Cervical lymph node TB: diagnostic yield and patient profile

BACKGROUND: Cervical lymph node TB (CL-TB) is the most prevalent form of extra-pulmonary TB, yet it remains underdiagnosed in endemic settings due to non-specific symptoms and inconsistent diagnostic pathways. We aimed to identify socio-demographic and clinical predictors of CL-TB in patients attending a tertiary hospital in Bangladesh and evaluate the diagnostic yield of available tests. METHODS: We conducted this cross-sectional study at Bangladesh Medical University. We screened 3,619 cervical lymphadenitis patients and enrolled 104 with presumptive CL-TB. Lymph node (LN) aspirates were tested using microscopy, cytopathology, GeneXpert, polymerase chain reaction (PCR), and culture. Data were analysed using STATA 15. RESULTS: Among 104 participants, 52 were confirmed to have CL-TB by either microscopy, cytopathology, GeneXpert, PCR, or culture. Younger age (18-30 years) and purulent aspirate appearance were independently associated with CL-TB. Cytopathology showed the highest diagnostic yield (82.7%), followed by GeneXpert (71.2%) and PCR (67.3%), while microscopy and culture detected