Hernández-Solís A, Cicero-Sabido R, Olivera H, Rivero V, Ramírez E, Escobar-Gutiérrez A
Unidad de Neumología, Hospital General de México and Facultad se Medicina, UNAM, México.
Epidemiol Infect. 2003 Dec;131(3):1071-6. doi: 10.1017/s0950268803001304.
To establish the frequency of infectious aetiology in Mexican adult patients with cervical lymphadenopathies (CLAs), 87 consecutive patients with enlarged cervical lymphatic nodes, HIV negative and without anti-tuberculous treatment, were selected from a tertiary-level speciality concentration hospital. Histopathological studies, investigation of acid-fast bacilli, cultures in Löwenstein Jensen and Mycobacterium growth indicator tube (MGIT) media, and in-house polymerase chain reaction (PCR) with IS6110-based primers for Mycobacterium tuberculosis complex were performed in resected lymphatic nodes. Non-infectious aetiology corresponded to 45 cases (52 %). Tuberculosis was suspected in 42 cases (48%) by histology and confirmed positive results were obtained by staining in 8 (19%), by culture in 23 (55%), and by PCR in 34 (81 %) patients. All were confirmed after therapeutic success. In addition to the epidemiological transition process occurring in Mexico, tuberculosis remains an important cause of CLA. Histopathology with confirmatory studies including PCR can detect tuberculous aetiology.
为确定墨西哥成年颈淋巴结病(CLA)患者感染性病因的发生率,我们从一家三级专科集中医院选取了87例连续的颈淋巴结肿大患者,这些患者HIV阴性且未接受抗结核治疗。对切除的淋巴结进行了组织病理学研究、抗酸杆菌检测、在罗氏培养基和分枝杆菌生长指示管(MGIT)培养基中培养,以及使用基于IS6110的引物进行结核分枝杆菌复合群的内部聚合酶链反应(PCR)。非感染性病因对应45例(52%)。通过组织学检查,42例(48%)怀疑为结核病,8例(19%)通过染色获得确诊阳性结果,23例(55%)通过培养确诊,34例(81%)通过PCR确诊。所有病例在治疗成功后均得到确诊。除了墨西哥正在发生的流行病学转变过程外,结核病仍然是CLA的重要病因。包括PCR在内的确诊性研究的组织病理学检查可以检测出结核病因。