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Open Access Research article

Clinico-pathological features of tuberculosis due to Mycobacterium tuberculosis Uganda genotype in patients with tuberculous lymphadenitis: a cross sectional study

Dan Wamala13*, Benon Asiimwe2, Edgar Kigozi2, Gerald Mboowa2, Moses Joloba2 and Gunilla Kallenius3

Author Affiliations

1 Department of Pathology, Mulago Hospital and Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda

2 Department of Medical Micobiology, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda

3 Department of Clinical Sciences and Education, Sodersjukhuset, Karolinska Institute, SE-171 77 Stockholm, Sweden

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BMC Clinical Pathology 2014, 14:14  doi:10.1186/1472-6890-14-14

Published: 2 April 2014

Abstract

Background

Tuberculous lymphadenitis is next to pulmonary tuberculosis as the most common cause of tuberculosis. Uganda genotype, one of the sub-lineages of Mycobacterium tuberculosis, is the most prevalent cause of pulmonary tuberculosis in Uganda. We here investigate the clinicopathological characteristics of patients with tuberculous lymphadenitis infected with M. tuberculosis Uganda genotype compared with those infected with M. tuberculosis non-Uganda genotype strains.

Methods

Between 2010 and 2012, we enrolled 121 patients (mean age 28.5 yrs, male 48%; female 52%) with tuberculous lymphadenitis, and categorized them by their M. tuberculosis genotypes. The clinical features and lymph node cytopathological parameters were compared between patients in the Uganda and non-Uganda categories using a crude and multivariable logistic regression model with adjustment for confounding factors.

Results

Of the 121participants, 56 (46%) were infected with strains of Uganda genotype. Patients infected with this genotype had significantly lower frequency of abdominal lymphadenopathy (odds ratio 0.4, pā€‰=ā€‰0.046) after adjusting for sex, age and HIV. Abdominal lymphadenopathy was also significantly associated with abnormal chest X-ray (pā€‰=ā€‰0.027).

Conclusion

Tuberculous lymphadenitis patients infected with M. tuberculosis Uganda genotype were significantly less prone to have abdominal lymphadenopathy indicating potential reduced ability to disseminate and supporting the concept that differences in M. tuberculosis genotype may have clinical implications.

Keywords:
Tuberculosis; Extra pulmonary; Mycobacterium; Genotype; Abdominal lymphadenopathy; Uganda