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Clinical Investigations: INFECTION |

Assessment of Lymph Node Tuberculosis in Northern Germany*: A Clinical Review

Henning Geldmacher, MD; Christian Taube, MD; Clemens Kroeger, MD; Helgo Magnussen, MD; Detlef K. Kirsten, MD, FCCP
Author and Funding Information

*From the Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Grosshansdorf, Germany.

Correspondence to: Detlef K. Kirsten, MD, FCCP, Krankenhaus Groβhansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Wöhrendamm 80, D-22927 Grosshansdorf, Germany; e-mail Hgeldmache@aol.com



Chest. 2002;121(4):1177-1182. doi:10.1378/chest.121.4.1177
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Aim of study: To evaluate patient profiles, diagnostic approaches, and treatment strategies in patients with lymph node tuberculosis.

Methods: Demographic data, diagnostic findings, and therapies were retrospectively analyzed in 60 patients with lymph node tuberculosis who were hospitalized between 1992 and 1999.

Results: Thirty percent (n = 18) of patients were natives, and 70% were immigrants (n = 42). The cervical lymph nodes were most frequently involved (63.3%), followed by the mediastinal lymph nodes (26.7%) and the axillary lymph nodes (8.3%). All patients (except one patient who was HIV-positive) showed a positive response to tuberculin skin testing. Lymph node excision and fine-needle aspiration (FNA) were similarly effective in obtaining sufficient material for histologic and microbiological analysis. Mycobacterium tuberculosis was identified in 43.3% of patients by microbiological testing, and culture methods showed the highest sensitivity. Despite standard treatment, the initial enlargement of the lymph nodes occurred in 20% of patients and local complications occurred in 10%.

Conclusion: Lymph node tuberculosis is still an important issue in developed countries and has to be considered in differential diagnosis. The best approach appears to be a combination of skin testing and FNA. Negative results in the identification of M tuberculosis do not exclude the diagnosis of lymph node tuberculosis.

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