Revista medica del Instituto Mexicano del Seguro Social · 2019
[Nontuberculous mycobacteria in cervical lymphadenopathies of HIV positive and HIV-negative adults].
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Hernández-Solís Alejandro, González-Villa Maribel, Ramírez-González Ernesto, González-González Heleodora, de la Torriente-Mata Rocío, Reding-Bernal Arturo, Cícero-Sabido Raúl
Аннотация
BACKGROUND: Tuberculosis is a global public health problem, especially in emerging countries. Mycobacterium tuberculosis is the main cause of cervical lymphadenopathy; nontuberculous mycobacteria are relatively common in children and rare in adults.
OBJECTIVE: To identify and establish the frequency of infectious etiology by nontuberculous mycobacteria in Mexican adult patients with cervical lymphadenopathy.
METHODS: The study included 85 patients over 18 years with cervical lymphadenopathy; 45 were HIV-positive, 40 were HIV-negative; they had no history of tuberculosis treatment and were selected from a third-level hospital. It was carried out a biopsy of the lymph node for the histopathological study, a search for acid-fast bacilli, a tube culture to indicate growth of Mycobacterium BACTEC (MGIT-960) and identification of mycobacterial strain by PCR-RFLP (restriction fragment length polymorfism) of hsp65.
RESULTS: In 42 HIV-positive patients (93%), strains corresponded to Mycobacterium tuberculosis complex, two (4.4%) to M. intracellulare and one (2.2%) to M. gordonae. Among HIV-negative patients, 39 of strains (97.5%) corresponded to patients with M. tuberculosis complex and one strain (2.5%) to M. fortuitum.
CONCLUSION: The presence of nontuberculous mycobacteria was found in 4.7% of all cases. Despite this low frequency, it must be taken into account as a possible cause of lymphadenopathy, since its prompt identification enables introducing specific treatment.
OBJECTIVE: To identify and establish the frequency of infectious etiology by nontuberculous mycobacteria in Mexican adult patients with cervical lymphadenopathy.
METHODS: The study included 85 patients over 18 years with cervical lymphadenopathy; 45 were HIV-positive, 40 were HIV-negative; they had no history of tuberculosis treatment and were selected from a third-level hospital. It was carried out a biopsy of the lymph node for the histopathological study, a search for acid-fast bacilli, a tube culture to indicate growth of Mycobacterium BACTEC (MGIT-960) and identification of mycobacterial strain by PCR-RFLP (restriction fragment length polymorfism) of hsp65.
RESULTS: In 42 HIV-positive patients (93%), strains corresponded to Mycobacterium tuberculosis complex, two (4.4%) to M. intracellulare and one (2.2%) to M. gordonae. Among HIV-negative patients, 39 of strains (97.5%) corresponded to patients with M. tuberculosis complex and one strain (2.5%) to M. fortuitum.
CONCLUSION: The presence of nontuberculous mycobacteria was found in 4.7% of all cases. Despite this low frequency, it must be taken into account as a possible cause of lymphadenopathy, since its prompt identification enables introducing specific treatment.