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Fine needle aspiration biopsy: An undervalued diagnostic modality in paediatric mycobacterial disease

dc.contributor.authorWright C.A.
dc.contributor.authorWarren R.M.
dc.contributor.authorMarais B.J.
dc.date.accessioned2011-05-15T16:16:45Z
dc.date.available2011-05-15T16:16:45Z
dc.date.issued2009
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation13
dc.identifier.citation12
dc.identifier.issn10273719
dc.identifier.urihttp://hdl.handle.net/10019.1/13921
dc.description.abstractMycobacterial disease, and particularly tuberculosis (TB), is an escalating problem in developing countries, fuelled by the parallel human immunodeficiency virus (HIV) pandemic. In TB endemic countries children carry a very high burden of disease, which may be unrecognised due to the difficulty in making a diagnosis based on clinical, radiological or laboratory methods. One of the main hurdles is the difficulty of obtaining adequate specimens for bacteriological confirmation of disease in children. TB lymphadenitis is the most common extrapulmonary manifestation of TB, and up to 22% of children with persistent cervical lymphadenopathy and no local cause may have tuberculous adenitis. Fine needle aspiration biopsy (FNAB), a simple and safe out-patient procedure that can be performed by nurses in resource-limited settings, and that provides material for direct microscopy as well as culture and susceptibility testing, provides an excellent opportunity to obtain bacteriological confirmation. However, it remains a greatly underutilised specimen collection modality. This review provides a comprehensive overview of the difficulties faced in the diagnosis of paediatric TB in resource-limited settings, and suggests ways to utilise FNAB as a practical modality for the rapid and effective diagnosis of mycobacterial disease in the significant subset of patients who present with peripheral lymphadenopathy. It also provides detail on how best to perform the technique, and suggests ways of making it more widely available in resource-limited settings, which carry the brunt of the paediatric TB disease burden. © 2009 The Union.
dc.subjectBCG vaccine
dc.subjectaspiration biopsy
dc.subjectautofluorescence
dc.subjectcell structure
dc.subjectcervical lymphadenopathy
dc.subjectclinical feature
dc.subjectdiagnostic procedure
dc.subjectdrug sensitivity
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectincidence
dc.subjectlaboratory test
dc.subjectnucleic acid amplification
dc.subjectoutpatient care
dc.subjectpriority journal
dc.subjectreview
dc.subjecttuberculosis
dc.subjecttuberculous lymphadenitis
dc.subjectvirus culture
dc.subjectziehl neelsen staining
dc.subjectBacteriological Techniques
dc.subjectBiopsy, Fine-Needle
dc.subjectChild
dc.subjectDeveloping Countries
dc.subjectHumans
dc.subjectMycobacterium
dc.subjectMycobacterium Infections
dc.subjectTuberculosis
dc.subjectTuberculosis, Lymph Node
dc.titleFine needle aspiration biopsy: An undervalued diagnostic modality in paediatric mycobacterial disease
dc.typeReview
dc.description.versionReview


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