Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; Centre for Global Health (GloHAU), Department of Public Health, Aarhus University, Aarhus, Denmark; International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.
Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark.
Int J Infect Dis. 2020 Sep;98:366-371. doi: 10.1016/j.ijid.2020.07.011. Epub 2020 Jul 11.
Tuberculous lymphadenitis (TBLA) is the most common extrapulmonary manifestation of tuberculosis (TB) in Denmark. However, the clinical features of patients with TBLA have never been systematically studied in this setting.
Patients treated for TBLA in Central Region Denmark from 2007 to 2016 were identified using the national TB surveillance register and The Danish Hospital Patient Registry. Data of clinical characteristics and treatment were extracted from hospital records.
Eighty-three TBLA patients were identified. The median age was 32 years (IQR 23-42); 71 (85.5%) were migrants; 58 (69.9%) presented with cervical lymphadenopathy; and 45 (54.2%) had one or more systemic TB symptom such as fever, chills, night sweats, fatigue, and weight loss. Sixty-five patients had no comorbidities (78.3%). HIV co-infection was seen in five (7.2%) of the 69 who were tested for HIV. Abscesses and/or draining sinuses were noted in 13 (15.7%) patients and 15 (18.1%) had concurrent pulmonary infection. The median time from first hospital contact to treatment initiation was 42 days (IQR 16-82) and admitted patients were hospitalised for a median of 7 days (IQR 3-13.5). For 24 patients (28.9%), lymph node material was not sent for mycobacterial culture and 52 (62.7%) had microbiologically confirmed TB. Treatment outcome was successful for 70 patients (84.3%).
In Denmark, TBLA is mainly seen among young and previously healthy migrants presenting with cervical lymphadenopathy and sparse systemic symptoms. The diagnosis is often considerably delayed and not microbiologically verified, implying diagnostic difficulties. Treatment outcome needs to be improved.
结核性淋巴结炎（TBLA）是丹麦最常见的肺外结核（TB）表现。然而，在这种情况下，从未对 TBLA 患者的临床特征进行过系统研究。
使用国家结核病监测登记处和丹麦医院患者登记处，确定 2007 年至 2016 年期间在丹麦中央大区接受 TBLA 治疗的患者。从医院记录中提取临床特征和治疗数据。
确定了 83 例 TBLA 患者。中位年龄为 32 岁（IQR 23-42）；71 例（85.5%）为移民；58 例（69.9%）表现为颈部淋巴结病；45 例（54.2%）有一个或多个全身 TB 症状，如发热、寒战、盗汗、疲劳和体重减轻。65 例患者无合并症（78.3%）。在 69 例接受 HIV 检测的患者中，有 5 例（7.2%）合并 HIV 感染。13 例（15.7%）患者有脓肿和/或引流窦道，15 例（18.1%）合并肺部感染。从首次就诊到开始治疗的中位时间为 42 天（IQR 16-82），住院患者的中位住院时间为 7 天（IQR 3-13.5）。24 例（28.9%）患者未送检淋巴结标本进行分枝杆菌培养，52 例（62.7%）有微生物学证实的结核病。70 例（84.3%）患者的治疗结果成功。
在丹麦，TBLA 主要见于年轻且既往健康的移民，表现为颈部淋巴结病和稀疏的全身症状。诊断通常明显延迟且未通过微生物学验证，这意味着诊断困难。治疗结果需要改善。
