Factors predicting outcome in cervical lymph node tuberculosis: insights from a Tunisian case series.

Q2 Pharmacology, Toxicology and Pharmaceutics

F1000Research Pub Date : 2025-09-30 eCollection Date: 2025-01-01 DOI:10.12688/f1000research.164097.2

Maissa Lajhouri, Selima Jouini, Yosra Ammar Mnejja, Azza Mediouni, Rihab Lahmar, Houda Chahed

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引用次数: 0

Abstract

Background: Tuberculosis remains a significant public health issue in Tunisia. This study aimed to describe the epidemiological, clinical, and therapeutic characteristics of cervical lymph node tuberculosis and identify factors influencing outcomes.

Methods: A retrospective study was conducted over a 3-year period in the ENT department at La Rabta Hospital, Tunis. Diagnosis was based on histopathological evidence, and disease progression was categorized as favorable (treatment <9 months, no additional surgery) or unfavorable (treatment >9 months and/or supplementary surgery).The study population was divided into two groups based on the outcome nature, and analytical analysis was performed to assess factors influencing outcomes.

Results: The study included 102 patients (32 men and 70 women), with a median age of 34.5 years (range: 8-83 years). Most patients (78.4%) had no significant medical history or known HIV infection. Thirty-nine patients (38.2%) had a history of consuming raw milk. In 65 cases (63.7%), lymph node size exceeded 3 cm. Hypoechogenicity (53.9%) and necrosis (40.1%) were the most common findings on ultrasound and CT scan, respectively. The initial diagnostic approach included adenectomy (56.8%), lymph node dissection (8.9%), and drainage of cold abscesses (34.3%). All patients received an initial four-drug antituberculosis regimen. Ethambutol treatment was extended beyond 2 months in 65 cases (63.7%). Fifty-six patients (54.9%) had a favorable outcome.Factors associated with a favorable outcome included intact skin, complete initial lymph node dissection, favorable progress at 2 months, and prolonged ethambutol therapy.

Conclusions: The management of lymph node tuberculosis remains challenging, especially with insufficient bacteriological confirmation. Regional epidemiological factors should be considered. The role of surgery is crucial; however, further standardization is needed to optimize patient outcomes.

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预测颈淋巴结结核预后的因素：来自突尼斯病例系列的见解。

背景：结核病在突尼斯仍然是一个重大的公共卫生问题。本研究旨在描述颈淋巴结结核的流行病学、临床和治疗特点，并确定影响预后的因素。方法：对突尼斯拉巴塔医院耳鼻喉科进行了为期3年的回顾性研究。诊断基于组织病理学证据，疾病进展被归类为有利（治疗9个月和/或补充手术）。根据结局性质将研究人群分为两组，对影响结局的因素进行分析分析。结果：研究纳入102例患者（男性32例，女性70例），中位年龄34.5岁（范围：8-83岁）。大多数患者（78.4%）没有明显的病史或已知的HIV感染。39例（38.2%）患者有食用生奶史。65例（63.7%）淋巴结大小超过3cm。超声和CT扫描最常见的表现分别为低回声（53.9%）和坏死（40.1%）。最初的诊断方法包括腺切除术（56.8%）、淋巴结清扫（8.9%）和冷脓肿引流（34.3%）。所有患者都接受了最初的四种药物抗结核治疗方案。乙胺丁醇治疗延长2个月以上65例（63.7%）。56例（54.9%）患者预后良好。与良好结果相关的因素包括皮肤完整、初始淋巴结清扫完全、2个月时良好的进展以及延长乙胺丁醇治疗。结论：淋巴结结核的治疗仍然具有挑战性，特别是在细菌学证实不足的情况下。应考虑区域流行病学因素。手术的作用是至关重要的；然而，需要进一步的标准化来优化患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

F1000Research Pharmacology, Toxicology and Pharmaceutics-Pharmacology, Toxicology and Pharmaceutics (all)

CiteScore

5.00

自引率

0.00%

发文量

1646

审稿时长

1 weeks

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