Treatment of cervical lymph node tuberculosis: When surgery should be performed? A retrospective cohort study.
Drug resistance
Lymph node tuberculosis
Paradoxical upgrading reaction
Recurrence
Surgical treatment
Journal
Annals of medicine and surgery (2012)
ISSN: 2049-0801
Titre abrégé: Ann Med Surg (Lond)
Pays: England
ID NLM: 101616869
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
25
03
2020
revised:
30
04
2020
accepted:
04
05
2020
entrez:
4
6
2020
pubmed:
4
6
2020
medline:
4
6
2020
Statut:
epublish
Résumé
lymph node tuberculosis is the most common form of extra pulmonary tuberculosis. Although diagnosis is usually difficult, therapeutic management remains a challenge and a subject of national and international debate. the medical records of patients with cervical lymph node tuberculosis who were treated at 20 August Hospital, Casablanca, Morocco, between May 2017 and November 2018 were reviewed. The results of the treatment were analyzed retrospectively.The aim of our work was to identify all causes of medical treatment failure in cervical lymph node tuberculosis, and to propose indications for the use of surgery in cervical lymph node tuberculosis in Morocco. Out of a total of 104 patients, the mean age was 24 years, the sex ratio was 0.51 (women: 66.3%), twenty (19.2%) patients received medical treatment alone, and 84 (80.8%) patients required medical and surgical treatment. Surgery was required when the size of the lymphadenopathies was greater than or equal to 3 cm (p = 0.005), when the patient presented with an abscess and/or fistula(p = 0.005), when the patient presented with resistance to antibacillary drugs(p = 0.032), or developed a paradoxical upgrading reactions (p = 0.001), or when the patient had a recurrence of lymph node tuberculosis(p = 0.008) on multivariate analysis. antibiotic therapy remains the main treatment for all patients in lymph node tuberculosis, but the results of our work show the value of surgery in some indications.
Sections du résumé
BACKGROUND
BACKGROUND
lymph node tuberculosis is the most common form of extra pulmonary tuberculosis. Although diagnosis is usually difficult, therapeutic management remains a challenge and a subject of national and international debate.
MATERIALS AND METHODS
METHODS
the medical records of patients with cervical lymph node tuberculosis who were treated at 20 August Hospital, Casablanca, Morocco, between May 2017 and November 2018 were reviewed. The results of the treatment were analyzed retrospectively.The aim of our work was to identify all causes of medical treatment failure in cervical lymph node tuberculosis, and to propose indications for the use of surgery in cervical lymph node tuberculosis in Morocco.
RESULTS
RESULTS
Out of a total of 104 patients, the mean age was 24 years, the sex ratio was 0.51 (women: 66.3%), twenty (19.2%) patients received medical treatment alone, and 84 (80.8%) patients required medical and surgical treatment. Surgery was required when the size of the lymphadenopathies was greater than or equal to 3 cm (p = 0.005), when the patient presented with an abscess and/or fistula(p = 0.005), when the patient presented with resistance to antibacillary drugs(p = 0.032), or developed a paradoxical upgrading reactions (p = 0.001), or when the patient had a recurrence of lymph node tuberculosis(p = 0.008) on multivariate analysis.
CONCLUSION
CONCLUSIONS
antibiotic therapy remains the main treatment for all patients in lymph node tuberculosis, but the results of our work show the value of surgery in some indications.
Identifiants
pubmed: 32489658
doi: 10.1016/j.amsu.2020.05.006
pii: S2049-0801(20)30093-5
pmc: PMC7256428
doi:
Types de publication
Journal Article
Langues
eng
Pagination
159-163Informations de copyright
© 2020 The Author(s).
Déclaration de conflit d'intérêts
All authors have no conflict of interest or financial support with this article.
Références
JMIR Public Health Surveill. 2019 Oct 9;5(4):e14252
pubmed: 31599732
Clin Infect Dis. 2011 Sep;53(6):555-62
pubmed: 21865192
J Infect. 2009 Jul;59(1):56-61
pubmed: 19535147
Arch Otolaryngol. 1985 Dec;111(12):816-9
pubmed: 4062653
Medicine (Baltimore). 2005 Nov;84(6):350-62
pubmed: 16267410
J Infect. 2010 Nov;61(5):430-4
pubmed: 20831881
Am Rev Respir Dis. 1971 Jun;103(6):816-20
pubmed: 5089876
Southeast Asian J Trop Med Public Health. 2014 Nov;45(6):1419-24
pubmed: 26466428
Auris Nasus Larynx. 2016 Dec;43(6):672-6
pubmed: 26856305
J Assoc Physicians India. 2009 Aug;57:585-90
pubmed: 20209720
Trop Med Int Health. 2005 Nov;10(11):1090-8
pubmed: 16262733
Tubercle. 1990 Mar;71(1):1-3
pubmed: 2196725
Laryngoscope. 2001 Oct;111(10):1791-6
pubmed: 11801947
Br J Surg. 1993 Dec;80(12):1547-8
pubmed: 8298921
Clin Infect Dis. 2005 May 1;40(9):1368-71
pubmed: 15825042
Clin Infect Dis. 1994 Dec;19(6):1092-9
pubmed: 7888539
Int J Surg. 2017 Oct;46:198-202
pubmed: 28890409
Br J Surg. 1962 Nov;50:302-14
pubmed: 13964780
Clin Infect Dis. 2005 Sep 15;41(6):915-6; author reply 916-7
pubmed: 16107998
Aust N Z J Surg. 1983 Jun;53(3):253-7
pubmed: 6576777