OBJECTIVES: Limited data are available regarding the incidence and outcomes of lymphadenopathy after completing tuberculosis (TB) treatment. METHODS: We prospectively evaluated the incidence and outcomes of post-treatment lymphadenopathy in 154 patients with newly diagnosed lymph node TB (group 1) and in 12 patients previously treated for TB (group 2). We assessed the rates of microbiological recurrence, clinical recurrence, and post-treatment paradoxical response (PR) (defined as no microbiological recurrence with spontaneous improvement). RESULTS: Post-treatment lymphadenopathy occurred in 24 (15.6%) patients of group 1 and in 12 patients of group 2. Re-biopsy was performed in 23 of these 36 patients. AFB stain was positive in four (17.4%) cases, and TB-PCR was positive in 11 (47.8%), but all samples were sterile (no microbiological recurrence). Granuloma was present in 12 (52.2%) histological specimens. Thirty-three (91.7%) of the 36 patients with lymphadenopathy improved spontaneously (post-treatment PR) and 3 (8.3%) were improved with retreatment (clinical recurrence). The overall incidence of post-treatment PR in patients with lymph node TB (group 1) was 8.6 per 100 person-years (95% CI, 5.8-12.7). CONCLUSIONS: Lymphadenopathy after TB treatment was more likely to be associated with post-treatment PR rather than with microbiological recurrence, and it should be monitored until PR resolve.
OBJECTIVES: Limited data are available regarding the incidence and outcomes of lymphadenopathy after completing tuberculosis (TB) treatment. METHODS: We prospectively evaluated the incidence and outcomes of post-treatment lymphadenopathy in 154 patients with newly diagnosed lymph node TB (group 1) and in 12 patients previously treated for TB (group 2). We assessed the rates of microbiological recurrence, clinical recurrence, and post-treatment paradoxical response (PR) (defined as no microbiological recurrence with spontaneous improvement). RESULTS: Post-treatment lymphadenopathy occurred in 24 (15.6%) patients of group 1 and in 12 patients of group 2. Re-biopsy was performed in 23 of these 36 patients. AFB stain was positive in four (17.4%) cases, and TB-PCR was positive in 11 (47.8%), but all samples were sterile (no microbiological recurrence). Granuloma was present in 12 (52.2%) histological specimens. Thirty-three (91.7%) of the 36 patients with lymphadenopathy improved spontaneously (post-treatment PR) and 3 (8.3%) were improved with retreatment (clinical recurrence). The overall incidence of post-treatment PR in patients with lymph node TB (group 1) was 8.6 per 100 person-years (95% CI, 5.8-12.7). CONCLUSIONS:Lymphadenopathy after TB treatment was more likely to be associated with post-treatment PR rather than with microbiological recurrence, and it should be monitored until PR resolve.
Authors: Yun Jae Seol; Se Yoon Park; Shi Nae Yu; Tark Kim; Eun Jung Lee; Min Huok Jeon; Eun Ju Choo; Tae Hyong Kim Journal: Infect Chemother Date: 2017-05-24
Authors: D A Barr; A K Coussens; S Irvine; N D Ritchie; K Herbert; B Choo-Kang; D Raeside; D J Bell; R A Seaton Journal: Int J Tuberc Lung Dis Date: 2017-06-01 Impact factor: 2.373
Authors: Hyeri Seok; Ji Hoon Jeon; Kyung Ho Oh; Hee Kyoung Choi; Won Suk Choi; Young Hen Lee; Hyung Suk Seo; Soon Young Kwon; Dae Won Park Journal: BMC Infect Dis Date: 2019-10-21 Impact factor: 3.090