Lack of granuloma formation in tuberculous lymphadenitis--clue to the diagnosis of human immunodeficiency virus infection.

Since the emergence of acquired immune deficiency syndrome (AIDS), tuberculosis and human immune defi­ ciency virus (HIV) infection have been intimately linked. Several studies have clearly shown that the incidence of active tuberculosis is increased in HIV infected patients (1). AIDS patients with tuberculosis have a higher inci­ dence of extra-pulmonary and pleural disease. The most common sites of extra-pulmonary involvement are blood and extra-thoracic lymph nodes, followed by bone marrow, genitourinary tract and the central nervous system (2).