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.
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Claims the paper makes
47 No full text of the sources · 20 No basis given · 14 Sources not found · 7 Own interpretation · 6 Not checked yet · 5 Partly supported · 2 Supported · 2 Not supported · 1 Own method · 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)
plain- Asserted: passes — The authors put it forward as true.
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- 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)
plaindirect- Asserted: passes — The authors put it forward as true.
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- 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)
plain- Asserted: passes — The authors put it forward as true.
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The 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)
hedgedconditionaln = 407- Asserted: passes — The authors put it forward as true.
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- 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)
plainn = 407- Asserted: passes — The authors put it forward as true.
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- 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.
plaincorrelationaln = 180- Asserted: passes — The authors put it forward as true.
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In 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None 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)”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In a review of extrapulmonary tuberculosis in the United States, traditional risk factors for pulmonary tuberculosis, such as homelessness and excess alcohol use, were associated with a lower risk of disease [7].”
What the sources say
- Not checked — no full text of the sourcecites [7] 7. Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 19932006. Clin Infect Dis 2009 ; 49:1350-7. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In a study from Zambia, symmetrical adenopathy with nodes typically , 3 cm was reported in 94% of patients with HIV-induced lymphadenopathy, compared with 29% of patients with HIV-associated tuberculous lymphadenitis.”
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.
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- 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
“Cervical chain involvement is most common and is reported in 45%-70% of cases”
What the sources say
- Not checked — no full text of the sourcecites [2] 2. Shriner KA, Mathisen GE, Goetz MB. Comparison of mycobacterial lymphadenitis among persons infected with human immunodeficiency virus and seronegative controls. Clin Infect Dis 1992 ; 15:601-5. 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
- 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
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In settings where tuberculosis is not endemic, the finding of GI may not be as specific for tuberculosis.”
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.
hedgedconditionaln = 97- Asserted: passes — The authors put it forward as true.
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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
“Histologic features, such as nonspecific lymphoid infiltrates, noncaseating granulomas, or Langerhan giant cells in areas of extensive caseous necrosis, support a diagnosis of probable tuberculosis in AFB-negative, culture-negative cases.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Unilateral involvement of 1-3 nodes has been noted in 85% of cases [8].”
What the sources say
- Not checked — no full text of the sourcecites [8] 8. Wark P, Goldberg H, Ferson M, McKenzie D, Lau E, Rivas K. Mycobacterial lymphadenitis in eastern Sydney. Aust N Z J Med 1998 ; 28:453-8. source
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“A consistent observation in studies from nonendemic countries is that immigrants from Southeast Asia and India appear to have a special predilection for tuberculous lymphadenitis [4, 5, 8, 11].”
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
- Not checked — no full text of the sourcecites [8] 8. Wark P, Goldberg H, Ferson M, McKenzie D, Lau E, Rivas K. Mycobacterial lymphadenitis in eastern Sydney. Aust N Z J Med 1998 ; 28:453-8. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Excisional biopsy is the most invasive approach to diagnosis; however, it has the highest sensitivity”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“may produce a more rapid and favorable symptomatic response [3]”
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.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“However, of note, in the majority of FNA studies from these regions, the diagnosis of tuberculosis was based on detection of granulomatous inflammation (GI).”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“with higher rates among HIV-positive patients than among HIV-negative patients (90% of 10 vs 28% of 25 in a study from Los Angeles) [2].”
What the sources say
- Not checked — no full text of the sourcecites [2] 2. Shriner KA, Mathisen GE, Goetz MB. Comparison of mycobacterial lymphadenitis among persons infected with human immunodeficiency virus and seronegative controls. Clin Infect Dis 1992 ; 15:601-5. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In a study from California, 18% of FNA specimens from 180 patients (106 HIV-positive) yielded positive culture results.”
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
plainn = 180- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 indolent presentation is similar to that seen with M. tuberculosis , although other diagnostic features may differ (Table 5).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“The pathogenesis of PUR in patients with HIV infection and tuberculous lymphadenitis is more complex, because IRIS from newly initiated antiretroviral therapy (ART) also contributes to the exaggerated inflammatory response, as it does in pulmonary tuberculosis [54].”
What the sources say
- Not checked — no full text of the sourcecites [54] 54. Narita M, Ashkin D, Hollender ES, Pitchenik AE. Paradoxical worsening of tuberculosis following antiretroviral therapy in patients with AIDS. Am J Respir Crit Care Med 1998 ; 158:157-61. source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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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
“Only uncontrolled studies are available on treatment outcomes in adults with peripheral lymphadenitis [49, 50].”
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
- 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
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Adjuvant immunotherapy with anti-tumor necrosis factor agents has been studied in small numbers of patients for routine treatment of all forms of tuberculosis, but available data are insufficient to make a recommendation [51].”
What the sources say
- Not matchedcites [51] 51. Wallis RS. Reconsidering adjuvant immunotherapy for tuberculosis. Clin Infect Dis 2005 ; 41:201-8.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“When positive culture results were combined with detection of AFB, the sensitivity of FNA specimens was 46% and specificity was 100% [29].”
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
plainn = 180- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Tuberculous lymphadenitis was associated with higher incidence of surrounding soft-tissue edema, homogeneity, intranodal cystic necrosis, matting, and posterior enhancement, compared with lymph node metastases on neck ultrasound [40].”
What the sources say
- Not checked — no full text of the sourcecites [40] 40. Ying M, Ahuja AT, Evans R, King W, Metreweli C. Cervical lymphadenopathy: sonographic differentiation between tuberculous nodes and nodal metastases from non-head and neck carcinomas. J Clin Ultrasound 1998 ; 26:383-9. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“PURhas been reported in 20%-23% of HIV-negative patients [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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“A unique and disturbing feature of successful treatment of drugsusceptible tuberculous lymphadenitis is the frequency with which patients experience worsening of symptoms during treatment (ie, paradoxical upgrading reaction [PUR]).”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“TST reactions may be falsely positive in persons with prior BCG or prior infections with nontuberculous mycobacteria (which may produce TST reactions of 5-14 mm) [38].”
What the sources say
- Not checked — no full text of the sourcecites [38] 38. von Reyn CF, Williams DE, Horsburgh CR Jr, et al. Dual skin testing with Mycobacterium avium sensitin and purified protein derivative to discriminate pulmonary disease due to M. avium complex from pulmonary disease due to Mycobacterium tuberculosis . J Infect Dis 1998 ; 177:730-6. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Rates of systemic symptoms reported in different series vary depending in part on geographic origin and case selection (Table 2).”
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 addition, increased adenopathy has also been reported in 9%-11% of patients a mean of 27 months after successful treatment [5, 53].”
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 [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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In the evaluation of abdominal lymph nodes by contrast-enhanced CT, tuberculous lymphadenitis was associated with higher incidence of peripheral enhancement with multilocular appearance and heterogeneous attenuation, compared with lymphoma [41].”
What the sources say
- Not checked — no full text of the sourcecites [41] 41. Yang ZG, Min PQ, Sone S, et al. Tuberculosis versus lymphomas in the abdominal lymph nodes: evaluation with contrast-enhanced CT. AJR Am J Roentgenol 1999 ; 172:619-23. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Rates of PUR and/or IRIS have ranged from 22% to 60% in reported series involving HIV-positive patients treated for tuberculous lymphadenitis who have initiated ART [5, 54, 57].”
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 [54] 54. Narita M, Ashkin D, Hollender ES, Pitchenik AE. Paradoxical worsening of tuberculosis following antiretroviral therapy in patients with AIDS. Am J Respir Crit Care Med 1998 ; 158:157-61. source
- Not checked — no full text of the sourcecites [57] 57. Wendel KA, Alwood KS, Gachuhi R, Chaisson RE, Bishai WR, Sterling TR. Paradoxical worsening of tuberculosis in HIV-infected persons. Chest 2001 ; 120:193-7. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Fluorescence microscopy using light-emitting diodes is an inexpensive and robust method of AFB smear analysis of FNA specimens from children with tuberculous lymphadenitis in South Africa [34].”
What the sources say
- Not matchedcites [34] 34. van Wyk AC, Marais BJ, Warren RM, van Wyk SS, Wright CA. The use of light-emitting diode fluorescence to diagnose mycobacterial lymphadenitis in fine-needle aspirates from children. Int J Tuberc Lung Dis 2011 ; 15:56-60.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Fifty-four (70%) of 77 FNA specimens with GI had cultures positive for M. tuberculosis [12].”
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.
plaincorrelationaln = 77- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Treatment of nontuberculous mycobacteria adenitis is surgical and achieves resolution rates . 70% [43].”
What the sources say
- Not checked — no full text of the sourcecites [43] 43. Panesar J, Higgins K, Daya H, Forte V, Allen U. Nontuberculous mycobacterial cervical adenitis: a ten-year retrospective review. Laryngoscope 2003 ; 113:149-54. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Nucleic acid amplification tests (NAATs) may provide a rapid, specific, and sensitive means of diagnosis.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Thus, worsening of tuberculous lymphadenitis in patients with HIV infection and newly initiated ART may reflect the sum of the expected rate of PUR among HIV-negative persons plus an additional contribution from IRIS.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Furthermore, HIV-positive patients with apparent sole pulmonary tuberculosis may develop peripheral or central lymphadenitis as the manifestation of IRIS [58].”
What the sources say
- Not checked — no full text of the sourcecites [58] 58. Lawn SD, Myer L, Bekker LG, Wood R. Tuberculosis-associated immune reconstitution disease: incidence, risk factors and impact in an antiretroviral treatment service in South Africa. AIDS 2007 ; 21:335-41. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“With the addition of NAAT of the FNA specimens, 18 (82%) of 22 cases were detected [30].”
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.
plaindirectn = 22- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Steroids have been used selectively for local discomfort [31], a significant issue for some patients in our experience.”
What the sources say
- Not matchedcites [31] 31. Blaikley JF, Khalid S, Ormerod LP. Management of peripheral lymph node tuberculosis in routine practice: an unselected 10-year cohort. Int J Tuberc Lung Dis 2011 ; 15:375-8.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
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
“These features are consistent with a robust immune response to M. tuberculosis with initiation of antibiotic therapy and release of mycobacterial antigens.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“The benefit of routine corticosteroid therapy for peripheral tuberculous lymphadenitis is unknown.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In the United States, 90 (98%) of 92 HIV-negative patients with tuberculous lymphadenitis had a positive tuberculin skin test (TST) result [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
plaincorrelationaln = 92- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In a retrospective review, aspiration, incision, and drainage or excision were associated with a trend toward a shorter duration of PUR [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
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Although surgical excision combined with antibiotic therapy has produced favorable outcomes [60], we are not aware of controlled studies that have compared excision plus antibiotic therapy with antibiotic therapy alone.”
What the sources say
- Not checked — no full text of the sourcecites [60] 60. Iles PB, Emerson PA. Tuberculous lymphadenitis. Br Med J 1974 ; 1:143-5. source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- 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.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.
plainn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.
plainn = 12,904- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“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.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.”
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably 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.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“FNA is safer, less invasive, and more practical than biopsy, especially in resource-limited settings.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Although formerly a disease of children, the peak age range in recent series has been 30-40 years.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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
plainn = 104- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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.
plainn = 97- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a 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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“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.”
plaincorrelationaln = 904- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a 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
“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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a 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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
plaincorrelationaln = 22- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“persistent pain and swelling are common”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a 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
“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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“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).”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Steroids have been considered as a means to reduce the robust immune response in PUR, but their use is controversial.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.”
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“The role of steroids is controversial.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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
plainn = 106- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a 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 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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Disease rates are highest among patients aged 30-40 years, and disease is more common among women and patients of Asian descent.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Tuberculous lymphadenitis represents 10% of cases of tuberculosis in the United States and is frequently the sole manifestation of extrapulmonary tuberculosis.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably 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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
“| Excisional Biopsy | 24/34 (71%) | 15/39 (38%) | 36/31 (88%) | N/A | N/A |”
Reported 88 · recomputed 116.129032
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ ANCILLARY DIAGNOSTIC TESTS · p. 4
“Chest radiograph findings may be positive in 10%-40% of patients”
§ ANCILLARY DIAGNOSTIC TESTS · p. 5
“| UK (1996) [25] | 23 | NA | 55 | NA | NA |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ CLINICAL FEATURES · p. 3
“Concomitant pulmonary tuberculosis is reported in 18%-42% of patients (Table 1)”
§ EPIDEMIOLOGY · p. 2
“| 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
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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
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Cited by
Sorted by citations
Diagnosis and Treatment of Extrapulmonary Tuberculosis
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Extrapulmonary tuberculosis: an overview
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Xpert ® MTB/RIF assay for extrapulmonary tuberculosis and rifampicin resistance
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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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