Tuberculous Cervical Lymphadenitis: 5 Year Experience in Chao Phya Abhaibhubejhr Hospital, Prachin Buri - วัณโรคต่อมน้ำเหลืองที่คอ ประสบการณ์ 5 ปี ในโรงพยาบาลเจ้าพระยาอภัยภูเบศร จังหวัดปราจีนบุรี

บทคัดย่อ

         Tuberculous Cervical Lymphadenitis (TCL) is the most common extrapulmonary tuberculosis. The objective of this retrospective descriptive study was to assess TCL related to ages, sex, HIV infection, concomitant pulmonary tuberculosis, distribution of the involved lymphnodes, diagnostic procedures, treatment protocol and treatment outcomes in non HIV and HIV patients. In all 128 cases of TCL in Chao Phya Abhaibhubejhr Hospital, Prachin Buri between 1st October 2003 and 30th September 2008 were included.

        The study revealed that 70 females and 58 males (1.2:1) were included, reporting 44 cases (34.4%) of HIV infection and 30 cases (23.4%) with pulmonary tuberculosis. The common age group was 15-50 years.

         Lymph nodes in the posterior triangle (PT) were found to be the most common (43.1%), while unilateral involvement was observed in 82 percent. A single group of lymph nodes was involved in 73.4 percent of cases with TCL. Conventional biopsies had been done in 108 cases (84.4%) followed by FNAB c AFB staining in 20 cases. (15.6%) Good outcomes of treatment (85.7% cures), using 2 HRZ/4HR (CAT III) and 2 HRZE/4HR (CAT I) in TCL c Non HIV patients was found. Drug refractory and poor response to the treatment was observed in TCL c HIV patients leading to a markedly high case-fatality rate (15.9%).

Key words: TCL (Tuberculous Cervical Lymphadenitis), HIV (Human Immunosuppressive Virus)