Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional study

Abstract Background Tubercular lymphadenitis (TBLN) is the most common extrapulmonary tuberculosis (EPTB) followed by tubercular pleural effusion (TPE). The bacteriological confirmation to diagnose EPTB is more difficult due to its paucibacillary nature often leading to delay or misdiagnosis. The ro...

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Main Authors: Rahul Gupta, Ashok Kumar Janmeja, Arjun Kumar, Balbir Singh, Pramod Kumar Shridhar
Format: Article
Language:English
Published: SpringerOpen 2025-02-01
Series:The Egyptian Journal of Bronchology
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Online Access:https://doi.org/10.1186/s43168-025-00369-3
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author Rahul Gupta
Ashok Kumar Janmeja
Arjun Kumar
Balbir Singh
Pramod Kumar Shridhar
author_facet Rahul Gupta
Ashok Kumar Janmeja
Arjun Kumar
Balbir Singh
Pramod Kumar Shridhar
author_sort Rahul Gupta
collection DOAJ
description Abstract Background Tubercular lymphadenitis (TBLN) is the most common extrapulmonary tuberculosis (EPTB) followed by tubercular pleural effusion (TPE). The bacteriological confirmation to diagnose EPTB is more difficult due to its paucibacillary nature often leading to delay or misdiagnosis. The role of the CBNAAT test for the diagnosis of EPTB is highly variable among different populations. Hence, the aim of the present study was to evaluate the role of CBNAAT in the diagnosis of EPTB in a tertiary care center in north India. Methods This was a cross-sectional study conducted in the 100 stable patients of EPTB (55 TPE and 45 TBLN) who came to the Respiratory Medicine Department in MMMC&H, Solan, India. The total duration of the study was eighteen months from April 2021 to September 2022. Fine needle aspirate and pleural fluid samples were collected from all suspected TPE and TBLN patients respectively and were subjected to CBNAAT investigation. All other recommended investigations used for diagnosis of TBLN and TPE were also performed including ZN stain, FNAC, biochemical analysis of pleural fluid, Mantoux test, radiological imaging, and other routine investigations. The data analysis was done using SPSS version 20 software. Results Out of 100 patients of EPTB, 55 were TPE, and 45 were TBLN patients. The positivity of CBNAAT was higher in TBLN patients (57.8%) as compared to TPE (23.7%) patients. The correlation between CBNAAT and ZN stain was statistically significant in both TBLN (p = 0.008) and TPE (p = 0.001) patients. The correlation of CBNAAT with FNAC, duration of illness, erythrocyte sedimentation rate (ESR), and Mantoux were all statistically significant (p < 0.05). Conclusion Our study finding showed higher positivity of CBNAAT in the TBLN as compared to that in patients of TPE. The positivity of CBNAAT in the TBLN patients was higher in pus and cheesy FNAC samples, Mantoux-positive patients, and those with high ESR value.
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spelling doaj-art-5646e81d5b35409db54e549de20c3bde2025-02-09T12:16:18ZengSpringerOpenThe Egyptian Journal of Bronchology2314-85512025-02-011911710.1186/s43168-025-00369-3Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional studyRahul Gupta0Ashok Kumar Janmeja1Arjun Kumar2Balbir Singh3Pramod Kumar Shridhar4Department of Respiratory Medicine, Maharishi Markandeshwar Medical College and HospitalDepartment of Respiratory Medicine, Maharishi Markandeshwar Medical College and HospitalDepartment of Respiratory Medicine, Maharishi Markandeshwar Medical College and HospitalDepartment of Respiratory Medicine, Maharishi Markandeshwar Medical College and HospitalDepartment of Respiratory Medicine, Maharishi Markandeshwar Medical College and HospitalAbstract Background Tubercular lymphadenitis (TBLN) is the most common extrapulmonary tuberculosis (EPTB) followed by tubercular pleural effusion (TPE). The bacteriological confirmation to diagnose EPTB is more difficult due to its paucibacillary nature often leading to delay or misdiagnosis. The role of the CBNAAT test for the diagnosis of EPTB is highly variable among different populations. Hence, the aim of the present study was to evaluate the role of CBNAAT in the diagnosis of EPTB in a tertiary care center in north India. Methods This was a cross-sectional study conducted in the 100 stable patients of EPTB (55 TPE and 45 TBLN) who came to the Respiratory Medicine Department in MMMC&H, Solan, India. The total duration of the study was eighteen months from April 2021 to September 2022. Fine needle aspirate and pleural fluid samples were collected from all suspected TPE and TBLN patients respectively and were subjected to CBNAAT investigation. All other recommended investigations used for diagnosis of TBLN and TPE were also performed including ZN stain, FNAC, biochemical analysis of pleural fluid, Mantoux test, radiological imaging, and other routine investigations. The data analysis was done using SPSS version 20 software. Results Out of 100 patients of EPTB, 55 were TPE, and 45 were TBLN patients. The positivity of CBNAAT was higher in TBLN patients (57.8%) as compared to TPE (23.7%) patients. The correlation between CBNAAT and ZN stain was statistically significant in both TBLN (p = 0.008) and TPE (p = 0.001) patients. The correlation of CBNAAT with FNAC, duration of illness, erythrocyte sedimentation rate (ESR), and Mantoux were all statistically significant (p < 0.05). Conclusion Our study finding showed higher positivity of CBNAAT in the TBLN as compared to that in patients of TPE. The positivity of CBNAAT in the TBLN patients was higher in pus and cheesy FNAC samples, Mantoux-positive patients, and those with high ESR value.https://doi.org/10.1186/s43168-025-00369-3Tubercular pleural effusionPulmonary tuberculosisCBNAATTBLNEPTBFNAC
spellingShingle Rahul Gupta
Ashok Kumar Janmeja
Arjun Kumar
Balbir Singh
Pramod Kumar Shridhar
Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional study
The Egyptian Journal of Bronchology
Tubercular pleural effusion
Pulmonary tuberculosis
CBNAAT
TBLN
EPTB
FNAC
title Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional study
title_full Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional study
title_fullStr Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional study
title_full_unstemmed Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional study
title_short Role of CBNAAT in the diagnosis of extrapulmonary tuberculosis: a prospective cross-sectional study
title_sort role of cbnaat in the diagnosis of extrapulmonary tuberculosis a prospective cross sectional study
topic Tubercular pleural effusion
Pulmonary tuberculosis
CBNAAT
TBLN
EPTB
FNAC
url https://doi.org/10.1186/s43168-025-00369-3
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AT arjunkumar roleofcbnaatinthediagnosisofextrapulmonarytuberculosisaprospectivecrosssectionalstudy
AT balbirsingh roleofcbnaatinthediagnosisofextrapulmonarytuberculosisaprospectivecrosssectionalstudy
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