Outcomes of category III and I in immunocompetent patients of tuberculous lymphadenopathy treated in revised national tuberculosis control programme

BACKGROUND: Retrospective observation analysis to evaluate the outcome of six month treatment regimen, CAT-III and CAT-I, for all patients diagnosed with tubercular lymphadenopathy at M.G.M. Medical College and M.Y. Hospital, Indore, India from January 2006 to December 2008. MATERIALS AND METHODS: Out of 3158 cases of tuberculosis, there were 337 (10.67%) lymphnode cases; 31 (9.19%) HIV positive and 11(3.26 %) defaulters were excluded from the study. Of the remaining 295 cases of lymphadenopathy enrolled, 240 were on CAT-III and 55 cases of complicated lymphadenopathy were on CAT-I. All patients were followed for six months, to monitor response and complications. Patients with abscess formation or sinus formation underwent aspiration, AFB smear and culture sensitivity. In patients with persistent lymphadenopathy, repeat FNAC of the gland and in cases of hard lymphnode excision biopsy was done before receiving re-treatment regimen category –II or reserved drugs. RESULT: Out of 295 patients, 212 (71.86%) responded to treatment, however, 83 (28.14%) did not show response at the end of treatment. Of the 83 patients, 54 (65.06%) responded to re-treatment regimen CAT-II, while 29 (34.93%) were found to be drug resistant and were given second line anti tubercular drugs. In the follow-up at six months and later after the end of treatment, 11 (5.18%) relapse was seen. CONCLUSION: In our study, success rate of currently recommended regimens, category III and I under the revised national tuberculosis control programme in tubercular lymphadenopathy was 71.86%; with 28.34% of patients requiring re-treatment regimen. This requires a lager study involving more number of patients to prove adequacy of regimen.