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 <7% of CL-TB cases. CONCLUSION: Combinations of cytopathology with GeneXpert or PCR yielded near-perfect CL-TB detection. This was the first study in Bangladesh to utilise LN aspirates directly for PCR alongside cytopathology, GeneXpert, microscopy, and culture, demonstrating a feasible diagnostic approach in high-burden settings like Bangladesh and offering improved detection and reduced delay.
Luba et al. (Sun,) studied this question.