Gender differences in the clinical diagnosis of tuberculous lymphadenitis--a hospital-based study from Central India.

Objective: Tuberculous lymphadenitis can be difficult to diagnose clinically, and as it is thought to be more common in females, we describe here the clinical characteristics of cervical tuberculous lymphadenitis in men and women and compare this with cytology to assess their diagnostic value.

Methods: Two hundred and nineteen patients with tuberculous lymphadenitis, aged 14 years or more, who presented with a neck mass to the Department of Pathology, Ujjain Hospital, Ujjain, India were included in the study. The presenting clinical symptoms and signs were compared between men and women and with the cytology of fine needle aspirates from the lymph nodes.

Results: Seventy-five percent of the patients were aged between 14 and 35 years, with a male to female ratio of 1:2.1. One or more constitutional symptoms were present in 56.6% of patients on presentation. There were more men with clinical symptoms than women. Fever was the most common manifestation in both gender groups. Fever for more than 30 days, cough, weight loss, and night sweats were significantly more common in men. On cytology, necrotic granulomas were found to be associated with constitutional symptoms.

Conclusions: Constitutional symptoms were more frequently reported by men than by women and showed a correlation with necrotic granulomas on cytology.