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Prayudi Santoso, Arto Y Soeroto, Rianita Juniati, Yovita Hartantri, Rudi Wisaksana, Bachti Alisjabana, Heda M Nataprawira, Ida Parwati
BACKGROUND: diagnostic of pulmonary TB in HIV patients is a problem due to non specific clinical features, or radiological appearance. HIV patients with CD4≤200 cells/mL infected with M. tuberculosis have less capacity in containing M. tuberculosis, developing granulomas, casseous necrosis, or cavities. This condition is caused by weakend inflammatory which later reduced sputum production and may cause false negative result. This study aimed to assess differences in the positivity level of acid fast bacilli (AFB) and cultures of M...
October 2017: Acta Medica Indonesiana
Azka Ali, Jason Chertoff, Christopher Harden, Dara Wakefield, James Wynne
Hypersensitivity pneumonitis (HSP) is a rare syndrome characterised by granulomatous inflammatory lung disease due to repeated sensitisation from a specific antigen. We present the case of a 61-year old male veteran with a history of nodular eczema who presented with 2 weeks of progressive dyspnoea on exertion and pleuritic chest pain. The patient was started on ustekinumab 5 weeks prior to presentation. Initial workup revealed ground-glass opacities on computed tomography (CT) scan of the chest. Cardiac workup was unrevealing with a normal myocardial perfusion stress test...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
Farah Idrees, Muhammad Irfan, Kauser Jabeen, Joveria Farooqi, Rumina Hasan
BACKGROUND: MTBDRplus line probe assay (LiPA) has been endorsed by the World Health Organization for pulmonary tuberculosis (TB) diagnosis. However, its value for Mycobacterium tuberculosis (MTB) detection in bronchoalveolar lavage (BAL) needs exploration. This study determined the diagnostic performance of MTBDRplus in BAL for MTB complex detection and isoniazid/rifampicin resistance in smear-negative and sputum scarce patients. MATERIALS AND METHODS: Retrospective evaluation of data (January-December 2013) from patients who underwent bronchoscopy was done...
April 2017: International Journal of Mycobacteriology
Monika Agrawal, Ashish Bajaj, Vinay Bhatia, Sarjana Dutt
INTRODUCTION: Tuberculosis remains one of the deadliest communicable diseases. There are number of tests available for the diagnosis of tuberculosis but conventional microscopy has low sensitivity and culture although gold standard, but takes longer time for positivity. On the other side, Nucleic acid amplification techniques due to its rapidity and sensitivity not only help in early diagnosis and management of tuberculosis especially in patients with high clinical suspicion like immunocompromised patients, history of contact with active tuberculosis patient etc...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Abdullah Şimşek, İlhami Yapıcı, Mesiha Babalık, Zekiye Şimşek, Mustafa Kolsuz
OBJECTIVE: To determine the proportional distribution of endobronchial tuberculosis (EBTB) subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. METHODS: This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. RESULTS: The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22...
May 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
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
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...
July 6, 2015: BMJ Case Reports
Abhamoni Baro, Ira Shah, Parmarth Chandane, Indu Khosla
Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease. Diagnosis is established by bronchoalveolar lavage (BAL), which has macroscopic 'milky appearance', and in the presence of typical computed tomography, findings are diagnostic of PAP but, however, the feature of periodic acid-Schiff-positive eosinophilic proteinaceous fluid raises the confidence of the diagnosis. We report late-onset PAP in a 10-year-old girl who had acid fast bacilli on an initial BAL examination, but was subsequently diagnosed as PAP...
June 2015: Oxford Medical Case Reports
K Madhuri, Smita Deshpande, Sujata Dharmashale, Renu Bharadwaj
BACKGROUND: Despite endorsement of the line probe assay (LPA) for the diagnosis of drug-resistant pulmonary tuberculosis patients, there is limited data available on the performance of LPAs in India, especially from high burden states like Maharashtra, for the early diagnosis and detection of drug resistance, in order to initiate timely and appropriate treatment. OBJECTIVE: To evaluate the utility of the line probe assay (LPA) for the early diagnosis of drug-resistant pulmonary tuberculosis as compared to the 'Gold standard' 1% proportion method (PM)...
April 2015: Journal of Global Infectious Diseases
Kanwal Fatima Khalil, Tariq Butt
OBJECTIVE: To measure the diagnostic yield of Bronchoalveolar Lavage (BAL) gene Xpert (Xpert MTB/RIF assay), to detect Mycobacterium tuberculosis (MTB) and rifampicin resistance and compare it with that of mycobacterial cultures in a suspected case of pulmonary tuberculosis. STUDY DESIGN: An analytical study. PLACE AND DURATION OF STUDY: Department of Pulmonology, Fauji Foundation Hospital (FFH), Rawalpindi, from December 2012 to August 2013...
February 2015: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Sandeep Arora, Arvinder Singh Bal, Sukriti Baveja, Aradhana Sood, Khushi Ram Rathi, Pradeep Patil
A 50-year-old male presented with recurrent swelling of the muzzle area of the face with history of low-grade intermittent fever of 3 year duration managed variously with antibiotics, systemic steroids, and antituberculous therapy. Skin biopsy revealed a granulomatous infiltration negative for acid-fast bacilli and leishmania donovan bodies. Immunochromatography test for rK 39 antigen and polymerase chain reaction for leishmania was positive. He was diagnosed as a case of post kala azar dermal leishmaniasis, managed with injection sodium stibogluconate and followed-up thereafter...
January 2015: Indian Journal of Dermatology
Karen S Strenge, Julie E Kunkel, Alan A George, Thomas Mailhiot, Samantha L Butler
OBJECTIVE: Reflexive testing of bronchoalveolar lavage (BAL) specimens with Gomori methenamine silver (GMS) and acid-fast bacillus (AFB) stains is not routinely performed by most institutions. Instead, these stains are usually ordered to evaluate for the presence of fungal elements and/or acid-fast organisms if initial histopathologic assessment suggests the presence of these pathogens. Our institution, however, performs these stains on all BAL specimens. Thus, we sought to determine whether this practice was cost effective, considering the turnaround time and diagnostic efficacy of these tests...
2015: Laboratory Medicine
Laleh Ehsani, Sujan C Reddy, Mario Mosunjac, Colleen S Kraft, Jeannette Guarner
Mycobacterium kansasii is a photochromogenic, slow-growing mycobacterium species that can cause pulmonary infection in patients with predisposing lung diseases, as well as extrapulmonary or disseminated disease in immunosuppressed patients. We describe a patient with a myelodysplastic syndrome, disseminated M kansasii infection, and ruptured aortic aneurysm. He had a recent diagnosis of mycobacterium cavitary lung lesions and was transferred to our facility for possible surgical intervention of an aortic aneurysm...
March 2015: Human Pathology
Zaw Min, Mohan Amlani
A 66-year-old male presented with chest pain, malaise, generalized weakness, and weight loss. He had been receiving etanercept injection for rheumatoid arthritis. Chest X-ray revealed a right upper lobe mass. Chest computed tomography (CT) showed a right apical mass, highly suggestive of a Pancoast tumor. The thoracic fluorine-18 fluoro-deoxy-glucose ((18)F-FDG) positron emission tomography (PET) scan demonstrated significantly high metabolic pulmonary lesions with the standardized uptake value (SUV) of 12...
2014: Case Reports in Pulmonology
Michael Ghobrial, Hany Farag
ILD Student/Resident Case Report PostersSESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Pulmonary Talcosis (PT) is a rare disease mostly due to inhalation of talc. Intravascular PT is a variant that might be seen in IVDU who inject crushed tablets. We report a case of PT in IVDU mimicking pneumonia with unique cutaneous foreign body giant cell reaction similar to the lung lesion.CASE PRESENTATION: A 63 yo AA male with a PMH of HTN, chronic HCV & h/o IVDU presented with persistent dry cough, worsening dyspnea & night sweats for more than 2 months...
October 1, 2014: Chest
Bashar Mourad, Hammad Bhatti, James Cury, Adil Shujaat
Miscellaneous Student/Resident Case Report Posters IISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Cocaine use is widespread in the United States, with 5 to 8 million current abusers. The principal method of intoxication is smoked cocaine, often referred to as "crack". It is the most commonly used illicit drug among patients seen in the emergency department, and the most frequent cause of drug-related deaths. Pulmonary sequelae include respiratory symptoms, such as persistent cough, wheeze, dyspnea and hemoptysis, deterioration in lung function, and pulmonary infiltrates or interstitial pneumonitis...
October 1, 2014: Chest
Richard May, Chinenye Emuwa, Amee Patrawalla, Andrew Berman
Infectious Disease Student/Resident CasesSESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 07:30 AM - 08:30 AMINTRODUCTION: Bacillus Calmette-Guerin (BCG) is a live attenuated bacterium derived from Mycobacterium bovis. When given intravesicularly, BCG is an effective form of immunotherapy for early-stage bladder cancer. Intravesical BCG treatment is usually well tolerated. Infrequently, systemic absorption of BCG can result in disseminated infection. We describe a case of disseminated Mycobacterium bovis infection in an immunocompetent adult after intravesical BCG immunotherapy...
October 1, 2014: Chest
O'Dene Lewis, Babak Shokrani, Doshi Saumil, Marc Phillpotts
SESSION TITLE: Infectious Disease Student/Resident Case Report Posters IIISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Toxoplasmosis is the most common parasitic opportunistic infection of the central nervous system (CNS) in AIDS patients who are not on appropriate prophylaxis. Extra-cerebral sites may be involved with or without CNS toxoplasmosis. Pulmonary involvement is uncommon but is second to the CNS as the major site of disease...
October 1, 2014: Chest
Walter James, Lisa Brath, Orlando Debesa
SESSION TITLE: Infectious Disease Cases IISESSION TYPE: Affiliate Case Report SlidePRESENTED ON: Wednesday, October 29, 2014 at 11:00 AM - 12:15 PMINTRODUCTION: Acute Respiratory Distress Syndrome (ARDS) is a disease with significant morbidity, mortality and cost. Pulmonary tuberculosis(TB) causing ARDS is rare. This case report describes a unique case of ARDS secondary to Pulmonary TB that was successfully managed with extracorporeal membrane oxygenation (ECMO). CASE PRESENTATION: A 31 year-old Liberian male was transferred with progressive respiratory failure requiring mechanical ventilation...
October 1, 2014: Chest
Christina Silkaitis, Laura Bardowski, Cara Coomer, Kathryn Trakas, Mary Alice Lavin, Susheel Reddy, Maureen K Bolon, Teresa R Zembower
Institution of appropriate airborne infection isolation (AII) precautions for patients with suspected Mycobacterium tuberculosis is critical to prevent disease transmission. We compared the yield of acid-fast bacilli smears from different types of respiratory specimens and found that smear sensitivity was highest for specimens obtained by endotracheal aspirates (92%), followed by sputum (79%), and then by bronchoalveolar lavage (37%). As a result of this study, our institutional policy regarding discontinuation of AII precautions was amended...
November 2014: American Journal of Infection Control
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