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corticosteroids therapy in tuberculosis

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https://www.readbyqxmd.com/read/28884751/tuberculous-meningitis
#1
REVIEW
Robert J Wilkinson, Ursula Rohlwink, Usha Kant Misra, Reinout van Crevel, Nguyen Thi Hoang Mai, Kelly E Dooley, Maxine Caws, Anthony Figaji, Rada Savic, Regan Solomons, Guy E Thwaites
Tuberculosis remains a global health problem, with an estimated 10.4 million cases and 1.8 million deaths resulting from the disease in 2015. The most lethal and disabling form of tuberculosis is tuberculous meningitis (TBM), for which more than 100,000 new cases are estimated to occur per year. In patients who are co-infected with HIV-1, TBM has a mortality approaching 50%. Study of TBM pathogenesis is hampered by a lack of experimental models that recapitulate all the features of the human disease. Diagnosis of TBM is often delayed by the insensitive and lengthy culture technique required for disease confirmation...
September 8, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28883243/an-hiv-positive-case-of-obstructive-jaundice-caused-by-immune-reconstitution-inflammatory-syndrome-of-tuberculous-lymphadenitis-successfully-treated-with-corticosteroids
#2
Naoaki Watanabe, Ryota Sato, Hideaki Nagai, Hirotoshi Matsui, Akira Yamane, Masahiro Kawashima, Junko Suzuki, Hiroyuki Tashimo, Nobuharu Ohshima, Kimihiko Masuda, Atsuhisa Tamura, Shinobu Akagawa, Akira Hebisawa, Ken Ohta
A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after the initiation of anti-tuberculous therapy. Two weeks later, jaundice appeared with dilatation of the biliary tract due to further enlargement of the lymph nodes, which seemed to be immune reconstitution inflammatory syndrome (IRIS)...
September 6, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28767612/pyoderma-gangrenosum-in-a-patient-with-chronic-granulomatous-disease-a-case-report
#3
Sideris Nanoudis, Afroditi Tsona, Olga Tsachouridou, Petros Morfesis, Georgia Loli, Adamantini Georgiou, Pantelis Zebekakis, Symeon Metallidis
RATIONALE: The simultaneous occurrence of pyoderma gangrenosum (PG) and chronic granulomatous disease (CGD) is uncommon and few cases have been reported worldwide. PATIENT CONCERNS: PG is a rare, chronic, ulcerative, neutrophilic skin disease of unknown etiology that requires immunosuppressive treatment. CGD belongs to Primary Immune Deficiencies in which the main defect lies in an inability of the phagocytic cells to generate superoxide making patients susceptible to serious, potentially life-threatening bacterial and fungal infections...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28714745/long-term-use-of-inhaled-corticosteroids-and-risk-of-upper-respiratory-tract-infection-in-chronic-obstructive-pulmonary-disease-a-meta-analysis
#4
Mingjin Yang, Hong Chen, Yan Zhang, Yuejun Du, Ying Xu, Ping Jiang, Zhibo Xu
Recent studies have suggested that inhaled corticosteroids (ICS) may be associated with higher risks of tuberculosis and pneumonia in patients with COPD. However, it is not known whether ICS increases the risk of upper respiratory tract infection (URTI). Aim of this study was to explore the relationship between ICS and URTI. Through a comprehensive literature search of PubMed, EMBASE, Cochrane Library, and Google Scholar from inception to March 2016, we identified randomized controlled trials of ICS therapy lasting at least 6 months...
April 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28690859/case-report-of-a-lupus-patient-with-a-severe-flare-and-miliary-tuberculosis-need-for-proper-guidelines-for-management
#5
Masooma Hashmat, Ramsa Suhail Rana, Tafazzul-E-Haque Mahmud, Aflak Rasheed, Ata Ur Rehman, Syed Ali Rukh Pirzada, Muhammad Ammad Asghar, Sadia Asif, Amjad Ali
Systemic lupus erythematosus (SLE) is an autoimmune disease that is frequently treated with high doses of corticosteroids and other immunosuppressive drugs. Thus patients with SLE are at increased risk for infections with several pathogens including Mycobacterium tuberculosis. There are no established guidelines available for treatment of tuberculosis in SLE patients with high disease activity due to lack of relevant studies and management based more on physician expertise. We report a case of a young SLE patient with high disease activity index (SLEDAI19) as evidenced by the presence of a vasculitic rash, non-healing ulcer on forearm and proteinuria of >1 g/d along with miliary tuberculosis...
July 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28670226/management-of-crohn-s-disease-in-taiwan-consensus-guideline-of-the-taiwan-society-of-inflammatory-bowel-disease
#6
REVIEW
Shu-Chen Wei, Ting-An Chang, Te-Hsin Chao, Jinn-Shiun Chen, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tien-Yu Huang, Tzu-Chi Hsu, Chun-Chi Lin, Hung-Hsin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Yuk-Ming Tsang, Cheng-Yi Wang, Horng-Yuan Wang, Meng-Tzu Weng, Deng-Chyang Wu, Wen-Chieh Wu, Hsu-Heng Yen, Jau-Min Wong
Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD...
July 2017: Intestinal Research
https://www.readbyqxmd.com/read/28646434/performance-of-quantiferon-%C3%A2-tb-gold-in-tube-assay-in-children-receiving-disease-modifying-anti-rheumatic-drugs
#7
Francesca Gabriele, Maria Trachana, Maria Simitsopoulou, Polixeni Pratsidou-Gertsi, Elias Iosifidis, Zoi Dorothea Pana, Emmanuel Roilides
BACKGROUND: To evaluate the performance of the Quantiferon(®)-TB Gold In-Tube (QFT-IT) interferon (IFN)-γ assay for the detection of latent tuberculosis infection (LTBI) in children receiving anti-rheumatic treatment in a tertiary referral hospital of Northern Greece. METHODS: A total of 79 consecutive children receiving anti-rheumatic treatment [of which 18 screened prior to antitumor necrosis factor (TNF)-α treatment] were tested using Mantoux tuberculin skin test (TST) and QFT-IT...
June 22, 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28586583/eales-disease
#8
Mohammad Naeem Khan, Syed Shahmeer Raza, Shayan Qadir, Hana Rehman, Amer Kamal Hussain, Muhammad Daniyal Nadeem, Farhan Ullah
Eales disease is an eponym after a British ophthalmologist Henry Eales. The aetiology behind Eales disease is ill-understood and stands controversial. Various systemic diseases associated with peripheral retinal revascularization and Retinal vasculitis could imitate the proliferative and inflammatory phases of Eales' disease, respectively. We present a case of a 30 years old female patient with Eales disease and discuss the clinical features, treatment plan and its outcome in our patient. Tuberculosis appears to be the cause of Eales disease but the relation is yet to be established and clinically proven...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28534271/optic-disc-granuloma-with-epididymitis-a-diagnostic-challenge
#9
Parthopratim Dutta Majumder, Sowkath Ali, Jyotirmay Biswas
BACKGROUND: Sarcoidosis and tuberculosis (TB) share epidemiological, immunological, and molecular features common to both, and often, it becomes difficult to differentiate them especially in a highly TB-endemic country like India. We report a case of optic disc granuloma along with epididymitis and infertility in a male who showed a response to treatment with anti-tuberculosis therapy and steroids. RESULTS: A 35-year-old Indian male who presented with complaints of blurring vision in the right eye for 6 months and treated elsewhere with two intravitreal injections of anti-VEGF was found to have optic disc granuloma in the right eye...
December 2017: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/28463219/-possible-paradoxical-reaction-to-treatment-of-tubercular-meningitis-in-an-hiv-negative-patient
#10
Ana C Rey Deutsch, Luz M Curi Dasso, José Stringa, Sebastián Grinspon, Mariano Volpachio, Octavio Mazzocchi
The paradoxical response to tuberculosis treatment consists in the appearance of new clinical or radiologic manifestations or worsening of previous injuries after an initial improvement with anti-tuberculosis therapy. It can be observed in 6 to 30 percent of the cases of tubercular meningitis. It is the consequence of an exaggerated immune reaction that should be considered since the treatment is based on the use of immunomodulators and not in the change of anti-tuberculous drugs. We present the case of an HIV negative adult with tuberculous meningitis with a good initial response to specific therapy who showed, 10 weeks later, a paradoxical reaction to treatment that responded successfully to corticosteroids...
2017: Medicina
https://www.readbyqxmd.com/read/28458584/anti-vegf-therapy-for-central-retinal-vein-occlusion-caused-by-tuberculosis-associated-uveitis-a-case-report
#11
Manzo Taguchi, Yutaka Sakurai, Takayuki Kanda, Masaru Takeuchi
BACKGROUND: Tuberculosis (TB)-associated uveitis presents periphlebitis, occasionally causing central retinal vascular occlusion (CRVO). Intravitreal injection of ranibizumab (IVR) is an effective treatment for CRVO, which improves macular edema (ME) by reducing vascular permeability and prevents progression of retinal nonperfusion in CRVO. We report a case of CRVO due to TB-associated uveitis, which initially remitted by repeated IVR as an adjunct to anti-TB therapy and systemic corticosteroids, but subsequently led to severe vitreous hemorrhage (VH)...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28427701/multiple-sclerosis-showing-elevation-of-adenosine-deaminase-levels-in-the-cerebrospinal-fluid
#12
Miharu Samuraki, Kenji Sakai, Yasuko Odake, Mitsuhiro Yoshita, Kouichi Misaki, Mitsutoshi Nakada, Masahito Yamada
An 80-year-old man developed dysarthria, quadriplegia, sensory disturbance and ataxia in all limbs. Brain and spinal magnetic resonance imaging (MRI) revealed multiple enhanced lesions. Cerebrospinal fluid (CSF) levels of adenosine deaminase (ADA) remarkably elevated. Tuberculosis DNA was not detected, and tuberculosis was not cultured either in the CSF. Brain biopsy revealed the inflammatory demyelinating lesions. With the diagnosis of multiple sclerosis, corticosteroid therapy resulted in rapid improvement of his symptoms and MRI abnormalities...
April 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28405483/treatment-results-in-serpiginous-choroiditis-and-multifocal-serpiginoid-choroiditis-associated-with-latent-tuberculosis
#13
Merih Oray, Zaur Zakiev, Tülin Çağatay, İlknur Tuğal-Tutkun
OBJECTIVES: To compare the results of systemic antitubercular therapy (ATT) and immunomodulatory therapy (IMT) in patients with serpiginous choroiditis (SC) or multifocal serpiginoid choroiditis (MSC). MATERIALS AND METHODS: The clinical records of 28 patients with SC and MSC were reviewed. Patients were divided into 2 groups according to the treatment applied. Group 1 included 12 patients with MSC and 5 with SC treated with ATT and corticosteroid (CS); group 2 included 9 patients with MSC and 2 with SC treated with conventional IMT, interferon alpha-2a, and/or CS monotherapy...
April 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28387180/mycobacterium-marinum
#14
REVIEW
Alexandra Aubry, Faiza Mougari, Florence Reibel, Emmanuelle Cambau
Mycobacterium marinum is a well-known pathogenic mycobacterium for skin and soft tissue infections and is associated with fishes and water. Among nontuberculous mycobacteria (NTM), it is the leading cause of extrarespiratory human infections worldwide. In addition, there is a specific scientific interest in M. marinum because of its genetic relatedness to Mycobacterium tuberculosis and because experimental infection of M. marinum in fishes mimics tuberculosis pathogenesis. Microbiological characteristics include the fact that it grows in 7 to 14 days with photochromogenic colonies and is difficult to differentiate from Mycobacterium ulcerans and other mycolactone-producing NTM on a molecular basis...
April 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28384925/sle-and-tuberculosis-a-case-series-and-review-of-literature
#15
Prasanta Kumar Bhattacharya, Md Jamil, Aakash Roy, Kishore Kumar Talukdar
Systemic Lupus Erythematosus (SLE) and Tuberculosis (TB) are intricately related with an increase in the risk of TB in SLE. Primary mechanisms pertaining to the increased susceptibility for TB are the inherent immunodeficient state of SLE and use of immunosuppressant agents in the treatment of SLE. We report a case series of five female patients of SLE with TB who presented between January 2015 and December 2015 in a tertiary care teaching hospital in North Eastern India. All the patients were young to middle aged females having SLE with or without lupus nephritis who were on immunosuppressive therapy with corticosteroids, mycophenolate mofetil or cyclophosphamide...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28329650/increased-risk-of-opportunistic-infections-among-patients-with-moderate-to-severe-psoriasis-a-population-based-cohort-study-in-the-united-kingdom
#16
Junko Takeshita, Daniel B Shin, Alexis Ogdie, Joel M Gelfand
Infection is the second leading cause of death among psoriasis patients on phototherapy or systemic medications. The types of infections associated with psoriasis remain poorly understood. The aim of our study was to determine the risk of opportunistic infection (OI) among patients with psoriasis. We conducted a cohort study of patients with (N=199,700) and without (N=954,315) psoriasis in The Health Improvement Network electronic medical record database. Patients receiving phototherapy or systemic therapy were considered to have moderate-to-severe psoriasis (N=12,442)...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28318350/clinical-course-and-outcomes-of-pediatric-tubercular-uveitis-in-north-india
#17
Savleen Kaur, Kanika Aggarwal, Aniruddha Agarwal, Deepti Suri, Anju Gupta, Ramandeep Singh, Reema Bansal, Surjit Singh, Nirbhai Singh, Amod Gupta, Vishali Gupta
PURPOSE: To analyze the clinical features, course, management, and outcomes of tubercular (TB) uveitis in the pediatric population and assess the response to anti-tubercular therapy (ATT). METHODS: Hospital records of children (≤16 years) from a large tertiary-care institute between January 2001 and December 2015 were reviewed. RESULTS: A total of 32 children (mean age: 10.7 ± 4.27 years; range 2-16) were diagnosed with TB-associated uveitis...
March 20, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28297815/-clinical-characteristics-and-prognosis-of-mediastinal-fibrosis
#18
J P Liao, Y Hu, J X Qiu, Z Jin, H Zhang, J Ma, G F Wang
Objective: To investigate the clinical characteristics and prognosis of mediastinal fibrosis. Methods: Twelve patients with mediastinal fibrosis diagnosed between 2008 and 2015 in our hospital were studied retrospectively. Clinical manifestations, radiological characteristics, endoscopic features, treatment and prognosis were analyzed. Results: There were 3 males and 9 females, with a mean age of 68.8 years.Six patients had previous tuberculosis infection. The most common clinical symptoms were dyspnea on exertion (11 cases), cough (7 cases), and wheezing (6 cases)...
March 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28281443/central-nervous-system-tuberculosis
#19
REVIEW
John M Leonard
Central nervous system tuberculosis (CNS-TB) takes three clinical forms: meningitis (TBM), intracranial tuberculoma, and spinal arachnoiditis. TBM predominates in the western world and presents as a subacute to chronic meningitis syndrome with a prodrome of malaise, fever, and headache progressing to altered mentation and focal neurologic signs, followed by stupor, coma, and death within five to eight weeks of onset. The CSF formula typically shows a lymphocytic pleocytosis, and low glucose and high protein concentrations...
March 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28279633/kikuchi-fujimoto-disease-a-rare-cause-of-lymphadenopathy-in-africa-description-of-the-first-case-in-senegal-and-review-of-the-literature
#20
C-A Lame, B Loum, A-K Fall, J Cucherousset, A-R Ndiaye
INTRODUCTION: Kikuchi-Fujimoto disease, or histiocytic necrotizing lymphadenitis, is a benign disease most commonly affecting adult females. It generally presents in the form of febrile cervical lymphadenopathy. This diagnosis must be considered in the setting of tropical medicine, dominated by a high prevalence of tuberculous lymphadenitis and haematological malignancies. CASE REPORT: The authors report the case of a 33-year-old Senegalese woman who presented with subacute cervical lymphadenopathy associated with fever and laboratory signs of inflammation...
March 6, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
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