Fine-needle aspiration biopsy: A fi rst-line diagnostic procedure in paediatric tuberculosis suspects with peripheral lymphadenopathy?
Date
2009
Authors
Wright C.A.
Hesseling A.C.
Bamford C.
Burgess S.M.
Warren R.
Marais B.J.
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Abstract
OBJECTIVE: To evaluate the diagnostic yield and time to diagnosis of fi ne-needle aspiration biopsy (FNAB) vs. routine respiratory specimens collected from children with a palpable peripheral lymph node mass and symptoms suspicious of tuberculosis (TB). DESIGN: We performed a retrospective review of laboratory records at Tygerberg Hospital over a 4-year period from January 2003 to December 2006. All children (aged <13 years) in whom an FNAB and other mycobacterial specimens were collected as part of their diagnostic workup were included. RESULTS: In 95 children, the following specimens were collected: FNAB (n = 95), gastric aspirates (n = 142), other respiratory specimens (n = 36), non-respiratory specimens (n = 26). Mycobacterial disease was diagnosed in 70 (73.7%) patients. Children without respiratory specimens (n = 6) and/or with Mycobacterium bovis bacille Calmette-Guérin disease (n = 15) were excluded from comparative analysis. In the remainder, FNAB was positive in 45/74 (60.8%) vs. any respiratory specimen in 29/74 (39.2%, P < 0.001). The mean time to bacteriological diagnosis with FNAB was 7.1 days (95%CI 4.2-10.1) compared to 22.5 days (95%CI 15.8-29.1) for any respiratory specimen. CONCLUSION: FNAB is a simple, rapid and effective modality for achieving confi rmation of mycobacterial disease in paediatric TB suspects with a palpable peripheral lymph node mass. © 2009 The Union.
Description
Keywords
acid aspiration, article, aspiration biopsy, bacterial infection, bcg disease, child, clinical effectiveness, comorbidity, controlled study, diagnostic procedure, female, gastric suction, human, infant, intermethod comparison, lymph node, lymphadenopathy, major clinical study, male, microbiological examination, mycobacteriosis, Mycobacterium, Mycobacterium bovis, pediatrics, preschool child, priority journal, retrospective study, sampling, school child, tuberculosis, isolation and purification, microbiology, needle biopsy, palpation, prediction and forecasting, sputum, stomach juice, time, tuberculous lymphadenitis, Bacteriological Techniques, Biopsy, Fine-Needle, Child, Child, Preschool, Female, Gastrointestinal Contents, Humans, Infant, Male, Mycobacterium, Palpation, Predictive Value of Tests, Retrospective Studies, Sputum, Time Factors, Tuberculosis, Tuberculosis, Lymph Node
Citation
International Journal of Tuberculosis and Lung Disease
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