AI Article Synopsis
- - The study investigates how prior anti-tuberculosis (TB) treatments affect the diagnosis of tuberculous lymphadenitis (TBLN) by evaluating various diagnostic methods like histology, microbiology, and molecular tests.
- - A total of 89 patients were assessed, with significant findings showing that previous TB treatment notably lowered the culture test's effectiveness, while the Xpert test showed reduced sensitivity for those treated for over three months.
- - The researchers concluded that for patients with a history of long-term TB treatment, it is crucial to use a combination of diagnostic tests to minimize the risk of false negatives, especially from the culture method.
Article Abstract
Objective: The influence of anti-tuberculosis (TB) treatment history on tuberculous lymphadenitis (TBLN) diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN.
Methods: In this study, suspected patients with TBLN and having different anti-TB treatment background were enrolled. All the samples were tested simultaneously by histology, Ziehl-Neelsen (ZN) staining, mycobacterial culture (culture), Xpert MTB/RIF (xpert), real-time PCR, and high-resolution melting curve PCR (HRM). Thereafter, the performance of these methods on samples with different anti-TB treatment background was assessed.
Results: In our study, 89 patients were prospectively included 82 patients with TBLN and 7 with other diseases. The overall sensitivities of Xpert, real-time PCR, histology, ZN staining, and culture were 86.6%, 69.5%, 58.5%, 43.9%, and 22.0%, respectively. The anti-TB treatment history revealed dramatic influences on the sensitivity of culture (P < 0.0001). In fact, the treatment that lasted over 3 months also influenced the sensitivity of Xpert (P < 0.05). However, the treatment history did not affect the performance of remaining tests (P > 0.05). For rifampicin drug susceptibility test (DST), the anti-TB treatment showed only significant influence on the success rate of culture DST (P = 0.001), but not on those of Xpert and HRM tests (P > 0.05).
Conclusion: Other tests as well as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.
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| http://dx.doi.org/10.3967/bes2017.055 | DOI Listing |
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