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BAL for lung Tuberculosis

Benjamin J Garcia, Andre G Loxton, Gregory M Dolganov, Tran T Van, J Lucian Davis, Bouke C de Jong, Martin I Voskuil, Sonia M Leach, Gary K Schoolnik, Gerhard Walzl, Michael Strong, Nicholas D Walter
Pathogen-targeted transcriptional profiling in human sputum may elucidate the physiologic state of Mycobacterium tuberculosis (M. tuberculosis) during infection and treatment. However, whether M. tuberculosis transcription in sputum recapitulates transcription in the lung is uncertain. We therefore compared M. tuberculosis transcription in human sputum and bronchoalveolar lavage (BAL) samples from 11 HIV-negative South African patients with pulmonary tuberculosis. We additionally compared these clinical samples with in vitro log phase aerobic growth and hypoxic non-replicating persistence (NRP-2)...
September 2016: Tuberculosis
Y Mok, T Y Tan, T R Tay, H S Wong, P Y Tiew, J W Kam, C Siao
BACKGROUND: Studies evaluating the role of transbronchial lung biopsy (TBLB) in diagnosing pulmonary tuberculosis (PTB) date back decades and have shaped current practice. However, with the recent advent of bronchoalveolar lavage (BAL) Xpert® MTB/RIF, it is time to re-evaluate the role of TBLB. OBJECTIVE: To assess the impact of BAL and TBLB with the addition of BAL Xpert on diagnostic PTB yields and time to treatment initiation in sputum-scarce or acid-fast bacilli (AFB) smear-negative PTB patients...
May 2016: International Journal of Tuberculosis and Lung Disease
Anagha Malur, Barbara P Barna, Janki Patel, Matthew McPeek, Christopher J Wingard, Larry Dobbs, Mary Jane Thomassen
Recent studies suggest additive effects of environmental pollutants and microbial antigens on respiratory disease. We established a granuloma model in which instilled multiwall carbon nanotubes (MWCNT) elicit granulomatous pathology. We hypothesized that mycobacterial antigen ESAT-6, a T cell activator associated with tuberculosis and sarcoidosis, might alter pathology. Wild-type C57Bl/6 mice received MWCNT with or without ESAT-6 peptide. Controls received vehicle (surfactant-PBS) or ESAT-6 alone. Mice were evaluated 60 days later for granulomas, fibrosis, and bronchoalveolar lavage (BAL) cell expression of inflammatory mediators (CCL2, MMP-12, and Osteopontin)...
December 2015: Journal of Nanomedicine & Nanotechnology
Sahajal Dhooria, Amanjit Bal, Inderpaul Singh Sehgal, Ashutosh Nath Aggarwal, Digambar Behera, Ritesh Agarwal
Sarcoidosis and tuberculosis are granulomatous disorders that mimic each other both clinically and radiologically. Both can present with fever and pulmonary nodules and often require the performance of transbronchial lung biopsy (TBLB) for diagnosis. In recent studies, the flexible cryoprobe for carrying out TBLB has been found to be useful in the diagnosis of disorders diffusely involving the lung parenchyma. Here, we present the case of a 29-year-old man who presented with fever and cough and was found to have multiple small nodules in both lungs...
January 2016: Lung India: Official Organ of Indian Chest Society
Sampanna Jung Rayamajhi, Bhagwant Rai Mittal, Venkata Nagarjuna Maturu, Ritesh Agarwal, Amanjit Bal, Pranab Dey, Jaya Shukla, Dheeraj Gupta
PURPOSE: There is currently no single modality for accurate characterization of enlarged mediastinal lymph nodes into benign or malignant. Recently (18)F-fluorothymidine (FLT) has been used as a proliferation marker. In this prospective study, we examined the role of (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) and (18)F-FLT PET/CT in categorizing mediastinal lymph nodes as benign or malignant. MATERIALS AND METHODS: A total of 70 consecutive patients with mediastinal lymphadenopathy detected on computed tomography (CT) or chest radiograph underwent whole body (18)F-FLT PET/CT and (18)F-FDG PET/CT (within 1 week of each other)...
April 2016: Annals of Nuclear Medicine
Hakan Tanriverdi, Fatma Erboy, Bulent Altinsoy, Firat Uygur, Mehmet Arasli, Ishak Ozel Tekin, Muge Meltem Tor, Figen Atalay
BACKGROUND: Bronchoalveolar lavage (BAL) is a noninvasive and useful technique for evaluating interstitial lung diseases (ILDs). Flow cytometric analysis of BAL fluid reveals specific diagnostic information in some unusual ILDs, and helps to narrow down the possible causes of interstitial diseases in most patients with more common disorders. A high BAL CD4/CD8 ratio is highly specific for sarcoidosis but can also be seen in other ILDs. OBJECTIVES: In this retrospective, descriptive, cross-sectional study, we compared BAL fluid characteristics and clinical variables in patients with sarcoidosis and non-sarcoidosis ILDs in a large cohort...
October 2015: Iranian Red Crescent Medical Journal
T Omar, E Variava, E Moroe, A Billioux, R E Chaisson, L Lebina, N Martinson
BACKGROUND: A high proportion of deaths in Africa occur at home, where cause of death (CoD) is often unknown. We ascertained undiagnosed pulmonary tuberculosis (TB) by performing limited autopsies in adults dying at home in whom there was no apparent CoD. METHODS: Mortuaries in Matlosana, South Africa, identified potentially eligible adults with no ante-mortem diagnosis and/or no recent hospital admission. A questionnaire was administered to family members. Bilateral lung core biopsies and modified bronchoalveolar lavage (BAL) were performed...
November 2015: International Journal of Tuberculosis and Lung Disease
Maryam Haddadzadeh
We report the second case of Mycobacterium kansasii spondylitis in a 14-year-old Caucasian girl who presented with pain in the thoracolumbar region. There was collapsed T8 and discitis, and a cavitary lesion in new chest CT. Biopsy taken from thoracic lesion T8 with CT guidance which had evidence of osteomyelitis and its smear were negative for acid fast bacilli. Bronchoalveolar lavage (BAL) was performed - PCR was negative for acid fast bacilli. Empirical treatment of tuberculosis started and her symptoms resolved...
March 2014: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Raquel Ramos Garcia, Nitin Bhanot, Zaw Min
A 77-year-old man with myasthenia gravis receiving prednisone and plasmapheresis was found to have right upper lobe cavitary pneumonia on radiological imaging studies after thymectomy. He had a remote history of treated pulmonary tuberculosis (TB) at the age of 19. On the basis of history of TB and current prednisone therapy, reactivation of pulmonary TB was highly suspected. Branching Gram-positive bacilli were identified on bronchoalveolar lavage (BAL). BAL Ziehl-Neelsen Acid-fast bacilli stain was negative, but a modified Kinyoun stain revealed branching, beaded, filamentous bacilli, suggestive of Nocardia spp...
2015: BMJ Case Reports
Albert Joachim Omlor, Juliane Nguyen, Robert Bals, Quoc Thai Dinh
Like two sides of the same coin, nanotechnology can be both boon and bane for respiratory medicine. Nanomaterials open new ways in diagnostics and treatment of lung diseases. Nanoparticle based drug delivery systems can help against diseases such as lung cancer, tuberculosis, and pulmonary fibrosis. Moreover, nanoparticles can be loaded with DNA and act as vectors for gene therapy in diseases like cystic fibrosis. Even lung diagnostics with computer tomography (CT) or magnetic resonance imaging (MRI) profits from new nanoparticle based contrast agents...
2015: Respiratory Research
S Dharmic, Shraddha Nair, M Harish
A 65 year old female, known asthmatic on steroids intermittently, with no other co-morbidity presented with fever, breathlessness and cough with mucoid expectoration of ten days duration with bilateral crepts, went for Type II respiratory failure and was intubated followed by tracheostomy in view of prolonged ventilator support. In spite of high end antibiotics as per sputum culture sensitivity, weaning off the ventilator was not possible. Blood investigations revealed leucocytosis with neutrophilic predominance and IgE levels were within normal limits...
April 2015: Journal of Pharmacy & Bioallied Sciences
Lucila Garcia Contreras, Jean Sung, Mariam Ibrahim, Katharina Elbert, David Edwards, Anthony Hickey
Tuberculosis (TB) is a life-threatening infection that requires a lengthy treatment process that is often associated with adverse effects. Pulmonary delivery of anti-TB drugs has the potential to increase efficacy of treatment by increasing drug concentrations at the lungs, the primary site of infection. The aim of the present study is to evaluate the disposition of rifampicin (RIF) after its pulmonary administration as porous particles (PPs) to guinea pigs and contrast it to that after oral administration...
August 3, 2015: Molecular Pharmaceutics
Raj Kumar, Nitesh Gupta
BACKGROUND: The introduction of flexible bronchoscope has revolutionized the field of pulmonary medicine and is a standard instrument used for diagnostic purpose. A retrospective analysis of the clinico-radiological profile, indication, biopsy procedure and complications, for patients undergoing bronchoscopy at one of the respiratory unit at a tertiary care center in India. METHODS: Retrospective analysis of 712 bronchoscopies was done in regard to demographic profile, clinical and radiological presentation and diagnostic indication...
January 2015: Indian Journal of Tuberculosis
L Pérez-Lago, J J Palacios, M Herranz, M J Ruiz Serrano, E Bouza, D García-de-Viedma
The analysis of microevolution events, its functional relevance and impact on molecular epidemiology strategies, constitutes one of the most challenging aspects of the study of clonal complexity in infection by Mycobacterium tuberculosis. In this study, we retrospectively evaluated whether two improved sampling schemes could provide access to the clonal complexity that is undetected by the current standards (analysis of one isolate from one sputum). We evaluated in 48 patients the analysis by mycobacterial interspersed repetitive unit-variable number tandem repeat of M...
February 2015: Clinical Microbiology and Infection
John G Y Chan, Anneliese S Tyne, Angel Pang, Andrew J McLachlan, Vidya Perera, Joseph C Y Chan, Warwick J Britton, Hak Kim Chan, Colin C Duke, Paul M Young, Daniela Traini
A novel inhalable rifapentine dry powder formulation could improve pulmonary rifapentine concentrations resulting in a significantly shorter time to treat tuberculosis infection. The pharmacokinetics of rifapentine (20mg/kg) in healthy mice was compared following intratracheal (IT) and intraperitoneal (IP) administration. Plasma, bronchoalveolar lavage (BAL) and tissue samples were collected and drug levels were quantified at time points up to 24h. Concentration-time data were analysed using a mixed-effects modelling approach to provide model-based estimates of area under the concentration-time curve from time 0 to infinity (AUC0-∞)...
March 2015: International Journal of Antimicrobial Agents
Sistla Radha, Tameem Afroz, Sudheer Prasad, Nallagonda Ravindra
INTRODUCTION: Bronchoalveolar lavage (BAL) is a diagnostic procedure by which cells and other components from bronchial and alveolar spaces are obtained for various studies. One of the main advantages of BAL is that it can be done as a day care procedure. Material obtained by BAL can give a definite diagnosis in conditions such as infections and malignancies. AIMS: The aims and objective of this study were to assess the utility of BAL as a diagnostic tool to determine the diagnostic accuracy of the material obtained from BAL in various infections and neoplastic lesions to study the limitations of BAL in certain lung disorders...
July 2014: Journal of Cytology
Esmaeil Mortaz, Hoda Gudarzi, Payam Tabarsi, Ian M Adcock, Mohamad Reza Masjedi, Hamid Reza Jamaati, Johan Garssen, Ali Akbar Velayati, Frank A Redegeld
The use of flow cytometry in the clinical laboratory has grown substantially in the past decade. Flow cytometric analysis provides a rapid qualitative and quantitative description of multiple characteristics of individual cells. For example, it is possible to detect the cell size and granularity, aspects of DNA and RNA content and the presence of cell surface and nuclear markers which are used to characterize the phenotype of single cells. Flow cytometry has been used for the immunophenotyping of a variety of specimens including whole blood, bone marrow, serous cavity fluids, (cerebrospinal fluid) CSF, urine and all types of body fluids...
February 2015: Iranian Journal of Allergy, Asthma, and Immunology
Kondwani C Jambo, Dominic H Banda, Louise Afran, Anstead M Kankwatira, Rose D Malamba, Theresa J Allain, Stephen B Gordon, Robert S Heyderman, David G Russell, Henry C Mwandumba
RATIONALE: HIV-infected persons on antiretroviral therapy (ART) remain at higher risk of pulmonary tuberculosis (TB) than HIV-uninfected individuals. This increased susceptibility may be caused by impairment of alveolar macrophage (AM) function and/or mycobacteria-specific alveolar CD4(+) T-cell responses observed in HIV-infected ART-naive adults. OBJECTIVES: To determine whether ART was associated with improvement in both AM function, assessed by phagosomal proteolysis, and alveolar CD4(+) T-cell responses to Mycobacterium in HIV-infected individuals...
October 15, 2014: American Journal of Respiratory and Critical Care Medicine
Yusuke Tsujimura, Hiroyasu Inada, Misao Yoneda, Tomoyuki Fujita, Kazuhiro Matsuo, Yasuhiro Yasutomi
Many epidemiological studies have suggested that the recent increase in prevalence and severity of allergic diseases such as asthma is inversely correlated with Mycobacterium bovis bacillus Calmette Guerin (BCG) vaccination. However, the underlying mechanisms by which mycobacterial components suppress allergic diseases are not yet fully understood. Here we showed the inhibitory mechanisms for development of allergic airway inflammation by using highly purified recombinant Ag85B (rAg85B), which is one of the major protein antigens secreted from M...
2014: PloS One
Kerstin A Heyl, Tilman E Klassert, Annina Heinrich, Mario M Müller, Esther Klaile, Hendrik Dienemann, Christiane Grünewald, Robert Bals, Bernhard B Singer, Hortense Slevogt
UNLABELLED: The C-type lectin receptor Dectin-1 is expressed mainly on myeloid cells mediating the immune response targeting respiratory pathogens such as Aspergillus fumigatus and Mycobacterium tuberculosis. The pulmonary epithelium serves as an important interface for interactions between these pathogens and the respiratory tract. Therefore, we analyzed the expression pattern of Dectin-1 in the human lung. Immunohistochemically stained human lung sections from 17 out of 19 individuals were positive for Dectin-1, which was expressed mainly apically on bronchial and alveolar epithelium...
2014: MBio
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