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https://www.readbyqxmd.com/read/28500120/the-clinical-conundrum-of-diagnosing-and-treating-systemic-sarcoidosis-in-a-high-tb-burden-area
#1
Krishnadas Thulasidoss, Lavanya Asokan, Piyush Chandra, Pravinkumar Rejliwal
A 53-year-old woman from Southern India presented with weight loss, anorexia, fever and asthenia. Whole body positron emission tomography/computed tomography (PET-CT) showed fluorodeoxyglucose-avid mediastinal and abdominal lymphadenopathy with hepatic, splenic, parotid and lacrimal glandular inflammations. Endoscopic ultrasound-guided fine needle aspiration of subcarinal lymph node showed non-caseating granulomas. Initial serum ACE level was elevated but with normal calcium. Despite the suspicion of sarcoidosis, a trial of antituberculosis therapy was started empirically due to similar presentations of disseminated tuberculosis (TB) in this high endemic area...
May 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28484568/concurrent-multiple-intracranial-and-intramedullary-conus-tuberculoma-a-rare-case-report
#2
Manish Jaiswal, Ashok Gandhi, Devendra Purohit, Radhey Shyam Mittal
Central nervous system (CNS) tuberculosis commonly manifests as tubercular meningitis. CNS tuberculomas are more common intracranially and less frequently involve the spinal cord. Combination of intramedullary with intracranial tuberculomas is extremely rare. We report a case of concurrent occurrence of intramedullary tuberculoma with multiple intracranial tuberculomas in a young 16-year-old boy, who presented with two weeks history of paresthesias and weakness of the lower limbs and diminution of vision in left eye, who had been treated for pulmonary tuberculosis...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28482714/risk-and-impact-of-tuberculosis-in-patients-with-multiple-myeloma
#3
Chun-Kuang Tsai, Leh-Kiong Huon, Shuo-Ming Ou, Ai-Seon Kuan, Chiu-Mei Yeh, Yu-Ting Lee, Yao-Chung Liu, Tzeng-Ji Chen, Jin-Hwang Liu, Chia-Jen Liu
We investigated the risk and impact of mycobacterium tuberculosis (TB) infection in patients with multiple myeloma (MM). We identified 3979 MM patients from Taiwan's National Health Insurance database between 2000 and 2011 and compared the incidence rates of TB infection in these patients with 15,916 randomly selected age-, sex-, and comorbidity-matched subjects without MM. The risk of TB was higher in the myeloma cohort (adjusted hazard ratio [HR] 3.11, 95% confidence interval [CI] 2.41-4.02). Risk factors for MM patients contracting TB were age ≥65 (adjusted HR 1...
May 9, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28472944/risk-of-incident-active-tuberculosis-disease-in-patients-treated-with-non-steroidal-anti-inflammatory-drugs-a-population-based-study
#4
Chun-Wei Wu, Jiunn-Yih Wu, Meng-Tse Gabriel Lee, Chih-Cheng Lai, I-Lin Wu, Yi-Wen Tsai, Shy-Shin Chang, Chien-Chang Lee
BACKGROUND: Mycobacterium tuberculosis (TB) is one of the world's most devastating public health threats. Our goal is to evaluate whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) affect the risk of new incident active TB disease. METHODS: We conducted a nested case-control analysis by using a 1 million longitudinally followed cohort, from Taiwan's national health insurance research database. Effects of NSAIDs on active TB were estimated by conditional logistic regression and adjusted using a TB-specific disease risk score (DRS)...
May 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28449695/intermediate-uveitis-pattern-of-etiology-complications-treatment-and-outcome-in-a-tertiary-academic-center
#5
Thomas Ness, Daniel Boehringer, Sonja Heinzelmann
BACKGROUND: Patients with intermediate uveitis (IU) represent a heterogenous group characterized by a wide spectrum of etiologies and regional differences. Aim of the study was to analyze the characteristics of patients with IU examined in an academic center in Germany. METHODS: We conducted a retrospective analysis of the clinical records of all patients with intermediate uveitis referred to the Eye Center, University of Freiburg from 2007 to 2014. Diagnosis followed the Standardization in Uveitis Nomenclature (SUN) criteria...
April 27, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28447377/lupus-miliaris-disseminatus-faciei-a-resistant-case-with-response-to-cyclosporine
#6
Kabir Sardana, Shikha Chugh, Rashmi Ranjan, Nita Khurana
Lupus miliaris disseminatus faciei (LMDF) is a chronic, inflammatory dermatosis of unknown etiology, characterized by multiple, monomorphic, symmetrical, reddish-brown papules over forehead, cheeks, and eyelids. Histopathology shows perifollicular epitheloid cell granuloma. Though numerous therapies, ranging from cyclines, macrolides, dapsone tranilast, isotretinoin, steroids, and tacrolimus have been tried, the results are inconsistent, except with systemic steroids. One approach is to administer therapies based on the histological findings and the corresponding mode of action of drugs, thus antibiotics and dapsone are effective in the early inflammatory stage while clofazamine can be used in the granulomatous stage of the disease...
April 26, 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/28438256/clinical-profile-and-outcome-of-patients-with-biopsy-proven-acute-interstitial-nephritis-in-cape-town-a-10-year-review%C3%A2
#7
Emmanuel E Effa, Udeme E Ekrikpo, Megan Borkum, Brian L Rayner, Peter Heering, Ikechi G Okpechi
BACKGROUND: Acute interstitial nephritis (AIN) is a common cause of acute kidney injury that has not been adequately characterized in Sub-Saharan Africa (SSA) despite an increasing use of potentially inciting agents for the treatment of human immunodeficiency virus (HIV) and tuberculosis in the region. METHODS: A retrospective audit of records of patients with biopsy-proven AIN diagnosed at Groote Schuur Hospital, Cape Town from the 1st of January, 2006, to the 31st of December, 2015...
April 25, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28422773/infections-in-rheumatoid-arthritis
#8
Fabiola Atzeni, Ignazio Francesco Masala, Manuela di Franco, Piercarlo Sarzi-Puttini
PURPOSE OF REVIEW: The purpose of this review is to provide an update concerning recent advances in the evidence- based study of serious infections in patients with rheumatoid arthritis (RA) treated with biological drugs or conventional disease-modifying antirheumatic drugs (DMARDs), concentrating on studies published in the last 18 months. RECENT FINDINGS: New studies have further strengthened existing evidence relating the use of biological drugs to serious infections...
April 18, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28420846/intrathecal-isoniazid-for-refractory-tuberculous-meningitis-with-cerebral-infarction
#9
Yuko Nakatani, Yutaka Suto, Kazuki Fukuma, Mika Yamawaki, Ryoichi Sakata, Shotaro Takahashi, Hiroyuki Nakayasu, Kenji Nakashima
A 30-year-old Vietnamese woman, about 19 weeks pregnant, was admitted for acute cerebral infarction with stenosis of the left middle cerebral artery (LMCA), tuberculous meningitis, and miliary tuberculosis. Treatment with heparin, quadruple anti-tuberculosis therapy, and dexamethasone afforded prompt symptomatic improvement. However, she delivered a stillbirth, after which there was recurrence of acute cerebral infarction with LMCA occlusion, sinus thrombosis, and cranial base inflammation. A thrice-weekly 100 mg dose of intrathecal isoniazid (INH) improved the signs of meningeal inflammation...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28416000/brain-tuberculoma-an-unusual-cause-of-stroke-in-a-child-with-trisomy-21-a-case-report
#10
Abdelmoneim E M Kheir, Salah A Ibrahim, Ahlam A Hamed, Badreldin M Yousif, Farouk A Hamid
BACKGROUND: Tuberculosis remains a public health problem in developing countries and is associated with lethal central nervous system complications. Intracranial tuberculomas occur in 13% of children with neurotuberculosis. Patients with trisomy 21 have an increased risk for stroke, which usually stems from cardiovascular defects. CASE PRESENTATION: We report a case of a 12-year-old Sudanese boy with trisomy 21 who was presented to our hospital with focal convulsions and right-sided weakness...
April 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28396742/single-centre-experience-of-granulomatous-interstitial-nephritis-time-for-a-new-approach
#11
Ben Oliveira, Satish Jayawardene, Sapna Shah
Background: Differentiating between renal-limited sarcoidosis and tuberculosis (TB) infection as a cause of granulomatous interstitial nephritis (GIN) can be difficult. This series compares clinical features and response to treatment between the different underlying aetiologies in order to propose a management algorithm for GIN to assist with diagnosis and treatment. Methods: This retrospective study reports on all patients presenting with a histological diagnosis of GIN between 2000 and 2012 at our unit. Results: Twenty-one patients were identified, 57% were male and the mean age was 53 years...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28377529/catabolism-of-the-last-two-steroid-rings-in-mycobacterium-tuberculosis-and-other-bacteria
#12
Adam M Crowe, Israël Casabon, Kirstin L Brown, Jie Liu, Jennifer Lian, Jason C Rogalski, Timothy E Hurst, Victor Snieckus, Leonard J Foster, Lindsay D Eltis
Most mycolic acid-containing actinobacteria and some proteobacteria use steroids as growth substrates, but the catabolism of the last two steroid rings has yet to be elucidated. In Mycobacterium tuberculosis, this pathway includes virulence determinants and has been proposed to be encoded by the KstR2-regulated genes, which include a predicted coenzyme A (CoA) transferase gene (ipdAB) and an acyl-CoA reductase gene (ipdC). In the presence of cholesterol, ΔipdC and ΔipdAB mutants of either M. tuberculosis or Rhodococcus jostii strain RHA1 accumulated previously undescribed metabolites: 3aα-H-4α(carboxyl-CoA)-5-hydroxy-7aβ-methylhexahydro-1-indanone (5-OH HIC-CoA) and (R)-2-(2-carboxyethyl)-3-methyl-6-oxocyclohex-1-ene-1-carboxyl-CoA (COCHEA-CoA), respectively...
April 4, 2017: MBio
https://www.readbyqxmd.com/read/28341896/role-of-conservative-management-in-tubercular-abdominal-cocoon-a-case-series
#13
Vishal Sharma, Harshal S Mandavdhare, Surinder S Rana, Harjeet Singh, Amit Kumar, Rajesh Gupta
BACKGROUND: Sclerosing encapsulating peritonitis (Abdominal cocoon) is an uncommon cause of intestinal obstruction and tuberculosis is an important etiology. Appropriate management of this entity is still uncertain. METHODS: We did a retrospective analysis of patients with abdominal cocoon who were seen over a two year period at a tertiary care center in North India. We included patients with tubercular abdominal cocoon (TAC) who were managed primarily with antitubercular therapy in the present report...
March 24, 2017: Infection
https://www.readbyqxmd.com/read/28333182/early-tuberculin-skin-test-for-the-diagnosis-of-latent-tuberculosis-infection-in-patients-with-inflammatory-bowel-disease
#14
Carlos Taxonera, Ángel Ponferrada, Fernando Bermejo, Sabino Riestra, Cristina Saro, María Dolores Martín-Arranz, José Luis Cabriada, Manuel Barreiro-de Acosta, María Luisa de Castro, Pilar López-Serrano, Jesús Barrio, Cristina Suarez, Eva Iglesias, Federico Argüelles-Arias, Isabel Ferrer, Ignacio Marín-Jiménez, Alejandro Hernández-Camba, Guillermo Bastida, Manuel Van Domselaar, Pilar Martínez-Montiel, David Olivares, Cristina Alba, Javier P Gisbert
Background and Aim: Sensitivity of tuberculin skin test [TST] during screening for latent tuberculosis infection [LTBI] is affected by steroid and/or immunosuppressant therapy. The aim of this study was to compare performance of the two-step TST in inflammatory bowel disease patients immediately before anti-tumour necrosis factor [TNF] therapy as part of routine screening for LTBI vs control patients when the TST was carried out at an early stage. Methods: In this multicentre prospective controlled study, we evaluated the performance of two-step TST with 5-mm threshold...
February 17, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28293057/kikuchi-fujimoto-disease-a-rare-presentation-with-localized-iliac-lymphadenitis
#15
Shrihari Anil Anikhindi, Anil Arora, Shashi Dhawan, Naresh Bansal, Praveen Sharma, Vikas Singla, Ashish Kumar
Kikuchi-Fujimoto disease (KFD) is a benign, self-limiting disease characterized by histiocytic necrotising lymphadenitis. Though several viral agents or an autoimmune etiology has been proposed as causative, the exact cause remains unknown. It has a female predilection and most commonly seen among young Asian people. Patients usually present with a febrile illness and the presence of lymphadenopathy may provide a clue to diagnosis. The most common site of lymphadenopathy is cervical lymph nodes while intra-abdominal involvement is uncommon...
January 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28278765/antimycobacterial-docking-and-molecular-dynamic-studies-of-pentacyclic-triterpenes-from-buddleja-saligna-leaves
#16
Alveera Singh, Katharigatta N Venugopala, Mohammed A Khedr, Mellendran Pillay, Kenneth U Nwaeze, Yacoob Coovadia, Francis Shode, Bharti Odhav
Buddleja saligna (family Buddlejaceae) is a medicinal plant endemic to South Africa. Two isomeric pentacyclic triterpenes, oleanolic acid and ursolic acid, were isolated from the leaves of B. saligna using silica gel column chromatography. Compounds oleanolic acid and ursolic acid were subjected to derivatization with acetic anhydride in the presence of pyridine to obtain oleanolic acid-3-acetate and ursolic acid-3-acetate, respectively. The structures of these compounds were fully characterized by detailed nuclear magnetic resonance (NMR) investigations, which included (1)H and (13)C NMR...
September 22, 2016: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/28260482/late-diagnosis-of-e148q-mutation-positive-familial-mediterranean-fever-in-a-kidney-transplant-patient-with-fever-of-unknown-origin-a-case-report
#17
Erhan Tatar, Adam Uslu, Cenk Simsek, Ahmet Aykas, Giray Bozkaya, Cetin Imamoglu
Fever of unknown origin is a rare condition after solid organ transplant and is generally associated with atypical infections (eg, tuberculosis, fungal infections) and/or lymphoproliferative disorders. Here, we present a kidney transplant patient with a late diagnosis of E148Q mutation-positive familial Mediterranean fever as the cause of fever of unknown origin. A 22-year-old female patient with a previous history of 4 years of hemodialysis and unknown primary renal disease received a deceased-donor kidney transplant at our center 5 years previously...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28254396/new-insights-on-tuberculous-aortitis
#18
Laure Delaval, Tiphaine Goulenok, Paul Achouh, David Saadoun, Julien Gaudric, Quentin Pellenc, Jean-Emmanuel Kahn, Nicoletta Pasi, Damien van Gysel, Patrick Bruneval, Thomas Papo, Karim Sacre
OBJECTIVE: Aortitis is an exceedingly rare manifestation of tuberculosis. We describe 11 patients with tuberculous aortitis (TA). METHODS: Multicenter medical charts of patients hospitalized between 2003 and 2015 with TA in Paris, France, were reviewed. Demographic, medical history, laboratory, imaging, pathologic findings, treatment, and follow-up data were extracted from medical records. TA was considered when aortitis was diagnosed in a patient with active tuberculosis...
February 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28220322/serious-fungal-infections-in-the-philippines
#19
M C R Batac, D Denning
The Philippines is a low middle-income, tropical country in Southeast Asia. Infectious diseases remain the main causes of morbidity, including tuberculosis. AIDS/HIV prevalence is still low at <1%, but is rapidly increasing. Fungal disease surveillance has not been done, and its burden has never been estimated. This becomes more important as the population of immunocompromised patients increases, drawn from patients with AIDS, TB, malignancies, and autoimmune diseases requiring chronic steroid use. Using the methodology of the LIFE program ( www...
February 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28217856/molecular-characterization-of-a-new-gene-cluster-for-steroid-degradation-in-mycobacterium-smegmatis
#20
Lorena Fernández-Cabezón, Esther García-Fernández, Beatriz Galán, José L García
The C-19 steroids 4-androstene-3,17-dione (AD), 1,4-androstadiene-3,17-dione (ADD) or 9α-hydroxy-4-androstene-3,17-dione (9OH-AD), which have been postulated as intermediates of the cholesterol catabolic pathway in Mycobacterium smegmatis, cannot be used as sole carbon and energy sources by this bacterium. Only the ΔkstR mutant which constitutively expresses the genes repressed by the KstR regulator can metabolize AD and ADD with severe difficulties but still cannot metabolize 9OH-AD, suggesting that these compounds are not true intermediates but side products of the cholesterol pathway...
February 20, 2017: Environmental Microbiology
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