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extrapulmonary tuberculosis

Maritza Samayoa-Peláez, Nancy Ayala, Zaida E Yadon, Einar Heldal
Objective To assess whether the National Tuberculosis Program (NTP) guidelines for culture and drug sensitivity testing (DST) in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB) or previously treated TB, by documenting notification rates by department (geographic area), disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates...
January 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Begoña Santiago-García, Daniel Blázquez-Gamero, Fernando Baquero-Artigao, Jesús Ruíz-Contreras, Jose M Bellón, Maria A Muñoz-Fernández, María J Mellado-Peña
BACKGROUND: Children are at higher risk of tuberculosis (TB) dissemination and extrapulmonary disease, contributing greatly to TB-associated morbidity and long-term sequelae. However, there are very few studies that assess the impact and clinical spectrum of pediatric extrapulmonary TB (EPTB) in low-prevalence regions. METHODS: Children <18 years of age diagnosed with TB in Madrid region (2005-2013) were reviewed. We compared the epidemiology, clinical characteristics and the performance of diagnostic tests in childhood extrapulmonary and pulmonary disease...
November 2016: Pediatric Infectious Disease Journal
Amin S I Banaga, Nihad K Siddiq, Randa T Alsayed, Rasha Babiker, Khalifa Elmusharaf
Tuberculosis (TB) is a major health problem in the developing countries. There are limited data about the prevalence of TB patients on maintenance hemodialysis (HD) in Sudan. The aim of this study is to identify the prevalence and presentation of TB among Sudanese maintenance HD patients. This is a hospital-based descriptive study. The participants of the study are all HD patients distributed in 13 HD centers in Khartoum and Khartoum North Provinces in Sudan. All patients attended the HD centers from November 1, 2014 to February 1, 2015, were interviewed by a questionnaire focused on personal and clinical data...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Ranjana Arora, Lisa Armitige, Audrey Wanger, Robert L Hunter, Shen-An Hwang
Trehalose 6,6'dimycolate (TDM) is a glycolipid found in nearly pure form on the surface of virulent Mycobacterium tuberculosis (MTB). This manuscript investigated the production of TDM, growth rate and colony morphology of multiple strains of MTB, each of which had been isolated from both pulmonary (sputum) and extrapulmonary sites of multiple patients. Since sputum contains MTB primarily from cavities and extrapulmonary biopsies are typically granulomas, this provided an opportunity to compare the behavior of single strains of MTB that had been isolated from cavities and granulomas...
September 28, 2016: Tuberculosis
Jennifer K Roe, Niclas Thomas, Eliza Gil, Katharine Best, Evdokia Tsaliki, Stephen Morris-Jones, Sian Stafford, Nandi Simpson, Karolina D Witt, Benjamin Chain, Robert F Miller, Adrian Martineau, Mahdad Noursadeghi
BACKGROUND. Novel rapid diagnostics for active tuberculosis (TB) are required to overcome the time delays and inadequate sensitivity of current microbiological tests that are critically dependent on sampling the site of disease. Multiparametric blood transcriptomic signatures of TB have been described as potential diagnostic tests. We sought to identify the best transcript candidates as host biomarkers for active TB, extend the evaluation of their specificity by comparison with other infectious diseases, and to test their performance in both pulmonary and extrapulmonary TB...
October 6, 2016: JCI Insight
Padmavali Palange, Rahul Narang, Venkataramana Kandi
BACKGROUND: Laboratory diagnosis of tuberculosis has undergone a rapid change during last few years and a number of techniques for culture as well as molecular diagnosis have been used with their respective advantages and disadvantages. Sporadic studies have also reported the isolation of M. tuberculosis on standard blood agar (BA), which at one time was not considered as a suitable medium for mycobacterial culture. The present study was conducted to evaluate the routine use of 5% sheep BA in a mycobacteriology laboratory by comparing isolation rates and time for isolation of mycobacteria from pulmonary and extrapulmonary samples with those on Lowenstein-Jensen (LJ) medium...
August 30, 2016: Curēus
Preeti Sule, Ronak Tilvawala, Parnia Behinaein, Grant K Walkup, Jeffrey D Cirillo
Although tuberculosis (TB) is one of the most common causes of morbidity and mortality in humans worldwide and diagnostic methods have been in place for more than 100 years, diagnosis remains a challenge. The main problems with diagnosis relate to the time needed to obtain a definitive result, difficulty in obtaining sputum, the primary clinical material used, and the ability of the causative agent, Mycobacterium tuberculosis, to cause disease in nearly any tissue within the body. In order to decrease incidence of TB, discovery of a novel interventions will be required, since current technologies have only been able to control numbers of infections, not reduce them...
September 28, 2016: Tuberculosis
Xu Qian, Duc T M Nguyen, Yaojun Li, Jianxin Lyu, Edward A Graviss, Tony Y Hu
BACKGROUND: There is an urgent need for methods that can rapidly and accurately assess therapeutic responses in patients with active tuberculosis (TB) in order to predict treatment outcomes. Exposure to bacterial pathogens can rapidly activate the plasma contact system, triggering the release of bradykinin (BK) and its metabolite desArg(9)-bradykinin (DABK) to induce inflammation and innate immune responses. We hypothesized that serum BK and DABK levels might act as sensitive immune response signatures for changes in Mycobacterium tuberculosis (Mtb) burden, and therefore examined how serum levels of these markers corresponded with anti-TB therapy in a small cohort of active TB cases...
September 28, 2016: Tuberculosis
James Benjamin Gleason, Basheer Tashtoush, Jinesh Mehta, Edward Savage, Felipe Martinez, Atul C Mehta
Extrapulmonary tuberculosis refers to Mycobacterium tuberculosis involving organs other than the lungs (eg, pleura, lymph nodes, genitourinary tract, abdomen, skin, joints and bones, or meninges). In non-HIV-endemic areas, where reactivation is the predominant mechanism of tuberculosis, pleural involvement occurs in 4% of cases. We present an extremely rare case of a 62-year-old immunocompetent patient with pleural tuberculosis confirmed by surgical pleural biopsies, who presented with a large mediastinal mass and evidence of pulmonary artery invasion on CT scanning and endobronchial ultrasonography imaging, highlighting a unique and malignant-like character of the disease...
October 2016: Chest
Kathrin Zürcher, Marcel Zwahlen, Marie Ballif, Hans L Rieder, Matthias Egger, Lukas Fenner
BACKGROUND: Tuberculosis (TB) mortality declined in the northern hemisphere over the last 200 years, but peaked during the Russian (1889) and the Spanish (1918) influenza pandemics. We studied the impact of these two pandemics on TB mortality. METHODS: We retrieved historic data from mortality registers for the city of Bern and countrywide for Switzerland. We used Poisson regression models to quantify the excess pulmonary TB (PTB) mortality attributable to influenza...
2016: PloS One
Nicola Casali, Agnieszka Broda, Simon R Harris, Julian Parkhill, Timothy Brown, Francis Drobniewski
BACKGROUND: A large isoniazid-resistant tuberculosis outbreak centred on London, United Kingdom, has been ongoing since 1995. The aim of this study was to investigate the power and value of whole genome sequencing (WGS) to resolve the transmission network compared to current molecular strain typing approaches, including analysis of intra-host diversity within a specimen, across body sites, and over time, with identification of genetic factors underlying the epidemiological success of this cluster...
October 2016: PLoS Medicine
M El Amrani, M Asserraji, A Bahadi, D El Kabbaj, M Benyahia
Chronic uremia puts patients at increased risk of infectious complications, in particular, tuberculosis. In this prospective study, we analyzed the clinical, paraclinical, and therapeutic features as well as outcome for all patients on chronic hemodialysis with tuberculosis from January 2010 through August 2012. Sixty-one patients were admitted for bacterial infections, 23% of them for tuberculosis. Fever was present in 71% of cases, and CRP elevated in all cases. The tuberculin skin test was positive in only 2 of 9 cases, and Mycobacterium tuberculosis isolated in 2 of 10 cases...
August 1, 2016: Médecine et Santé Tropicales
Michał Zieliński, Henryka Mazur-Zielińska, Jerzy Kozielski
Due to an increasing amount of patients on immunosuppressive treatment, the number of tuberculosis (TB) of atypical course and extrapulmonary tuberculosis cases increase. Locomotor system is a place of every fifth case of extrapulmonary TB. Because of lack of characteristic symptoms, as well as rare co-occurrence of active lung lesions in radiological imaging, proper diagnosis is hard to establish. We present a case of patient on immunosuppressive therapy due to myositis, in whom we diagnosed musculoskeletal tuberculosis in form of involvement of tendon sheath and formation of synovial cyst...
2016: Pneumonologia i Alergologia Polska
George Sikalengo, Adria Ramirez, Diana Faini, Kim Mwamelo, Manuel Battegay, Levan Jugheli, Christoph Hatz, Klaus Reither, Emilio Letang
BACKGROUND: Extrapulmonary tuberculosis (EPTB) is associated with high rates of morbidity and mortality. Diagnosis of EPTB is challenging in resource-limited settings due to difficulties in obtaining samples, as well as the paucibacillarity of the specimens. Skeletal tuberculosis accounts for 10-35 % of EPTB cases, with vertebral osteomyelitis (Pott's disease) representing 50 % of the cases. We present two cases of suspected Pott's disease, diagnosed through GeneXpert MTB/RIF assay in urine at a rural Tanzanian hospital...
September 26, 2016: BMC Infectious Diseases
Ozgul Yigit, Meltem Erol, Ozlem Bostan Gayret, Isıl Ustun, Selami Ulas
INTRODUCTION: Tuberculosis remains a major public health problem in developing countries. Diagnosing extrapulmonary tuberculosis can be difficult, as it requires a higher index of suspicion than primary tuberculosis. Extrapulmonary tuberculosis may mimic malignancies and many other diseases, so it should be included in the differential diagnosis. Here, we present a case of extrapulmonary tuberculosis associated with Pott's disease and hip arthritis in a patient who recovered after 12 months of antituberculosis therapy...
July 2016: Iranian Red Crescent Medical Journal
Mei Yuan, Yan Lyu, Su Ting Chen, Chao Cai, Yuan Li, Zhi Guo Zhang, Yun Xu Li, Ling Ling Dong, Yu Hong Fu, Hai Rong Huang, Ji Min Gao, Wei Min Li
We evaluate the performance of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis (EPTB) in China. The performance of Xpert was evaluated compared to the composite reference standard (CRS), drug susceptibility testing (DST), and imaging examination. The overall sensitivity and specificity of Xpert were 64.1% (195/304) and 100% (24/24), respectively, using CRS as the gold standard. The sensitivity was significantly higher than that of culture for pus (P<0.05). The proportion of EPTB-positive cases diagnosed by imaging was two times more than that diagnosed using Xpert; however, 6 out of 19 cases may have been overdiagnosed by imaging...
August 2016: Biomedical and Environmental Sciences: BES
C Trigo, P E A A do Brasil, M J M Costa, L de Castro
Occult hepatitis B virus infection (OBI) is characterized by the absence of HBsAg and persistence of the virus genome (HBV-DNA) in liver tissue and/or blood. OBI has been reported in several clinical contexts. However, the clinical significance of OBI in tuberculosis (TB) treatment is unknown. We investigated the OBI prevalence and its impact on the risk of drug-induced liver injury (DILI) during TB treatment. This was a prospective cohort study with one hundred patients who were treated for TB from 2008 to 2015...
September 13, 2016: Journal of Viral Hepatitis
Adrián Peñata, Richard Salazar, Tatiana Castaño, Julián Bustamante, Sigifredo Ospina
INTRODUCTION: Tuberculosis continues to be a global public health problem, the extrapulmonary form being estimated to occur in 10-20% of immunocompetent individuals, increasing in patients who are carriers of the human immunodeficiency virus (HIV); its diagnosis is difficult with conventional methods due to the paucibacillary nature of samples. The Xpert® MTB/RIF test represents an important development in the molecular detection of Mycobacterium tuberculosis and has been used with a variety of non-respiratory clinical samples...
2016: Biomédica: Revista del Instituto Nacional de Salud
Johanna Osorio, Jackeline Barreto, Jhonattan Benavides, Óscar López, Ángela Cuenca, Esperanza García
Tuberculous pyomyositis is a rare manifestation of extrapulmonary tuberculosis, most common in immunosuppressed patients, with clinical manifestations similar to pyomyositis of other etiologies, although with a lower age of presentation; notable risk factors include prior tuberculosis infection and pharmacological immunosuppression. Diagnosis depends on a high clinical suspicion of the infection in a susceptible population, given that microbiological isolation is often impossible. The response to treatment and prognosis are good...
2016: Biomédica: Revista del Instituto Nacional de Salud
Payam Nahid, Susan E Dorman, Narges Alipanah, Pennan M Barry, Jan L Brozek, Adithya Cattamanchi, Lelia H Chaisson, Richard E Chaisson, Charles L Daley, Malgosia Grzemska, Julie M Higashi, Christine S Ho, Philip C Hopewell, Salmaan A Keshavjee, Christian Lienhardt, Richard Menzies, Cynthia Merrifield, Masahiro Narita, Rick O'Brien, Charles A Peloquin, Ann Raftery, Jussi Saukkonen, H Simon Schaaf, Giovanni Sotgiu, Jeffrey R Starke, Giovanni Battista Migliori, Andrew Vernon
The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline...
October 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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