Comparative Analysis of Gene Expert Assay In Addition To Z-N Microscopy for Detection of Extra -Pulmonary TB in A Fine Needle Aspiration Samples
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 7
Abstract
Abstract:Tuberculosis (TB) remains one of the worlds deadliest communicable disease. Extrapulmonary tuberculosis (EPTB) can occur in isolation or along with pulmonary focus with disseminated tuberculosis. Since clinical presentation of EPTB is atypical and poor yeild of conventional diagnostic method, the diagnosis often delayed. Though Z-N staining low cost,high specificity and does not required high laboratory standards, the gene Xpert MTB/RIF assay provide early ,distinguishes MTB and mycobacteria other than tuberculosis and also provide rifampicin resistance simultaneously in a Fine needle aspirated sampling. The aim is to assess and to compare the value of GeneXpert in diagnosis of EPTB in addition Ziehl-Neelson smear microscopy in Fine needle aspirated samples. It was retrospective study carried out in department of laboratory medicine, Yashoda hospital, Malakpet branch Hyderabad during period of November 2015 to July 2017 (twenty months). Fourty, immunocompetent, out patient cases from all departments, diagnosed as extrapulmonary tuberculosis evaluated with Z-N smear microcopy and GeneXpert in Fine needle aspiration sampling with or without radiological assistance. EPTB incidence was 3.5%. Females are more commonly affected with male to female ratio 1:2.Second to third decade was commonly affected group. Cervical lymphadenopathy was most common presentation (62.5%).Epitheloidgranulomas with caseation necrosis (40%) was most common cytological picture. Overall AFB positivity seen in 62.5% compare to 100% positive gene X-pert findings and Rifampicin resistance seen in 2.5% cases. EPTB diagnosis is great challenge. Image guidence FNAC plays first line investigation. GeneX-pert has shown higher levels of sensitivity and specificity for diagnosis of EPTB compare to cytology and Z-N microsopy. Keywords:EPTB; FNAC; Gene X-PERT,; Cytology ; Z-N staining.
Authors and Affiliations
Majed Momin, Amitha G, Anamika Aluri, Sandeep S
Keywords
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