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What tests should be done to find tuberculosis?

Hi Doctor

First FNAC Site of Cervical Gland on 05 March 2013 got impression Pyogenic Abscess and AFB:negative, CBC & ESR normal, chest x-ray normal, mantoux test positive.

Second FNAC site of Cervical Gland on 09 April 2013 got AFB: negative, Granulomatous Lymphadenitis.
Microscopic:- Smears show predominantly small & large lymphocytes, neutrophils, macrophages, Few number of epithelioid cells are seen. No giant cells/casation necrosis seen.

This is sufficient find to Tuberculosis symptoms are need to do again chest X-Ray.

Please suggest me.
Asked On : Sun, 14 Apr 2013
Answers:  2 Views:  80
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Lab Tests
Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

The first FNAC report of the cervical gland suggests collection of pus (inflammtory cells).
Pus collection can occur due to bacterial infection.
However, this report is negative for acid fast bacilli (AFB).
AFB is the causative of tuberculosis.
The second FNAC report shows inflammatory cells and granulomas.
Granulomas are present in cases of tuberculosis.
Presence of giant cells and necrosis are characteristic of tuberculosis.
However, absence of giant cells and necrosis does not rule out tuberculosis.

Mantoux test and X-ray chest are other tests which further potentiates the diagnosis of tuberculosis.

The treatment of tuberculosis is anti-tubercular treatment (ATT).
ATT consists of multiple drugs and for long duration of time.
So, 100% confirmation of tuberculosis is required to start ATT.
Presence of AFB and/or positive culture for tuberculosis is the confirmatory test for tuberculosis.
If these tests are negative, PCR is needed to confirm the diagnosis.

thanks and take care
Dr Shailja P Wahal
Answered: Sat, 25 May 2013
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Pathologist and Microbiologist Dr. Shailja Puri 's  Response
Hello and welcome to HCM,

The first FNAC report suggests infection/ accumulation of pus in the cervical lymph node.
Accumulation of pus occurs due to bacterial infection.
The second lymph node aspiration report suggests infection by mycobacterium tuberculosis.
The presence of epithelioid cells indicates tuberculous infection.
Giant cells and necrosis further potentiates the tuberculus infection.
However, AFB positivity or positive culture for AFB is confirmatory for the tuberculus infetion.
AFB stands for acid fast bacilli.
The treatment of tubeculosis is anti-tubercular treatment (ATT)
The treatment consists of multiple drugs and it lasts for a period of 9-12 months.
So, 100% confirmation for tuberculus infection is needed to start the treatment.
A X-ray chest and Montaux test are other tests which further potentiate the diagnosis.
PCR for tuberculosis is another test to confirm the diagnosis.

Thanks and take care
Dr Shailja P Wahal
Answered: Sat, 25 May 2013
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
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