technique in diagnoses of extrapulmonary TB in formalin-fixed paraffin embedded tissue sections.https://www.nepjol.info/index.php/AJMS/article/view/56009tuberculosis; extrapulmonary; ziehl-neelsen stain; immunohistochemistry |
| spellingShingle | Veera Raghavan Gurusamy Kanimozhi Sundararajan Gowri Prakasam Vincy TM Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistry Asian Journal of Medical Sciences tuberculosis; extrapulmonary; ziehl-neelsen stain; immunohistochemistry |
| title | Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistry |
| title_full | Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistry |
| title_fullStr | Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistry |
| title_full_unstemmed | Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistry |
| title_short | Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistry |
| title_sort | extrapulmonary tuberculosis a cross sectional study comparing the utility of ziehl neelsen stain and immunohistochemistry |
| topic | tuberculosis; extrapulmonary; ziehl-neelsen stain; immunohistochemistry |
| url | https://www.nepjol.info/index.php/AJMS/article/view/56009 |
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