The DOI matches its Crossref record; 65 of the 66 references it cites were found in a registry or an index; 9 of the 108 sources its claims cite were checked for support.
Current diagnosis and management of peripheral tuberculous lymphadenitis.
Abstract
Peripheral tuberculous lymphadenitis accounts for ~10% of tuberculosis cases in the United States. Epidemiologic characteristics include a 1.4:1 female-to-male ratio, a peak age range of 30-40 years, and dominant foreign birth, especially East Asian. Patients present with a 1-2 month history of painless swelling of a single group of cervical lymph nodes. Definitive diagnosis is by culture or nucleic amplification of Mycobacterium tuberculosis; demonstration of acid fast bacilli and granulomatous inflammation may be helpful. Excisional biopsy has the highest sensitivity at 80%, but fine-needle aspiration is less invasive and may be useful, especially in immunocompromised hosts and in resource-limited settings. Antimycobacterial therapy remains the cornerstone of treatment, but response is slower than with pulmonary tuberculosis; persistent pain and swelling are common, and paradoxical upgrading reactions may occur in 20% of patients. The role of steroids is controversial. Initial excisional biopsy deserves consideration for both optimal diagnosis and management of the otherwise slow response to therapy.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This narrative review summarizes the epidemiology, clinical presentation, diagnosis, and management of peripheral tuberculous lymphadenitis, emphasizing its distinct features and frequent slow or paradoxical response to therapy. It concludes that excisional biopsy offers the best diagnostic yield and may be considered as an adjunct to standard antimycobacterial treatment, while corticosteroid use remains controversial.
Key findings
- Peripheral tuberculous lymphadenitis accounted for about 10% of US tuberculosis cases; in 2008, 1,103 of 12,904 cases (8.5%) were lymphadenitis. It is more common in women (composite female-to-male ratio 1.4:1), peaks at ages 30–40 years, and in non-endemic countries predominantly affects foreign-born patients, especially those from Southeast Asia and India.
- Typical presentation is painless swelling of a single cervical lymph node group lasting 1–2 months; median node size is 3 cm, cervical involvement is reported in 45%–70%, and concomitant pulmonary tuberculosis in 18%–42%. Systemic symptoms are more frequent in HIV-positive patients.
- Definitive diagnosis requires culture or nucleic acid amplification of *Mycobacterium tuberculosis*. Excisional biopsy had the highest sensitivity in one Hong Kong study (80% culture-positive vs 17% for fine-needle aspiration), though FNA is less invasive and useful in resource-limited or immunocompromised settings. NAAT performance was highly variable (sensitivity 2%–100%; specificity 28%–100%).
- IDSA recommends 6 months of antimycobacterial therapy, supported by cure rates of 89%–94% and relapse rates of 3%. Paradoxical upgrading reactions occurred in 20%–23% of HIV-negative patients and 22%–60% of HIV-positive patients initiating ART; steroids are controversial, and early excisional biopsy may improve diagnosis and management of slow responses.
Methods
- Narrative review of English-language articles identified through Medline using “Tuberculosis, Lymph Node” as a major Medical Subject Heading from 1990 through 2011.
- Synthesized epidemiologic data from 14 studies, along with literature on diagnostic tests, antibiotic treatment, steroid therapy, paradoxical reactions, and surgical management.
- No primary data collection or formal meta-analysis was performed.
Limitations
- The paper does not explicitly state limitations. Evident from the text: it is a narrative review restricted to English-language Medline articles from 1990–2011, so selection and language bias are possible and study quality was not systematically appraised.
- Evident from the text: reported rates of paradoxical upgrading reactions vary with definitions, and many cited studies are retrospective or uncontrolled, particularly those on steroid use in adults.
- Evident from the text: the recommendation to consider early excisional biopsy as an adjunct lacks controlled comparisons against antibiotic therapy alone, as the authors note.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
9 of 108 cited sources checked · 2 supported · 2 flagged · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In contrast, fever and weight loss were reported in 40%-60% of HIV-negative patients in series from Qatar and India [17, 24].”
What the sources say
- Not matchedcites [17] 17. Khan FY. Clinical pattern of tuberculous adenitis in Qatar: experience with 35 patients. Scand J Infect Dis 2009 ; 41:128-34.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Partly supportedcites [24] 24. Purohit MR, Mustafa T, Morkve O, Sviland L. Gender differences in the clinical diagnosis of tuberculous lymphadenitis-a hospital-based study from Central India. Int J Infect Dis 2009 ; 13:600-5. sourceExperimental — accuracy not yet measured
The Results report that none of the 219 patients in the Indian series had HIV infection, and identify fever and weight loss as symptoms. They give 56.6% for patients with one or more constitutional symptoms, not a 40%–60% rate for fever and weight loss individually. The Qatar series is not assessed against this source. (LLM, conf=0.82)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
Every source the paper cites for this claim was checked and supports it.
In the paper
“M. tuberculosis is the usual cause of tuberculous lymphadenitis [23].”
What the sources say
- Supportedcites [23] 23. Yates MD, Grange JM. Bacteriological survey of tuberculous lymphadenitis in southeast England, 1981-1989. J Epidemiol Community Health 1992 ; 46:332-5. source
The Abstract and Results report that 1,677 of 1,817 patients with mycobacterial lymphadenitis had M. tuberculosis, far more than any other species. This supports calling it the usual cause in the southeast England cases surveyed. (LLM, conf=0.92)
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Tuberculous lymphadenitis usually presents as a slowly progressive, painless swelling of a single group of lymph nodes [3, 24].”
What the sources say
- Not checked — no full text of the sourcecites [3] 3. Artenstein AW, Kim JH, Williams WJ, Chung RC. Isolated peripheral tuberculous lymphadenitis in adults: current clinical and diagnostic issues. Clin Infect Dis 1995 ; 20:876-82.
- Partly supportedcites [24] 24. Purohit MR, Mustafa T, Morkve O, Sviland L. Gender differences in the clinical diagnosis of tuberculous lymphadenitis-a hospital-based study from Central India. Int J Infect Dis 2009 ; 13:600-5. sourceExperimental — accuracy not yet measured
The Results (page unavailable) report that all 219 patients presented with a neck mass, with durations ranging from four days to eight months. The Discussion (page unavailable) says women usually had a single unilateral node, but describes different patterns in men. The paper does not establish that swelling is usually slowly progressive or painless, or that a single group of nodes is the usual presentation across patients. (LLM, conf=0.84)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe cited sources support only part of this claim — read each source’s verdict below.
In the paper
“which suggests that Africans may also have an increased risk of lymph node tuberculosis.”
What the sources say
- Partly supportedcites [6] 6. Rock RB, Sutherland WM, Baker C, Williams DN. Extrapulmonary tuberculosis among Somalis in Minnesota. Emerg Infect Dis 2006 ; 12:1434-6. sourceExperimental — accuracy not yet measured
The Conclusions (page unavailable) report that extrapulmonary tuberculosis was more common among Somalis in Minnesota than among foreign-born tuberculosis patients overall, and that 50% of Somali patients with extrapulmonary tuberculosis had lymphatic disease. This suggests a possible elevated risk in the studied Somali population, but the paper does not establish an increased risk of lymph node tuberculosis among Africans generally. (LLM, conf=0.84)
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In a study involving HIV-negative Somalis in Minnesota [6], 30% of 407 patients with tuberculosis had lymphadenitis”
What the sources say
- Partly supportedcites [6] 6. Rock RB, Sutherland WM, Baker C, Williams DN. Extrapulmonary tuberculosis among Somalis in Minnesota. Emerg Infect Dis 2006 ; 12:1434-6. sourceExperimental — accuracy not yet measured
The Study reports 407 Somali tuberculosis cases, of which 239 had extrapulmonary involvement; lymph nodes accounted for 50% of extrapulmonary disease sites, approximately 30% of the 407 cases. But the 407-patient cohort was not established as HIV-negative: HIV results are reported for only 179 of the 239 patients with extrapulmonary tuberculosis, and two tested positive. (LLM, conf=0.88)
Strength:plain· not yet calibratedn = 407Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Partly supported
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“FNA has emerged as a first-line diagnostic technique, especially in tuberculosis-endemic countries, where the test is both sensitive and specific [29, 33].”
What the sources say
- Not checked — no full text of the sourcecites [29] 29. Ellison E, Lapuerta P, Martin SE. Fine needle aspiration diagnosis of mycobacterial lymphadenitis. Sensitivity and predictive value in the United States. Acta Cytol 1999 ; 43:153-7. source
- Not checked — no full text of the sourcecites [33] 33. Wright CA, van der Burg M, Geiger D, Noordzij JG, Burgess SM, Marais BJ. Diagnosing mycobacterial lymphadenitis in children using fine needle aspiration biopsy: cytomorphology, ZN staining and autofluorescence-making more of less. Diagn Cytopathol 2008 ; 36:245-51.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“HIV-positive patients with tuberculous lymphadenitis typically have a higher rate of disseminated disease than do HIV-negative patients (38% vs 8%; P , .001) [27].”
What the sources say
- Not checked — no full text of the sourcecites [27] 27. Shafer RW, Kim DS, Weiss JP, Quale JM. Extrapulmonary tuberculosis in patients with human immunodeficiency virus infection. Medicine (Baltimore) 1991 ; 70:384-97. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Systemic symptoms are reported more frequently in HIV-positive patients than in HIV-negative patients (76% of 21 vs 12% of 43 in a report from Taiwan) [15].”
What the sources say
- Not checked — no full text of the sourcecites [15] 15. Wei YF, Liaw YS, Ku SC, Chang YL, Yang PC. Clinical features and predictors of a complicated treatment course in peripheral tuberculous lymphadenitis. J Formos Med Assoc 2008 ; 107:225-31. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Concomitant pulmonary tuberculosis is reported in 18%-42% of patients (Table 1)”
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“In a study from Hong Kong, 80% of specimens from excisional biopsy yielded positive culture results, compared with 17% from fine-needle aspiration (FNA) specimens [32].”
What the sources say
- Not checked — no full text of the sourcecites [32] 32. Lau SK, Wei WI, Hsu C, Engzell UC. Efficacy of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenopathy. J Laryngol Otol 1990 ; 104:24-7. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- Probably not a substantial claim. 24
- It may state two separate claims as one. 40
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“A draining sinus may be present in 4%-11% of cases [3, 17, 24].”
What the sources say
- Not checked — no full text of the sourcecites [3] 3. Artenstein AW, Kim JH, Williams WJ, Chung RC. Isolated peripheral tuberculous lymphadenitis in adults: current clinical and diagnostic issues. Clin Infect Dis 1995 ; 20:876-82. source
- Not matchedcites [17] 17. Khan FY. Clinical pattern of tuberculous adenitis in Qatar: experience with 35 patients. Scand J Infect Dis 2009 ; 41:128-34.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Disputedcites [24] 24. Purohit MR, Mustafa T, Morkve O, Sviland L. Gender differences in the clinical diagnosis of tuberculous lymphadenitis-a hospital-based study from Central India. Int J Infect Dis 2009 ; 13:600-5. sourceExperimental — accuracy not yet measured
The Results report a discharging sinus in three of 219 patients (1.4%), below the claimed 4%–11% range. The paper confirms that a sinus can occur, but its reported frequency is contrary to the range attributed to it. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“In a study from Germany, 6 of 10 tuberculous lymphadenitis cases confirmed by culture were detected by the newer GeneXpert test; 3 cases with positive results had negative culture results, but subsequent investigation suggested that these were true cases [36].”
What the sources say
- Disputedcites [36] 36. Hillemann D, Ruesch-Gerdes S, Boehme C, Richter E. Rapid molecular detection of extrapulmonary tuberculosis by automated GeneXpert(R) MTB/RIF system. J Clin Microbiol 2011 ; 49:1202-5. sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Checked by a reasoning model — may be wrong.
Strength:plain· not yet calibratedn = 10Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Disputed
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a series of patients in India, the mean duration of symptoms was significantly longer in men than in women [24].”
What the sources say
- Supportedcites [24] 24. Purohit MR, Mustafa T, Morkve O, Sviland L. Gender differences in the clinical diagnosis of tuberculous lymphadenitis-a hospital-based study from Central India. Int J Infect Dis 2009 ; 13:600-5. source
The Results report that all patients presented with a neck mass and that its mean duration at presentation was significantly longer in men than in women (p=0.015). The cited comparison is specifically about the duration of the neck mass. (LLM, conf=0.92)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The duration of symptoms at the time of presentation is typically 1-2 months, varying from 3 weeks to 8 months [3, 5, 24].”
What the sources say
- Not checked — no full text of the sourcecites [3] 3. Artenstein AW, Kim JH, Williams WJ, Chung RC. Isolated peripheral tuberculous lymphadenitis in adults: current clinical and diagnostic issues. Clin Infect Dis 1995 ; 20:876-82. source
- Not checked — no full text of the sourcecites [5] 5. Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005 ; 84:350-62. source
- Partly supportedcites [24] 24. Purohit MR, Mustafa T, Morkve O, Sviland L. Gender differences in the clinical diagnosis of tuberculous lymphadenitis-a hospital-based study from Central India. Int J Infect Dis 2009 ; 13:600-5. sourceExperimental — accuracy not yet measured
The Results (page not available in our copy) report a neck-mass duration of 3 weeks to 8 months for men, but 4 days to 8 weeks for women; the range for all patients is 4 days to 8 months. The paper does not establish that symptom duration was typically 1–2 months, and the cited 3-week lower bound does not apply to the full cohort. (LLM, conf=0.87)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Median lymph node size is 3 cm, but nodes may be up to 8-10 cm in diameter [15].”
What the sources say
- Not checked — no full text of the sourcecites [15] 15. Wei YF, Liaw YS, Ku SC, Chang YL, Yang PC. Clinical features and predictors of a complicated treatment course in peripheral tuberculous lymphadenitis. J Formos Med Assoc 2008 ; 107:225-31. source
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“M. bovis was historically a common cause of tuberculous lymphadenitis, but pasteurization and bovine tuberculosis programs have virtually eliminated this source of human infection in developed countries”
What the sources say
- Not checked — no full text of the sourcecites [22] 22. Kazwala RR, Daborn CJ, Sharp JM, Kambarage DM, Jiwa SF, Mbembati NA. Isolation of Mycobacterium bovis from human cases of cervical adenitis in Tanzania: a cause for concern? Int J Tuberc Lung Dis 2001 ; 5:87-91.
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Of the 12 904 cases of tuberculosis in the United States in 2008, 1103 (8.5%) represented lymphadenitis [1].”
What the sources say
- Not matchedcites [1] 1. CDC. Reported tuberculosis in the United States, 2008. Atlanta, GA: U.S. Department of Health and Human Services, CDC, 2009. September 2009.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedn = 12,904Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In countries where tuberculosis is not endemic, the majority of patients are foreign-born, with a pattern consistent with reactivation disease.”
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients do not generally report significant pain at presentation, and node tenderness during examination is noted in only 10%-35% of cases [3, 15, 17].”
What the sources say
- Not checked — no full text of the sourcecites [3] 3. Artenstein AW, Kim JH, Williams WJ, Chung RC. Isolated peripheral tuberculous lymphadenitis in adults: current clinical and diagnostic issues. Clin Infect Dis 1995 ; 20:876-82. source
- Not checked — no full text of the sourcecites [15] 15. Wei YF, Liaw YS, Ku SC, Chang YL, Yang PC. Clinical features and predictors of a complicated treatment course in peripheral tuberculous lymphadenitis. J Formos Med Assoc 2008 ; 107:225-31. source
- Not matchedcites [17] 17. Khan FY. Clinical pattern of tuberculous adenitis in Qatar: experience with 35 patients. Scand J Infect Dis 2009 ; 41:128-34.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Adefinitive diagnosis of tuberculous lymphadenitis can be made by culture or polymerase chain reaction demonstration of M. tuberculosis in an affected lymph node, thereby permitting distinction from other mycobacteria that may cause lymphadenitis.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although diabetes mellitus is a risk factor for pulmonary tuberculosis, studies suggest that it may reduce the relative risk of tuberculous lymphadenitis [4, 5].”
What the sources say
- Not matchedcites [4] 4. Gonzalez OY, Teeter LD, Thanh BT, Musser JM, Graviss EA. Extrathoracic tuberculosis lymphadenitis in adult HIV seronegative patients: a population-based analysis in Houston, Texas, USA. Int J Tuberc Lung Dis 2003 ; 7:987-93.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [5] 5. Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005 ; 84:350-62. source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“A positive acid-fast bacilli (AFB) stain result indicates a mycobacterial etiology and has excellent specificity for M. tuberculosis in adults.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“In a study from Texas, the odds ratio (OR) was 11.3 for patients from Southeast Asia ( P , .01) and 12.7 for patients from India ( P , .01), compared with other ethnicities [4].”
What the sources say
- Not matchedcites [4] 4. Gonzalez OY, Teeter LD, Thanh BT, Musser JM, Graviss EA. Extrathoracic tuberculosis lymphadenitis in adult HIV seronegative patients: a population-based analysis in Houston, Texas, USA. Int J Tuberc Lung Dis 2003 ; 7:987-93.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Not matched
In the paper
“Rare complications of biopsy include postsurgical pain, wound infection, sinus formation, and scar [28].”
What the sources say
- Not checked — no full text of the sourcecites [28] 28. Lee KC, Tami TA, Lalwani AK, Schecter G. Contemporary management of cervical tuberculosis. Laryngoscope 1992 ; 102:60-4. source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Culture remains the gold standard for diagnosis, but may take 2-4 weeks to yield results.”
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“FNA is safer, less invasive, and more practical than biopsy, especially in resource-limited settings.”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although formerly a disease of children, the peak age range in recent series has been 30-40 years.”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In a series of 104 predominantly HIV-negative patients from California, fever was reported in 19% and weight loss in 16% [5].”
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005 ; 84:350-62. source
Strength:plain· not yet calibratedn = 104Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In most series, tuberculous lymphadenitis is more common among women than among men (composite ratio, 1.4:1)-a different pattern than for pulmonary tuberculosis, for which disease is more common among men [13].”
What the sources say
- Not checked — no full text of the sourcecites [13] 13. Chen YM, Lee PY, Su WJ, Perng RP. Lymph node tuberculosis: 7-year experience in Veterans General hospital, Taipei, Taiwan. Tubercle Lung Dis 1992 ; 73:368-71. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In a study of 97 cases from the United Kingdom (90% of which were in foreign-born patients), 67% of FNA specimens had positive culture results, and 79% had GI.”
What the sources say
- Not matchedcites [12] 12. Asimacopoulos EP, Berry M, Garfield B, et al. The diagnostic efficacy of fine-needle aspiration using cytology and culture in tuberculous lymphadenitis. Int J Tuberc Lung Dis 2010 ; 14:93-8.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedn = 97Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Extrapulmonary tuberculosis, including lymphatic tuberculosis, is more common among immunocompromised patients, including those with HIV infection [20, 21].”
What the sources say
- Not checked — no full text of the sourcecites [20] 20. Aaron L, Saadoun D, Calatroni I, et al. Tuberculosis in HIV-infected patients: a comprehensive review. Clin Microbiol Infect 2004 ; 10:388-98. source
- Not checked — no full text of the sourcecites [21] 21. Lee PP, Chan KW, Jiang L, et al. Susceptibility to mycobacterial infections in children with X-linked chronic granulomatous disease: a review of 17 patients living in a region endemic for tuberculosis. Pediatr Infect Dis J 2008 ; 27:224-30. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In contrast, symmetrical adenopathy was observed in only 11% of HIV-negative patients with tuberculosis lymphadenitis, and nodes in this group were typically . 3 cm [14].”
What the sources say
- Not matchedcites [14] 14. Bem C. Human immunodeficiency virus-positive tuberculous lymphadenitis in Central Africa: clinical presentation of 157 cases. Int J Tuberc Lung Dis 1997 ; 1:215-9.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Not matched
In the paper
“Male sex (OR, 2.60) and the presence of local tenderness at the time of diagnosis (OR, 2.90) were independently associated with PUR [49].”
What the sources say
- Not checked — no full text of the sourcecites [49] 49. Cho OH, Park KH, Kim T, et al. Paradoxical responses in non-HIVinfected patients with peripheral lymph node tuberculosis. J Infect 2009 ; 59:56-61. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In a study of tuberculous lymphadenitis from South Korea, the sensitivity and specificity of TST were 86% and 67%, respectively, and of IGRAs, 86% and 87%, respectively [37].”
What the sources say
- Not checked — no full text of the sourcecites [37] 37. Song KH, Jeon JH, Park WB, et al. Usefulness of the whole-blood interferon-gamma release assay for diagnosis of extrapulmonary tuberculosis. Diagn Microbiol Infect Dis 2009 ; 63:182-7. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The 6-month recommendation is supported by studies that showed no difference between 6 and 9 months of treatment in cure rates (89%-94%) [45, 46] or relapse rates (3%) [47].”
What the sources say
- Not checked — no full text of the sourcecites [45] 45. Campbell IA, Ormerod LP, Friend JA, Jenkins PA, Prescott RJ. Six months versus nine months chemotherapy for tuberculosis of lymph nodes: final results. Respir Med 1993 ; 87:621-3. source
- Not checked — no full text of the sourcecites [46] 46. Yuen AP, Wong SH, Tam CM, Chan SL, Wei WI, Lau SK. Prospective randomized study of thrice weekly six-month and nine-month chemotherapy for cervical tuberculous lymphadenopathy. Otolaryngol Head Neck Surg 1997 ; 116:189-92. source
- Not checked — no full text of the sourcecites [47] 47. van Loenhout-Rooyackers JH, Laheij RJ, Richter C, Verbeek AL. Shortening the duration of treatment for cervical tuberculous lymphadenitis. Eur Respir J 2000 ; 15:192-5. source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“While overall rates of pulmonary tuberculosis have continued to decrease in the United States, the proportion of extrapulmonary cases, with their principal subset, lymphadenitis, has increased.”
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“IRIS usually develops after at least several weeks of ART, 90% of cases occur within 3 months after starting ART, and rates are higher when ART is started at lower CD4 cell counts [55, 56].”
What the sources say
- Not checked — no full text of the sourcecites [55] 55. Haddow LJ, Easterbrook PJ, Mosam A, et al. Defining immune reconstitution inflammatory syndrome: evaluation of expert opinion versus 2 case definitions in a South African cohort. Clin Infect Dis 2009 ; 49:1424-32. source
- Not checked — no full text of the sourcecites [56] 56. Breton G, Duval X, Estellat C, et al. Determinants of immune reconstitution inflammatory syndrome in HIV type 1-infected patients with tuberculosis after initiation of antiretroviral therapy. Clin Infect Dis 2004 ; 39:1709-12. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Because interferonc release assays (IGRAs) are not affected by BCG or nontuberculous mycobacteria other than M. marinum , M. kansasii, and M. szulgai, they are more specific than the TST [39].”
What the sources say
- Not checked — no full text of the sourcecites [39] 39. Pai M, Riley LW, Colford JM Jr. Interferon-gamma assays in the immunodiagnosis of tuberculosis: a systematic review. Lancet Infect Dis 2004 ; 4:761-76. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Manifestations of PUR have included enlarging lymph nodes in 32%-68% of cases [50], new nodes in 27%-36%, pain in 60%, and draining sinuses in 12%60% [5, 49, 50].”
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005 ; 84:350-62. source
- Not checked — no full text of the sourcecites [49] 49. Cho OH, Park KH, Kim T, et al. Paradoxical responses in non-HIVinfected patients with peripheral lymph node tuberculosis. J Infect 2009 ; 59:56-61. source
- Not checked — no full text of the sourcecites [50] 50. Hawkey CR, Yap T, Pereira J, et al. Characterization and management of paradoxical upgrading reactions in HIV-uninfected patients with lymph node tuberculosis. Clin Infect Dis 2005 ; 40:1368-71. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In a study from India, 17 (77%) of 22 cases diagnosed by culture and detection of GI were detected by testing of excisional biopsy samples, compared with 9 (41%) of 22 by testing of FNA samples.”
What the sources say
- Not checked — no full text of the sourcecites [30] 30. Singh KK, Muralidhar M, Kumar A, et al. Comparison of in house polymerase chain reaction with conventional techniques for the detection of Mycobacterium tuberculosis DNA in granulomatous lymphadenopathy. J Clin Pathol 2000 ; 53:355-61. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“persistent pain and swelling are common”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“IDSA guidelines do not recommend the use of steroids in the treatment of tuberculous lymphadenitis [44].”
What the sources say
- Not matchedcites [44] 44. Treatment of tuberculosis. Centers for Disease Control. MMWR Recomm Rep 2003 ; 52:1-77.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“In reports from California and South Korea, onset occurred at a mean of 2-3.5 months after initiation of treatment and resolved at a mean of 3.9 additional months [5, 49].”
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005 ; 84:350-62. source
- Not checked — no full text of the sourcecites [49] 49. Cho OH, Park KH, Kim T, et al. Paradoxical responses in non-HIVinfected patients with peripheral lymph node tuberculosis. J Infect 2009 ; 59:56-61. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“It occurred at a median of 1.5 months (46 days; interquartile range, 21-139 days) after initiation of treatment in a study from London and persisted for a median of 2 months (67 days; interquartile range, 34-111 days) [50].”
What the sources say
- Not checked — no full text of the sourcecites [50] 50. Hawkey CR, Yap T, Pereira J, et al. Characterization and management of paradoxical upgrading reactions in HIV-uninfected patients with lymph node tuberculosis. Clin Infect Dis 2005 ; 40:1368-71. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Biopsy or culture of nodes involved in PUR typically shows granuloma formation and negative culture results with or without positive AFB stains [5, 50].”
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005 ; 84:350-62. source
- Not checked — no full text of the sourcecites [50] 50. Hawkey CR, Yap T, Pereira J, et al. Characterization and management of paradoxical upgrading reactions in HIV-uninfected patients with lymph node tuberculosis. Clin Infect Dis 2005 ; 40:1368-71. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“A systematic review of NAAT in tuberculous lymphadenitis revealed highly variable and inconsistent results (sensitivity, 2%-100%; specificity, 28%100%), with more favorable performance from commercial assays and with sample sizes . 20 uL [35].”
What the sources say
- Not matchedcites [35] 35. Daley P, Thomas S, Pai M. Nucleic acid amplification tests for the diagnosis of tuberculous lymphadenitis: a systematic review. Int J Tuberc Lung Dis 2007 ; 11:1166-76.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Ancillary diagnostic tests may be useful in raising the suspicion of tuberculous lymphadenitis before definitive diagnosis or in supporting the diagnosis of cases with nondiagnostic microbiologic or histologic findings (Table 4).”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Steroids have been considered as a means to reduce the robust immune response in PUR, but their use is controversial.”
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Chest radiograph findings may be positive in 10%-40% of patients”
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Reported rates of PUR vary and depend, in part, on the definition that has been applied.”
Strength:plain· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“paradoxical upgrading reactions may occur in 20% of patients.”
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Mycobacterial adenitis, caused by nontuberculous mycobacteria, such as M. avium complex, is typically seen in non-BCG immunized children in developed countries [42].”
What the sources say
- Not checked — no full text of the sourcecites [42] 42. Romanus V, Hallander HO, Wahlen P, Olinder-Nielsen AM, Magnusson PH, Juhlin I. Atypical mycobacteria in extrapulmonary disease among children. Incidence in Sweden from 1969 to 1990, related to changing BCG-vaccination coverage. Tubercle Lung Dis 1995 ; 76:300-10. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“response to therapy may be slow or paradoxical, with the frequent development of enlarging or new lymph nodes during and even after effective treatment in HIV-negative patients and of immune reconstitution inflammatory syndrome (IRIS) in HIV-positive patients.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The Infectious Disease Society of America (IDSA) recommends 6 months of the following treatment for lymphadenitis caused by drug-susceptible organisms [44]: isoniazid, rifampin, pyrazinamide, and ethambutol for 2 months, followed by isoniazid and rifampin for another 4 months.”
What the sources say
- Not matchedcites [44] 44. Treatment of tuberculosis. Centers for Disease Control. MMWR Recomm Rep 2003 ; 52:1-77.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Antimycobacterial therapy remains the cornerstone of treatment, but response is slower than with pulmonary tuberculosis”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We searched Medline for English articles with use of the Medical Subject Heading term ''Tuberculosis, Lymph Node'' as a major topic from 1990 through 2011”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Some authors report benefit [52, 53], but retrospective studies have shown that steroids did not prevent PUR in patients who received them from the onset of treatment [59] and had no effect on the duration of PUR [49, 50].”
What the sources say
- Not checked — no full text of the sourcecites [52] 52. Garcia Vidal C, Garau J. Systemic steroid treatment of paradoxical upgrading reaction in patients with lymph node tuberculosis. Clin Infect Dis 2005 ; 41:915-6; author reply 6-7. source
- Not checked — no full text of the sourcecites [53] 53. Park KH, Cho OH, Chong YP, et al. Post-therapy paradoxical response in immunocompetent patients with lymph node tuberculosis. J Infect 2010 ; 61:430-4. source
- Not checked — no full text of the sourcecites [59] 59. Afghani B, Lieberman JM. Paradoxical enlargement or development of intracranial tuberculomas during therapy: case report and review. Clin Infect Dis 1994 ; 19:1092-9. source
- Not checked — no full text of the sourcecites [49] 49. Cho OH, Park KH, Kim T, et al. Paradoxical responses in non-HIVinfected patients with peripheral lymph node tuberculosis. J Infect 2009 ; 59:56-61. source
- Not checked — no full text of the sourcecites [50] 50. Hawkey CR, Yap T, Pereira J, et al. Characterization and management of paradoxical upgrading reactions in HIV-uninfected patients with lymph node tuberculosis. Clin Infect Dis 2005 ; 40:1368-71. source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The role of steroids is controversial.”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Definitions of paradoxical IRIS in HIV infection vary but typically require some evidence of response to ART (eg, decreased viral load or increased CD4 cell count) and evidence of a worsening of the complicating infection [55].”
What the sources say
- Not checked — no full text of the sourcecites [55] 55. Haddow LJ, Easterbrook PJ, Mosam A, et al. Defining immune reconstitution inflammatory syndrome: evaluation of expert opinion versus 2 case definitions in a South African cohort. Clin Infect Dis 2009 ; 49:1424-32. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Among 106 predominantly HIV-negative cases from California, the rate of culture positivity from excisional biopsy and FNA specimens was similar (71% and 62% respectively; P 5 .4) [5].”
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005 ; 84:350-62. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Surgical excision is the recommended therapy for cervical lymphadenitis due to nontuberculous mycobacteria in children and has been associated with better outcomes than 3 months of 2-drug antibiotic therapy [62-64].”
What the sources say
- Not checked — no full text of the sourcecites [62] 62. Lindeboom JA, Kuijper EJ, Bruijnesteijn van Coppenraet ES, Lindeboom R, Prins JM. Surgical excision versus antibiotic treatment for nontuberculous mycobacterial cervicofacial lymphadenitis in children: a multicenter, randomized, controlled trial. Clin Infect Dis 2007 ; 44:1057-64. source
- Not checked — no full text of the sourcecites [63] 63. Zeharia A, Eidlitz-Markus T, Haimi-Cohen Y, Samra Z, Kaufman L, Amir J. Management of nontuberculous mycobacteria-induced cervical lymphadenitis with observation alone. Pediatr Infect Dis J 2008 ; 27:920-2. source
- Not checked — no full text of the sourcecites [64] 64. Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007 ; 175:367-416. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Disease rates are highest among patients aged 30-40 years, and disease is more common among women and patients of Asian descent.”
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Surgical excision has been recommended for PUR and for treatment failure in cases of tuberculous lymphadenitis and for patients who have discomfort from tense, fluctuant lymph nodes [5, 61].”
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005 ; 84:350-62. source
- Not checked — no full text of the sourcecites [61] 61. Ammari FF, Bani Hani AH, Ghariebeh KI. Tuberculosis of the lymph glands of the neck: a limited role for surgery. Otolaryngol Head Neck Surg 2003 ; 128:576-80. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Tuberculous lymphadenitis may respond slowly to standard antibiotic treatment, with persistent discomfort and the development of culture-negative paradoxical upgrading reactions in as many as 20% of patients.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Tuberculous lymphadenitis represents 10% of cases of tuberculosis in the United States and is frequently the sole manifestation of extrapulmonary tuberculosis.”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“IDSA guidelines recommend surgical excision only in unusual circumstances, and these circumstances are not defined explicitly [44].”
What the sources say
- Not matchedcites [44] 44. Treatment of tuberculosis. Centers for Disease Control. MMWR Recomm Rep 2003 ; 52:1-77.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
The paper relies on this without support.
Local discomfort is a significant problem for some patients with peripheral tuberculous lymphadenitis.
“Steroids have been used selectively for local discomfort [31], a significant issue for some patients in our experience.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Biopsy result has more positive specimens than specimens tested
MajorTable 3 reports 36 positive specimens out of 31 tested as 88%. That fraction is approximately 116%, so at least one of the three figures is wrong.
Reported 88 · recomputed 116.129032
“| Excisional Biopsy | 24/34 (71%) | 15/39 (38%) | 36/31 (88%) | N/A | N/A |”
Chest-radiograph range excludes a value in Table 4
MinorThe text gives a 10%-40% range, whereas Table 4 reports abnormal chest radiographs in 55% of the UK study.
“Chest radiograph findings may be positive in 10%-40% of patients”
“| UK (1996) [25] | 23 | NA | 55 | NA | NA |”
Pulmonary-involvement range excludes a value in Table 1
MinorThe stated range starts at 18%, but Table 1 reports pulmonary involvement of 3% for the Australian study.
“Concomitant pulmonary tuberculosis is reported in 18%-42% of patients (Table 1)”
“| Australia [8] | 1998 | 31 | 35 | NA | 87 | 0 | 3 |”
Citations
Cites
Griffith, D. E., Aksamit, T., Brown-Elliott, B. A., Catanzaro, A., Daley, C., Gordin, F., Holland, S. M., Horsburgh, R., Huitt, G., Iademarco, M. F., et al. (2007) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200604-571st · Cited by 6,110
Self-citationInterferon-γ assays in the immunodiagnosis of tuberculosis: a systematic review
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Epidemiology of Extrapulmonary Tuberculosis in the United States, 1993–2006
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Paradoxical Worsening of Tuberculosis Following Antiretroviral Therapy in Patients with AIDS
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Rapid Molecular Detection of Extrapulmonary Tuberculosis by the Automated GeneXpert MTB/RIF System
Hillemann, D., Rüsch-Gerdes, S., Boehme, C., & Richter, E. (2011) · Journal of Clinical Microbiology · doi:10.1128/jcm.02268-10 · Cited by 413
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Tuberculosis in HIV-infected patients: a comprehensive review
Aaron, L., Saadoun, D., Calatroni, I., Launay, O., Mémain, N., Vincent, V., Marchal, G., Dupont, B., Bouchaud, O., Valeyre, D., et al. (2004) · Clinical Microbiology and Infection · doi:10.1111/j.1469-0691.2004.00758.x · Cited by 330
Extrapulmonary Tuberculosis in Patients with Human Immunodeficiency Virus Infection
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Efficacy of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenopathy
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Peripheral Tuberculous Lymphadenitis: Epidemiology, Diagnosis, Treatment, and Outcome
Polesky, A., Grove, W., & Bhatia, G. (2005) · Medicine · doi:10.1097/01.md.0000189090.52626.7a · Cited by 165
Assessment of Lymph Node Tuberculosis in Northern Germany
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Paradoxical Worsening of Tuberculosis in HIV-Infected Persons
Wendel, K. A., Alwood, K. S., Gachuhi, R., Chaisson, R. E., Bishai, W. R., & Sterling, T. R. (2001) · Chest · doi:10.1378/chest.120.1.193 · Cited by 157
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Flagged first, then by citations
1 of the 66 references couldn’t be matched to a known paper.
Research works printed but not linked: 11
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Cited by
Sorted by citations
Diagnosis and Treatment of Extrapulmonary Tuberculosis
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Extrapulmonary tuberculosis: an overview
Ramírez-Lapausa, M., Menéndez-Saldaña, A., & Noguerado-Asensio, A. (2015) · Cited by 478
Xpert ® MTB/RIF assay for extrapulmonary tuberculosis and rifampicin resistance
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Tuberculosis extrapulmonar, una revisión
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Metadata
- Authors
- Fontanilla, J.-M., Barnes, A., & von Reyn, C. F.
- Affiliations
- Marshall University (US)
- University of Mississippi Medical Center (US)
- ORCID
- Barnes, A.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-08-24
- Volume
- 53
- Issue
- 6
- Pages
- 555-562
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2170899957
- Cited by
- 299
- References
- 66
- Citations by year
- 2026: 24 · 2025: 17 · 2024: 14 · 2023: 26 · 2022: 26 · 2021: 28 · 2020: 25 · 2019: 16 · 2018: 18 · 2017: 29 · 2016: 23 · 2015: 20 · 2014: 12 · 2013: 16 · 2012: 5
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Diagnosis and treatment of tuberculosis
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphadenopathy Diagnosis and Analysis
- Keywords
- cervical lymphadenopathy, Mycobacterium tuberculosis, excisional biopsy, fine-needle aspiration, acid-fast bacilli, granulomatous inflammation, antimycobacterial therapy, paradoxical reaction, corticosteroids, immunocompromised patients, tuberculosis epidemiology
- MeSH terms
- Adult, Antitubercular Agents, Female, Humans, Male, Mycobacterium tuberculosis, Tuberculosis, Lymph Node, United States, Disease Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-01, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-01 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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