A case of tubercular lymphadenopathy and review of literature

Tubercle bacilli infects approximately one-third of the world's population as per the World Health Organization. New cases of the active disease developing each year constitute eight million of which three million people die. Tubercular lymphadenopathy is often rare compared to pulmonary tuberculosis. We present a case of a 29-year-old Indian female, who was immunocompetent and HIV negative, with a 3-month history of recurring fever, loss of appetite, abdominal pain, vomiting, and loss of weight. On examination, she had disseminated lymphadenopathy including supraclavicular lymph nodes. Fine-needle aspiration cytology of the right supraclavicular node showed acid-fast bacilli along with caseation necrosis and was consistent with tubercular lymphadenopathy. Disseminated tubercular lymphadenopathy is extremely rare in immunocompetent individuals. The crux in the approach to disseminated lymphadenopathy lies in the diagnosis of tubercular lymphadenopathy, confirmed by histological and microbiological findings since it has a good prognosis with an active antituberculous treatment regime resulting in a favorable outcome.