Tuberculosis risk factors and Mycobacterium tuberculosis transmission among HIV-infected patients in Vietnam.

lymph nodes. Respiratory, cardiovascular and abdominal examination were normal. Results and Conclusion: He had normocytic normochromic anaemia (HB-9g/dL), ESR80mm/hr, normal CXR, negative sputum for AFB and Gene x-pert and positive Mantoux (15mm). FNAC of left cervical lymph node revealed scattered epithelial histiocytes and multi nucleated giant cells with a background of caseating necrosis. Samples for Gene Xpert from lymph node were positive. He was started on ATT and continued for 2 months with periodic assessment. Despite ATT his lymph nodes continued to enlarge and there were discharging sinuses. He was subjected to USS neck which revealed multiple abscess formation in the cervical area and they were drained. He was also subjected to a true cut biopsy from the enlarged lymph nodes which revealed multiple collections of histiocytes and Langerhans type giant cells with large areas of caseous necrosis and Reed–Sternberg cells. Immunostaining revealed mixed cellular subtype Hodgkin’s lymphoma. He was started on chemotherapy with ATT after discussion at cancer MDT. Poor response to conventional ATT can be associated with an alternative diagnosis in which active investigations are targeted for.