Mouna SOUALHI, Asmaa JNIENE, Mahassine BOUASSEL, Imane NAYME, Ghali IRAQI, Rachida ZAHRAOUI

Epidemiological, therapeutic and evolutionary profiles in patients with lymph node tuberculosis

Tüberküloz özellikle üçüncü dünya ülkelerinde bir toplum sağlığı sorunu olmayı sürdürmektedir. Lenf bezi tüberküloz en sık görülen akciğer dışı yerleşim alanıdır. Gelişmekte olan ülkelerden gelişmiş olanlara modern taşıma ve göçlerden dolayı, tüm klinisyenler için bu tanı olasılığını akılda tutmak önemlidir. Lenf bezi tüberkülozu doğrulanmış hastalarda tedavinin yanı sıra demografik özellikler, tanısal yaklaşımlar, terapötik yaklaşımlar ve gelişimsel yönlerinin değerlendirilmesi amaçlanmıştır. Dört yıllık süre boyunca Rabatta 2 merkezden 69 hastanın verileri retrospektif olarak incelendi. Hastalarda kadın (%70) ve genç yaş hakimiyeti vardı. Medyan semptom başlangıç süresi ve tanı süresi uzundu: 115 gün (interquartile range 34-150 gün), bu durum düşük sosyoekonomik şartlarla açıklandı (p< 0.05). En sık tutulan servikal lenf bezleriydi (%85.5). Tanı %98.5 histolojik, %1.5 lenf bezi aspirasyonundan bakteriyel olarak konuldu. Hastaların %48i ulusal tüberküloz rehberine göre tedavi edilmişti. Hastaların yarısı paradoksik yanıt nedeniyle yedi buçuk aylık (7.3 month +/-1.3) uzamış tedavi almışlardı (p< 0.05). Tedavi bitiminde lenf nodları hastaların %80inde normal boyutlarına dönmüştü, %11.6sında rezidüel lenf bezi ve %8.6sında scrofula saptadık. Lenf bezi tüberkülozunun tanısında gecikme halen önemlidir ve tedavi paradoksik yanıt nedeniyle uzamaktadır.

Lenf bezi tüberkülozu olan hastalarda epidemiyolojik, terapötik ve gelişimsel profiller

Tuberculosis remains a public health concern worldwide particularly in Third World countries. Lymph node (LN) tuberculosis is the most frequent extra lung localization. Because of modern transport and mass migration from the developing to the developed world, it is important for all clinicians to keep this diagnostic possibility in mind. Evaluate demographic characteristics, diagnosis approaches, therapeutic strategies and evolutionary aspects while treatment in patients with confirmed LN tuberculosis. Data were retrospectively analyzed in 69 patients collected in 2 health centers in Rabat over a period of 4 years. There was a female (70%) and a young age predominance of patients (31.4 year +/-13.1). The median duration between the onset of symptoms and diagnosis was long: 115 days (interquartile range 34-150 days) explicated by low Socioeconomic conditions (p< 0.05). The cervical LN were most frequently involved (85.5%). The confirmation was histological in 98.5%, bacterial in the liquid from puncture LN in 1.5% of cases. 48% of patients had received treatment according to the national guide of tuberculosis. Half of the patients had received prolonged treatment on average of 7 months and a half (7.3 month +/-1.3) because of the paradoxical response (PR) (p< 0.05). At the end of treatment, LN had returned to their normal size in 80% of patients, we noted residual nodes in 11.6%, and a scrofula in 8.6%. The delay of diagnosis of LN tuberculosis is still important, and the treatment is prolonged because of PR.

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