A 23yr old male presents with fever for 3 days, cervical lymphadenitis since a week and generalised weakness. No history of loss of appetite or weight loss.No history of cough or any other symptoms. On examination vitals are stable. FNAC and excision biopsy of the lymph nodes were suggestive of acute inflammatory reaction and was negative for TB. Even GeneXpert was negative. Patient was discharged on antibiotics. After 4 weeks TB culture report was positive. What's the probability of TB lymphadenitis in this case? What's the further management?
Smear.. negative Genxprt.. negative HP...and fnac..acute inflammatory reaction Mycobacterial culture.. positive. Culture report appears dubious. Go by clinico imaging correlation. Do not start ATT..solely on basis of this culture report. Periodic follow up with a course of broad spectrum antibiotics..is suggested.
All related test like smear negative, Lymph node biopsy negative Xenexpert negative 3. Sputum test negative Xay chest normal no sign of tuberculosis Only culture came positive Very difficult to take up as tuberculosis Go CBNAAT. Keep watch for 3 months the repeat to make any conclusion.
Smear.. negative Genxprt.. negative HP...and fnac..acute inflammatory reaction Mycobacterial culture.. positive. Culture report appears dubious. Go by clinico imaging correlation. Do not start ATT..solely on basis of this culture report. Periodic follow up with a course of broad spectrum antibiotics..is suggested.
Excision biopsy HPE would be GOLD standard diagnostically. But if culture report is positive for TB, start 1st line drugs as per body weight. May give 6to 9 months therapy. Evaluate for HIV status. Also see for atypical mycobacterium complex.
Case of tuberculosis ad X-ray chest CBNAAT & sputum exam then start AaTafter reports are available
IT'S A..CASE OF.. ? TUBERCULOS LYMPHADENOPATHY.. NEED'S.. ANTI TUBERCULOS TREATMENT.. FURTHER INVESTIGATIONS..
Usually criteria for TB Such as x ray chest Sputum AFB Cytosmear Geexpert All negative Only culture positive It is doughtful Repeat it Clinicopathologic also correlation
TB Lymphadenitis Rept FNAC again Start ATT
Yes sir I do admit your opinion, I think repeat culture before going for any further specific treatment.
ADVISABLE.. CLINICO. IMAGING.. CORRELATION PERIODIC. FOLLOW. UP.. BROAD. SPECTRUM. ANTIBIOTICS
Cases that would interest you
- Login to View the image
pt 2 yr female child with cervical lymphadenopathy h/o intermittent fever since 2 days . Diagnosis please
Y.sunder Kumar5 Likes30 Answers - Login to View the image
a 4th class girl low grade fever with this swelling which was noticed by her from 4 to 5wks back...no treatment yet.
Dr. Jayanth Chilakala3 Likes34 Answers - Login to View the image
25 yr male neck swellings of 10 days durarion..no constitutional symptoms..no active PT.apettite normal.management please
Dr. Avula Govindarajulu4 Likes27 Answers - Login to View the image
10yr boy came with c/o cervical lymphadenopathy and cough from 3weeks. ESR 40, MT nonreactive, FNAC below... pt didn't responded to antibiotics, usg below... discuss...
Dr. Manish Verma2 Likes18 Answers - Login to View the image
2 months old baby with swelling in the neck. had received BCG at birth and was on steroids prescribed by PP for weight gain
Dr. Mohan Kundal2 Likes17 Answers
2 Likes