In Denmark, tuberculous lymphadenitis (TBLA) is the most common extrapulmonary manifestation of tuberculosis (TB). Yet, the clinical features of these patients have never been studied systematically in our setting.
Patients treated for TBLA in Central Region Denmark from 2007 through 2016 were identified using the national TB surveillance register and The Danish Hospital Patient Registry. Data of clinical characteristics and treatment was extracted from hospital records.
We identified 83 TBLA patients. Median age was 32 (IQR 23-42), 85.5% (n = 71) were migrants. 69.9% (n = 58) presented with cervical lymphadenopathy. 54.2% of the patients (n = 45) had one or more systemic TB symptoms such as fever, chills, night sweats, fatigue, and weight loss. Most patients had no comorbidities (n = 65, 78.3%) and HIV-coinfection was only seen among 7.2% (n = 5) of the 69 that were HIV-tested. Abscesses and/or draining sinuses were noted for 15.7% (n = 13) and 18.1% (n = 15) had concurrent pulmonary infection. The median time from first hospital contact to treatment initiation was 42 days (IQR, 16-82) and admitted patients were hospitalized for a median of 7 days (IQR, 3-13.5). For 28.9% (n = 24) of the patients, lymph node material was not sent for mycobacterial culture and only 62.7% (n = 52) had microbiologically confirmed TB. Treatment outcome was successful for 84.3% (n = 70).
In Denmark, TBLA is mainly seen among young previously healthy migrants presenting with cervical lymphadenopathy and sparse systemic symptoms. The diagnosis is often considerably delayed and not verified microbiologically implying diagnostic difficulties. Treatment outcome needs to be improved.
Copyright © 2020. Published by Elsevier Ltd.