Tuberculous Lymphadenitis in Children

Objective: Tuberculous lymphadenitis is the most common extrapulmonary tuberculosis in childhood. Due to absence of specific tuberculous lymphadenitis symptoms, diagnosis is often delayed. In this study, it was aimed to reveal the diagnostic methods, treatment and follow up results by retrospectively examining the pediatric patients diagnosed with tuberculous lymphadenitis in our hospital. Material and Methods: Demographic, clinical, radiological, microbiological and histopathological features of pediatric patients diagnosed with tuberculous lymphadenitis in Pediatric Infectious Diseases Clinic of our hospital, between 2012-2019, were retrospectively evaluated from medical records. Results: Of the patients, diagnosed with tuberculous lymphadenitis, 10 (58.8%) were girl, seven (41.2%) were boy. Age range was 5-192 months, mean age was 88.7 +/- 63 months. None of patients had known tuberuculous exposure. The most common complaint was swelling on lymph node region. Median complaint time was 60 days, min: 5-max: 4800 days. The most common enlarged lymph node localization was cervical region. Tuberculin skin test was positive in 15 (88.2%) patients, interferon gamma releasing assay was performed in 13 patients and was positive in 12 (92.3%). Chest X-Ray was normal in 12 (70.2%) patients. Computered thorax tomography was performed for five (29.4%) of remaining patients and one patient was diagnosed with pulmonary tuberculosis. Lymph node biopsy was performed in 14 patients. By histopathological and microbiological evaluation of tissue samples; bacille was seen in two patients (14%) via Ehrlich-Zhiel-Neelsen staining, Mycobacterium tuberculosis polimerase chain reaction positivity in five (83%) patients and M. tuberculosis culture positivity was detected in one (20%) patient. Apart from one patient denied treatment and two lost the follow up, remaining patients were treated with antituberculosis drugs. Conclusion: Tuberculous lymphadenitis should be kept in mind espescially when the lymph nodes are firm and immobile, lasting minimum then one week, and do not heal with nonspesific antibiotic treatment.