keyword
https://read.qxmd.com/read/38425779/tuberculous-meningitis-with-stroke-a-case-report-of-diagnostic-dilemma-and-therapeutic-triumph
#1
Shailendra Katwal, Anjila Thapa, Aayush Adhikari, Pratik Baral, Mukhtar Alam Ansari
Tuberculous Meningitis (TBM) is a rare manifestation of Mycobacterium tuberculosis infection affecting the meninges. We present a case of a 40-year-old male initially presenting with neurological deficits mimicking ischemic stroke. Despite classic signs, including fever, headache, and neck stiffness, TBM was initially overlooked, leading to delayed treatment. Comprehensive assessment, imaging findings, and characteristic cerebrospinal fluid findings, confirming TBM with tubercular stroke. The patient responded positively to antitubercular therapy and steroids...
May 2024: Radiology Case Reports
https://read.qxmd.com/read/38417459/-allergic-bronchopullmonary-aspergillosis-abpa-an-update
#2
JOURNAL ARTICLE
Marcus Joest, Johanna Klein, Daniel Kütting, Dirk Skowasch
Allergic bronchopulmonary aspergillosis (ABPA) is a regular occurrence in everyday pneumology. ABPA should be considered in patients with severe asthma, in mould allergic patients with very high serum IgE levels and in patients with cystic fibrosis. The aim should be to make the diagnosis as early as possible in the course of the disease to avoid late complications such as bronchiectasis and fibrotic lung remodelling. Symptoms are highly variable and rather non-specific, overlapping with those of the underlying primary disease...
March 2024: Pneumologie
https://read.qxmd.com/read/38414086/igg4-disease-with-multiorgan-involvement-a-case-report
#3
JOURNAL ARTICLE
M N Vidanapathirana, D Wijayaratne
BACKGROUND: IgG4-related disease (IgG4RD) is a rare fibroinflammatory disease with multiorgan involvement. It presents insidiously over several years and can be a diagnostic enigma. Delays in diagnosis occur due to failure to consider IgG4 as a differential diagnosis, atypical presentations, and an insidious clinical course. CASE PRESENTATION: We report the case of a 70-year-old Sri Lankan man with pulmonary, renal, and neurological involvement of IgG4-related disease...
February 28, 2024: Journal of Medical Case Reports
https://read.qxmd.com/read/38408402/steroid-immune-responsive-gene-regulation-in-mycobacterium-tuberculosis-infection-in-vitro
#4
JOURNAL ARTICLE
Maria Eduarda de Albuquerque Borborema, Débora Elienai de Oliveira Miranda, Thays Maria Costa de Lucena, Virgínia Maria Barros de Lorena, Michelle Christiane da Silva Rabello, Jaqueline de Azevêdo Silva
Tuberculosis (TB) is an infectious disease displaying a multifactorial pathology. The immunomodulatory role attributed to steroid hormones, such as vitamin D3 (VD3 ) and 17β-estradiol (E2 ), highlighted the importance of these hormones against Mycobacterium tuberculosis (Mtb) infection. In order to understand their influence upon gene expression of immune and inflammatory responsive genes against Mtb we tested it in vitro using peripheral blood mononuclear cells (PBMCs). Cells were pretreated with VD3 (50 ng/mL) or E2 (100 nM/mL) and co-cultured with H37Rv Mtb or stimulated with lipopolysaccharide from Escherichia coli (LPS)...
February 20, 2024: Tuberculosis
https://read.qxmd.com/read/38406079/pattern-and-predictors-of-infection-among-patients-with-rheumatological-disease-on-immunosuppressive-medications-a-retrospective-study-in-a-tertiary-care-hospital-in-bangladesh
#5
JOURNAL ARTICLE
S K Jakaria Been Sayeed, Md Moniruzzaman, A K M Humayon Kabir, Md Uzzwal Mallik, Bikas Chandra Mondal, Shahin Mahmud, Fahim T Rahman, Mehrin Rahman, Md Mujibur Rahman
Background Immunomodulatory therapy for chronic rheumatic disease carries a risk for infectious complications. In Bangladesh, there is limited information regarding patterns and factors associated with infections among patients receiving immunosuppressive medications. Objective The present study aimed to find out patterns and predictors associated with infection among patients who were on different immunosuppressive medications due to chronic rheumatological disease. Methodology This was a retrospective study; all confirmed cases of (new and old) different rheumatological diseases on disease-modifying agents attended at the rheumatology clinic of Dhaka Medical College Hospital from January 2019 to December 2021 were enrolled...
January 2024: Curēus
https://read.qxmd.com/read/38385377/spectrum-of-pneumonia-in-renal-transplant-recipients-an-indian-experience
#6
JOURNAL ARTICLE
Sukanya Govindan, Sahil Bagai, Raja Ramachandran, Vivek Kumar, Manish Rathi, Harbir S Kohli, Ashish Sharma, Krishan Lal Gupta
OBJECTIVES: Respiratory tract infections are life-threatening infections in solid-organ transplant recipients that pose risk to the graft and to the patient. This study was undertaken to examine the clinical and microbiological spectrum of pneumonia in renal transplant recipients. MATERIALS AND METHODS: Of 400 consecutive renal transplant recipients, 87 recipients (21.8%) were hospitalized between November 2014 and October 2016 with pneumonia. We examined demographic profiles and clinical investigations...
January 2024: Experimental and Clinical Transplantation
https://read.qxmd.com/read/38347433/tofacitinib-use-in-ulcerative-colitis-an-expert-consensus-for-day-to-day-clinical-practice
#7
JOURNAL ARTICLE
Rupa Banerjee, Vishal Sharma, Rajendra Patel, Anuraag Jena, Partha Pal, Nalini Raghunathan, Ajay Kumar, Ajit Sood, Amarender S Puri, Bhabhadev Goswami, Devendra Desai, Dhanush Mekala, G N Ramesh, G V Rao, Kiran Peddi, Mathew Philip, Manu Tandon, Shobna Bhatia, Shubhankar Godbole, Sumit Bhatia, Uday C Ghoshal, Usha Dutta, Vandana Midha, V G Mohan Prasad, D Nageshwar Reddy
Rising number of inflammatory bowel disease (IBD) cases in developing countries necessitate clear guidance for clinicians for the appropriate use of advanced therapies. An expert consensus document was generated to guide the usage of tofacitinib, a Janus kinase inhibitor, in ulcerative colitis. Tofacitinib is a useful agent for the induction and maintenance of remission in ulcerative colitis. It can be used in the setting of biological failure or even steroid-dependent and thiopurine refractory disease...
February 12, 2024: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://read.qxmd.com/read/38346478/synthesis-of-steroidal-inhibitors-for-mycobacterium-tuberculosis
#8
JOURNAL ARTICLE
Luke R Churchman, James R Beckett, Lendl Tan, Kyra Woods, Daniel Z Doherty, Amna Ghith, Paul V Bernhardt, Stephen G Bell, Nicholas P West, James J De Voss
Oxidised derivatives of cholesterol have been shown to inhibit the growth of Mycobacterium tuberculosis (Mtb). The bacteriostatic activity of these compounds has been attributed to their inhibition of CYP125A1 and CYP142A1, two metabolically critical cytochromes P450 that initiate degradation of the sterol side chain. Here, we synthesise and characterise an extensive library of 28 cholesterol derivatives to develop a structure-activity relationship for this class of inhibitors. The candidate compounds were evaluated for MIC with virulent Mtb and in binding studies with CYP125A1 and CYP142A1 from Mtb...
February 10, 2024: Journal of Steroid Biochemistry and Molecular Biology
https://read.qxmd.com/read/38330155/the-role-of-corticosteroids-and-immunomodulatory-therapy-in-the-management-of-infectious-uveitis
#9
REVIEW
Amir Akhavanrezayat, Gunay Uludag Kirimli, Wataru Matsumiya, Hassan Khojasteh, Christopher Or, Irmak Karaca, Brandon Pham, Prapatsorn Ongpalakorn, Sherin Lajevardi, Brandon Lam, Jaclyn Joyce Hwang, Ngoc Trong Tuong Than, SungWho Park, Negin Yavari, Vahid Bazojoo, Azadeh Mobasserian, Anadi Khatri, Muhammad Sohail Halim, Zheng Xian Thng, Hashem Ghoraba, Diana V Do, Ilknur Tugal-Tutkun, Vishali Gupta, Marc de Smet, Quan Dong Nguyen
PURPOSE: The index review aims to provide an update on the role of corticosteroids and steroid-sparing immunomodulatory therapy (IMT) in managing patients with infectious uveitis. METHOD: Narrative literature review. RESULTS: Corticosteroids and immunomodulatory therapy (IMT) focus on the host defense system instead of the pathogen, adjusting exaggerated inflammatory reactions to reduce potential harm to ocular tissues. Systemic or local corticosteroids are primarily selected as adjunctive medication for infectious uveitis...
February 8, 2024: Ocular Immunology and Inflammation
https://read.qxmd.com/read/38296473/significance-of-epidemiological-background-in-preventing-the-misdiagnosis-of-intestinal-tuberculosis-as-crohn-s-disease
#10
JOURNAL ARTICLE
Motoki Kaneko, Masashi Matsushima, Takashi Ueda, Hirohiko Sato, Masaya Sano, Erika Teramura, Mia Fujisawa, Hidekazu Suzuki
The misdiagnosis of intestinal tuberculosis (ITB), such as Crohn's disease (CD), and subsequent treatment with immunosuppressive therapies can lead to severe outcomes. However, the differential diagnosis between these two conditions can be challenging. We herein report a patient from Myanmar who was initially diagnosed with CD due to the presence of non-caseating granulomas. The patient's symptoms were aggravated with steroid treatment, eventually leading to a diagnosis of ITB. In the international medical community, we encounter patients from countries, such as Myanmar, where tuberculosis is endemic...
February 1, 2024: Internal Medicine
https://read.qxmd.com/read/38293280/tuberculous-meningitis-presenting-with-bilateral-optic-neuritis-a-case-report-and-review-of-literature
#11
Khaled W Sadek, Mohamed A Atta, Najwa Y Sultan, Anas A Ashour
INTRODUCTION: Tuberculosis (TB) is a major global cause of morbidity and mortality. TB meningitis (TBM) is an implication of systemic dissemination of a primary TB infection that indicates a poorer disease prognosis with various long-term neurological sequelae. Consequently, it is crucial to understand the different clinical presentations and manifestations of such condition. In TBM, vision loss, which is one of the most devastating complications, may result from optic nerve inflammation and atrophy...
2024: Case Reports in Neurology
https://read.qxmd.com/read/38293201/jak-stat-signaling-predominates-in-human-and-murine-fungal-post-infectious-inflammatory-response-syndrome
#12
Jessica C Hargarten, Kenneth Ssebambulidde, Seher H Anjum, Malcolm J Vaughan, Jintao Xu, Brian Song, Anutosh Ganguly, Yoon-Dong Park, Terri Scott, Dima A Hammoud, Michal A Olszewski, Peter R Williamson
Post-infection inflammatory syndromes have been increasingly recognized as a cause of host damage in a variety of infectious diseases including tuberculosis, bacterial meningitis, and COVID-19. Recently, a post-infectious inflammatory response syndrome (PIIRS) was described in non-HIV-infected cryptococcal fungal meningoencephalitis (CM) as a major cause of mortality. Inflammatory syndromes are particularly severe in neurological infections due to the skull's rigid structure which limits unchecked tissue expansion from inflammatory-induced edema...
January 21, 2024: medRxiv
https://read.qxmd.com/read/38229805/isolated-tuberculous-transverse-myelitis-without-meningitis-among-patients-with-aids-a-case-report
#13
Kirun Angkanavisan, Minth Punpichet, Worapong Nasomsong
Acute transverse myelitis is an inflammatory disorder of the spinal cord, characterized by acute or subacute onset of paraparesis, bilateral sensory deficit, and impaired urinary bladder and sphincter tone function. Mycobacterium tuberculosis , a very rare cause of transverse myelitis, especially tuberculous myelitis without meningitis, is extremely rare. The main etiologic mechanism consists of an abnormal activation of the immune system against the spinal cord as well as the direct invasion by the bacillus...
December 2023: Curēus
https://read.qxmd.com/read/38222121/spectacular-improvement-of-paradoxical-reaction-in-tuberculosis-after-tumor-necrosis-factor-alpha-antagonist-therapy
#14
Myriam Samad, Charles Antoine Dallevet, Yacine Tandjaoui-Lambiotte, Anne Bourgarit, Pierre Jaquet
We report the case of a 42-year-old immunocompetent Indian patient presenting with miliary tuberculosis complicated by respiratory failure requiring intubation. Conventional quadritherapy was initiated for wild-type Mycobacterium tuberculosis . On day 29 of antibiotic treatment, persistent fever and neurological deterioration prompted the diagnosis of multiple brain and medullary tuberculomas, some surrounded by edema. Laboratory investigations ruled out meningitis and subtherapeutic drug concentrations. To enhance cerebrospinal fluid penetration, ethambutol was replaced with levofloxacin on day 30, and rifampicin doses were increased to 30 mg/kg...
December 2023: Curēus
https://read.qxmd.com/read/38186434/disseminated-miliary-and-intestinal-tuberculosis-mimicking-inflammatory-bowel-disease
#15
Danny Tran, Kunaal Patel, Areeba Ashfaq, Brittany Lyons
The hematogenous dissemination of Mycobacterium tuberculosis ( M. tb ) is commonly via the pulmonary system. Less commonly, ingestion of M. tb can lead to primary intestinal tuberculosis (TB), often misdiagnosed as inflammatory bowel disease (IBD). In extremely rare cases, the dissemination can involve cardiac infiltration/tuberculoma. One such case involves a 21-year-old man from Guatemala who spoke a rare dialect of Spanish with nonspecific complaints and an abdominal CT scan showing terminal ileum thickening suggestive of Crohn's disease (CD)...
December 2023: Curēus
https://read.qxmd.com/read/38186190/polyphyllin-ii-inhibits-nlpr3-inflammasome-activation-and-inflammatory-response-of-mycobacterium-tuberculosis-infected-human-bronchial-epithelial-cells
#16
JOURNAL ARTICLE
Guodong Cheng, Gengzhi Ye, Ying Ma, Yuqing Wang
BACKGROUND: The bronchial infection by Mycobacterium tuberculosis (Mtb) is increasing in prevalence and severity worldwide. Despite appropriate tuberculosis treatment, most patients still develop bronchial stenosis, which often leads to disability. Polyphyllin II (PP2) is a steroidal saponin extracted from Rhizoma Paridis. In this study, we aimed to explore the effect of PP2 on the advancement of Mtb -induced bronchial infection. METHOD: The effects of PP2 on cell viability were measured by using MTT and lactate dehydrogenase (LDH) kit...
2024: Allergologia et Immunopathologia
https://read.qxmd.com/read/38159920/a-retrospective-record-review-of-tuberculous-infections-in-rheumatoid-arthritis-patients-on-biologics-in-malaysia
#17
JOURNAL ARTICLE
A M N Nor Hashimah, A L Lim, M Mohd Zain, S C Gun, L Mohd Isa, H C Chong, A Mohamed Ismail, S A Wan Mohamad Akbar, G R Ling, H H Ariff, C R Ng, S C Ng, A Mohd, E Mageswaren
INTRODUCTION: The aim of this study was to analyse the clinical characteristics of patients with rheumatoid arthritis receiving biologics therapy and investigate the association between types of biologics and tuberculosis (TB) infections in 13 tertiary hospitals in Malaysia. MATERIALS AND METHODS: This was a retrospective study that included all RA patients receiving biologics therapy in 13 tertiary hospitals in Malaysia from January 2008 to December 2018. RESULTS: We had 735 RA patients who received biologics therapy...
December 2023: Medical Journal of Malaysia
https://read.qxmd.com/read/38146383/acquired-thrombotic-thrombocytopenic-purpura-as-a-clinical-manifestation-of-pulmonary-tuberculosis-a-case-report
#18
Kateir Contreras, Oscar Miguel Contreras Amorocho, Julian Serrano Giraldo
INTRODUCTION: Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy associated with severe ADAMTS13 deficiency that can be potentially fatal if not treated in a timely manner. CASE REPORT: A 49-year-old previously healthy woman was admitted with a 3-month history of thoracoabdominal pain and headache associated with loss of appetite, emesis, nocturnal diaphoresis, and unintentional loss of 10 kg. On admission she presented anemia, thrombocytopenia, schistocytes in peripheral blood smear, and ADAMTS13 in 1...
September 2023: Germs
https://read.qxmd.com/read/38136689/diagnosis-of-tuberculosis-in-a-case-of-chronic-urticaria-following-omalizumab-therapy
#19
Alberto Zolezzi, Gina Gualano, Maria A Licata, Silvia Mosti, Paola Mencarini, Roberta Papagni, Antonella Vulcano, Angela Cannas, Alberta Villanacci, Fabrizio Albarello, Franca Del Nonno, Daniele Colombo, Fabrizio Palmieri
In Italy, tuberculosis (TB) incidence in the last decade has remained constant at under 10 cases/100,000 inhabitants. In the Philippines, TB annual incidence is greater than 500 cases/100,000 inhabitants. Omalizumab is a humanized anti-IgE monoclonal antibody approved for the treatment of chronic spontaneous urticaria. We report the case of a 32-year-old Filipino woman who suffered from chronic urticaria, treated with topic steroids since June 2022 and systemic steroids for 2 weeks. In November 2022, she started omalizumab therapy at a monthly dose of 300 mg; she was not screened for TB infection...
November 24, 2023: Antibiotics
https://read.qxmd.com/read/38130328/prevalence-of-indeterminate-tuberculosis-interferon-gamma-release-assays-in-covid-19-patients-systematic-review-and-meta-analysis
#20
JOURNAL ARTICLE
Aicha Ben Tekaya, Ameni Jerbi, Mouna Ben Sassi, Salma Mokaddem, Ines Mahmoud, Chedli Dziri, Leila Abdelmoula
BACKGROUND AND AIMS: The reliability of interferon-gamma-release-assays (IGRAs) for tuberculosis (TB) testing in coronavirus disease 2019 (COVID-19) patients is unknown. This study aimed to systematically review the prevalence of indeterminate TB-IGRA following SARS-CoV-2 infection or vaccination and to review associated factors. METHODS: This systematic literature review was guided according to the PRISMA guidelines by searching PubMed, Scopus, Web of Science, Clinicalkey, and Cochrane Library...
December 2023: Health Science Reports
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