Comparative Study of Bacteriological Techniques, Cytology and Molecular Technique (PCR) using Fine Needle Aspirate in the Diagnosis of Tuberculous Lymphadenitis.

Aneeta, Alexis (2006) Comparative Study of Bacteriological Techniques, Cytology and Molecular Technique (PCR) using Fine Needle Aspirate in the Diagnosis of Tuberculous Lymphadenitis. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION : Tuberculosis has co-existed with humanity since the days before recorded history and evidence of tuberculosis has been found in the skeletal remains of mummies. Hippocrates not only described the disease but also named it ‘phthisis’ which means to mart or waste away. It is one of the most important diseases in the history of humanity and remains even today as an extraordinary burden to mankind. In the past tuberculosis was the greatest killer and earned the term, ‘The captain of all the men of death’ from John Bunyan and the ‘white plaque’ from Rene and Jean Dubars. Tuberculosis is one of the most serious health problems in India and accounts for 30% of the global burden. About 40% of Indian population is infected with Tubercle bacilli. Every year 1.8 million people developed TB of which nearly 8 lakhs are infectious smear positive cases. Every day, more than 20,000 people become infectious with tuberculosis and about 5000 develop disease. AIMS AND OBJECTIVES : Isolation of Mycobacterium tuberculosis from the fine needle aspirate samples by employing conventional bacteriological methods in patients clinically diagnosed as tuberculous lymphadenitis. Sputum smear examination by Ziehl- Neelsen technique and culture isolation of Mycobacterium tuberculosis in patients with pulmonary symptoms. Identification of Mycobacterium species employing standard phenotypic methods. Performing drug susceptibility tests on the isolates identified as Mycobacterium tuberculosis. Detection of M. tuberculosis specific gene by performing PCR on fine needle aspirate samples. Screening the study patients for the presence of HIV infection. Correlation of the conventional techniques, such as smear & bacteriological isolation, cytomorphologic features with molecular technique in the laboratory diagnosis of tuberculous lymphadenitis. MATERIALS AND METHODS : Study Population - One hundred and twenty five Patients who were clinically suspected as tuberculous lymphadenitis cases were included in this study. Study size : 125 clinically suspected tuberculous lymphadenitis cases Study Period : 2 years from December 2003 to January 2006. The present study was conducted in Stanley Medical College for a period of two years. Seventy five patients with strong clinical features suggestive of Tuberculous lymphadenitis from both out patient and in-patient, Department of Medicine and surgery of Government Stanley Hospital and 50 patients from Govt. Hospital of Thoracic Medicine, Tambaram Sanatorium, Chennai were included in the study. CONCLUSION : Diagnosis of tuberculous lymphadenitis based on clinical finding alone gives false positive results. Single diagnostic parameter alone is not sufficient for correct diagnosis. Fluorescent staining found to be more sensitive than Ziehl Neelsen staining for the demonstration of AFB in direct smear. Cytological positivity (p < 0.001) and demonstration of AFB in direct smear (P < 0.034) of the fine needle aspirate has significant statistical association with culture. FNAC is more significantly associated. Among FNAC, Direct smear and PCR, PCR (P < 0.001) is most significantly associated with culture. PCR is the most sensitive technique. 20% of tuberculous lymphadenitis patients were co-infected with HIV.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Bacteriological Techniques ; Cytology ; Molecular Technique (PCR) ; Fine Needle Aspirate ; Diagnosis ; Tuberculous Lymphadenitis ; Comparative study.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 02 Aug 2017 01:00
Last Modified: 02 Aug 2017 01:00

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