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Titolo:
Diagnosis and treatment of isolated tuberculous mediastinal lymphadenopathy in adults
Autore:
Ayed, AK; Behbehani, NA;
Indirizzi:
Kuwait Univ, Dept Surg, Fac Med, Safat 13110, Kuwait Kuwait Univ Safat Kuwait 13110 , Dept Surg, Fac Med, Safat 13110, Kuwait Kuwait Univ, Dept Med, Fac Med, Safat 13110, Kuwait Kuwait Univ Safat Kuwait 13110 v, Dept Med, Fac Med, Safat 13110, Kuwait
Titolo Testata:
EUROPEAN JOURNAL OF SURGERY
fascicolo: 5, volume: 167, anno: 2001,
pagine: 334 - 338
SICI:
1102-4151(200105)167:5<334:DATOIT>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
LYMPH-NODE TUBERCULOSIS; NEEDLE ASPIRATION; LYMPHADENITIS; BIOPSY;
Keywords:
bronchoscopy; computed tomography; diagnosis; lymph nodes; mediastinoscopy; mediastinal tuberculosis; mediastinum; tuberculosis; tuberculous lymphadenitis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Ayed, AK Kuwait Univ, Dept Surg, Fac Med, POB 24923, Safat 13110, Kuwait Kuwait Univ POB 24923 Safat Kuwait 13110 23, Safat 13110, Kuwait
Citazione:
A.K. Ayed e N.A. Behbehani, "Diagnosis and treatment of isolated tuberculous mediastinal lymphadenopathy in adults", EURO J SURG, 167(5), 2001, pp. 334-338

Abstract

Objective: To evaluate the diagnostic yield of bronchoscopy and mediastinoscopy in adults with isolated mediastinal tuberculous lymphadenitis and to assess the effect of antituberculous treatment. Design: Prospective longitudinal cohort study of 34 patients with mediastinal tuberculous lymphadenitis followed for 6 to 19 months after completion of treatment. Setting: Tertiary care hospital, Kuwait. Patients: 34 consecutive patients who presented with isolated mediastinal lymphadenopathy from 1996 to 1998. Interventions: Bronchoscopy and cervical mediastinoscopy for all patients. Main outcome measures: Diagnostic yield of bronchoscopy and mediastinoscopy, and the outcome of treatment in patients with tuberculous lymphadenopathy. Results: The mean age was 35 years (range 15-58). The most common symptomswere cough, fever, and weight loss. The chest radiographs and computed tomograms showed abnormal mediastinal shadows with no evidence of parenchymal disease. All patients had right sided paratracheal lymphadenopathy. Tuberculin skin test gave a weal of > 15mm in 17 patients (50%. Sputum smears and cultures failed to grow acid-fast bacilli in any patient. Seven patients had an endobronchial abnormality and samples taken at bronchoscopy gave a definite diagnosis in 3 (9%). Paratracheal lymph node biopsy and. culture by mediastinoscopy diagnosed tuberculosis in all cases. All patients were treated by a six month course of rifampicin and isoniazid supplemented initiallyby pyrazinamide for two months. Twenty-eight patients had a good response and the remaining patients were treated for a further 3 months. Conclusions: Bronchoscopy has a low diagnostic yield in mediastinal tuberculous lymphadenopathy in the absence of a parenchymal lesion. Mediastinoscopy is a safe but invasive procedure and provides a tissue diagnosis in mostcases. Six months treatment with rifampicin and isoniazid supplemented initially by pyrazinamide is adequate treatment for most adults with tuberculous mediastinal lymphadenopathy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 18:45:57