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extrapulmonary tuberculosis

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https://www.readbyqxmd.com/read/29028148/follow-up-of-1887-patients-receiving-tumor-necrosis-alpha-antagonists-tuberculin-skin-test-conversion-and-tuberculosis-risk
#1
Tulin Cagatay, Zuleyha Bingol, Esen Kıyan, Zeynep Yegin, Gulfer Okumus, Orhan Arseven, Feyza Erkan, Ziya Gulbaran, Mustafa Erelel, Turhan Ece, Penbe Cagatay', Zeki Kılıçaslan
OBJECTIVES: To evaluate the characteristics of patients who developed tuberculosis while receiving tumor necrosis factor-alpha (TNF-α) antagonists and the related factors with tuberculosis. METHODS: Patient's demographics, tuberculin skin test (TST), isoniazid prophylaxis, type of TNF-α antagonist were recorded. TST conversion (>5mm increase) was evaluated for patients who had baseline and 1-year TST. RESULTS: Files of 1887 patients who were receiving TNF-α antagonists between August2005 and June 2015 were evaluated...
October 13, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29022963/tuberculous-osteomyelitis-of-orbit-a-case-report
#2
Chandana Chakraborti, Krittika Pal Choudhury, Jayanta Das
BACKGROUND: Orbital tuberculosis is a rare manifestation of extrapulmonary tuberculosis. We report an interesting case of osteomyelitis of orbital bone in an Indian child. CASE REPORT: A 9- year old girl presented with a gradually increasing painless swelling of left upper lid and blepharoptosis along with swelling of left side of forehead for last two months. The swelling was soft, fluctuating and non-tender. Diagnostic tap revealed thick pus which prompted us to do an incisional drainage of the abscess...
January 2017: Nepalese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29022528/diagnostic-accuracy-of-genexpert-mtb-rif-in-musculoskeletal-tuberculosis-high-sensitivity-in-tissue-samples-of-hiv-infected-and-hiv-uninfected-patients
#3
M Held, M Laubscher, L Workman, H J Zar, R Dunn
BACKGROUND: GeneXpert MTB/RIF is useful for the diagnosis of pulmonary TB in adults, but there is limited evidence on its usefulness in extrapulmonary TB. OBJECTIVES: To investigate the diagnostic accuracy of GeneXpert MTB/RIF in HIV-infected and HIV-uninfected patients with suspected musculoskeletal TB. METHODS: A prospective study of patients with suspected musculoskeletal (bone and joint) TB was undertaken. The diagnostic accuracy of GeneXpert MTB/RIF was compared with the reference standards of culture and histopathology...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29021926/enigma-of-extrapulmonary-tuberculosis-where-do-we-stand
#4
Faisal Inayat, Munnam S Jafar, Nouman Safdar Ali, Qulsoom Hussain, Abu Hurairah
Tuberculosis remains a worldwide public health concern. Atypical extrapulmonary presentations may delay its diagnosis and treatment. The present study illustrates the importance of ruling out extrapulmonary tuberculosis in patients presenting with nonspecific symptoms of abdominal diseases. Furthermore, we discuss the variety of clinical presentations, diagnostic challenges, current therapeutic protocols, and prognostic factors associated with extrapulmonary tuberculosis. Early diagnosis and effective treatment may decrease morbidity and mortality in such patients...
August 9, 2017: Curēus
https://www.readbyqxmd.com/read/29021660/18f-fludeoxyglucose-positron-emission-tomography-computed-tomography-guided-diagnosis-of-prostatic-and-leptomeningeal-tuberculosis
#5
Madhuri Shimpi Mahajan, Akshay Bedmutha, Natasha Singh
Genitourinary tuberculosis contributes to 10%-14% of extrapulmonary TB. Prostate tuberculosis is rare and usually found incidentally following transurethral resection of the prostate for benign prostatic hyperplasia. We report a case of an immunocompetent patient with pyrexia of unknown origin, on evaluation with whole-body 18F-fludeoxyglucose positron emission tomography computed tomography scan found to have suspicious prostatic primary, with hypermetabolic abnormalities involving the brain. Histopathological diagnosis was established as multifocal tuberculosis involving prostate, meninges, and intracranial tuberculomas...
October 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29021467/tuberculosis-of-the-wrist-accompanied-with-calcium-pyrophosphate-a-case-report
#6
Kenya Watanabe, Yoshitaka Yamazaki, Mariko Sugawara
This is a rare case of tuberculosis (TB) complicated with pseudogout of the wrist joint in a non-immunocompromised 84-year-old female with a history of pulmonary tuberculosis. She was diagnosed with extrapulmonary tuberculosis of the wrist based on a polymerase chain reaction (PCR) study and synovial fluid aspiration in which the cytology was positive for acid-fast bacilli. Calcium pyrophosphate was also positive. We must be careful not to miss articular tuberculosis as it may mimic common inflammatory arthritis, such as pseudogout of the wrist...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29017219/-consensus-based-guidelines-for-diagnosis-prevention-and-treatment-of-tuberculosis-in-children-and-adolescents-a-guideline-on-behalf-of-the-german-society-for-pediatric-infectious-diseases-dgpi
#7
C Feiterna-Sperling, F Brinkmann, C Adamczick, F Ahrens, M Barker, C Berger, L D Berthold, M Bogyi, U von Both, T Frischer, W Haas, P Hartmann, D Hillemann, F W Hirsch, K Kranzer, F Kunitz, E Maritz, A Pizzulli, N Ritz, R Schlags, T Spindler, S Thee, K Weizsäcker
Recently, epidemiological data shows an increase of childhood tuberculosis in Germany. In addition to this, drug resistant tuberculosis becomes more frequent. Therefore, diagnosis, prevention and therapy in childhood and adolescence remain a challenge. Adult guidelines do not work for children, as there are age specific differences in manifestation, risk of progression and diagnostic as well as therapeutic pathways.The German Society for Pediatric Infectious Diseases (DGPI) has initiated a consensus-based (S2k) process and completed a paediatric guideline in order to improve and standardize care for children and adolescents with tuberculosis exposure, infection or disease...
October 2017: Pneumologie
https://www.readbyqxmd.com/read/28993352/delays-in-diagnosis-and-treatment-of-extrapulmonary-tuberculosis-in-guatemala
#8
Pooja Ajay Shah, Merida Coj, Peter Rohloff
A 23-year-old indigenous Guatemalan man presented in 2016 to our clinic in Sololá, Guatemala, with 10 months of recurrent neck swelling, fevers, night sweats and weight loss. Previously, he had sought care in three different medical settings, including a private physician-run clinic, a tertiary private cancer treatment centre and, finally, a rural government health post. With assistance from our institution's accompaniment staff, the patient was admitted to a public tertiary care hospital for work-up. Rifampin-susceptible tuberculosis was diagnosed, and appropriate treatment was begun...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28991694/dilemmas-in-the-diagnosis-and-treatment-of-intracranial-tuberculomas
#9
REVIEW
Rajeswari Ramachandran, M Muniyandi, Vijay Iyer, T Sripriya, B Priya, T G Govindarajan
Tuberculosis (TB) remains a major public health problem across the globe. A common form of extrapulmonary TB (EPTB) with high mortality and morbidity is neuro TB or tuberculosis of the nervous system. The management of brain TB remains a big challenge due to the lack of specific diagnostic tools and appropriate treatment guidelines. In this context, this manuscript discusses clinical, diagnostic and treatment dilemmas in the management of intracranial tuberculomas. Brain tuberculoma may occur at any site within the cranium, no part of the brain substance or ventricular surface being exempt...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28974949/the-recombinant-bacille-calmette-gu%C3%A3-rin-vaccine-vpm1002-ready-for-clinical-efficacy-testing
#10
REVIEW
Natalie E Nieuwenhuizen, Prasad S Kulkarni, Umesh Shaligram, Mark F Cotton, Cyrill A Rentsch, Bernd Eisele, Leander Grode, Stefan H E Kaufmann
The only licensed vaccine against tuberculosis (TB), bacille Calmette-Guérin (BCG), protects against severe extrapulmonary forms of TB but is virtually ineffective against the most prevalent form of the disease, pulmonary TB. BCG was genetically modified at the Max Planck Institute for Infection Biology to improve its immunogenicity by replacing the urease C encoding gene with the listeriolysin encoding gene from Listeria monocytogenes. Listeriolysin perturbates the phagosomal membrane at acidic pH. Urease C is involved in neutralization of the phagosome harboring BCG...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28974222/treating-tuberculosis-with-high-doses-of-anti-tb-drugs-mechanisms-and-outcomes
#11
REVIEW
Yuhui Xu, Jianan Wu, Sha Liao, Zhaogang Sun
Tuberculosis (TB) is considered as one of the most serious threats to public health in many parts of the world. The threat is even more severe in the developing countries where there is a lack of advanced medical amenities and contemporary anti-TB drugs. In such situations, dosage optimization of existing medication regimens seems to be the only viable option. Therapeutic drug monitoring study results suggest that high-dose treatment regimens can compensate the low serum concentration of anti-TB drugs and shorten the therapy duration...
October 3, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28972418/challenges-in-pleural-tuberculosis-diagnosis-existing-reference-standards-and-nucleic-acid-tests
#12
Shaifali Tyagi, Neera Sharma, Jaya Sivaswami Tyagi, Sagarika Haldar
Pleural tuberculosis (pTB) is a grave form of extrapulmonary tuberculosis. Microbiological tests are usually found to be inadequate for pTB diagnosis. The absence of a uniform 'composite reference standard' is challenging; therefore, diagnosis is usually performed using a combination of diversified criteria. Nucleic acid tests vary in diagnostic accuracy and have not yet been integrated into clinical decision making. This review assesses the varied criteria used for pTB classification and the challenges afflicting pleural fluid-based DNA diagnostic tests, namely, PCR and Xpert(®) MTB/RIF...
October 2017: Future Microbiology
https://www.readbyqxmd.com/read/28959695/fatal-pulmonary-embolism-in-the-setting-of-immune-reconstitution-inflammatory-syndrome-attributed-to-ovarian-tuberculosis
#13
Israel Ugalde, Daniela Pirela, Saberio Lo Presti, Molly Bilderback, Andrés Pirela, Joseph Chan
In developed countries, tuberculosis remains a health care challenge due to human immunodeficiency virus (HIV) and immigration from endemic regions. The Centers for Disease Control and Prevention reported 9557 new cases in 2015, with extrapulmonary involvement in 20.2% of the cases. We present a 33-year-old woman from Cape Town, South Africa, who developed abdominal pain and fever while working on a cruise ship. She sought medical where she underwent computed tomography of her chest, abdomen, and pelvis with findings suggestive of pulmonary tuberculosis and an 8...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28957400/hiv-and-tuberculosis-co-infection-among-migrants-in-europe-a-systematic-review-on-the-prevalence-incidence-and-mortality
#14
Ana Maria Tavares, Inês Fronteira, Isabel Couto, Diana Machado, Miguel Viveiros, Ana B Abecasis, Sónia Dias
BACKGROUND: International human migration has been rapidly growing. Migrants coming from low and middle income countries continue to be considerably vulnerable and at higher risk for infectious diseases, namely HIV (Human Immunodeficiency Virus) and tuberculosis (TB). In Europe, the number of patients with HIV-TB co-infection has been increasing and migration could be one of the potential driving forces. OBJECTIVE: This systematic review aims to improve the understanding on the burden of HIV-TB co-infection among migrants in Europe and to assess whether these populations are particularly vulnerable to this co-infection compared to nationals...
2017: PloS One
https://www.readbyqxmd.com/read/28955338/cellular-architecture-of-spinal-granulomas-and-the-immunological-response-in-tuberculosis-patients-coinfected-with-hiv
#15
Debapriya Bhattacharya, Siva Danaviah, Daniel M Muema, Ngomu Akeem Akilimali, Prashini Moodley, Thumbi Ndung'u, Gobardhan Das
Mycobacterium tuberculosis (M.tb) and HIV are individually responsible for the most deaths worldwide among all infectious agents, and coinfection with M.tb and HIV is a significant public health challenge in the developing world. Although the lung is the primary target organ for tuberculosis (TB), M.tb can also cause extrapulmonary tuberculosis (EPTB) such as in the bones and joints. Treatment of EPTB is much more challenging than treatment of pulmonary TB. The hallmark of the host immune response against TB is the formation of organized structures called granulomas that are infiltrated with immune cells and are rich in cytokines and chemokines...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28951414/vitamin-d-status-in-tuberculosis-patients-with-diabetes-prediabetes-and-normal-blood-glucose-in-china-a-cross-sectional-study
#16
Xin Zhao, Yanli Yuan, Yan Lin, Tiejuan Zhang, Jianjun Ma, Wanli Kang, Yunlong Bai, Yunlong Wang, Hongshan Shao, Riitta A Dlodlo, Anthony D Harries
OBJECTIVE: The association between tuberculosis (TB), diabetes mellitus (DM) and vitamin D status is poorly characterised. We therefore: (1) determined vitamin D status in patients with TB in relation to whether they had normal fasting blood glucose (FBG), pre-DM or DM and (2) assessed whether baseline characteristics in patients with TB, including their DM status, were associated with vitamin D deficiency. METHODS: In patients with TB consecutively attending six clinics or hospitals in China, we measured 25-hydroxycholecalciferol (25-(OH)D3) at the time of registration using electrochemiluminescence in a COBASE 601 Roche analyser by chemiluminescence immunoassay...
September 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28947646/rhesus-macaques-are-more-susceptible-to-progressive-tuberculosis-than-cynomolgus-macaques-a-quantitative-comparison
#17
Pauline Maiello, Robert M DiFazio, Anthony M Cadena, Mark A Rodgers, Philana Ling Lin, Charles A Scanga, JoAnne L Flynn
In the past two decades, it has become increasingly clear that non-human primates, specifically macaques, are useful models for human tuberculosis (TB). Several macaque species have been used for TB studies, and questions remain about the similarities and differences in TB pathogenesis among macaque species, which can complicate decisions about the best species for a specific experiment. Here we provide a quantitative assessment, using serial positron emission tomography and computed tomography (PET-CT) imaging and precise quantitative determination of bacterial burdens, of low-dose M...
September 25, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28947041/treatment-outcomes-of-rifampin-sparing-treatment-in-patients-with-pulmonary-tuberculosis-with-rifampin-mono-resistance-or-rifampin-adverse-events-a-retrospective-cohort-analysis
#18
Shinhee Park, Kyung-Wook Jo, Sang Do Lee, Woo Sung Kim, Tae Sun Shim
BACKGROUND: Rifampin (RIF) mono-resistant tuberculosis (RMR-TB) is a rare disease. Current guidelines recommend that RMR-TB be treated as multidrug-resistant TB (MDR-TB) but the evidence is scarce. METHODS: We conducted a retrospective cohort study on pulmonary TB patients to investigate the characteristics and outcomes of RMR-TB. The characteristics of RMR-TB were compared with those with adverse events to rifampin (RAE-TB). RESULTS: Forty-four RMR-TB and 29 RAE-TB patients were enrolled...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28941855/diagnosis-of-clinically-suspected-and-unsuspected-tubercular-lymphadenopathy-by-cytology-culture-and-smear-microscopy
#19
Vivek Gupta, Arvind Bhake
BACKGROUND: Tubercular lymphadenopathy (TBLN) accounts for 20-40% cases of extrapulmonary tuberculosis. But the common presenting symptoms of tuberculosis like fever, cough, weight loss, fatigue, and night sweats are not always associated with tuberculosis lymphadenopathy, thereby, making its diagnosis difficult. Our aim was to study if Fine Needle Aspiration Cytology (FNAC) combined with Zeihl Neelsen stain and culture for Mycobacterium tuberculosis bacilli could improve the diagnostic accuracy in patients clinically suspected and unsuspected for tubercular lymphadenitis...
October 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28931830/circulating-mycobacterium-tuberculosis-dosr-latency-antigen-specific-polyfunctional-regulatory-il10-th17-cd4-t-cells-differentiate-latent-from-active-tuberculosis
#20
Srabanti Rakshit, Vasista Adiga, Soumya Nayak, Pravat Nalini Sahoo, Prabhat Kumar Sharma, Krista E van Meijgaarden, Anto Jesuraj Uk J, Chirag Dhar, George D Souza, Greg Finak, Stephen C De Rosa, Tom H M Ottenhoff, Annapurna Vyakarnam
The functional heterogeneity of T cell responses to diverse antigens expressed at different stages of Mycobacterium tuberculosis (Mtb) infection, in particular early secreted versus dormancy related latency antigens expressed later, that distinguish subjects with latent (LTBI), pulmonary (PTB) or extrapulmonary (EPTB) tuberculosis remains unclear. Here we show blood central memory CD4 T-cell responses specific to Mtb dormancy related (DosR) latency, but not classical immunodominant secretory antigens, to clearly differentiate LTBI from EPTB and PTB...
September 20, 2017: Scientific Reports
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