Rekik K, Hammami F, Koubaa M, Jemaa MB (2024) A Silent Epidemic: Cervical Lymph Node Tuberculosis. Ann Clin Pathol 11(2): 1172.

Tuberculosis (TB) has persistently challenged global healthcare, with a stealthy form now demanding our attention. Cervical Lymph Node Tuberculosis (CLNTB), a relatively concealed variant, is quietly surging in incidence. We aimed to illuminate this emerging trend, dissect its epidemiology, and emphasize the critical need for robust prevention strategies.

Epidemiology Unveiled: The Resurgent CLNTB

While pulmonary tuberculosis continues to command the spotlight, extrapulmonary manifestations are on the rise, with CLNTB leading the charge [1]. This subtle yet significant form, characterized by lymph node involvement in the neck, has seen a notable surge in recent years. The implications of this resurgence are far-reaching, necessitating a comprehensive understanding of its epidemiological landscape.

The Silent Surge: Unmasking CLNTB’s Underlying Trends

Cervical Lymph Node Tuberculosis (CLNTB), once a relatively rare form of the disease, is now asserting itself as a significant public health concern. Its prevalence has been steadily climbing, marking a departure from historical trends. This rise warrants a thorough exploration of contributing factors, including immunocompromised populations, inadequate healthcare access, and evolving bacterial strains [1].

A Vulnerable Cohort: Not only immunocompromised Populations

Immunocompromised individuals, particularly those living with HIV, represent a highly susceptible demographic. The weakened immune response in these populations provides an opportunistic environment for the tuberculosis bacterium, heightening the risk of extrapulmonary manifestations such as CLNTB [2]. Recognizing this vulnerability is crucial in tailoring prevention and intervention strategies. Cervical lymph node tuberculosis affects not only immunocompromised individuals. It can also occur in those with normal immune function.

Diagnostic Complexities: Navigating the Path to Accurate Diagnosis

Diagnosing CLNTB presents unique challenges due to its subtle clinical presentation and the potential for misidentification. Distinguishing it from other cervical lymph node pathologies demands a sophisticated diagnostic approach. Molecular assays, fine-needle aspiration cytology, and advanced imaging techniques have emerged as crucial tools in securing precise diagnoses, ensuring timely and targeted treatment [3].

The Imperative for Prevention: A Multifaceted Approach

Prevention remains our most potent weapon against tuberculosis, and extrapulmonary forms, including CLNTB, are no exception. Prioritizing vaccination programs, contact tracing, and early case detection is pivotal. While the Bacille Calmette- Guérin (BCG) vaccine primarily targets pulmonary TB, emerging evidence suggests potential benefits in reducing extrapulmonary cases. Strengthening vaccination efforts is paramount, especially in regions with high disease burdens [4].

Infection Control Measures: Breaking the Chain of Transmission

Healthcare settings play a pivotal role in preventing the spread of CLNTB. Implementing stringent infection control measures, particularly during diagnostic procedures, can significantly mitigate the risk of transmission. Adherence to protocols for the sterilization and disposal of infectious materials is paramount. Comprehensive training of healthcare personnel in infection control practices is equally vital.

Empowering Communities: Raising Awareness, Ensuring Access

Community engagement is central to any successful tuberculosis prevention program. Disseminating knowledge about the disease, its modes of transmission, and available preventive measures is crucial. Ensuring equitable access to healthcare facilities, particularly in remote or underserved areas, is equally imperative. Mobile clinics, telemedicine, and community health workers play a pivotal role in bridging this accessibility gap [5].

The surge in CLNTB presents a formidable challenge, demanding a united global response. Through early diagnosis, advanced diagnostic techniques, and robust prevention strategies, we can reverse this alarming trend. By prioritizing prevention, we take a significant stride towards a world free from the scourge of tuberculosis. Together, through collaborative efforts and unwavering determination, we can unmask and conquer this hidden epidemic.

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2. Hammami F, Koubaa M, Chakroun A, Rekik K, Feki W, Marrakchi C, etal. Comparative analysis between tuberculous meningitis and other forms of extrapulmonary tuberculosis. Germs. 2021; 11: 23-31.
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