Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
10691609 | Ultrasound in Medicine & Biology | 2014 | 8 Pages |
Abstract
Abdominal lymphadenopathy in human immunodeficiency virus (HIV) infection remains a diagnostic challenge. We performed a prospective cohort study by recruiting 31 symptomatic HIV + patients with abdominal lymphadenopathy and assessing the diagnostic yield of endoscopic ultrasound fine-needle aspiration (EUS-FNA). Mean age was 38 years; 52% were female; and mean CD4 count and viral load were 124 cells/μL and 4 log, respectively. EUS confirmed additional mediastinal nodes in 26%. The porta hepatis was the most common abdominal site. Aspirates obtained by EUS-FNA were subjected to cytology, culture and polymerase chain reaction (PCR) analysis. Mycobacterial infections were confirmed in 67.7%, and 31% had reactive lymphadenopathy. Cytology and culture had low sensitivity, whereas PCR identified 90% of mycobacterial infections. By combining the appearance of aspirates obtained by EUS-FNA and cytologic specimens, we developed a diagnostic algorithm to indicate when analysis with PCR would be useful. PCR performed on material obtained by EUS-FNA was highly accurate in confirming mycobacterial disease and determining genotypic drug resistance.
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Authors
Martin Nieuwoudt, Roeland Lameris, Craig Corcoran, Theresa M. Rossouw, Tomas Slavik, Johannie Du Plessis, Jones A.O. Omoshoro-Jones, Paraskevi Stivaktas, Fritz Potgieter, Schalk W. Van der Merwe,