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Isolated tuberculous lymphadenitis presenting as bilateral buboes.

Palanisamy AP, Samuel S, Vadivel S, Kothandapany S - Indian J Sex Transm Dis (2015 Jan-Jun)

Bottom Line: After a complete evaluation, she was found to be a case of isolated inguinal tuberculous lymphadenitis.There was complete resolution with standard antituberculous therapy.In this era of syndromic management of sexually transmitted diseases, which carries its own pros and cons, this case report emphasizes the need to look beyond the venereal causes and calls for thorough evaluation and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and STD, Vinayaka Mission's Medical College and Hospital, Karaikal, Puducherry, India.

ABSTRACT
Inguinal and femoral buboes are defined as localized enlargement of lymph nodes in the groin that are painful, and may or may not be fluctuant. We report a case of 42-year-old female who presented with bilateral inguinal swelling of 6 months duration. After a complete evaluation, she was found to be a case of isolated inguinal tuberculous lymphadenitis. There was complete resolution with standard antituberculous therapy. Isolated inguinal tuberculous lymphadenitis though a rare entity in developed countries is not uncommon in developing nations. In this era of syndromic management of sexually transmitted diseases, which carries its own pros and cons, this case report emphasizes the need to look beyond the venereal causes and calls for thorough evaluation and management.

No MeSH data available.


Related in: MedlinePlus

Complete resolution of bilateral buboes with antituberculous treatment
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Figure 3: Complete resolution of bilateral buboes with antituberculous treatment

Mentions: Investigations showed hemoglobin 10.6 g%, total leukocyte count 7600/cmm, neutrophil 63%, lymphocyte 30%, eosinophil 4%. Erythrocyte sedimentation rate was 36 mm/h. Serum total protein, albumin and globulin ratio were within normal limits. Urine routine was normal. Chest X-ray, ultrasonography abdomen and pelvis, PAP smear were not contributory. Serological screening for retroviral status and syphilis were non-reactive. Mantoux test was highly positive showing induration of 25 mm (+++) [Figure 2]. Fine needle aspiration cytology (FNAC) of the lymph node showed presence of Langhans giant cells, epithelioid cells and lymphocytes suggestive of tuberculous lymphadenitis. She was not willing for lymph node biopsy. Category I anti-tubercular treatment comprised of 2 months intensive phase with isoniazid, rifampicin, pyrazinamide, ethambutol and 4 months continuation phase with isoniazid and rifampicin was instituted. Patient was followed-up periodically, and there was complete resolution by the end of treatment [Figure 3].


Isolated tuberculous lymphadenitis presenting as bilateral buboes.

Palanisamy AP, Samuel S, Vadivel S, Kothandapany S - Indian J Sex Transm Dis (2015 Jan-Jun)

Complete resolution of bilateral buboes with antituberculous treatment
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555907&req=5

Figure 3: Complete resolution of bilateral buboes with antituberculous treatment
Mentions: Investigations showed hemoglobin 10.6 g%, total leukocyte count 7600/cmm, neutrophil 63%, lymphocyte 30%, eosinophil 4%. Erythrocyte sedimentation rate was 36 mm/h. Serum total protein, albumin and globulin ratio were within normal limits. Urine routine was normal. Chest X-ray, ultrasonography abdomen and pelvis, PAP smear were not contributory. Serological screening for retroviral status and syphilis were non-reactive. Mantoux test was highly positive showing induration of 25 mm (+++) [Figure 2]. Fine needle aspiration cytology (FNAC) of the lymph node showed presence of Langhans giant cells, epithelioid cells and lymphocytes suggestive of tuberculous lymphadenitis. She was not willing for lymph node biopsy. Category I anti-tubercular treatment comprised of 2 months intensive phase with isoniazid, rifampicin, pyrazinamide, ethambutol and 4 months continuation phase with isoniazid and rifampicin was instituted. Patient was followed-up periodically, and there was complete resolution by the end of treatment [Figure 3].

Bottom Line: After a complete evaluation, she was found to be a case of isolated inguinal tuberculous lymphadenitis.There was complete resolution with standard antituberculous therapy.In this era of syndromic management of sexually transmitted diseases, which carries its own pros and cons, this case report emphasizes the need to look beyond the venereal causes and calls for thorough evaluation and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and STD, Vinayaka Mission's Medical College and Hospital, Karaikal, Puducherry, India.

ABSTRACT
Inguinal and femoral buboes are defined as localized enlargement of lymph nodes in the groin that are painful, and may or may not be fluctuant. We report a case of 42-year-old female who presented with bilateral inguinal swelling of 6 months duration. After a complete evaluation, she was found to be a case of isolated inguinal tuberculous lymphadenitis. There was complete resolution with standard antituberculous therapy. Isolated inguinal tuberculous lymphadenitis though a rare entity in developed countries is not uncommon in developing nations. In this era of syndromic management of sexually transmitted diseases, which carries its own pros and cons, this case report emphasizes the need to look beyond the venereal causes and calls for thorough evaluation and management.

No MeSH data available.


Related in: MedlinePlus