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. 2018 Dec;70(4):572-577.
doi: 10.1007/s12070-018-1364-x. Epub 2018 Apr 16.

CBNAAT: A Boon for Early Diagnosis of Tuberculosis-Head and Neck

Kavita Sachdeva  1 , Tanvi Shrivastava  1
Affiliations

CBNAAT: A Boon for Early Diagnosis of Tuberculosis-Head and Neck

Kavita Sachdeva et al. Indian J Otolaryngol Head Neck Surg. 2018 Dec.

Abstract

Tuberculosis of head and neck has been an under diagnosed entity due to large number of smear negative cases, which results in missing out the positive cases, further increasing the burden of TB. The role of cartridge- based nucleic acid amplification test (CBNAAT) with a potential to diagnose TB and rifampicin resistance within 2 h is promising. The study highlights the extended implications of CBNAAT in infectious lesions of head and neck, where the pus or aspirate was subjected to this test, along with other investigations which have been routinely used for detection of extra pulmonary tuberculosis. Twelve patients with infective lesions of head and neck were included in this prospective study, conducted in Department of Otorhinolaryngology, Netaji Subhash Chandra Bose Medical College and hospital, Jabalpur from September 2016 to March 2017. They were investigated for pulmonary and extra pulmonary TB. CBNAAT, microscopy, FNAC and HPR from the site of lesion were done. Nine out of twelve patients were diagnosed positive for Tuberculosis. Microscopy (ZN staining) could detect only two such cases, whereas FNAC showed granulomatous lesion in 3 cases (33.3%). CBNAAT was positive in 77.7% of the total positive cases. Histopathological examination showed 100% results but was feasible only in selected number of cases (4 in this study). CBNAAT provides a promising role in early diagnosis of TB in head and neck. Its high sensitivity and less time taking procedure makes it an excellent tool for timely diagnosis of such cases.

Keywords: CBNAAT; Extra-pulmonary TB; GeneXpert MTB/RIF; Head and neck TB.

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Conflict of interest statement

The authors have no conflict of interest. The CBNAAT test was done free of cost at the ICMR microbiology laboratory (endorsed by WHO-2010), Jabalpur with the permission of the Director of ICMR, Jabalpur; with no conflict of interests.All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Procedure CBNAAT on Xpert-MTB/RIF
Fig. 2
Fig. 2
Algorithm of interpretetion of Xpert MTB/RIF assay
Fig. 3
Fig. 3
Distribution of TB positive patients according to presenting complaints (LNpathy, lymphadenopathy; PAS, post aural swelling)
Fig. 4
Fig. 4
Diagnosis of TB as per various relevant investigations
See this image and copyright information in PMC

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