Modern management of cervical scrofula

Deitel, Mervyn; Bendago, M; Krajden, Sigmund; Ronald, A C; Borowy, Z. J.

doi:10.1002/hed.2880110111

Cited by 23 publications

(15 citation statements)

References 11 publications

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“…Extra-pulmonary tuberculosis is known to occur in the absence of pulmonary disease in /50% of cases [6]. The rate rises to /80 Á/90% for tuberculosis of the head and neck region, which is in accordance with the finding in our series.…”

Section: Discussionsupporting

confidence: 94%

Diagnosis of major salivary gland tuberculosis: Experience of eight cases and review of the literature

Kim

Jeong

Jung

et al. 2005

Acta Oto-Laryngologica

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The parotid and submandibular glands were involved in 5 (62.5%) and 3 cases (37.5%), respectively. Neck CT demonstrated typical findings of salivary gland tuberculosis in 3 patients (37.5%). Fine-needle aspiration cytology revealed chronic inflammation in 6/7 patients (85.7%), 2 of whom (33.3%) showed caseous necrosis, strongly suggesting tuberculosis. Five of the 8 patients (62.5%) required resection of the affected gland and 3 (37.5%) received open biopsy. PCR was performed in half of the cases and was affirmative in every case. No significant differences were found between the surgically resected and non-resected groups in terms of treatment results or morbidity. All patients received anti-tuberculous chemotherapy for 8-12 months, with no disease recurrence.

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Section: Discussionsupporting

confidence: 94%

Diagnosis of major salivary gland tuberculosis: Experience of eight cases and review of the literature

Kim

Jeong

Jung

et al. 2005

Acta Oto-Laryngologica

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“…In agreement with previous data, the incidence of tuberculous adenitis in our cohort was highest among women, and a positive TST was noted in 90% of cases [1][2][3]15,16,[20][21][22]29,36,[47][48][49]52,62,64,68 . TB patients without peripheral lymphadenitis in our clinic were older and had a higher male predominance, but were equally likely to have a positive TST (see Table 1).…”

Section: Discussionsupporting

confidence: 93%

“…In agreement with most series 1,2,5,16,21,22,40,48,62,80 , tuberculous lymphadenitis occurred in an insidious manner with a minority of patients having constitutional symptoms.…”

Section: Discussionsupporting

confidence: 85%

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Peripheral Tuberculous Lymphadenitis

2005

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We reviewed 106 patients referred to our institution for treatment of peripheral tuberculous adenitis to establish the epidemiologic, clinical, and pathologic manifestations of this disease. Tuberculous lymphadenitis occurred predominantly in young, foreign-born women a mean of 5 years after arrival in the United States. Tuberculin skin tests were positive in 94% of cases. Lymphadenopathy occurred most frequently in the neck (57%) or supraclavicular area (26%) and involved 1-3 nodes. Forty (38%) patients had an abnormal chest radiograph consistent with granulomatous infection. Culture-positive pulmonary tuberculosis was diagnosed in 41% of those patients with abnormal chest radiographs. Fine needle aspiration was an essential step in the evaluation and diagnosis of tuberculous lymphadenitis. Granulomas were seen in 61% of fine needle aspirates and 88% of surgical biopsies. Positive cultures for Mycobacterium tuberculosis were obtained from 62% of fine needle aspirate samples and 71% of excisional biopsies. The presence of necrosis and/or neutrophilic inflammation in tissue samples correlated with culture positivity. Given the high yield of positive cultures from fine needle aspirates, surgery was rarely indicated as an initial step in immunocompetent adults. In this cohort, 101 patients received a final diagnosis of peripheral tuberculous lymphadenitis. Eighty-two percent received their entire therapy under direct observation, and response to antituberculous therapy was uniformly successful. Paradoxical expansion of adenopathy was seen in 20% of all patients and was more commonly noted in human immunodeficiency virus-seropositive patients. We present a diagnostic algorithm based on our experience.

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“…The disease is treated with a combination of anti-tuberculous drugs for either 6 or 9 months. Most clinicians agree that anti-tuberculous chemotherapy is the definitive modality of treatment for tuberculous lymphadenitis (9). Similarly, Weiler et al (10), in their series, found that anti-tuberculous chemotherapy, with or without surgical excision of the involved cervical lymph nodes, is the treatment of choice for this disease.…”

Section: Introductionmentioning

confidence: 97%