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Cavitary tuberculosis

Alvaro Proaño, David Bui, José W López, Nancy M Vu, Marjory A Bravard, Gwenyth O Lee, Brian H Tracey, Ziyue Xu, Germán Comina, Eduardo Ticona, Daniel J Mollura, Jon S Friedland, David A J Moore, Carlton A Evans, Philip Caligiuri, Robert H Gilman
BACKGROUND: Cough frequency, and its duration, is a lab-free biomarker that can be used in low-resource settings and has been associated with transmission and treatment response. Radiological characteristics associated with increased cough frequency may be important in understanding transmission. The relationship between cough frequency and cavitary lung disease has never been studied. METHODS: We analyzed 41 human immunodeficiency virus-negative adults with culture-confirmed, drug-susceptible pulmonary tuberculosis throughout treatment...
March 17, 2018: Chest
Michael E Urbanowski, Elizabeth A Ihms, Kristina Bigelow, André Kübler, Paul T Elkington, William R Bishai
Background: Cavitation is a serious consequence of tuberculosis. We tested the hypothesis that repetitive exposure to the same total bacterial burden of Mtb drives greater lung destruction than a single exposure. We also tested whether inhibition of endogenous MMP1 may inhibit cavitation during TB. Methods: Over a three weeks interval we infected rabbits with either 5 aerosols of 500 CFU of Mtb or a single aerosol of 2500 CFU plus four sham aerosols. We administered the MMP1 inhibitor cipemastat (100 mg/kg daily) from week 5-10 to a subset of the animals...
March 15, 2018: Journal of Infectious Diseases
Matthew T Koroscil, Andrew Skabelund
Introduction: Blastomyces dermatitidis is a dimorphic fungus endemic to the Mississippi River valley. We describe a rare case of chronic pulmonary blastomycosis complicated by large pulmonary cavitation in a young service member who was misdiagnosed with active pulmonary tuberculosis. Case Presentation: A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL)...
March 14, 2018: Military Medicine
Ye-Jin Lee, Sung Koo Han, Ju Hee Park, Jung Kyu Lee, Deog Keom Kim, Hee Soon Chung, Eun Young Heo
Background/Aims: Patients with diabetes mellitus (DM) and tuberculosis (TB) have increased morbidity and a high risk of treatment failure or recurrence. It is important to manage both diseases simultaneously. Among anti-diabetic drugs, metformin inhibits intracellular growth of mycobacteria. Therefore, we examined the effects of metformin on TB treatment, especially in patients with DM. Methods: This retrospective cohort study included patients with culture-positive pulmonary TB diagnosed between 2011 and 2012...
March 16, 2018: Korean Journal of Internal Medicine
Jae Kyoung Kim, Ina Jeong, Ji Yeon Lee, Jung Hyun Kim, Ah Yeon Han, So Yeon Kim, Joon Sung Joh
BACKGROUND: The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. METHODS: We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015...
March 7, 2018: Tuberculosis and Respiratory Diseases
S Ben Saad, B Melki, L Douik El Gharbi, F Soraya, N Chaouch, H Aouina, J Cherif, A Hamzaoui, A Merghli, H Daghfous, F Tritar
BACKGROUND: Pneumothorax is a serious complication of cavitary pulmonary tuberculosis. The aim of this study was to describe clinical futures, to highlight challenges of its management. METHODS: A retrospective multicentric and descriptive study including 65 patients treated for PT (1999-2015) was conducted to figure out clinical futures and its work-up. RESULTS: The mean age was 37.8 years. The sex ratio was 3.6. Smoking history and incarceration were noted respectively in 67...
March 6, 2018: Revue de Pneumologie Clinique
Hamida Kwas, Ines Zendah, Habib Ghedira
INTRODUCTION: Spontaneous pneumothorax (SP) is a frequent complication of pulmonary tuberculosis (TB) and a severe form of the disease. In spite of the fact that TB is a common cause of pneumothorax, a very few series, have been reported. METHODS: We retrospectively analysed the experience of SP secondary to TB in patients who were hospitalized in our department between 2005 and 2015. RESULTS: The mean age of patients was 38,5±19 years. Two patients had a history of pulmonary tuberculosis...
April 2017: La Tunisie Médicale
Sonali Agrawal, Om Parkash, Alangudi Natarajan Palaniappan, Ashok Kumar Bhatia, Santosh Kumar, Devendra Singh Chauhan, M Madhan Kumar
Treatment monitoring is an essential aspect for tuberculosis (TB) disease management. Sputum smear microscopy is the only available tool for monitoring, but it suffers from demerits. Therefore, we sought to evaluate markers and cellular subsets of T regulatory (Treg) cells and T helper (Th) 17 cells in pulmonary TB patients (PTB) for TB treatment monitoring. Peripheral blood mononuclear cells (PBMCs) were stimulated in vitro (with purified protein derivative (PPD)) overnight which was followed by a polychromatic flow cytometry approach to study Treg and Th17 markers and cellular subsets in PTB ( n  = 12) undergoing antituberculous treatment (ATT)...
2018: Frontiers in Immunology
Michael Chavarria, Larry Lutwick, Bonny L Dickinson
Mycobacterium celatum is a slow-growing, non-tuberculous mycobacterium (NTM) and a rare cause of infection in humans. Infection occurs primarily by inhalation or direct inoculation from environmental sources, and this pathogen has been reported to cause localized infections in the lungs and lymph nodes of both immunocompetent and immunocompromised patients, and disseminated disease in immunocompromised patients. Here, we present a case of pulmonary infection with M. celatum in an immunocompetent 68-year-old male with clinical features similar to tuberculosis...
2018: IDCases
L Y Xu, G X Lai, Q Hu, L Zhang, D L Liu, G B Zhu, X H Li, H H Shi, C Xu, Y H Yu, Y W Bao, W Chen
Objective: To improve the understanding of chronic pulmonary aspergillosis (CPA) by analyzing the clinical manifestations, imaging and pathological features, diagnosis, treatment and prognosis of this disease. Methods: Cases of CPA, proven by microbiological evidence based on pathological study in Fuzhou General Hospital of the People's Liberation Army and Affiliated Fuzhou City First Hospital of Fijian Medical University from January 2006 to October 2016 were retrospectively analyzed. Results: The patients consisted of 17 males and 12 females, aged 24 to 75 years, mean (42±16) years...
February 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Shweta Kishore, Varun Mittal, Shradha Ahuja, Vikas Majithia
A 55-year-old woman presented with progressive enlarging and painful non-healing ulcers on her bilateral lower extremities; biopsy was consistent with pyoderma gangrenosum. Workup for an underlying illness revealed a cavitary lung nodule and an ulcerating mass in the anal canal. Patient did not have any respiratory or gastrointestinal symptoms. Differential diagnosis included inflammatory bowel disease, rectal carcinoma or infection such as tuberculosis, fungal process. Histopathology did not reveal any malignancy, inflammatory bowel disease or infection...
January 31, 2018: BMJ Case Reports
Yosra M Alkabab, Mushira A Enani, Nouf Y Indarkiri, Scott K Heysell
Background: Prior research suggests that diabetes mellitus (DM) is associated with increasing risk for developing cavitary lung disease in patients with pulmonary tuberculosis (TB). Additionally, chest computed tomography (CT) scan may be more sensitive than chest X-ray in detecting cavitary disease in such patients. The aim of this study was to compare the performance of chest CT to chest X-ray in detecting cavitary lung disease and to compare the frequency of cavities between TB patients with DM and without DM...
2018: Infection and Drug Resistance
Darren Patrick Moloney, Liam Chawke, Mairead Therese Crowley, Terence M O'Connor
Hypercalcaemia occurs in many granulomatous diseases. Among them, sarcoidosis and tuberculosis are the most common causes. Other causes include berylliosis, coccidioidomycosis, histoplasmosis, Crohn's disease, silicone-induced granulomas, cat-scratch disease, Wegener's granulomatosis and Pneumocystis carinii pneumonia. Hypercalcaemia in granulomatous disease occurs as a consequence of dysregulated production of 1,25-(OH)2 D3 (calcitriol) by activated macrophages in granulomas. Hypercalcaemia in patients with Mycobacterium tuberculosis infection has been reported in 0%-28% of cases...
January 26, 2018: BMJ Case Reports
Y A Melsew, T N Doan, M Gambhir, A C Cheng, E McBryde, J M Trauer
We performed a systematic review and meta-analyses of studies assessing tuberculosis (TB) patient-related risk factors for transmission of Mycobacterium tuberculosis infection. Meta-analyses were conducted for sputum smear-positivity, lung cavitation and HIV seropositivity of index patients with both crude and adjusted odds ratios (AORs) pooled using random effect models. Thirty-seven studies were included in the review. We found that demographic characteristics such as age and sex were not significant risk factors, while behaviours such as smoking and alcohol intake were associated with infectiousness although inconsistently...
January 17, 2018: Epidemiology and Infection
Sumit Fogla, Vaishali M Pansare, Luis G Camero, Uzma Syeda, Naveen Patil, Arun Chaudhury
We report the case of a 68-year-old gentleman who presented with musculoskeletal chest pain which appeared suddenly when he bent over with his dog. The chest pain was localized to the left lower chest and increased with movement and deep breathing. The patient did not complain weight loss, night sweat, fever or chill. He complained of mild cough, with expectoration of whitish mucus. Imaging revealed cavitary chest lesion in the right upper lobe, which was initially suspected to be lung cancer. The patient had a 50-year-old history of smoking 2 packs per day...
2018: Respiratory Medicine Case Reports
Nicholas R Degner, Jann-Yuan Wang, Jonathan E Golub, Petros C Karakousis
Background: The global type 2 diabetes mellitus (DM) epidemic threatens progress made in reducing tuberculosis (TB)-related mortality worldwide. Previous clinical studies have not fully evaluated potential confounding variables in addressing the impact of DM on TB treatment outcomes. The antidiabetic agent metformin regulates autophagy and may play a role as a host-directed therapeutic adjuvant to antitubercular treatment. Methods: We conducted a retrospective cohort study comprising patients aged ≥13 years undergoing treatment for culture-confirmed, drug-susceptible pulmonary TB...
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ajay Handa, Sahajal Dhooria, Inderpaul Singh Sehgal, Ritesh Agarwal
Primary cavitary sarcoidosis (PCS) is a rare form of pulmonary sarcoidosis. In this report, we present a case of a 47-year-old male patient with PCS who was initially treated as pulmonary tuberculosis. We also systematically review the literature on PCS and propose a new classification for this entity.
January 2018: Lung India: Official Organ of Indian Chest Society
Venkata R Parasa, Jagadeeswara R Muvva, Jeronimo F Rose, Clara Braian, Susanna Brighenti, Maria Lerm
Granulomas are hallmarks of pulmonary tuberculosis (TB) and traditionally viewed as host-protective structures. However, recent evidence suggest that Mycobacterium tuberculosis (Mtb) uses its virulence factors to stimulate the formation of granuloma. In the present study, we investigated the contribution of matrix metalloproteinases (MMPs), host enzymes that cause degradation of the extracellular matrix, to granuloma formation and bacterial load in Mtb-infected tissue. To this end, we used our lung tissue model for TB, which is based on human lung-derived cells and primary human monocyte-derived macrophages...
2017: Frontiers in Microbiology
Dmitry Borisovich Giller, Boris Dmitrievich Giller, Galina Vitalievna Giller, Galina Vladimirovna Shcherbakova, Anuar Bahtibaevich Bizhanov, Inga Igorevna Enilenis, Aleksey Aleksandrovich Glotov
OBJECTIVES: Surgical interventional has been key in the treatment of tuberculosis (TB) for a long time. Its importance diminished after the emergence of chemotherapy. However, the spread of rapid multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB has led us to return to surgery to treat TB. Today, every second patient in Russia with destructive TB has either MDR or XDR TB, which is the reason for the low efficacy of conservative treatment. In 2015, treatment with drugs resulted in clinical recovery in only 29...
December 12, 2017: European Journal of Cardio-thoracic Surgery
Hyun Lee, Soohyun Ahn, Na Young Hwang, Kyeongman Jeon, O Jung Kwon, Hee Jae Huh, Nam Yong Lee, Chang-Ki Kim, Won-Jung Koh
Recent data conflict on the clinical efficacy of later-generation fluoroquinolones, such as moxifloxacin or levofloxacin, for the treatment of multidrug-resistant tuberculosis (MDR-TB) that is resistant to ofloxacin but susceptible to moxifloxacin. The purpose of the present study was to evaluate whether later-generation fluoroquinolones can improve treatment outcomes in patients with ofloxacin-resistant, moxifloxacin-susceptible MDR-TB. A retrospective cohort study was performed on 208 patients with moxifloxacin-susceptible MDR-TB who were treated between 2006 and 2011...
February 2018: Antimicrobial Agents and Chemotherapy
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