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Sample records for active pulmonary tuberculosis

  1. s-Findings of active pulmonary tuberculosis in computed tomography

    Purpose: Tuberculosis remains the most important infectious disease all over the world. We report on the CT findings of lung tuberculosis. Material and methods: Standardised retrospective analysis of the computed tomographic examinations in a total of 100 patients suffering from cultural or histological proven pulmonary tuberculosis. Results: The most common finding in our study group were micronodules and lobular opacities accompanied by enlarged lymph nodes. Cavitation and alteration of the bronchial system (esp. bronchial wall thickening) were found less common. The so-called tree- in bud-appearance which had been estimated by other authors to be rather characteristic for active pulmonary tuberculosis was seen in only 12/100 examinations. It is often found in cases showing severe bronchogenic spreading of the disease. Conclusion: The active pulmonary tuberculosis does not show any pathognomonic sign but the combination of findings as opacities and cavitation and segmental spreaded micronodules make the diagnosis probable. This holds also for the so-called tree- in-bud appearances which may be rather suggestive but is seen only in cases suffering from severe bronchiogenic propagation. (orig.)

  2. Macrophage activation and resistance to pulmonary tuberculosis.

    Lefford, M J

    1980-01-01

    Mice were vaccinated with 300 micrograms of BCG cell walls (BCG-CW) in oil-in-water emulsion intravenously or with a high or low dose of living BCG by inhalation (BCG-HD or BCG-LD, respectively). The consequences of vaccination were evaluated in terms of the growth of BCG in the lungs and spleen, lung and spleen weight, resistance to intravenous and airborne challenge with Listeria monocytogenes, airborne challenge with virulent Mycobacterium tuberculosis H37Rv, and transfer of adoptive immun...

  3. 38 CFR 3.370 - Pulmonary tuberculosis shown by X-ray in active service.

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Pulmonary tuberculosis... Rating Considerations Relative to Specific Diseases § 3.370 Pulmonary tuberculosis shown by X-ray in active service. (a) Active disease. X-ray evidence alone may be adequate for grant of direct...

  4. The usefulness of 99mTc-MIBI in the detection of active pulmonary tuberculosis

    The use of radiopharmaceuticals in evaluation of pulmonary tuberculosis may help to resolve difficult diagnostic problems such as discordance between sputum examinations and chest roentgenographic findings. We investigated the usefulness of 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy in the detection of active pulmonary tuberculosis. Forty-six patients with suspected active pulmonary tuberculosis were studied with sputum smear of AFB, sputum AFB culture, chest X-ray and MIBI scan. MIBI image was obtained 15 and 60 min after intravenous injection of 370MBq(10mCi) 99mTc-MIBI. In 16 patients of them Ga scans were performed in addition to MIBI scan. Repeated MIBI scans were done in 7 patients with active pulmonary tuberculosis after 4∼6 months of antituberculous chemotherapy. Thirty-two patients were confirmed as active tuberculosis by sputum culture. Sensitivity of MIBI scan to active tuberculosis was 87.5%(28/32) and MIBI findings were negative in all of 14 patients with inactive disease. Focal uptake of MIBI was dense in the area that was strongly suggested active tuberculous lesions by chest roentgenogram. There was no discordance between MIBI and Ga image in 16 patients. But the uptake areas of Ga images were broader than that of MIBI images. After 4∼6 months of antituberculous treatment all repeated MIBI scans revealed negative findings except 1 patient with persistent active pulmonary tuberculosis due to drug resistance. MIBI scan could be used in the detection of active pulmonary tuberculosis as a useful noninvasive diagnostic tool

  5. Analysis of immune responses against a wide range of Mycobacterium tuberculosis antigens in patients with active pulmonary tuberculosis

    Kassa, D.; Ran, L.; Geberemeskel, W.; Tebeje, M; Alemu, A.; Selase, A.; Tegbaru, B.; Franken, K. L. M. C.; Friggen, A. H.; van Meijgaarden, K. E.; Ottenhoff, T. H. M.; Wolday, D.; Messele, T.; van Baarle, D.

    2012-01-01

    Characterizing host immune responses to molecular targets of Mycobacterium tuberculosis is essential to develop effective immunodiagnostics and better vaccines. We investigated the immune response against a large series of M. tuberculosis antigens, including 5 classical and 64 nonclassical (39 DosR regulon-encoded, 4 resuscitation-promoting factor [RPF], and 21 reactivation-associated) antigens in active-pulmonary-tuberculosis (TB) patients. Whole blood from TB patients (n = 34) was stimulate...

  6. Determination of the activity of pulmonary tuberculosis : the utility of high-resolution computed tomography

    Chung, Myung Hee; Lee, Hae Giu; Yu, Won Jong; Chung, Hong Jun; Yang, Bo Sung; Kwon, Soon Suck; Park, Seog Hee [The Catholic University of Korea, Seoul (Korea, Republic of)

    2000-05-01

    To evaluate the utility of high-resolution computed tomography (HRCT), as used to determine the activity of tuberculosis, and to analyze the HRCT findings in active and in inactive tuberculosis. We analyzed the HRCT findings of 100 patients (54 men, 46 women; average age, 54 years) who according to the results of chest radiography had pulmonary tuberculosis of undetermined activity. We assessed HRCT findings such as the presence of a centrilobular, macro-, or micronodule; consolidation, ground-glass opacity, cavity, interlobular septal thickening, irregular linear opacities, bronchial wall thickening, bronchovascular bundle distortion, bronchiectasis, atelectasis, and pericicatrical emphysema. We compared the ratio of the area of nodule and consolidation to that of whole lung, and compared the findings between active and inactive tuberculosis. Eleven of 100 patients were excluded because the final diagnosis was other than tuberculosis. In 59 patients, the presence of active pulmonary tuberculosis was proven by positive sputum smear and/or culture for mycobacterium tuberculosis. On the basis of the negative results of these tests, pulmonary tuberculosis was found to be inactive in 30 patients; serial chest radiographs indicated that their condition remained stable over a 6-month period. For HRCT, sensitivity was 96.6%, specificity 56.7%, positive predictive value 81.4%, negative predictive value 89.5%, and accuracy 83.1%. For active tuberculosis, the presence of centrilobular nodules, tree-in-bud, macronodules, cavity within the nodule, and consolidations was statistically significant, while for inactive tuberculosis, that of irregular linear opacities, micronodules, bronchiectasis, and cicatrization atectasis was similarly significant. The CT score for the area of nodules and consolidations was higher in active than in inactive tuberculosis, but only the nodule score showed statistical significance. HRCT can be a useful diagnostic tool for evaluating the activity

  7. Determination of the activity of pulmonary tuberculosis : the utility of high-resolution computed tomography

    To evaluate the utility of high-resolution computed tomography (HRCT), as used to determine the activity of tuberculosis, and to analyze the HRCT findings in active and in inactive tuberculosis. We analyzed the HRCT findings of 100 patients (54 men, 46 women; average age, 54 years) who according to the results of chest radiography had pulmonary tuberculosis of undetermined activity. We assessed HRCT findings such as the presence of a centrilobular, macro-, or micronodule; consolidation, ground-glass opacity, cavity, interlobular septal thickening, irregular linear opacities, bronchial wall thickening, bronchovascular bundle distortion, bronchiectasis, atelectasis, and pericicatrical emphysema. We compared the ratio of the area of nodule and consolidation to that of whole lung, and compared the findings between active and inactive tuberculosis. Eleven of 100 patients were excluded because the final diagnosis was other than tuberculosis. In 59 patients, the presence of active pulmonary tuberculosis was proven by positive sputum smear and/or culture for mycobacterium tuberculosis. On the basis of the negative results of these tests, pulmonary tuberculosis was found to be inactive in 30 patients; serial chest radiographs indicated that their condition remained stable over a 6-month period. For HRCT, sensitivity was 96.6%, specificity 56.7%, positive predictive value 81.4%, negative predictive value 89.5%, and accuracy 83.1%. For active tuberculosis, the presence of centrilobular nodules, tree-in-bud, macronodules, cavity within the nodule, and consolidations was statistically significant, while for inactive tuberculosis, that of irregular linear opacities, micronodules, bronchiectasis, and cicatrization atectasis was similarly significant. The CT score for the area of nodules and consolidations was higher in active than in inactive tuberculosis, but only the nodule score showed statistical significance. HRCT can be a useful diagnostic tool for evaluating the activity

  8. Pulmonary tuberculosis

    Dissemination of the tubercle bacillus is of three types: bronchogenic, hematogenous, and lymphangitic. Bronchogenic dissemination occurs when exudate from a cavity or small area of caseation drains into a bronchus and is aspirated into previously uninfected areas either on the same or on the opposite side. This type of spreading occurs frequently after bleeding and when there is a cavity emptying into a bronchus. Hematogenous dissemination leads to miliary tuberculosis and to extrapulmonary lesions throughout the body. Acute massive hematogenous spread causes miliary tuberculosis, while chronic spread in smaller amounts usually results in the chronic extrapulmonary foci. Lymphangitic dissemination is common in primary infection. It is responsible for involvement with subsequent enlargement of hilar and mediastinal nodes that is often seen in children and in young black adults. The reaction to M. tuberculosis depends on the presence or absence of immunity to tuberculoprotein. In individuals having no tissue hypersensitivity or immunity, primary tuberculosis results. In those with immunity produced by previous infection or BCG vaccination, the reactivation (reinfection) disease may develop

  9. Comparison between 18F-FDG PET and CT in evaluating the activity of pulmonary tuberculosis

    Objective: To compare the difference between 18F-FDG PET and CT for evaluating the activity of pulmonary tuberculosis. Methods: 18F-FDG PET-CT was performed in 31 pulmonary tuberculosis patients,the activity of the tuberculosis lesions was evaluated by PET and CT images, the results of the two imaging methods were compared separately. Results: The results obtained with the two imaging methods were consistent in 26 cases and inconsistent in 5 cases.6 eases which CT diagnosed as inactive tuberculosis (healed lesions) were also judged as inactive lesions by PET imaging. In 16 cases, CT displayed that most of the lesions were calcified and associated with little streaks and diagnosed as inactive tuberculosis (obsolete lesions), among them PET judged 5 cases as active lesions, of which 3 cases with partly calcified lesion associated with mild radioactive uptake, 2 eases with streaks associated with mild radioactive uptake. 9 cases which CT diagnosed as active pulmonary tuberculosis, PET judged as active lesions too. Conclusions: 18FFDG PET and CT have the same judgment in diagnosing healed and active tuberculosis lesions, while 18FFDG PET is superior to CT in evaluating the active lesions residue in obsolete lesions. (authors)

  10. Densely calcified tuberculous constrictive pericarditis with concurrent active pulmonary tuberculosis infection

    S Laudari

    2015-07-01

    Full Text Available Though pulmonary tuberculosis is a common chronic infection in the developing countries like Nepal, the incidence of tubercular constrictive pericarditis is very low. Here we report a patient of active pulmonary tuberculosis with sputum positive for acid fast bacilli along with densely calcified constrictive pericarditis which has been reported as a very rare presentation in the literature.DOI: http://dx.doi.org/10.3126/jcmsn.v10i2.12955 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2; 41-43

  11. 38 CFR 3.378 - Changes from activity in pulmonary tuberculosis pension cases.

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Changes from activity in pulmonary tuberculosis pension cases. 3.378 Section 3.378 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity...

  12. Loss of receptor on tuberculin-reactive T-cells marks active pulmonary tuberculosis.

    Mathias Streitz

    Full Text Available BACKGROUND: Tuberculin-specific T-cell responses have low diagnostic specificity in BCG vaccinated populations. While subunit-antigen (e.g. ESAT-6, CFP-10 based tests are useful for diagnosing latent tuberculosis infection, there is no reliable immunological test for active pulmonary tuberculosis. Notably, all existing immunological tuberculosis-tests are based on T-cell response size, whereas the diagnostic potential of T-cell response quality has never been explored. This includes surface marker expression and functionality of mycobacterial antigen specific T-cells. METHODOLOGY/PRINCIPAL FINDINGS: Flow-cytometry was used to examine over-night antigen-stimulated T-cells from tuberculosis patients and controls. Tuberculin and/or the relatively M. tuberculosis specific ESAT-6 protein were used as stimulants. A set of classic surface markers of T-cell naïve/memory differentiation was selected and IFN-gamma production was used to identify T-cells recognizing these antigens. The percentage of tuberculin-specific T-helper-cells lacking the surface receptor CD27, a state associated with advanced differentiation, varied considerably between individuals (from less than 5% to more than 95%. Healthy BCG vaccinated individuals had significantly fewer CD27-negative tuberculin-reactive CD4 T-cells than patients with smear and/or culture positive pulmonary tuberculosis, discriminating these groups with high sensitivity and specificity, whereas individuals with latent tuberculosis infection exhibited levels in between. CONCLUSIONS/SIGNIFICANCE: Smear and/or culture positive pulmonary tuberculosis can be diagnosed by a rapid and reliable immunological test based on the distribution of CD27 expression on peripheral blood tuberculin specific T-cells. This test works very well even in a BCG vaccinated population. It is simple and will be of great utility in situations where sputum specimens are difficult to obtain or sputum-smear is negative. It will also help

  13. We nuclear physicians might have used the term 'activity' of pulmonary tuberculosis differently from clinicians who treat patients with tuberculosis

    It is difficult to determine the activity of tuberculosis radiologically. Therefore there have been efforts to assess the activity using radiopharmaceuticals such as 67Ga, 99mTc-tetrofosmin, and 99mTc-MIBI. But there may be some discrepancy in difining the term 'activity' between clinicians and nuclear physicians. While negative conversion of sputum acid fast bacilli (AFB) is defined as 'disappearance of activity' by clinicians, a loss of uptake in previously positive lesion is accepted as 'disappearance of activity' by nuclear physicians. We designed a prospective study to see if the negative conversion of sputum AFB could directly match the disappearance of radioactivity of the lesion. Fifteen patients with bacteriologically confirmed active localized pulmonary tuberculosis were scanned 10 and 60 min after intravenous injection of 550 MBq 99mTc-MIBI. In 6 patients, who showed negative conversion of sputum AFB after 3-7 months of chemotherapy, 99mTc-MIBI scan was repeated. For the purpose of comparison, target/nontarget raitos of the lesions were determined. 12/15 (80%) patients with active pulmonary tuberculosis showed increased uptake of 99mTc-MIBI in tuberculous lesion. After negative conversion of sputum AFB, 5/6 (83%) patients still showed increased uptake, although the intensity of uptake decreased. Uptake of radioactivity decreased but did not disappear after negative conversion of sputum AFB. 99mTc-MIBI scan may be useful to address the degree of inflammation of pulmonary tuberculous lesion, but the uptake did not directly match the activity defined by positivity of sputum AFB. We nuclear physicians might have used the term 'activity' somewhat differently from clinicians who treat patients with tuberculosis

  14. Imaging of pulmonary tuberculosis

    Tuberculosis, more than any other infectious disease, has always been a challenge, since it has been responsible for a great amount of morbidity and mortality in humans. After a steady decline in the number of new cases during the twentieth century, due to improved social and environmental conditions, early diagnosis, and the development of antituberculous medication, a stagnation and even an increase in the number of new cases was noted in the mid-1980s. The epidemiological alteration is multifactorial: global increase in developing countries; minority groups (HIV and other immunocompromised patients); and elderly patients due to an altered immune status. Other factors that may be responsible are a delayed diagnosis, especially in elderly patients, incomplete or inadequate therapy, and the emergence of multidrug-resistant tuberculosis. The course of the disease and its corresponding clinicoradiological pattern depends on the interaction between the organism and the host response. Classically, pulmonary tuberculosis has been classified in primary tuberculosis, which occurred previously in children, and postprimary tuberculosis, occurring in adult patients. In industrialized countries, however, there seems to be a shift of primary tuberculosis towards adults. Furthermore, due to an altered immunological response in certain groups, such as immunocompromised and elderly patients, an atypical radioclinical pattern may occur. The changing landscape, in which tuberculosis occurs, as well as the global resurgence, and the changed spectrum of the clinical and radiological presentation, justify a renewed interest of radiologists for the imaging features of pulmonary tuberculosis. This article deals with the usual imaging features of pulmonary tuberculosis as well as the atypical patterns encountered in immunodepressed and elderly patients. (orig.)

  15. Serum calcium in pulmonary tuberculosis

    Subhash C. Sharma

    1981-01-01

    Serum calcium was studied serially in 94 patients with active pulmonary tuberculosis. An equal number of age- and sex-matched patients with chronic obstructive pulmonary disease were controls. Seventy patients in the study group were normocalcaemic and 10 were hypercalcaemic. These 10 were on a higher supplement of vitamin D than the 70 normocalcaemic patients. There was a positive correlation between the daily vitamin intake and the degree and duration of hypercalcaemia. None of the controls...

  16. Tobacco smoking and pulmonary tuberculosis

    Kolappan, C.; Gopi, P

    2002-01-01

    Background: The prevalence of tuberculosis in adult men in India is 2–4 times higher than in women. Tobacco smoking is prevalent almost exclusively among men, so it is possible that tobacco smoking may be a risk factor for developing pulmonary tuberculosis. A nested case control study was carried out to study the association between tobacco smoking and pulmonary tuberculosis.

  17. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    Objectives: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis. However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis. The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis. Materials and methods: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria. Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis. The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan. Results: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3). The lesions were located most commonly in the right lower lobe (n=4). The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population. Conclusion: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia

  18. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    Chung, Myung Jin; Goo, Jin Mo E-mail: jmgoo@plaza.snu.ac.kr; Im, Jung-Gi

    2004-11-01

    Objectives: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis. However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis. The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis. Materials and methods: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria. Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis. The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan. Results: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3). The lesions were located most commonly in the right lower lobe (n=4). The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population. Conclusion: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia.

  19. Pediatric postprimary pulmonary tuberculosis

    Heading AbstractBackground. Postprimary pulmonary tuberculosis (TB) is not commonly seen in children.Objective. The purpose of this study was to determine the radiographic findings and patient characteristics of pediatric postprimary pulmonary TB.Materials and methods. We reviewed the clinical charts and chest radiographs in six patients.Results. The radiographic findings of pediatric postprimary pulmonary TB include upper-lobe consolidation and cavitation, multifocal ill-defined airspace opacities, evidence of prior pulmonary TB, and apical pleural thickening. Pleural effusions and lymphadenopathy are not commonly present. Although postprimary disease typically does not affect young children, five of the children in this series were less than ten years of age at the time of presentation.Conclusion The possibility of postprimary TB should be considered in pediatric patients at risk for this disease who present with upper-lobe pulmonary consolidation and cavitation. These patients are highly infectious and early recognition and treatment can limit transmission of TB. (orig.)

  20. A prospective cohort study of latent tuberculosis in adult close contacts of active pulmonary tuberculosis patients in Korea

    Park, Sun Hyo; Lee, Seung Jun; Cho, Yu Ji; Jeong, Yi Yeong; Kim, Ho Cheol; Lee, Jong Deog; Kim, Hee Jin; Menzies, Dick

    2016-01-01

    Background/Aims: The objective of this prospective study was to evaluate the diagnosis and treatment of latent tuberculosis infection (LTBI) in adult close contacts of active pulmonary tuberculosis (TB) patients in Korea. Methods: Adult close contacts of active pulmonary TB patients were recruited at a regional tertiary hospital in Korea. The participants were tested for LTBI using the tuberculin skin test (TST) and/or QuantiFERON-TB Gold (QFT-G) test. LTBI patients, who consented to treatment, were randomly assigned to receive isoniazid for 9 months (9INH) or rifampin for 4 months (4RIF). Results: We examined 189 adult close contacts (> 18 years) of 107 active pulmonary TB patients. The TST and QFT-G were positive (≥ 10 mm) in 75/183 (39.7%) and 45/118 (38.1%) tested participants, respectively. Among 88 TST or QFT-G positive LTBI participants, 45 participants were randomly assigned to receive 4RIF (n = 21) or 9INH (n = 24), respectively. The average treatment duration for the 4RIF and 9INH groups was 3.3 ± 1.3 and 6.1 ± 2.7 months, respectively. Treatment was completed in 25 participants (4RIF, n = 16; 9INH, n = 9). LTBI participants who accepted treatment were more likely to be women and have more cavitary lesions on the chest radiographs of index cases and positive TST and QFT-G results compared to those who refused treatment. Conclusions: About 40% of adult close contacts of active pulmonary TB patients had LTBI; about 50% of these LTBI participants agreed to treatment. PMID:27052266

  1. Diagnostics for pulmonary tuberculosis

    Cudahy, Patrick

    2016-01-01

    Tuberculosis (TB) remains a leading cause of human suffering and mortality despite decades of effective treatment being available. Accurate and timely diagnosis remains an unmet goal. The HIV epidemic has also led to new challenges in the diagnosis of TB. Several new developments in TB diagnostics have the potential to positively influence the global campaign against TB. We aim to review the performance of both established as well as new diagnostics for pulmonary TB in adults, and discuss the ongoing challenges. PMID:27005271

  2. Diagnostics for pulmonary tuberculosis

    Cudahy, Patrick; Shenoi, Sheela

    2016-01-01

    Tuberculosis (TB) remains a leading cause of human suffering and mortality despite decades of effective treatment being available. Accurate and timely diagnosis remains an unmet goal. The HIV epidemic has also led to new challenges in the diagnosis of TB. Several new developments in TB diagnostics have the potential to positively influence the global campaign against TB. We aim to review the performance of both established as well as new diagnostics for pulmonary TB in adults, and discuss the...

  3. Reactive thrombocytosis in pulmonary tuberculosis.

    Baynes, R D; Bothwell, T H; Flax, H.; McDonald, T P; Atkinson, P.; Chetty, N.; Bezwoda, W. R.; Mendelow, B V

    1987-01-01

    The incidence of reactive thrombocytosis in active pulmonary tuberculosis was studied in 122 patients. Thrombocytosis was common, platelet counts often exceeding 1 X 10(12)/1. A significant inverse correlation was noted between the mean platelet volume and the platelet count (r = -0.54, p less than 0.0001). Interval estimation suggested that this relation was non-linear. Further studies were done in a small group of six patients. Platelet survival was considerably shortened, the platelets agg...

  4. Coincident helminth infection modulates systemic inflammation and immune activation in active pulmonary tuberculosis.

    Parakkal Jovvian George

    Full Text Available Helminth infections are known to modulate innate and adaptive immune responses in active and latent tuberculosis (TB. However, the role of helminth infections in modulating responses associated with inflammation and immune activation (reflecting disease activity and/or severity in TB is not known.We measured markers of inflammation and immune activation in active pulmonary TB individuals (ATB with co-incidental Strongyloides stercoralis (Ss infection. These included systemic levels of acute phase proteins, matrix metalloproteinases and their endogenous inhibitors and immune activation markers. As a control, we measured the systemic levels of the same molecules in TB-uninfected individuals (NTB with or without Ss infection.Our data confirm that ATB is associated with elevated levels of the various measured molecules when compared to those seen in NTB. Our data also reveal that co-incident Ss infection in ATB individuals is associated with significantly decreased circulating levels of acute phase proteins, matrix metalloproteinases, tissue inhibitors of matrix metalloproteinases as well as the systemic immune activation markers, sCD14 and sCD163. These changes are specific to ATB since they are absent in NTB individuals with Ss infection.Our data therefore reveal a profound effect of Ss infection on the markers associated with TB disease activity and severity and indicate that co-incidental helminth infections might dampen the severity of TB disease.

  5. Inflammasome genetics contributes to the development and control of active pulmonary tuberculosis.

    Souza de Lima, D; Ogusku, M M; Sadahiro, A; Pontillo, A

    2016-07-01

    Tuberculosis (TB) continues to be a major public health problem. An estimated one-third of the world's population is infected with Mycobacterium tuberculosis (Mtb) but remains asymptomatic (latent TB) and only 5% to 10% of these latent individuals will develop active pulmonary TB. Factors affecting the balance between latent and active TB are mostly unknown, even if host genome has been shown to contribute to the outcome of Mtb response. Acute inflammation and Th1 response are important in the early clearance of the bacteria as it was emphasized by the association between immune genes (i.e.: HLA, IFNG, TNF, NRPAM1, IL10) variants and the development of active pulmonary TB. Recently, the role of the inflammasome in experimental TB has been demonstrated, however, to our knowledge, no data still exist about the contribution of inflammasome genetics to Mtb susceptibility and/or to the development of active TB. For this reason, selected polymorphisms in inflammasome genes were analysed in a case/control cohort of individuals with active pulmonary TB from an endemic area of Brazil Amazon. Our data evidence the novel association between polymorphisms in NLRP3-inflammasome encoding genes and active pulmonary TB, and replicated the association between P2X7 and TB observed in other populations. These results emphasize the role of NLRP3-inflammasome also in human TB, and contribute to our knowledge about pathways involved in the development of active TB, even if deeper investigation are needed to fully elucidate the role of the complex in Mtb infection. PMID:27101784

  6. Comparison of sensitivity of quantiferon-tb gold test and tuberculin skin test in active pulmonary tuberculosis

    Objective: To compare the sensitivity of tuberculin skin test (TST) and quantiFERON-TB gold test (QFT-G) in active pulmonary tuberculosis. Study Design: Analytical study. Place and Duration of Study: Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi, from July 2011 to January 2012. Methodology: QuantiFERON-TB gold test (QFT-G) was evaluated and compared it with tuberculin skin test (TST) in 50 cases of active pulmonary tuberculosis, in whom tuberculous infection was suspected on clinical, radiological and microbiological grounds. Sensitivity was determined against positive growth for Mycobacterium tuberculosis. Results: Out of 50 cases, 43 were females and 7 were males. The mean age was 41.84 A+- 19.03 years. Sensitivity of QFT-G was 80% while that of TST was 28%. Conclusion: QFT-G has much higher sensitivity than TST for active pulmonary tuberculosis. It is unaffected by prior BCG administration and prior exposure to atypical mycobacteria. A positive QFT-G result can be an adjunct to diagnosis in patients having clinical and radiological data compatible with pulmonary tuberculosis. (author)

  7. High-resolution CT for identify patients with smear-positive, active pulmonary tuberculosis

    Purpose: This study evaluates the use of high-resolution computed tomography (HRCT) to differentiate smear-positive, active pulmonary tuberculosis (PTB) from other pulmonary infections in the emergency room (ER) setting. Methods: One hundred and eighty-three patients diagnosed with pulmonary infections in an ER were divided into an acid fast bacillus (AFB) smear-positive, active PTB group (G1 = 84) and a non-AFB smear-positive, pulmonary infection group (G2 = 99). HRCT images from a 64-Multidetector CT were analyzed, retrospectively, for the morphology, number, and segmental distribution of pulmonary lesions. Results: Utilizing multivariate analysis, five variables were found to be independent risk factors predictive of G1: (1) consolidation involving the apex segment of right upper lobe, posterior segment of the right upper lobe, or apico-posterior segment of the left upper lobe; (2) consolidation involving the superior segment of the right or left lower lobe; (3) presence of a cavitary lesion; (4) presence of clusters of nodules; (5) absence of centrilobular nodules. A G1 prediction score was generated based on these 5 criteria to help differentiate G1 from G2. The area under the receiver operating characteristic (ROC) curve was 0.96 ± 0.012 in our prediction model. With an ideal cut-off point score of 3, the specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) are 90.9%, 96.4%, 90.0% and 96.8%, respectively. Conclusion: The use of this AFB smear-positive, active PTB prediction model based on 5 key HRCT findings may help ER physicians determine whether or not isolation is required while awaiting serial sputum smear results in high risk patients.

  8. Anemia and Peripheral Blood Changes in Pulmonary Tuberculosis

    N. Gharabaghi; Rahimi, E; A. Eishi

    2009-01-01

    Introduction & Objective: Tuberculosis is an ancient disease that will affect human health in the future. Tuberculosis is a systemic disease and more body systems are affected such as hematologic system. This study was conducted to determine peripheral blood changes in pulmonary tuberculosis detecting by H3 technicon in Urmia hospitals in the west of Iran.Materials & Methods: In this study 85 patients with active pulmonary tuberculosis were evaluated for peripheral blood manifestation before ...

  9. Effect of pulmonary hypertension on outcome of pulmonary tuberculosis

    Majid Marjani; Parvaneh Baghaei; Majid Malekmohammad; Payam Tabarsi; Babak Sharif-Kashani; , Neda Behzadnia; Davood Mansouri; Mohammad Reza Masjedi; Ali Akbar Velayati

    2014-01-01

    Background: This study performed at the National Research Institute of Tuberculosis and Lung Disease, Tehran, Iran, aimed to evaluate the effect of concomitant pulmonary hypertension on the outcome of pulmonary tuberculosis. Methods: New cases of pulmonary tuberculosis were recruited for the study. Pulmonary hypertension was defined as systolic pulmonary arterial pressure ≥35 mm Hg estimated by transthoracic Doppler echocardiography. We assessed the relationship between pulmonary hypertensi...

  10. Radioiodine uptake in inactive pulmonary tuberculosis

    Radioiodine may accumulate at sites of inflammation or infection. We have seen such accumulation in six thyroid cancer patients with a history of previously treated pulmonary tuberculosis. We also review the causes of false-positive radioiodine uptake in lung infection/inflammation. Eight foci of radioiodine uptake were seen on six iodine-123 diagnostic scans. In three foci, the uptake was focal and indistinguishable from thyroid cancer pulmonary metastases from thyroid cancer. In the remaining foci, the uptake appeared nonsegmental, linear or lobar, suggesting a false-positive finding. The uptake was unchanged, variable in appearance or non-persistent on follow-up scans and less extensive than the fibrocystic changes seen on chest radiographs. In the two patients studied, thyroid hormone level did not affect the radioiodine lung uptake and there was congruent gallium-67 uptake. None of the patients had any evidence of thyroid cancer recurrence or of reactivation of tuberculosis and only two patients had chronic intermittent chest symptoms. Severe bronchiectasis, active tuberculosis, acute bronchitis, respiratory bronchiolitis, rheumatoid arthritis-associated lung disease and fungal infection such as Allescheria boydii and aspergillosis can lead to different patterns of radioiodine chest uptake mimicking pulmonary metastases. Pulmonary scarring secondary to tuberculosis may predispose to localized radioiodine accumulation even in the absence of clinically evident active infection. False-positive radioiodine uptake due to pulmonary infection/inflammation should be considered in thyroid cancer patients prior to the diagnosis of pulmonary metastases. (orig.)

  11. The presence of a booster phenomenon among contacts of active pulmonary tuberculosis cases: a retrospective cohort

    Queiroz-Mello Fernanda C

    2007-03-01

    Full Text Available Abstract Background Assuming a higher risk of latent tuberculosis (TB infection in the population of Rio de Janeiro, Brazil, in October of 1998 the TB Control Program of Clementino Fraga Filho Hospital (CFFH routinely started to recommend a two-step tuberculin skin test (TST in contacts of pulmonary TB cases in order to distinguish a boosting reaction due to a recall of delayed hypersensitivity previously established by infection with Mycobacterium tuberculosis (M.tb or BCG vaccination from a tuberculin conversion. The aim of this study was to assess the prevalence of boosted tuberculin skin tests among contacts of individuals with active pulmonary tuberculosis (TB. Methods Retrospective cohort of TB contacts ≥ 12 years old who were evaluated between October 1st, 1998 and October 31st 2001. Contacts with an initial TST ≤ 4 mm were considered negative and had a second TST applied after 7–14 days. Boosting reaction was defined as a second TST ≥ 10 mm with an increase in induration ≥ 6 mm related to the first TST. All contacts with either a positive initial or repeat TST had a chest x-ray to rule out active TB disease, and initially positive contacts were offered isoniazid preventive therapy. Contacts that boosted did not receive treatment for latent TB infection and were followed for 24 months to monitor the development of TB. Statistical analysis of dichotomous variables was performed using Chi-square test. Differences were considered significant at a p Results Fifty four percent (572/1060 of contacts had an initial negative TST and 79% of them (455/572 had a second TST. Boosting was identified in 6% (28/455. The mean age of contacts with a boosting reaction was 42.3 ± 21.1 and with no boosting was 28.7 ± 21.7 (p = 0.01. Fifty percent (14/28 of individuals whose test boosted met criteria for TST conversion on the second TST (increase in induration ≥ 10 mm. None of the 28 contacts whose reaction boosted developed TB disease within

  12. The pattern of active pulmonary tuberculosis in adults at King Hussein Medical Center, Jordan

    To identify the pattern of the clinical, radiological, and diagnostic procedures of the diagnosed cases of active pulmonary tuberculosis (TB) patients presented to the Respiratory Medicine Division at King Hussein Medical Center over the last 10 years. This is a retrospective analysis of the medical records and chest radiographs of 137 active pulmonary TB patients who were diagnosed between March 1995 and October 2005. Patient's symptoms were recorded and analyzed. Radiological findings were assessed. Procedures used to identify Mycobacterium TB were identified. One hundred and thirty-seven patients medical records were retrieved and analyzed (84 males and 53 females). The mean age (range) was 48.43 +/- 14.65 (14-83) years. The most common presenting symptoms were cough (79%), weight loss (74%), and fatigue (69%). Other presenting complaints were fever (69%), excessive night sweating (55%), chest pain (41%) and dyspnea (39%). Thirty-one percent of the cohort presented with hemoptysis. Seventy-one patients had different types of opacities and infiltrates in their chest x-ray. Micro- or macro- nodular lung changes were reported in 22 (16%) patients. Lung cavitations and pleural effusions were present in 13% of the studied patients. In 7% of cases, bronchiectasis was noted as a sequelae of long-standing lung disease. The right lung was involved in 51% of cases; the left lung in 27% and bilateral lung involvement was noted in 22% of patients. The upper lobes were involved in 63%. Sputum for acid-fast bacilli (AFB) Z-Nielson stain and culture was positive in 51%, bronchial wash was positive in 27% of cases. The diagnosis was made by histopathological examination in 15% of cases. This study showed that active pulmonary TB patients vary in clinical presentation. The radiological manifestations of pulmonary TB are heterogeneous. Sputum for AFB remains an important, easy and inexpensive measure for TB diagnosis, but may not be always helpful in early diagnosis. Bronchoscopy

  13. Chest radiography and thoracic computed tomography findings in children who have family members with active pulmonary tuberculosis

    Objective: The chest radiography and TCT findings in children who had contacted with adult family members with active pulmonary tuberculosis were compared. The contributions of thoracic computed tomography to the diagnosis of tuberculosis were investigated. Methods and material: The children who were 0-16 years old (n=173) and children of families with an adult member which was diagnosed as pulmonary tuberculosis were evaluated. The children were considered in two groups based on the absence (n=125) or presence (n=48) of complaints and/or ambiguous symptoms such as lack of appetite, mild cough, sweating, history of lung infection, low body weight and those with suspicious chest radiography findings (12 cases) were included in this study. Asymptomatic patients (n=125) did not undergo TCT. Patients who had positive PPD skin tests only received isoniazid. If the TCT demonstrated enlarged lymph nodes or parenchymal lesions, minimally active pulmonary tuberculosis was diagnosed and antituberculous treatment was given. Results and discussions: TCT revealed lymph node enlargement or parenchymal lesions in 39 children (81.2%). Of the 12 children whose CXRs revealed suspicious lymph node enlargement and/or infiltration, five had normal findings in TCT whereas the initial findings were confirmed in the remaining seven. These data suggest that there is a correlation between the presence of ambiguous symptoms in exposed children and TCT findings; chest radiography and TCT findings do not yield parallel findings. All the patients who received anti-TB treatment were resolved in the control examinations. Conclusion: In this study there is a correlation between presence of ambiguous symptoms and TCT findings, but the chest radiography and TCT findings do not yield harmony in exposed children with ambiguous symptoms (suspicious tuberculosis cases). These observations should be considered in children with symptoms similar to those of exposed children, but with no definite history of

  14. Pulmonary mycoses among the clinically suspected cases of pulmonary tuberculosis

    Tshering Ongmu Bhutia; Luna Adhikari

    2015-01-01

    Background: This study was carried with the main objectives: (1) to find out the occurrence of pulmonary mycoses in clinically suspected pulmonary tuberculosis cases at central referral hospital, Tadong, Sikkim. (2) To find out the various fungi causing pulmonary mycoses in clinically suspected pulmonary tuberculosis cases. Methods: 200 clinically suspected pulmonary tuberculosis cases who visited the department of microbiology for the diagnostic microscopic examination of sputum sample f...

  15. Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis

    Sharma, Madhurima, E-mail: madhurimashrm88@gmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Sandhu, Manavjit Singh, E-mail: manavjitsandhu@yahoo.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Gorsi, Ujjwal, E-mail: ujjwalgorsi@gmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Gupta, Dheeraj, E-mail: dheeraj1910@gmail.com [Department of Pulmonary Medicine, PGIMER, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India)

    2015-09-15

    Highlights: • Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. • These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. • Digital tomosynthesis has a sensitivity of 100% in detection of cavities. • Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. • Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. - Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better

  16. Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis

    Highlights: • Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. • These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. • Digital tomosynthesis has a sensitivity of 100% in detection of cavities. • Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. • Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. - Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better

  17. Determining the Diagnostic Value of Mycobacterium Tuberculosis DNA in the Differentiation of Blood Samples of Patients with Active Pulmonary Tuberculosis and Healthy Controls Using Polymerase Chain Reaction

    Abasali Niazi; Nezarali Muolai; Mosayeb Shahriar; Reza Karimian; Farzaneh Peykfalak

    2013-01-01

    Background: Tuberculosis (TB) is now a major cause of mortality and morbidity in the world. Nowadays, different methods are used to diagnose tuberculosis. Although classical microbiological methods (such as sputum smear) are specific, they have little sensitivity and the culture is also time-consuming. Using Polymerase Chain Reaction (PCR) in blood samples in terms of Mycobacterium tuberculosis DNA, this study examines diagnostic power of this test in the diagnosis of pulmonary tuberculosis c...

  18. Early Bactericidal Activity of Moxifloxacin in Treatment of Pulmonary Tuberculosis: a Prospective, Randomized Study

    Pletz, Mathias W. R.; De Roux, Andres; Roth, Andreas; NEUMANN, Karl-Heinz; Mauch, Harald; Lode, Hartmut

    2004-01-01

    Moxifloxacin is the most active fluoroquinolone against Mycobacterium tuberculosis in vitro. However, data about the efficacy in patients are not available. We enrolled 17 patients with tuberculosis in a prospective, randomized study. After 5 days of monotherapy with either moxifloxacin or isoniazid, we detected significant decreases in mean CFU per milliliter in sputum in both groups. The calculated early bactericidal activities for isoniazid and moxifloxacin were 0.209 and 0.273 log10 CFU p...

  19. IL-10 dependent suppression of type 1, type 2 and type 17 cytokines in active pulmonary tuberculosis.

    Nathella Pavan Kumar

    Full Text Available BACKGROUND: Although Type 1 cytokine responses are considered protective in pulmonary tuberculosis (PTB, their role as well as those of Type 2, 17 and immunoregulatory cytokines in tuberculous lymphadenitis (TBL and latent tuberculosis (LTB have not been well studied. AIM AND METHODS: To identify cytokine responses associated with pulmonary tuberculosis (TB, TB lymphadenitits and latent TB, we examined mycobacterial antigen-specific immune responses of PTB, TBL and LTB individuals. More specifically, we examined ESAT-6 and CFP-10 induced Type 1, Type 2 and Type 17 cytokine production and their regulation using multiplex ELISA. RESULTS: PTB individuals exhibited a significantly lower baseline as well as antigen-specific production of Type 1 (IFNγ, TNFα and IL-2; Type 2 (IL-4 and Type 17 (IL-17A and IL-17F cytokines in comparison to both TBL and LTB individuals. TBL individuals exhibited significantly lower antigen-specific IFNγ responses alone in comparison to LTB individuals. Although, IL-10 levels were not significantly higher, neutralization of IL-10 during antigen stimulation resulted in significantly enhanced production of IFNγ, IL-4 and IL-17A in PTB individuals, indicating that IL-10 mediates (at least partially the suppression of cytokine responses in PTB. CONCLUSION: Pulmonary TB is characterized by an IL-10 dependent antigen-specific suppression of Type 1, Type 2 and Type 17 cytokines, reflecting an important association of these cytokines in the pathogenesis of active TB.

  20. Diagnostic value of the commercial MycoDotTM test in the diagnosis of active pulmonary tuberculosis in Nepalese population

    Anil Chander

    2012-10-01

    Full Text Available Background: A rapid, technically non-demanding and inexpensive diagnostic test is needed to improve the early detection and better management of active pulmonary tuberculosis especially in resource limited areas. Objective: To assess the diagnostic value and usefulness of the commercially available MycoDotTM (DynaGen Inc., Cambridge, MA, USA in the diagnosis of active pulmonary tuberculosis in Nepalese population. Materials and Methods: A prospective study was done from January 2008 to August 2008 on a group of 120 sputum smear positive adult patient group aged 17 to 78 years, confirmed cases of active pulmonary tuberculosis (with TB were enrolled and sera samples collected from them. The second group comprised of 105 healthy controls with no history of pulmonary tuberculosis (without TB and sera samples collected from them. The MycoDotTM serologic test was done on the sera samples collected from both the study groups according to the manufacturer’s instructions. Results: Of the sera collected from 120 sputum smear positive cases (with TB group, 48 sera specimens were MycoDotTM test positive (sensitivity = 40%; 95% CI 31.68–48.94. Healthy controls (without-TB group – 8 sera samples were found to be positive by the MycoDotTM test and the remaining 97 sera samples tested negative by this serologic test (specificity = 92.38%; 95% CI 85.68–96.09. The value for % false positive was 7.61% and for % false negative was 60%. The positive predictive value and the negative predictive value was 85.71% (95% CI 73.22–93.20 and 57.4% (95% CI 49.56–64.88, respectively. Conclusion: The MycoDotTM test with its rapidity (completed within 20 min, easy – to – perform format and no expensive instrumentation required – had high specificity but a relatively low sensitivity in the study group subjects and thus could be used only as an additional test in the diagnosis of active pulmonary tuberculosis and to be interpreted judiciously alongwith clinical

  1. Tc-99m Ciprofloxacin SPECT of Pulmonary Tuberculosis

    Lee, Min Kyung; Hwang, Kyung Hoon [Gachon University Gil Hospital, Incheon (Korea, Republic of); Yoon, Min Ki [Good Samaritan Hospital, Pohang (Korea, Republic of); Choe, Won Sick [Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    2010-06-15

    Tc-99m ciprofloxacin is available for imaging infection. However, there has been no study on employing single photon emission computed tomography (SPECT) with using Tc-99m ciprofloxacin to image active pulmonary tuberculosis. Therefore, we conducted this study to assess the efficacy of Tc-99m ciprofloxacin SPECT for imaging active pulmonary tuberculosis. Twenty-one participants were enrolled in this prospective study. They were divided into two groups according to the clinical and radiological assessment. Group one (Gr. 1) consisted of five normal volunteers and six patients with inactive pulmonary tuberculosis. Group two (Gr. 2) consisted of ten patients with active pulmonary tuberculosis. SPECT was performed 3 h after injecting 555 MBq (15 mCi) of Tc-99m ciprofloxacin. The findings of Tc-99m ciprofloxacin SPECT were interpreted by a nuclear medicine specialist and then the results were analyzed according to the patients' clinical and radiological classifications. The results of Tc-99m ciprofloxacin SPECT were as follows: eight true-positive cases, ten true-negative cases, one false-positive case and two false-negative cases. The sensitivity and specificity was 80.0% and 90.0%, respectively. The positive predictive value was 88.9% and the negative predictive value was 83.3%. Conclusions Tc-99m ciprofloxacin SPECT is feasible for imaging active pulmonary tuberculosis. It is a useful nuclear-imaging method for discriminating between the active and inactive tuberculosis states in patients with a past medical history of pulmonary tuberculosis.

  2. Tc-99m Ciprofloxacin SPECT of Pulmonary Tuberculosis

    Tc-99m ciprofloxacin is available for imaging infection. However, there has been no study on employing single photon emission computed tomography (SPECT) with using Tc-99m ciprofloxacin to image active pulmonary tuberculosis. Therefore, we conducted this study to assess the efficacy of Tc-99m ciprofloxacin SPECT for imaging active pulmonary tuberculosis. Twenty-one participants were enrolled in this prospective study. They were divided into two groups according to the clinical and radiological assessment. Group one (Gr. 1) consisted of five normal volunteers and six patients with inactive pulmonary tuberculosis. Group two (Gr. 2) consisted of ten patients with active pulmonary tuberculosis. SPECT was performed 3 h after injecting 555 MBq (15 mCi) of Tc-99m ciprofloxacin. The findings of Tc-99m ciprofloxacin SPECT were interpreted by a nuclear medicine specialist and then the results were analyzed according to the patients' clinical and radiological classifications. The results of Tc-99m ciprofloxacin SPECT were as follows: eight true-positive cases, ten true-negative cases, one false-positive case and two false-negative cases. The sensitivity and specificity was 80.0% and 90.0%, respectively. The positive predictive value was 88.9% and the negative predictive value was 83.3%. Conclusions Tc-99m ciprofloxacin SPECT is feasible for imaging active pulmonary tuberculosis. It is a useful nuclear-imaging method for discriminating between the active and inactive tuberculosis states in patients with a past medical history of pulmonary tuberculosis.

  3. Detección de la expresión génica in vivo de Mycobacterium tuberculosis durante la tuberculosis pulmonar activa Mycobacterium tuberculosis in vivo-expressed genes detection during active pulmonary tuberculosis

    Alejandra Otazo M

    2012-12-01

    Full Text Available El estudio de la expresión génica de Mycobacterium tuberculosis ha involucrado la experimentación "in vitro ", "ex vivo " e "in vivo " (modelos animales, pero aún sin el éxito esperado. Proponemos que revelar los factores clave de la tuberculosis humana requiere investigar la expresión génica de M. tuberculosis dentro del ser humano ("in vivo ". Para ello, aislamos el mRNA total de M. tuberculosis, desde muestras clínicas respiratorias de pacientes con diagnóstico de tuberculosis pulmonar; posteriormente, sintetizamos el dscDNA y lo analizamos mediante RT-PCR cualitativo. Detectamos la expresión de la secuencia de inserción IS6110 y de los genes "housekeeping " 16SrRNA y sigA en M. tuberculosis creciendo in vivo (tuberculosis pulmonar así como cultivado in vitro. La expresión de los genes mprA y mprB, que codifican el sistema de transducción de señales MprAB, sólo se detectó en M. tuberculosis crecido in vitro. Con nuestros resultados damos el primer paso hacia la implementación de un método no invasivo para el estudio del transcriptoma de M. tuberculosis, dentro de su único hospedero natural, con el fin de analizar la regulación "in vivo" de los determinantes genéticos requeridos para su virulencia y patogénesis.Mycobacterium tuberculosis gene expression studies have involved "in vitro", "ex vivo" and "in vivo" experiments (animal models, but without the expected success. We propose that key features of human tuberculosis could be discovered by studying the M. tuberculosis gene expression within the human host. Therefore, we isolated totalM. tuberculosis mRNA from human clinical respiratory specimens of patients diagnosed with pulmonary tuberculosis; after this, we synthesized the dscDNA and tested it by qualitative RT-PCR assays. We detected the expression of IS6110 insertion sequence and of the "housekeeping" genes 16SrRNA andsigA in M. tuberculosis grown in vivo (pulmonary tuberculosis as well as grown in vitro M

  4. Cytotoxic Activity of Dendritic Cells as a Possible Mechanism of Negative Regulation of T Lymphocytes in Pulmonary Tuberculosis

    Ludmila V. Sakhno

    2012-01-01

    Full Text Available The PD-1/B7-H1-mediated induction of T cell apoptosis/anergy as a possible mechanism of immune response failure was studied in 76 patients with pulmonary tuberculosis (TB with normal and low-proliferative response to antigens of M. tuberculosis (purified protein derivative (PPD. It was revealed that dendritic cells (DCs, generated in vitro from patient blood monocytes with GM-CSF + IFN-α, were characterized by increased B7-H1 expression, upproduction of IL-10, and reducing of allostimulatory activity in mixed lymphocyte culture (MLC. Moreover, DCs of patients with TB were able to enhance T cell apoptosis and to block T-cell division in MLC. It was shown that neutralizing anti-PD1 antibodies significantly decreased the proapoptogenic/tolerogenic effect of DCs. Correlation analysis revealed a direct relationship between IL-10 production and level of B7-H1 expression in the general group of investigated patients. It was demonstrated that generation of healthy donor DCs in the presence of IL-10 led to an increase in the number of DCs-expressed B7-H1 molecule, DC proapoptogenic activity, and a decrease in their allostimulatory activity. Obviously, the revealed phenomenon of the PD-1/B7-H1-mediated pro-apoptogenic activity of DCs is clinically significant since the cytotoxic/tolerogenic potential of DCs is more pronounced in patients with PPD anergy.

  5. Congenital Tuberculosis Complicated by Interstitial Pulmonary Emphysema

    Singh, Tarsem; Natt, Navreet Kaur; Sharma, Manu; Singh, Harmanjit

    2014-01-01

    We report a case of congenital tuberculosis, a rare entity itself; complicated by pulmonary interstitial emphysema, thus leading to air entrapment in lungs and prolonged oxygen dependence. The diagnosis of congenital tuberculosis is often missed and under-reported due to low index of suspicion and less sensitivity of diagnostic tools.

  6. Public Transportation and Pulmonary Tuberculosis, Lima, Peru

    Horna-Campos, Olivia J.; Sánchez-Pérez, Héctor J.; Sánchez, Inma; Bedoya, Alfredo; Martín, Miguel

    2007-01-01

    The association between public transportation for commuting and pulmonary tuberculosis (TB) was analyzed in workers in Lima, Peru. Traveling in minibuses was a risk factor for pulmonary TB. Preventive measures need to be taken by health services to prevent spread of this disease.

  7. Serial counts of Mycobacterium tuberculosis in sputum as surrogate markers of the sterilising activity of rifampicin and pyrazinamide in treating pulmonary tuberculosis

    Mitchison Denis

    2001-11-01

    Full Text Available Abstract Background Since the sterilising activity of new antituberculosis drugs is difficult to assess by conventional phase III studies, surrogate methods related to eventual relapse rates are required. Methods A suitable method is suggested by a retrospective analysis of viable counts of Mycobacterium tuberculosis in 12-hr sputum collections from 122 newly diagnosed patients with pulmonary tuberculosis in Nairobi, done pretreatment and at 2, 7, 14 and 28 days. Treatment was with isoniazid and streptomycin, supplemented with either thiacetazone (SHT or rifampicin + pyrazinamide (SHRZ. Results During days 0–2, a large kill due to isoniazid occurred, unrelated to treatment or HIV status; thereafter it decreased exponentially. SHRZ appeared to have greater sterilising activity than SHT during days 2–7 (p = 0.044, due to rifampicin, and during days 14–28, probably due mainly to pyrazinamide. The greatest discrimination between SHRZ and SHT treatments was found between regression estimates of kill over days 2–28 (p = 0.0005 in patients who remained positive up to 28 days with homogeneous kill rates. No associations were found between regression estimates and the age, sex, and extent of disease or cavitation. An increased kill in HIV seropositive patients, unrelated to the treatment effect, was evident during days 2–28 (p = 0.007, mainly during days 2–7. Conclusions Surrogate marker studies should either be in small groups treated with monotherapy during days 2 to about 7 or as add-ons or replacements in isoniazid-containing standard regimens from days 2 to 28 in large groups.

  8. Determining the Diagnostic Value of Mycobacterium Tuberculosis DNA in the Differentiation of Blood Samples of Patients with Active Pulmonary Tuberculosis and Healthy Controls Using Polymerase Chain Reaction

    Abasali Niazi

    2013-10-01

    Full Text Available Background: Tuberculosis (TB is now a major cause of mortality and morbidity in the world. Nowadays, different methods are used to diagnose tuberculosis. Although classical microbiological methods (such as sputum smear are specific, they have little sensitivity and the culture is also time-consuming. Using Polymerase Chain Reaction (PCR in blood samples in terms of Mycobacterium tuberculosis DNA, this study examines diagnostic power of this test in the diagnosis of pulmonary tuberculosis compared with other standard methods. Materials and Methods: In a cross-sectional descriptive-analytic study, blood samples were taken from 40 TB patients and 40 non-TB cases. Following DNA extraction by the commercial kit QIAGEN, the PCR assay was performed using IS6110 primer.Results: In this study, there were 80 people in two groups of TB and non-TB cases. Each group composed of 14 men (35% and 26 women (65%. Sensitivity, specificity as well as positive and negative predictive values obtained 37.5, 100, 100 and 61.5%, respectively.Conclusion: Despite high costs of using PCR for TB diagnosis, sensitivity of this method is low due to various factors and cannot replace current standard methods for TB diagnosis such as smear and culture. It can only be used as a complementary method to confirm diagnosis in strongly suspected cases of tuberculosis.

  9. Personal Determinants of Formation Disease Adaptation in Patients with Active Pulmonary Tuberculosis: a Comparative Analysis from the Standpoint of Gender Approach

    Sevostyanova M.S.,

    2014-01-01

    We present the design and results of empirical research, facing the actual problem of integration of theoretical and methodological knowledge of different areas of psychology to solve actual applied problems of modern physical medicine. For the first time, we described the use of gender-based approach to the study of psychological structures of disease internal picture in men aged 25 to 49, suffering from various forms of active pulmonary tuberculosis no more than 3 years. The hypothesis that...

  10. Pulmonary Immune-Compartment-Specific Interferon Gamma Responses in HIV-Infected Individuals with Active Tuberculosis (TB in an Area of High TB Prevalence

    S. Buldeo

    2012-01-01

    Full Text Available There is a paucity of data on the pulmonary immune-compartment interferon gamma (IFNγ response to M. tuberculosis, particularly in settings of high tuberculosis (TB prevalence and in HIV-coinfected individuals. This data is necessary to understand the diagnostic potential of commercially available interferon gamma release assays (IGRAs in both the pulmonary immune-compartment and peripheral blood. We used intracellular cytokine staining by flow cytometry to assess the IFNγ response to purified protein derivative (PPD and early secretory antigen 6 (ESAT6 in induced sputa (ISp and blood samples from HIV-infected, smear-negative, TB suspects. We found that individuals with active TB disease produced significantly less IFNγ in response to PPD in their induced sputa samples than individuals with non-active TB (control group. This difference was not reflected in the peripheral blood, even within the CD27− CD4+ memory T lymphocyte population. These findings suggest that progression to active TB disease may be associated with the loss of IFNγ secretion at the site of primary infection. Our findings highlight the importance of studying pulmonary immune-compartment M. tuberculosis specific responses to elucidate IFNγ secretion across the spectrum of TB disease.

  11. Prevalence and associated risk factors of pulmonary tuberculosis among prisoners in Eastern Ethiopia: An active screening study

    2009-01-01

    Background: Information on prevalence of tuberculosis (TB) in Ethiopian prisons is non-existent, despite its highly endemic nature. So, the aim of this study was to determine prevalence and associated risk factors for pulmonary TB (PTB) in three large prisons of Eastern Ethiopia. Methodology: A cross-sectional study was performed on 382 sampled prisoners (44 PTB cases and 338 PTB suspects) from July to November, 2008. A structured questionnaire was administered to prisoners who had ≥ 2 we...

  12. Evaluation of Antimicrobial Re sistance of New Cases of Pulmonary Tuberculosis, in Khorasan, Iran

    MasoodReza Movahede-Danesh; Kiarash Ghazvini; AliAkbar Heydari

    2015-01-01

    Background: Multi drug-resistant Mycobacterium tuberculosis (MDR-TB) is an infection with a causative bacillus which is resistant to at least two drugs, isoniazid and rifampin. The purpose of this study is to evaluate the prevalence of TB resistance to first-line drugs of newly diagnosed active pulmonary tuberculosis.Methods: This cross-sectional study was performed on 77 patients with newly diagnosed active pulmonary tuberculosis (according to national protocols of TB). Sputum samples were c...

  13. Imagem em tuberculose pulmonar Pulmonary tuberculosis imaging

    SIDNEY BOMBARDA

    2001-11-01

    with the active disease, such as centrilobular nodules segmentarily distributed, thick-walled cavities, thickened bronchial or bronchiolar walls, bronchiectasis and lymphadenopathy can be observed by computerized tomography. Thin-walled cavities, traction bronchiectasis, parenchymal bands, emphysema and mosaic pattern are signs suggestive of inactive disease. Gallium-67 citrate scyntigraphy is a complementary method useful in the detection of infectious diseases, including tuberculosis, especially in immunocompromised patients. Inhalation / perfusion analyses are used in the pre-operative assessment of patients carrying tuberculosis sequelaes and multiresistant tuberculosis. Positron emission tomography with fluorine-18 labeled deoxyglucose allows the detection of the inflammatory process that takes place during the active stage of tuberculosis and may persist, not so intense, after specific treatment is over. Imaging methods are valuable tools to be used in the diagnosis and follow up of pulmonary tuberculosis.

  14. Predictors of radiological sequelae of pulmonary tuberculosis

    In patients with pulmonary tuberculosis, clinical factors that are associated with poor radiological outcome have not been adequately addressed in the medical literature. The aim of this study was to explore some of these factors in patients admitted to a large chest hospital in Saudi Arabia with pulmonary tuberculosis. Material and Methods: Chest radiographs of 1080 patients with pulmonary tuberculosis were reviewed. Post-treatment residual changes were classified from 1 to 5 according to the severity of these changes. Data analysis was done by tabulating these classes against different variables that were likely to influence the final radiological appearance at the end of the treatment period. Results: Near-complete or complete clearance of chest radiography (Class 1) was seen in 43.5% of patients 40 years old (p8 weeks). Chest radiography clearance was more frequent (51.6%) in patients with good compliance with drug therapy compared to those with poor compliance (18.8%). Persistent cavitation (Class 5) was seen in 30.4% of cases with a past history of tuberculosis and in only 14% of cases with no such history. Conclusion: Old age, female gender, long duration of symptoms (delayed diagnosis), poor compliance with treatment and positive history of tuberculosis were associated with poor radiological outcome

  15. 38 CFR 3.374 - Effect of diagnosis of active tuberculosis.

    2010-07-01

    ... diagnosis. Service department diagnosis of active pulmonary tuberculosis will be accepted unless a board of... Affairs diagnosis. Diagnosis of active pulmonary tuberculosis by the medical authorities of the Department... diagnosis. Diagnosis of active pulmonary tuberculosis by private physicians on the basis of...

  16. Cavitary pulmonary tuberculosis HIV-related

    Introduction: It was usually assumed that pulmonary tuberculosis (TB) in HIV-seropositive patients represents reactivation TB, despite the radiographic appearance frequently consistent rather with a recent disease. Hence, these radiographic features were considered 'atypical'. We have hypothesised that the so called 'atypical' radiographic features could be due to a greater proportion of primary TB among these patients, representing the typical appearance of primary radiological pattern. Material and methods: We reviewed chest imaging of 219 HIV+ patients with microbiological proven pulmonary tuberculosis, who were assessed for the presence, number, distribution of cavitations and for associated pulmonary parenchymal abnormalities, adenopathies and pleural effusion, and were classified as a primary or post-primary pattern. Results: The patients with post-primary pattern were 50%, and the rate of cavitation was 63%, not wandering off the general population. Cavities still occurred with similar proportion in groups with CD4 200 cells/mm3. Conclusion: We suggest that HIV-related pulmonary tuberculosis is typical in its radiological appearances, consistent with those of the general population, and this could be confirmed by the most recent molecular epidemiological techniques that allow to definitely classify the tuberculosis episodes as either primary or post-primary disease

  17. [Management of respiratory failure in patients with pulmonary tuberculosis].

    Machida, Kazuko

    2003-02-01

    The prognosis is very poor in patients with acute respiratory failure (ARF) due to active pulmonary tuberculosis, especially in those who necessitate mechanical ventilation. The underlining factors of ARF are low nutrition, old age and severity because of patient's delay and doctor's delay. So, management consists of two parts, one, early patient detection considering of tuberculosis and early treatment, the other, focused control to high risk groups. Patients with chronic respiratory failure due to pulmonary tuberculosis sequelae have long insidious period and mainly restrictive, sometimes mixed pulmonary dysfunction. Hypercapnea, pulmonary hypertension and respiratory disorder during sleep are seen in high percentage in them. In acute on chronic failure the principles of therapy are treatment of precipitating factors such as respiratory infection or congestive heart failure, controlled (low flow) oxygen therapy, bronchial hygiene and maintaining adequate pulmonary and circulatory condition. In chronic stage patient education is very important. Management of chronic stage is constructed of nutrition control, long-term oxygen therapy, pharmacological therapy, pulmonary rehabilitation including controlled breathing technique, physical chest therapy and exercise training. Noninvasive positive pressure ventilation is effective on improvement of prognosis in chronic respiratory failure, and on treatment in acute on chronic failure. PMID:12664448

  18. HIV seropositivity in high risk individuals and in pulmonary tuberculosis

    Vinod Tyagi

    2016-08-01

    Conclusions: The prevalence of HIV seropositivity among pulmonary and extra pulmonary TB in the present study was 6.38%. Tuberculosis was associated with an increased incidence of HIV. HIV was associated most with heterosexual promiscuity as a risk factor and presented more with extra pulmonary tuberculosis. [Int J Res Med Sci 2016; 4(8.000: 3176-3179

  19. Association between cigarette smoking and pulmonary tuberculosis

    Objectives: To determine the association between cigarette smoking and pulmonary tuberculosis. Methodology: In this retrospective study which was carried out in Razi hospital, in Ahvaz a city southwest Iran, medical charts of patients with tuberculosis between 2005 and 2007 were reviewed. Sixty one patients aged 15-96 years with documented pulmonary tuberculosis (smear positive) were selected as cases and 122 age and sex matched persons without tuberculosis(patients hospitalized in surgery and orthopedic wards) were selected randomly as controls. Data on smoking status, quantity of cigarette smoked, and duration of smoking was collected from medical charts. The data in the two groups were statistically compared with SPSS version 16. The chi square test was used to compare the frequency of cigarette smoking in two groups. Ninety-five percent confidence intervals were calculated when appropriate. Differences with a P value of <0.05 were considered significant. Results: Of total 61 case, 42 (68.9%) were smoker, while, of total 122 controls 22(18%) were smoker. The estimated odds ratio (OR) of the relation between smoking and tuberculosis was 10.1 [(95% confidence interval (CI) 4.3 to 23.5), P<0.001]. The mean of pocket - year of smoked cigarette (20/pocket) in cases and controls were 15.9 +- 13.7 and 13.5 +- 9.1, respectively (P=0.5). Conclusion: This study showed that pulmonary tuberculosis is associated to cigarette smoking. The association is not dose-dependent. Smoking may be a risk factor for TB acquisition. (author)

  20. Rationale and design of a randomized controlled trial of the effect of retinol and vitamin D supplementation on treatment in active pulmonary tuberculosis patients with diabetes

    Wang, Qiuzhen; Ma, Aiguo; Bygbjerg, Ib Christian; Han, Xiuxia; Liu, Yufeng; Zhao, Shanliang; Cai, Jing

    2013-01-01

    The association between pulmonary tuberculosis (PTB) and diabetes mellitus (DM) has been previously attracted much attention. Diabetes alters immunity to tuberculosis, leading to more frequent treatment failure in TB patients with DM. Moreover, TB and DM often coincide with micronutrients...... deficiencies, such as retinol and vitamin D, which are especially important to immunity of the body and may influence pancreas β-cell function. However, the effects of retinol and vitamin D supplementation in active TB patients with diabetes on treatment outcomes, immune and nutrition state are still uncertain....... We are conducting a randomized controlled trial of vitamin A and/or D in active PTB patients with DM in a network of 4 TB treatment clinics to determine whether the supplementation could improve the outcome in the patients....

  1. Randomized Dose-Ranging Study of the 14-Day Early Bactericidal Activity of Bedaquiline (TMC207) in Patients with Sputum Microscopy Smear-Positive Pulmonary Tuberculosis

    Diacon, Andreas H; Dawson, Rodney; Von Groote-Bidlingmaier, Florian; Symons, Gregory; Venter, Amour; Donald, Peter R.; Conradie, Almari; Erondu, Ngozi; Ginsberg, Ann M.; Egizi, Erica; Winter, Helen; De Becker, Piet; Mendel, Carl M.

    2013-01-01

    Bedaquiline is a new antituberculosis agent targeting ATP synthase. This randomized, double-blinded study enrolling 68 sputum smear-positive pulmonary tuberculosis patients evaluated the 14-day early bactericidal activity of daily doses of 100 mg, 200 mg, 300 mg, and 400 mg bedaquiline, preceded by loading doses of 200 mg, 400 mg, 500 mg, and 700 mg, respectively, on the first treatment day and 100 mg, 300 mg, 400 mg, and 500 mg on the second treatment day. All groups showed activity with a m...

  2. Sputum smear negative pulmonary tuberculosis: sensitivity and specificity of diagnostic algorithm

    Mugusi Ferdinand M

    2011-11-01

    Full Text Available Abstract Background The diagnosis of pulmonary tuberculosis in patients with Human Immunodeficiency Virus (HIV is complicated by the increased presence of sputum smear negative tuberculosis. Diagnosis of smear negative pulmonary tuberculosis is made by an algorithm recommended by the National Tuberculosis and Leprosy Programme that uses symptoms, signs and laboratory results. The objective of this study is to determine the sensitivity and specificity of the tuberculosis treatment algorithm used for the diagnosis of sputum smear negative pulmonary tuberculosis. Methods A cross-section study with prospective enrollment of patients was conducted in Dar-es-Salaam Tanzania. For patients with sputum smear negative, sputum was sent for culture. All consenting recruited patients were counseled and tested for HIV. Patients were evaluated using the National Tuberculosis and Leprosy Programme guidelines and those fulfilling the criteria of having active pulmonary tuberculosis were started on anti tuberculosis therapy. Remaining patients were provided appropriate therapy. A chest X-ray, mantoux test, and Full Blood Picture were done for each patient. The sensitivity and specificity of the recommended algorithm was calculated. Predictors of sputum culture positive were determined using multivariate analysis. Results During the study, 467 subjects were enrolled. Of those, 318 (68.1% were HIV positive, 127 (27.2% had sputum culture positive for Mycobacteria Tuberculosis, of whom 66 (51.9% were correctly treated with anti-Tuberculosis drugs and 61 (48.1% were missed and did not get anti-Tuberculosis drugs. Of the 286 subjects with sputum culture negative, 107 (37.4% were incorrectly treated with anti-Tuberculosis drugs. The diagnostic algorithm for smear negative pulmonary tuberculosis had a sensitivity and specificity of 38.1% and 74.5% respectively. The presence of a dry cough, a high respiratory rate, a low eosinophil count, a mixed type of anaemia and

  3. Cystic changes associated with pulmonary tuberculosis: a case report

    CAI Hou-rong; CAO Min; MENG Fan-qing; LI Wei-chun

    2006-01-01

    @@ There are a wide range of computed tomography (CT) findings in patients with pulmonary tuberculosis, including diffuse or localized nodules,reticular opacities, ground glass attenuation, air trapping, consolidation, cavitation, fibrosis, lymph nodes enlargement, and septal thickening.1-3However, CT findings of pulmonary tuberculosis that appeared as multiple cystic lesions were very rare.3,4Herein, the CT findings appeared as multiple cystic lesions in a patient with pulmonary tuberculosis are reported.

  4. Utility of CT in the evaluation of pulmonary tuberculosis in patients without Aids

    Objective. To assess the utility of CT in the evaluation of pulmonary tuberculosis in patients without AIDS. Patients and methods. Thin-section CT scans for suspicion of pulmonary tuberculosis were obtained from 226 patients. A total of 38 patients were excluded; the reasons were unavailability of final results (n=18), patient unavailability for follow-up (n=13), and coexistence of tuberculosis and aspergilloma (n=7). The results from 188 patients were used for this study. After assessing the patterns of parenchymal lesion, involved segments, and presence of cavity, bronchiectases, and bronchogenic spread of the lesion with CT, tentative diagnosis and disease activity were recorded. Results. With CT, 133 of 146 patients (91%) with tuberculosis were correctly diagnosed as having pulmonary tuberculosis whereas 32 of 42 patients (76%) without tuberculosis were correctly excluded. CT diagnosis of lung cancer (n=8), bacterial pneumonia (n=2), pulmonary metastasis (n=1), chronic hypersensitivity pneumonia (n=1) and diffuse pan-bronchiolitis (n=1) turned out to be tuberculosis. Conversely CT diagnoses of tuberculosis appeared pathologically as lung cancer (n=5), bacterial pneumonia 71/89, 80%) and inactive state (51/57, 89%) of disease respectively could be correctly differentiated by CT. Conclusion. CT can be helpful in the diagnosis of pulmonary tuberculosis in most cases. On the basis of CT findings, distinction of active from inactive disease can be made in most cases. (authors)

  5. Intestinal permeability and malabsorption of rifampin and isoniazid in active pulmonary tuberculosis

    Valéria G. F. Pinheiro

    2006-12-01

    Full Text Available Low antimycobacterial drug concentrations have been observed in tuberculosis (TB patients under treatment. The lactulose/mannitol urinary excretion test (L/M, normally used to measure intestinal permeability, may be useful to assess drug absorption. The objective of this research was to study intestinal absorptive function and bioavailability of rifampin and isoniazid in TB patients. A cross sectional study was done with 41 patients and 28 healthy controls, using the L/M test. The bioavailabilities of rifampin (R and isoniazid (H were evaluated in 18 patients receiving full doses. Urinary excretion of mannitol and lactulose, measured by HPLC, was significantly lower in TB patients. The serum concentrations of the drugs were below the expected range for R (8-24 mcg/mL or H (3-6 mcg/mL in 16/18 patients. Analyzing the drugs individually, 12/18 patients had low serum concentrations of R, 13/18 for H and 8/18 for both drugs. We suggest that there is a decrease in the functional absorptive area of the intestine in TB patients, which would explain the reduced serum concentrations of antituberculosis drugs. There is a need for new approaches to improve drug bioavailability in TB patients.

  6. Differential diagnosis between pulmonary tuberculosis and lung abscess by contrast enhanced CT

    The contrast enhanced CT findings in 14 patients with active tuberculosis and 26 patients with lung abscess were retrospectively analyzed. Reflecting the difference of pathogenesis between tuberculosis and abscess, the findings are widely different. The findings suggesting pulmonary tuberculosis rather than lung abscess were as follows; multiple and irregular necrotic areas, positive CT angiogram sign, no marginal enhancement surrounding necrosis. Contrast enhanced CT may help to distinguish pulmonary tuberculosis from lung abscess, especially in cases of caseous pneumonia showing broad consolidations or mass-like shadows. (author)

  7. Evaluation of Tl-201 lung uptake and impairment of pulmonary perfusion on scintigraphies in pulmonary tuberculosis

    Fujii, Tadashige [Shinshu Univ., Matsumoto, Nagano (Japan). School of Allied Medical Sciences; Tanaka, Masao; Koizumi, Tomonori; Kubo, Keishi

    2000-02-01

    Tl-201 lung uptake in 74 patients (85 lesions) and pulmonary perfusion in 105 patients were studied to evaluate clinical usefulness of Tl-201 lung uptake and perfusion lung scintigraphy in pulmonary tuberculosis, using a scintillation camera with a mini-computer system. As indices of Tl-201 lung uptake, lung (lesion) to upper mediastinum uptake ratio (L/M) and visual grading were used. L/M in pulmonary tuberculosis was 1.96{+-}0.66, which was significantly larger than 1.04{+-}0.24 in healthy controls and lower than that in heart diseases with left heart failure and idiopathic interstitial pneumonia, and showed no significant differences with that in acute pneumonia, pyothorax, primary lung cancer and malignant mediastinal tumor. L/M in pulmonary tuberculosis did not correlate with CRP, erythrocyte sedimentation rate, Gaffky number of sputum and body temperature. It correlated with the type of pulmonary tuberculosis according to the Gakken Classification reflecting the disease activity. It was larger in the exudative type, caseo-infiltrative one, disseminated one, one with cavity in infiltrative lesion than the fibro-caseous one. On perfusion lung scintigram, impairment of pulmonary perfusion larger than area of the entire unilateral lung was observed in 68 cases (64.8%). Area of hypoperfused lung field, which correlated with % vital capacity (r=0.60, p=0.0002) and PaO{sub 2} (r=0.39,p=0.0024), was significantly larger in patients with silicosis and those with bilateral pleural involvements such as pleural callosity than in those with type III according to the Gakkai Classification. Most of the patients showed decreased pulmonary perfusion and Tl-201 accumulation of which grade reflects the disease activity in active tuberculous lesion. Patients with miliary tuberculosis and those with silicotuberculosis showed diffuse Tl-201 accumulation in the both lungs. Tl-201 lung scintigraphy seems to be useful for visualizing active tuberculous lesions, particularly the ones

  8. Evaluation of Tl-201 lung uptake and impairment of pulmonary perfusion on scintigraphies in pulmonary tuberculosis

    Tl-201 lung uptake in 74 patients (85 lesions) and pulmonary perfusion in 105 patients were studied to evaluate clinical usefulness of Tl-201 lung uptake and perfusion lung scintigraphy in pulmonary tuberculosis, using a scintillation camera with a mini-computer system. As indices of Tl-201 lung uptake, lung (lesion) to upper mediastinum uptake ratio (L/M) and visual grading were used. L/M in pulmonary tuberculosis was 1.96±0.66, which was significantly larger than 1.04±0.24 in healthy controls and lower than that in heart diseases with left heart failure and idiopathic interstitial pneumonia, and showed no significant differences with that in acute pneumonia, pyothorax, primary lung cancer and malignant mediastinal tumor. L/M in pulmonary tuberculosis did not correlate with CRP, erythrocyte sedimentation rate, Gaffky number of sputum and body temperature. It correlated with the type of pulmonary tuberculosis according to the Gakken Classification reflecting the disease activity. It was larger in the exudative type, caseo-infiltrative one, disseminated one, one with cavity in infiltrative lesion than the fibro-caseous one. On perfusion lung scintigram, impairment of pulmonary perfusion larger than area of the entire unilateral lung was observed in 68 cases (64.8%). Area of hypoperfused lung field, which correlated with % vital capacity (r=0.60, p=0.0002) and PaO2 (r=0.39,p=0.0024), was significantly larger in patients with silicosis and those with bilateral pleural involvements such as pleural callosity than in those with type III according to the Gakkai Classification. Most of the patients showed decreased pulmonary perfusion and Tl-201 accumulation of which grade reflects the disease activity in active tuberculous lesion. Patients with miliary tuberculosis and those with silicotuberculosis showed diffuse Tl-201 accumulation in the both lungs. Tl-201 lung scintigraphy seems to be useful for visualizing active tuberculous lesions, particularly the ones that could

  9. A novel whole-blood miRNA signature for a rapid diagnosis of pulmonary tuberculosis.

    Latorre, Irene; Leidinger, Petra; Backes, Christina; Dom??nguez, Jose; de Souza-Galvao, Mal??; Maldonado, Jose; Prat, Cristina; Ruiz, Juan Jes??s; S??nchez Mart??nez, Francisca; Casas, Irma; Keller, Andreas; Briesen, Hagen von; Knobel Freud, Hernando; Meese, Eckart; Meyerhans, Andreas

    2015-01-01

    Background: Deregulation of microRNAs (miRNAs)has been associated with various human pathologies including bacterial infections.Aim: To investigate the role of miRNAs as blood biomarkers for the diagnosis of active pulmonary tuberculosis (TB).Materials and methods: We studied 50 patients, classified into 3 groups:(i) 17individuals with latent tuberculosis infection (LTBI) (ii) 17 active pulmonary TB patients (iii) 16 healthy individuals. Blood was collected in a PAXgene Blood RNA tubefor thel...

  10. Drug resistance patterns in pulmonary tuberculosis

    Objective: To determine the resistance patterns of mycobacterium tuberculosis (MTB) isolates among category I and II patients of pulmonary tuberculosis. Methods: This cross sectional study was conducted at the Department of Medicine, Liaquat University of Medical and Health Sciences Jamshoro, from November 2008 to September 2009. Patients were divided into category I and II. The sputa were collected, stained with Ziehl-Nielsen (Z-N) staining and ultimately inoculated on Lowenstein-Jensen (L-J) media for six weeks. Out of 890 pulmonary tuberculosis (PTB) patients, the growth was obtained in 285 cases. The Drug sensitivity testing (DST) for Isoniazid (INH), Rifampicin (RIF), Ethambutol (EMB) Pyrazinamide (PZA) and Streptomycin (SM) were performed. The data was analyzed on SPSS 10.0. A p-value of <0.05 was taken as significant. Result: Out of 285 cases, 176 (61.75%) were male and 109 (38.24%) female. The mean age was 37 +- 19.90 years. The DST showed drug sensitive and drug resistant isolates in 80 (28.05%) and 205 (71.92%) cases respectively (p=0.001). The drug resistant tuberculosis (DR-TB) rates for individual drugs; INH, RIF, EMB, PZA and SM were 51,22%, 15.4%, 13.33%, 9%12, and 3.85% respectively (p=0.03). The MDR-TB isolates were detected in 120 (42.10%) cases, including 5 (5.88%) in category I and 115 (57.50%) in category II patients (p=0.0001). Conclusion: Drug resistant and multidrug resistant tuberculosis was observed mainly in category II patients. However, primary MDR was also observed in category I patients and reflects dissemination of MDR cases within the community. (author)

  11. High resolution chest CT in patients with pulmonary tuberculosis: Characteristic findings before and after antituberculous therapy

    Objective: The purpose of this study was (a) to describe HRCT findings for pulmonary tuberculosis before and after treatment, and (b) to evaluate the possible use of HRCT to assess disease activity. Patients and methods: We prospectively studied 52 patients with newly diagnosed pulmonary tuberculosis that was proven bacteriologically. HRCT scans were performed before and after treatment. Results: Micronodules, nodules, tree-in-bud appearance, consolidation, and cavities were the most common HRCT findings seen in active pulmonary tuberculosis. The disappearance of tree-in-bud appearance, pleural effusion and the presence of fibrotic change appear to be indications of the effectiveness of treatment. HRCT can differentiate old fibrotic lesions from newly active tuberculous lesions. Conclusions: HRCT may be helpful in the diagnosis of pulmonary tuberculosis and may be useful in the assessment of the efficacy of anti-tuberculous treatment

  12. CT findings of pulmonary tuberculosis in diabetic and immunocompromised patients

    To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients, we reviewed CT of the chest in 42 adult patients with active pulmonary tuberculosis. Forty-two had some underlying diseases or immunocompromised conditions (31 diabetes mellitus, 6 malignancies, 2 long-term steroid therapy, 2 pneumoconiosis, and one anorexia nervosa). In diabetic or immunocompromised patients, a high incidence of non-segmental distribution (27%) and multiple small cavities in a cavitary lesion (45%) was observed. Unusual localization of the lesions such as lower lung field disease was observed in 18% of cases (the incidence of unusual localization in patients with no underlying disease was equal to diabetic or immunocompromised patients). (author)

  13. CT findings of pulmonary tuberculosis in diabetic and immunocompromised patients

    Takeuchi, Noriyuki; Ikezoe, Junpei; Johkoh, Tsuyoshi (Osaka Univ. (Japan). Faculty of Medicine) (and others)

    1992-01-01

    To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients, we reviewed CT of the chest in 42 adult patients with active pulmonary tuberculosis. Forty-two had some underlying diseases or immunocompromised conditions (31 diabetes mellitus, 6 malignancies, 2 long-term steroid therapy, 2 pneumoconiosis, and one anorexia nervosa). In diabetic or immunocompromised patients, a high incidence of non-segmental distribution (27%) and multiple small cavities in a cavitary lesion (45%) was observed. Unusual localization of the lesions such as lower lung field disease was observed in 18% of cases (the incidence of unusual localization in patients with no underlying disease was equal to diabetic or immunocompromised patients). (author).

  14. Detección de la expresión génica in vivo de Mycobacterium tuberculosis durante la tuberculosis pulmonar activa Mycobacterium tuberculosis in vivo-expressed genes detection during active pulmonary tuberculosis

    Alejandra Otazo M; Ingrid Gutiérrez S; Víctor Acevedo F; Carlos Calderón A; Nancy P Maulén L

    2012-01-01

    El estudio de la expresión génica de Mycobacterium tuberculosis ha involucrado la experimentación "in vitro ", "ex vivo " e "in vivo " (modelos animales), pero aún sin el éxito esperado. Proponemos que revelar los factores clave de la tuberculosis humana requiere investigar la expresión génica de M. tuberculosis dentro del ser humano ("in vivo "). Para ello, aislamos el mRNA total de M. tuberculosis, desde muestras clínicas respiratorias de pacientes con diagnóstico de tuberculosis pulmonar; ...

  15. [Pulmonary function in patients with infiltrative pulmonary tuberculosis].

    Nefedov, V B; Popova, L A; Shergina, E A

    2007-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), R(aw), R(in),, R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 103 patients with infiltrative pulmonary tuberculosis. Pulmonary dysfunction was detected in 83.5% of the patients. Changes were found in lung volumes and capacities in 63.1%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 60.2 and 41.7%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC and FVC, and decreased and increased TGV and TLC; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, FEV1/VC% and increased R(aw) R(in), and R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, and PaO2 and decreased and increased PaCO2. The magnitude of the observed functional changes was generally slight. Significant disorders were observed rarely and very pronounced ones were exceptional. PMID:17915466

  16. [Pulmonary function in patients with disseminated pulmonary tuberculosis].

    Nefedov, V B; Shergina, E A; Popova, L A

    2007-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25%, MEF50%, MEF75%, TLS, TGV, pulmonary residual volume (PRV), Raw, Rin, Rex, DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 29 patients with disseminated pulmonary tuberculosis. Pulmonary dysfunction was detected in 93.1% of the patients. Changes were found in lung volumes and capacities in 65.5%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 79.3 and 37.9%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC, FVC, and TLS, decreased and increased TGV; impaired bronchial patency presented as decreased PEF, MEF25%, MEF50%, MEF75%, and FEV1/VC% and increased Raw, Rin, and Rex; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SS and PaO2 and decreased and increased PaCO2. The observed functional changes varied from slight to significant and pronounced with a preponderance of small disorders, a lower detection rate of significant disorders, and rare detection of very pronounced ones. PMID:18041129

  17. ALLELIC POLYMORPHISM OF IFNγ GENE IN PATIENTS WITH PULMONARY TUBERCULOSIS

    E. L. Nikulina; I. O. Naslednikova; Urazova, O. I.; O. V. Voronkova; V. V. Novitsky; E. V. Nekrasov; O. V. Filiniuk; E. G. Churina; K. O. Mikheyeva; R. R. Hasanova; V. A. Serebryakova; N. A. Sukhalentseva

    2014-01-01

    In present work, some immunogenetic aspects of pulmonary tuberculosis were studied, using modern techniques from molecular genetics and immunology. It is shown that carriage of Т allele and homozygous TT genotype in +874А/Т IFNγ gene polymorphism comprise a immunogenetic factor which correlated with a protective effect, regarding a susceptibility to pulmonary tuberculosis. Predisposition for tuberculosis infection is associated with A allele of this gene, as well as with АА and АТ genotypes o...

  18. The adult respiratory distress syndrome bronchogenic pulmonary tuberculosis.

    R. A. Dyer; Potgieter, P D

    1984-01-01

    In three cases of pulmonary tuberculosis associated with the adult respiratory distress syndrome the clinical features, which were similar to those of patients with miliary tuberculosis and adult respiratory distress syndrome, included a history of cough, fever, and dyspnoea on effort, and the physical signs of fever, tachypnoea, pulmonary adventitious sounds, tachycardia, and hepatomegaly. In these cases the radiological features, though suggestive of diffuse pulmonary oedema, were more prom...

  19. Pulmonary drug delivery systems for tuberculosis treatment.

    Pham, Dinh-Duy; Fattal, Elias; Tsapis, Nicolas

    2015-01-30

    Tuberculosis (TB) remains a major global health problem as it is the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). Conventional treatments fail either because of poor patient compliance to the drug regimen or due to the emergence of multidrug-resistant tuberculosis. The aim of this review is to give an update on the information available on tuberculosis, its pathogenesis and current antitubercular chemotherapies. Direct lung delivery of anti-TB drugs using pulmonary delivery systems is then reviewed since it appears as an interesting strategy to improve first and second line drugs. A particular focus is place on research performed on inhalable dry powder formulations of antitubercular drugs to target alveolar macrophages where the bacteria develop. Numerous studies show that anti-TB drugs can be incorporated into liposomes, microparticles or nanoparticles which can be delivered as dry powders to the deep lungs for instantaneous, targeted and/or controlled release. Treatments of infected animals show a significant reduction of the number of viable bacteria as well as a decrease in tissue damage. These new formulations appear as interesting alternatives to deliver directly drugs to the lungs and favor efficient TB treatment. PMID:25499020

  20. Primary mediastino pulmonary tuberculosis in infancy

    Primary mediastino pulmonary tuberculosis in infancy is increasing in France. Bacteriological diagnosis is difficult. The aim of the study is to assess the value of chest radiograph and CTscan for diagnosis of tuberculosis. We studied 15 infants, 3 month old to 18 month old, between November 1990 and June 1992. On plain film, lymphadenopathies were present in 13 cases and parenchymal disease in 10 cases, parenchymal nodular densities in 6 cases and pleural effusion in one case, displacement of the trachea in 6 cases. We found CTscan to be useful in delineating the lymphadenopathies and parenchymal changes. In 2 cases lymphadenopathies and in 2 cases alveolar condensation were discovered on CT scan as plain film was normal. In all cases lymphadenopathies were present in CTscan, often in right side and in al cases, lymphadenopathies were hypodense with peripheral enhancement. In conclusion, the association of right paratracheal nodes with displacement of trachea and alveolar consolidation is common in tuberculosis in infants. These findings when seen on chest radiographs must lead to perform a CTscan and suggest the diagnosis. (Authors). 19 refs., 5 figs., 4 tabs

  1. Impact of HIV co-infection on plasma level of cytokines and chemokines of pulmonary tuberculosis patients

    Mihret, Adane; Abebe, Markos; Bekele, Yonas; Aseffa, Abraham; Walzl, Gerhard; Howe, Rawleigh

    2014-01-01

    Background The immunologic environment during HIV/M. tuberculosis co-infection is characterized by cytokine and chemokine irregularities that have been shown to increase immune activation, viral replication, and T cell dysfunction. Methods We analysed ex vivo plasma samples from 17 HIV negative and 16 HIV pulmonary tuberculosis co infected cases using Luminex assay to see impact of HIV co-infection on plasma level of cytokines and chemokines of pulmonary tuberculosis patients before and after...

  2. Radiological analysis of image on geriatric pulmonary tuberculosis

    2005-01-01

    Objective: To evaluate the radiological features in the cases with geriatric pulmonary tuberculosis(GPTB). Methods: One hundred and two elderly patients with tuberculosis were studied in this paper. All patients had an examination on chest X-ray, and 63 of them had a chest scan of CT. Results: The pulmonary tuberculosis infiltration, caseous pneumonia and cavitary lesions were found in 85, 11 and 19 cases with GPTB respectively. Acute miliary tuberculosis was diagnosed in 2 cases. Pleural effusion was in 26 cases. In addition, Hilar and mediastinal lymphadenopathy was presented in the other 13 cases. Conclusion: Radiological findings of GPTB were atypical in general.

  3. [Pulmonary function in patients with focal pulmonary tuberculosis].

    Nefedov, V B; Popova, L A; Shergina, E A

    2008-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), Raw, Rin, Rcx, DLCO-SB, DLCO-SS/VA, PaO2, and PaCO2 were determined in 40 patients with focal pulmonary tuberculosis. Changes were found in lung volumes and capacities in 75%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 57.5 and 25%, respectively. The lung volume and capacity changes appeared mainly as increased TGV and PRV; impaired bronchial patency presented as decreased MEF50, MEF75, and FEV1/VC%; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, PaO2, and PaCO2. The magnitude of the observed functional changes was generally slight. TGV and PRL increased up to 148-187 and 142-223% of the normal values, respectively; MEF50, MEF75, FEV1/VC%, and DLCO decreased to 59-24, 58-26, 78-57, and 78-67% of the normal values and PaO2 and PaCO2 did to 79-69 and 34-30 cm Hg. PMID:18450075

  4. Commercial Serological Tests for the Diagnosis of Active Pulmonary and Extrapulmonary Tuberculosis: An Updated Systematic Review and Meta-Analysis

    Dowdy, David W; Steingart, Karen R; Pai, Madhukar

    2011-01-01

    Editors' Summary Background Every year, about 2 million people develop tuberculosis in India—a fifth of the global incidence of this highly contagious bacterial infection. Mycobacterium tuberculosis, the bacterium that causes tuberculosis, is spread in airborne droplets when people with the disease cough or sneeze and usually infects the lungs although it can also infect other organs. The characteristic symptoms of tuberculosis are a persistent cough, weight loss, and night sweats. Diagnostic...

  5. Evaluation of Antimicrobial Re sistance of New Cases of Pulmonary Tuberculosis, in Khorasan, Iran

    MasoodReza Movahede-Danesh

    2015-10-01

    Full Text Available Background: Multi drug-resistant Mycobacterium tuberculosis (MDR-TB is an infection with a causative bacillus which is resistant to at least two drugs, isoniazid and rifampin. The purpose of this study is to evaluate the prevalence of TB resistance to first-line drugs of newly diagnosed active pulmonary tuberculosis.Methods: This cross-sectional study was performed on 77 patients with newly diagnosed active pulmonary tuberculosis (according to national protocols of TB. Sputum samples were cultured and antibiogram for isoniazid, rifampin, pyrazinamide, ethambutol, and Streptomycin were performed on the positive cultures.Results: From 77 patients with tuberculosis, 48 cases have positive sputum culture. Antibiogram was done by proportional standard method and all samples were found to be fully sensitive to all first-line TB drugs.Conclusions: According to the results of this study, the primary resistance was low to the first-line drugs for pulmonary tuberculosis of the samples collected from Khorasan, an east province of Iran. The data showed that in all patients with active pulmonary tuberculosis who were diagnosed with Ziehl–Neelsen stain of sputum, the use of the first-line drugs for tuberculosis treatment is necessary and could be sufficient.

  6. Imaging diagnosis of pulmonary tuberculosis in immunocompromised patients

    Objective: To evaluate CT and X-ray features of pulmonary tuberculosis in diabetic patients, patients post kidney transplantation, and patients with acquired immunodeficiency syndrome (AIDS). Methods: The authors reviewed CT scans in 20 patients with diabetic patients, X-ray films in 10 cases after kidney transplantation, and CT scans in 2 patients with AIDS. Results: CT features of pulmonary tuberculosis in diabetic diseases included larger confluent consolidation (10 cases ), multiple small cavities within any given lesion (9 cases ) and non-segmental distribution (2 cases). Satellite lesions were found in most films. The X-ray appearances of pulmonary tuberculosis post kidney transplantation included patch and larger confluent consolidation (6 cases), and miliary tuberculosis(4 cases). The CT findings of pulmonary tuberculosis with AIDS were enlarged mediastinal lymph nodes (1 case), pulmonary infiltration (1 case), and extra chest lesions(2 cases) such as enlarged neck lymph nodes and post-peritoneal lymph nodes. Conclusion: The Main radiological findings of pulmonary tuberculosis in immunocompromised patients appear larger confluent consolidation, multiple small cavities within a given lesion, miliary tuberculosis, enlarged mediastinal lymph nodes, and extra chest enlarged lymph nodes

  7. Rapid Diagnosis of Active Tuberculosis by Lipoarabinomanna test

    Urmila A.Sharma

    2000-04-01

    Full Text Available Presence of antimicrobial antibodies were repidly detected in 47 out of 50 cases of active pulmonaryand extra-pulmonary tuberculosis. The lipoarabinomanan (LAM antigen binds with the opllmumconcentration of anti LAM antibodies from the serum. Our findll1gs showed that the LAM test ISsimple, low cost, rapi~ and reliable test for detecting active tuberculosis.

  8. Effect of T cell subset and inflammatory cytokine levels on prognosis in patients with pulmonary tuberculosis

    Cheng-Zhou Wu; Yan-Qiao Wu

    2016-01-01

    Objective:To explore the effect of T cell subset and inflammatory cytokine levels on the prognosis in patients with pulmonary tuberculosis.Methods:A total of 72 patients confirmed with pulmonary tuberculosis who were admitted in our hospital from February, 2013 to February, 2015 were included in the study and served as the experiment group, among which 58 cases had active tuberculosis, and 14 cases had static tuberculosis; while 50 healthy individuals who came for physical examinations were served as the control group. The sputum bacteria before treatment and 6 months after treatment in the two groups were detected. The sputum negative conversion rate was recorded. The absorption of pulmonary lesions and the closure of tuberculosis cavity were examined. The immune cell function of T cell subset was detected again.Results: The peripheral blood CD3, CD4, CD8, and CD4/CD8 levels in the experiment group were significantly lower than those in the control group, especially for the active tuberculosis patients (P<0.01). The peripheral blood CD4/CD8 levels in the static tuberculosis patients was lower than that in the control group, but was significantly higher than that in active tuberculosis patients (P<0.01). The serum IL-1, IL-6, and TNF-α levels in the experiment group were significantly higher than those in the control group, especially for the active tuberculosis patients (P<0.01).Conclusions:The cell subsets and inflammatory cytokines play an important role in patients with pulmonary tuberculosis, whose dynamic change can effectively display the immune function and severity degree, which is of great value in estimating the condition and assessing the prognosis; therefore, it deserves to be further explored in the clinic.

  9. Dynamic image characteristics of pulmonary tuberculosis with diabetes mellitus

    Objective: To analyze image characteristics of pulmonary tuberculosis associated with diabetes mellitus and observe the changes of pulmonary tuberculotic lesions influenced by the state of hyperglycosemia. Methods: Examinations of chest plain film and tomography were taken in 68 patients with pulmonary tuberculosis and diabetes, and additional CT scans were done in 38 patients among them. Radiological examinations of lung and blood sugar test were taken at the interval of 2, 3, and 4-6 months in all 68 patients under the treatment of regular blood sugar control and antituberculosis, which compared with 30 patients with pulmonary tuberculosis only. Results: The images of X-ray and CT showed major lesions of massive patchy shadow in 55 patients (80.9%), or multiple small patchy shadow in 13(19.1%) and cavity 61(89.7%). After 2 month's treatment, enlargement of patchy shadow and cavity were found in 9(23.7%)and 10(28.6%)cases, respectively with overall deterioration rates of 65.8% in group of 38 patients with level of blood sugar over 7.0 mmol/L, which was significantly higher than that of the control group 7.0 mmol/L(x2=16.4, P2 = 0.81, P>0.5) with the well controlled blood sugar after treatment of 3 months or more. The follow-up images showed similar results between the groups of pulmonary tuberculosis only and the group of pulmonary tuberculosis with high level of blood sugar, in which the overall deterioration rates was significant less than the group of pulmonary tuberculosis with level of blood sugar more than 8.0 mmol/L(x2 =5.46, P<0.025). Conclusion: There are imaging characteristics in patient with pulmonary tuberculosis and diabetes mellitus. The state of hyperglycosemia is a vital factor, which influences the radiological changes of pulmonary tuberculosis

  10. Pleuropulmonary Paragonimiasis mimicking Pulmonary Tuberculosis - A Report of Three Cases

    Singh T; Kananbala S; Devi K

    2005-01-01

    Paragonimiasis is an important cause of pulmonary disease worldwide. Infection in humans mainly occurs by ingestion of raw or undercooked freshwater crabs or crayfishes. The disease is well known in endemic regions of Asian countries, where culturally based methods of food preparation foster human transmission. Three patients with clinical and radiological features compatible with pulmonary tuberculosis had been treated for tuberculosis without remedy despite an inability to demonstrate acid ...

  11. Chest Radiography Findings in Primary Pulmonary Tuberculosis in Children

    Milković, Đurđica; Richter, Darko; Zoričić-Letoja, Ivka; Raos, Miljenko; Koncul, Ivan

    2005-01-01

    Plain chest radiography plays a major role in the diagnosis and follow-up of pulmonary tuberculosis in childhood. The aim of our study was to investigate the distribution of characteristic chest radiographic findings at diagnosis in children with pulmonary tuberculosis. The age of the patients and the type and localization of radiographic changes at admission were retrospectively analyzed. We reviewed chest radiographs in 204 children admitted from January 1, 1991 until June 30, 1994 for newl...

  12. Pulmonary tuberculosis - current radiological diagnosis of the ancient disease

    Incidence. Decreasing numbers of tuberculosis cases in the western countries have led to diminished attention towards this disease. But worldwide, tuberculosis still is the leading cause of mortality due to any one single infectious agent. In the industrialized countries, immigration, growth of low-income groups and increasing numbers of immunocompromised patients, mainly due to the HIV epidemic, supply a reservoir for tuberculosis. Diagnosis. Because of the option of a specific therapy, early diagnosis of tuberculosis is crucial for the course of the disease. In cases of multidrug resistant strains, further spread has to be prevented. Radiology with chest films and computed tomography has a central role in diagnosing tuberculosis. Findings. However, as the disease produces a broad spectrum of radiographic findings, there are often difficulties in determining the underlying diagnosis. Additionally, there have been reports of a typical presentations of tuberculosis in immunocompromised as well as immunocompetent patients. This article reviews the current state of radiological diagnosis of pulmonary tuberculosis. (orig.)

  13. Correlation of serum tumor necrosis factor-alpha, interleukin-4 and soluble interleukin-2 receptor levels with radiologic and clinical manifestations in active pulmonary tuberculosis.

    Levent Kart; Hakan Buyukoglan; Ishak O. Tekin; Remzi Altin; Zuhal Senturk; Inci Gulmez; Ramazan Demir; Mustafa Ozesmi

    2003-01-01

    The precise clinical manifestations of tuberculosis are likely to result from a complex interaction between the host and the pathogen. We took serum samples from a group of patients with a variety of clinical and radiological stages of pulmonary tuberculosis in order to characterize tumor necrosis factor-alpha (TNF-alpha), interleukin-4 (IL-4) and soluble interleukin-2 receptor (sIL-2R) response. We further evaluated whether the levels of TNF-alpha, IL-4 and soluble IL-2R are related with eac...

  14. Hypertrophic osteoarthropathy in association with pulmonary tuberculosis: a case report

    In this article the authors report a case of a patient with hypertrophic osteoarthropathy associated with pulmonary tuberculosis. This disorder is a rare complication of tuberculosis and may be associated with severe and fulminant disease. The imaging methods used in the diagnosis of this disease included lower limbs radiographs that showed bilateral periosteal reaction, and chest radiographs and computed tomography that revealed a mass in the upper lobe of the right lung. Although a fine needle aspiration was suggestive of tuberculosis, the definitive diagnosis was made after thoracotomy and histopathological examination of the mass. The patient presented symptomatic and radiological improvement after treatment of tuberculosis. (author)

  15. Pulmonary disease due to Mycobacterium tuberculosis in a horse: zoonotic concerns and limitations of antemortem testing

    A case of pulmonary tuberculosis caused by Mycobacterium tuberculosis was diagnosed in a horse. Clinical evaluation performed prior to euthanasia did not suggest tuberculosis, but postmortem examination provided pathological and bacteriological evidence of disease. In the lungs, multiple tuberculoid...

  16. γ-干扰素释放试验对活动性肺结核的诊断价值%Diagnostic value of interferon gamma release assay to active pulmonary tuberculosis

    吴静; 徐建; 张映铭; 王彩英

    2011-01-01

    Objective To evaluate the diagnostic value of interferon gamma release assay to active pulmonary tuberculosis. Methods The interferon gamma release assay based on enzyme linked immunospot assay was performed in 75 patients with suspected active pulmonary tuberculosis. And the result was compared with tuberculosis culture. Results The sensitivity, specificity and accuracy of interferon gamma release assay were 81.1%, 90.9% and 84. 0%, respectively. The sensitivity of interferon gamma release assay was higher than that of tuberculosis culture (P<0. 01). Among 23 cases af negative culture results, 16 cases were detected positive by interferon gamma release assay. Conclusion Interferon gamma release assay is highly sensitive, specific and helpful to the early and rapid detection of active pulmonary tuberculosis.%目的 评价γ-干扰素释放试验(interferon gamma release assay,IGRA)对活动性肺结核的诊断价值.方法 采用IGRA检测75例肺结核疑似病例,与结核菌培养结果进行比较.结果 IGRA诊断肺结核灵敏度为81.1%,特异度为90.9%,准确性为84.0%;IGRA灵敏度明显高于结核菌培养(P<0.01);在23例培养阴性的肺结核确诊病例中,16例IGRA阳性.结论 IGRA灵敏度高,特异度强,有助于活动性肺结核的早期、快速诊断.

  17. Computed tomography features of lung parenchymal changes in pulmonary tuberculosis

    Twenty-five patients with active pulmonary tuberculosis were prospectively studied with computed tomography (CT). Three major parenchymal patterns were noted. The nodular opacities pattern was seen in all cases. Confluent consolidation was seen in 37% of patients and consolidation with associated loss of volume (CWALV) was seen in 69% of patients. High-resolution CT (HRCT) features of bronchogenic spread included (i) a centrilobular nodule or a branching linear structure (92.3%); (ii) bronchial wall thickening (61.5%); (iii) a 'tree in bud' appearance (92.3%); and (iv) poorly marginated 5-8 mm nodules (61.5%). Most of the patterns showed satellite lesions in the form of small nodules or peripheral areas of increased attenuation. Cavitation was most common in CWALV lesions. Bronchiectasis was a common accompaniment (81.3%), and its occurrence paralleled the distribution of parenchymal lesions. Associated pleural thickening was noted in half the cases. To conclude, distinctive parenchymal changes were noted with CT in cases of pulmonary tuberculosis, which may suggest the diagnosis in the appropriate clinical setting. (authors)

  18. Plasma metabolomics in human pulmonary tuberculosis disease: a pilot study.

    Jennifer K Frediani

    Full Text Available We aimed to characterize metabolites during tuberculosis (TB disease and identify new pathophysiologic pathways involved in infection as well as biomarkers of TB onset, progression and resolution. Such data may inform development of new anti-tuberculosis drugs. Plasma samples from adults with newly diagnosed pulmonary TB disease and their matched, asymptomatic, sputum culture-negative household contacts were analyzed using liquid chromatography high-resolution mass spectrometry (LC-MS to identify metabolites. Statistical and bioinformatics methods were used to select accurate mass/charge (m/z ions that were significantly different between the two groups at a false discovery rate (FDR of q<0.05. Two-way hierarchical cluster analysis (HCA was used to identify clusters of ions contributing to separation of cases and controls, and metabolomics databases were used to match these ions to known metabolites. Identity of specific D-series resolvins, glutamate and Mycobacterium tuberculosis (Mtb-derived trehalose-6-mycolate was confirmed using LC-MS/MS analysis. Over 23,000 metabolites were detected in untargeted metabolomic analysis and 61 metabolites were significantly different between the two groups. HCA revealed 8 metabolite clusters containing metabolites largely upregulated in patients with TB disease, including anti-TB drugs, glutamate, choline derivatives, Mycobacterium tuberculosis-derived cell wall glycolipids (trehalose-6-mycolate and phosphatidylinositol and pro-resolving lipid mediators of inflammation, known to stimulate resolution, efferocytosis and microbial killing. The resolvins were confirmed to be RvD1, aspirin-triggered RvD1, and RvD2. This study shows that high-resolution metabolomic analysis can differentiate patients with active TB disease from their asymptomatic household contacts. Specific metabolites upregulated in the plasma of patients with active TB disease, including Mtb-derived glycolipids and resolvins, have potential as

  19. Plasma metabolomics in human pulmonary tuberculosis disease: a pilot study.

    Frediani, Jennifer K; Jones, Dean P; Tukvadze, Nestan; Uppal, Karan; Sanikidze, Eka; Kipiani, Maia; Tran, ViLinh T; Hebbar, Gautam; Walker, Douglas I; Kempker, Russell R; Kurani, Shaheen S; Colas, Romain A; Dalli, Jesmond; Tangpricha, Vin; Serhan, Charles N; Blumberg, Henry M; Ziegler, Thomas R

    2014-01-01

    We aimed to characterize metabolites during tuberculosis (TB) disease and identify new pathophysiologic pathways involved in infection as well as biomarkers of TB onset, progression and resolution. Such data may inform development of new anti-tuberculosis drugs. Plasma samples from adults with newly diagnosed pulmonary TB disease and their matched, asymptomatic, sputum culture-negative household contacts were analyzed using liquid chromatography high-resolution mass spectrometry (LC-MS) to identify metabolites. Statistical and bioinformatics methods were used to select accurate mass/charge (m/z) ions that were significantly different between the two groups at a false discovery rate (FDR) of qmetabolites. Identity of specific D-series resolvins, glutamate and Mycobacterium tuberculosis (Mtb)-derived trehalose-6-mycolate was confirmed using LC-MS/MS analysis. Over 23,000 metabolites were detected in untargeted metabolomic analysis and 61 metabolites were significantly different between the two groups. HCA revealed 8 metabolite clusters containing metabolites largely upregulated in patients with TB disease, including anti-TB drugs, glutamate, choline derivatives, Mycobacterium tuberculosis-derived cell wall glycolipids (trehalose-6-mycolate and phosphatidylinositol) and pro-resolving lipid mediators of inflammation, known to stimulate resolution, efferocytosis and microbial killing. The resolvins were confirmed to be RvD1, aspirin-triggered RvD1, and RvD2. This study shows that high-resolution metabolomic analysis can differentiate patients with active TB disease from their asymptomatic household contacts. Specific metabolites upregulated in the plasma of patients with active TB disease, including Mtb-derived glycolipids and resolvins, have potential as biomarkers and may reveal pathways involved in TB disease pathogenesis and resolution. PMID:25329995

  20. Spontaneous and induced sputum values in the diagnosis of pulmonary tuberculosis among patients with suspected pulmonary tuberculosis

    Katayoun Haji Bagheri; Shahla Afrasiabian; Behzad Mohsenpour; Naser Reshadmanesh

    2015-01-01

    Objectives: The quality of sputum samples is important for the diagnosis of pulmonary tuberculosis (TB). Unfortunately, it is not always possible to get a proper sputum sample. Now, sputum induction (SI) has been found to be useful for the diagnosis of many lung diseases. Therefore, this study compares the role of spontaneous sputum and induced sputum in the diagnosis of pulmonary TB among suspected pulmonary TB patients. Materials and Methods: A total of 27 patients admitted with suspected p...

  1. Scintigraphic study of blood perfusion of the pulmonary artery in pulmonary tuberculosis

    Blood perfusion in the pulmonary artery is studied by pulmonary scintigraphy with macroaggregated albumin 131I, in 74 cases of pulmonary tuberculosis. Results shown by scintigraphy are compared to those observed in roentgenography and also correlated with the extension and degree of the lesions, and with the presence of associated tuberculosis, considered capable of changing the scintigraphic picture. The reduction of blood flow in the pulmonary artery are observed in cases of infiltrative, fibrotic of caseous lesions, as well as in cases of minor lesions

  2. Empyema necessitans: very late complication of pulmonary tuberculosis.

    Gomes, Manuel Mendes; Alves, Márcia; Correia, José Bernardes; Santos, Lèlita

    2013-01-01

    Empyema necessitans is a rare clinical finding nowadays. We report the case of a patient admitted in our ward for investigation of an unknown onset anterior chest wall mass, with no accompanying signs or symptoms. It is noteworthy that the patient had had pulmonary tuberculosis submitted to thoracoplasty more than 60 years before. Thoracic MRI showed a large heterogeneous mass, with a thick wall and internal septations located at the right anterior chest wall, as well as a heterogeneous content inside the right pleural cavity, with direct communication between both. An aspirative puncture of both masses was performed, with positive cultures for Mycobacterium tuberculosis, thus leading to the diagnosis of pleural tuberculosis with anterior chest wall empyema necessitans. A drain was inserted and antibiotics started. This case draws our attention to a very rare complication of pulmonary tuberculosis and its surgical treatment, though it aroused many decades after primary infection. PMID:24326441

  3. A high-resolution computed tomography-based scoring system to differentiate the most infectious active pulmonary tuberculosis from community-acquired pneumonia in elderly and non-elderly patients

    Yeh, Jun-Jun [Ditmanson Medical Foundation Chia-Yi Christian Hospital, Section of Thoracic Imaging, Department of Chest Medicine and Family Medicine, Chiayi City (China); Chia Nan University of Pharmacy and Science, Tainan (China); Meiho University, Pingtung (China); Pingtung Christian Hospital, Pingtung (China); Chen, Solomon Chih-Cheng; Chen, Cheng-Ren [Ditmanson Medical Foundation Chia-Yi Christian Hospital, Department of Medical Research, Chiayi City (China); Yeh, Ting-Chun; Lin, Hsin-Kai; Hong, Jia-Bin; Wu, Bing-Tsang [Ditmanson Medical Foundation Chia-Yi Christian Hospital, Department of Family Medicine, Chiayi City (China); Wu, Ming-Ting [Department of Radiology, Kaohsiung Veterans General Hospital, Section of Thoracic and Circulation Imaging, Kaohsiung (China); School of Medicine, National Yang Ming University, Faculty of Medicine, Taipei (China)

    2014-10-15

    The objective of this study was to use high-resolution computed tomography (HRCT) imaging to predict the presence of smear-positive active pulmonary tuberculosis (PTB) in elderly (at least 65 years of age) and non-elderly patients (18-65 years of age). Patients with active pulmonary infections seen from November 2010 through December 2011 received HRCT chest imaging, sputum smears for acid-fast bacilli and sputum cultures for Mycobacterium tuberculosis. Smear-positive PTB was defined as at least one positive sputum smear and a positive culture for M. tuberculosis. Multivariate logistic regression analyses were performed to determine the HRCT predictors of smear-positive active PTB, and a prediction score was developed on the basis of receiver operating characteristic curve analysis. Of 1,255 patients included, 139 were diagnosed with smear-positive active PTB. According to ROC curve analysis, the sensitivity, specificity, positive predictive value, negative predictive value, false positive rates and false negative rates were 98.6 %, 95.8 %, 78.5 %, 99.8 %, 4.2 % and 1.4 %, respectively, for diagnosing smear-positive active PTB in elderly patients, and 100.0 %, 96.9 %, 76.5 %, 100.0 %, 3.1 % and 0.0 %, respectively, for non-elderly patients. HRCT can assist in the early diagnosis of the most infectious active PTB, thereby preventing transmission and minimizing unnecessary immediate respiratory isolation. (orig.)

  4. A high-resolution computed tomography-based scoring system to differentiate the most infectious active pulmonary tuberculosis from community-acquired pneumonia in elderly and non-elderly patients

    The objective of this study was to use high-resolution computed tomography (HRCT) imaging to predict the presence of smear-positive active pulmonary tuberculosis (PTB) in elderly (at least 65 years of age) and non-elderly patients (18-65 years of age). Patients with active pulmonary infections seen from November 2010 through December 2011 received HRCT chest imaging, sputum smears for acid-fast bacilli and sputum cultures for Mycobacterium tuberculosis. Smear-positive PTB was defined as at least one positive sputum smear and a positive culture for M. tuberculosis. Multivariate logistic regression analyses were performed to determine the HRCT predictors of smear-positive active PTB, and a prediction score was developed on the basis of receiver operating characteristic curve analysis. Of 1,255 patients included, 139 were diagnosed with smear-positive active PTB. According to ROC curve analysis, the sensitivity, specificity, positive predictive value, negative predictive value, false positive rates and false negative rates were 98.6 %, 95.8 %, 78.5 %, 99.8 %, 4.2 % and 1.4 %, respectively, for diagnosing smear-positive active PTB in elderly patients, and 100.0 %, 96.9 %, 76.5 %, 100.0 %, 3.1 % and 0.0 %, respectively, for non-elderly patients. HRCT can assist in the early diagnosis of the most infectious active PTB, thereby preventing transmission and minimizing unnecessary immediate respiratory isolation. (orig.)

  5. Bleached smear microscopy provides higher yield in diagnosing pulmonary tuberculosis

    Jithendra Kandati; Suresh Kumar Boorsu; Ramamohan Pathalapati; Madhavulu Buchineni

    2016-01-01

    Background: Tuberculosis (TB) remains one of the major deadliest communicable diseases throughout the world. Worldwide, 9.6 million people are estimated to have fallen ill with TB in 2014, India accounts for 23% of total global cases. The study evaluated the performance of direct sputum smear versus bleach concentration smear in diagnosis of pulmonary tuberculosis. Methods: Patients more than 10 years of age who presented with history of cough for >2 weeks duration were included. One spot ...

  6. Molecular Epidemiology of Pulmonary Tuberculosis in Belgrade, Central Serbia

    Vuković, Dragana; Rüsch-Gerdes, Sabine; Savić, Branislava; Niemann, Stefan

    2003-01-01

    In order to gain precise data on the actual epidemiology of tuberculosis (TB) in Belgrade, central Serbia, we conducted the molecular epidemiological investigation described herein. IS6110 restriction fragment length polymorphism (RFLP) typing of 176 Mycobacterium tuberculosis isolates was performed. These strains were obtained from 48.4% of all patients diagnosed with culture-proven pulmonary TB from April through September 1998 and from May through October 1999. Clusters containing strains ...

  7. Personal Determinants of Formation Disease Adaptation in Patients with Active Pulmonary Tuberculosis: a Comparative Analysis from the Standpoint of Gender Approach

    Sevostyanova M.S.,

    2014-08-01

    Full Text Available We present the design and results of empirical research, facing the actual problem of integration of theoretical and methodological knowledge of different areas of psychology to solve actual applied problems of modern physical medicine. For the first time, we described the use of gender-based approach to the study of psychological structures of disease internal picture in men aged 25 to 49, suffering from various forms of active pulmonary tuberculosis no more than 3 years. The hypothesis that individual gender characteristics are personality determinants of formation specific adaptation to the disease is confirmed by the results of empirical research. The main conclusions of the work: 1 individual gender appearance is an important psychological factor in the development of a healthy personality; 2 internalization of certain personal characteristics in individual gender space affects the features of the formation of certain types of patients relationship to the disease. The study conclusions highlight the need to complement the complex biopsychosocial rehabilitation programs of somatic patients by methods of psychological intervention from the standpoint of gender mainstreaming, thereby having significant practice oriented focus.

  8. [Differential diagnosis of pulmonary tuberculosis and community-acquired pneumonia].

    Deĭkina, O N; Mishin, V Iu; Demikhova, O V

    2007-01-01

    The purpose of this investigation was to enhance the efficiency of differential diagnosis of pneumonia and pulmonary tuberculosis. A hundred and fifty-nine adult patients were examined. These included 78 patients with pulmonary tuberculosis and 81 with community-acquired p neumonia. The clinical features of infiltrative pulmonary tuberculosis (n = 48) and mild community-acquired pneumonia (n = 51) were compared. The course of caseous pneumonia (n = 30) was compared with that of moderate and severe community-acquired pneumonia (n = 30). Significant differences in the manifestations of the intoxication and bronchopulmonary syndrome were not found in patients with community-acquired pneumonia and infiltrative pulmonary tuberculosis. Physical studies showed that in patients with community-acquired pneumonia, moist rale (54.9%) and crepitation (11.8%) were prevalent, but in those with infiltrative tuberculosis rale was absent in 60.4% of cases and the pattern of respiration was unchanged in 79.2%. Chest X-ray studies indicated that in patients with community-acquired pneumonia, lower lobar inflammatory changes were predominant in 62.8% of cases whereas in those with infiltrative pulmonary tuberculosis the process was mainly bilateral (43.8%) with the presence of destructive changes (83.3%) and bronchogenic dissemination (66.7%). In patients with caseous pneumonia, the intoxication syndrome was more significant than in those with severe community-acquired pneumonia. Chest X-ray studies demonstrated that in patients with caseous pneumonia, specific changes were bilateral with the involvement of 2 lobes or more, with destruction and bronchogenic dissemination while in those with community-acquired pneumonia, the pulmonary processes were predominantly bilateral (76.6%) at the lower lobar site (36.7%). PMID:17338353

  9. Frequency of otorhinolaryngologies' manifestations in patients with pulmonary tuberculosis

    Sousa, Renato Telles de

    2010-06-01

    Full Text Available Introduction: The tuberculosis continues being a world problem and in the last years had an increase in his incidence mainly by the growing number of patients with HIV. The tuberculosis has like an etiologic agent the Mycobacterium tuberculosis that possesses a period of latency generally prolonged between the initial infection and the illness. That illness can affect diverse organs and systems. M Method: This study is descriptive, transversal and prospective. Within, patients diagnosed with pulmonary tuberculosis by the service of pneumologia of the outpatient clinic Araújo Lima of the Federal University of the Amazon (UFAM, in Manaus, between the period of July of 2005 and May of 2006 were submitted to otorhinolaryngological exam in search of manifestations of the illness. Objectives: The main objective of the study was estimate the predominance of otorhinolaryngological manifestations in patients with tuberculosis and to describe the frequencies of the different manifestations. Results: They were analyzed 15 cases of pulmonary tuberculosis confirmed by the baciloscopia, being 7 of the female sex and 8 of the male sex. The majority of the patients were young adults between the third and fourth decade of life (46,7%. Only one of the patients had co-infection with the HIV virus. Conclusion: The otorhinolaryngological affection by the tuberculosis was observed in 2 patients corresponding to 13.33% of the sample, being a patient with tubercular medium otitis and a patient with linfoadenopatia cervical.

  10. Screening and intervention of diabetes mellitus in patients with pulmonary tuberculosis in poverty zones in China

    Wang, Qiuzhen; Han, Xiuxia; Ma, Aiguo;

    2012-01-01

    The merging epidemics of pulmonary tuberculosis (PTB) and diabetes mellitus (DM) have been raised concerns by many experts but no large scale screening and intervention have been launched yet, especially in low-income areas. The current study aims to understand the prevalence of DM in active PTB ...... patients and evaluate the outcomes of diet and living habit intervention in poverty zones in China....

  11. Sputum smear negative pulmonary tuberculosis: sensitivity and specificity of diagnostic algorithm

    Mugusi Ferdinand M; Swai Hedwiga F; Mbwambo Jessie K

    2011-01-01

    Abstract Background The diagnosis of pulmonary tuberculosis in patients with Human Immunodeficiency Virus (HIV) is complicated by the increased presence of sputum smear negative tuberculosis. Diagnosis of smear negative pulmonary tuberculosis is made by an algorithm recommended by the National Tuberculosis and Leprosy Programme that uses symptoms, signs and laboratory results. The objective of this study is to determine the sensitivity and specificity of the tuberculosis treatment algorithm u...

  12. Clinical application of whole blood interferon-γ release assay on diagnosis of active pulmonary tuberculosis%全血γ干扰素释放试验在活动性肺结核诊断中的应用

    周祖模; 金嘉琳; 王森; 黄河清; 石勇明; 陈林; 张文宏; 翁心华

    2012-01-01

    Objective To evaluate the application of whole blood interferon-γ release assay QuantiFERON-TB gold in tube (QFT-GIT) on the diagnosis of active pulmonary tuberculosis in China. Methods With the commercial whole blood interferon-γ QFT-GIT kit, interferon-γ released by specific T cells stimulated under early secreted antigenic target 6 kD protein ( ESAT-6) , culture filtrate protein 10 (CFP-10) and TB7. 7 were measured among 48 cases with active pulmonary tuberculosis and 55 BCG (bacillus calmette-guerin ) -vaccinated healthy controls, who had no tuberculosis contact history by questionnaire. Results The QFT-GIT was positive in 93. 8% patients with active pulmonary tuberculosis and 11.1% healthy controls, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of QFT-GIT were 93. 8% , 88. 9% , 88. 2% and 94. 1% , respectively. The antigen-specific IFN-γ release was significantly higher in patients with active pulmonary tuberculosis in comparison with that in the controls (P < 0.0001). Furthermore, after anti-tuberculosis treatment, the antigen-specific IFN-γ decreased significantly (P < 0.05). Conclusions QFT-GIT is a sensitive and specific assay for detecting tuberculosis, which could discriminate the active tuberculosis patients from BCG vaccinated healthy controls and could be a convenient and useful diagnostic tool for the diagnosis of tuberculosis.%目的 评价全血γ干扰素释放试验在活动性肺结核诊断中的应用价值.方法 应用一种全血γ干扰素释放检测试剂盒QuantiFERON-TB gold in tube(QFT-GIT)对48例活动性肺结核患者(活动性结核组)进行检测,同时选取55例健康者作为对照(对照组),均通过调查问卷排除结核病接触史.结果 本研究活动性结核组患者和对照组QFT-GIT阳性率分别为93.8%和11.1%,QFT-GIT诊断活动性肺结核的总体敏感性和特异性分别为93.8%和88.9%,阳性和阴性预测值分别为88.2%和94.1%.活动性

  13. Importance of polymerase chain reaction in diagnosis of pulmonary and extra-pulmonary tuberculosis

    Pakistan ranks eighth on the list of 22 high-burden tuberculosis (TB) countries in the world according to the World Health Organisation's (WHO) Global Tuberculosis Control 2009. Including other reasons the main cause is improper and late diagnosis of the disease. PCR may play an important role to control the disease with its rapid, sensitive and specific diagnosis. But in Pakistan due to lake of knowledge about this latest technique we are not using this technique appropriately. Clinicians still trust on conventional methods of TB diagnosis, which are time consuming or insensitive. The present study was arranged to highlight the importance of PCR in TB diagnosis in pulmonary and extra-pulmonary cases and its comparison with conventional methods. Methods: Samples obtained from 290 patients of suspected TB (pulmonary or extra-pulmonary) were subjected to ZN smear examination, LJ medium culture and PCR test by amplifying 541 bp fragment of Mycobacterium tuberculosis complex genome. The present prospective study is performed at Shalamar Hospital Lahore from November 2008 to November 2010. Results: A distinctly difference was observed in the test results done by PCR and other conventional techniques in pulmonary or extra-pulmonary tuberculosis samples (p<0.001). The sensitivity of different tests was 68.62% for PCR, 26.90% for LJ medium culture, and 14.14% for ZN smear examination (p<0.05). However, there was no significant difference between different tests as for as specificity was concerned. PCR test sensitivity in pulmonary and extra-pulmonary clinical samples was 78.34 and 61.76% respectively, being significantly higher (p<0.05) when compared with sensitivity of other tests. The mean detection time for M. tuberculosis was 25 days by LJ medium culture and less than 1 day by smear examination and PCR test. Conclusion: PCR test is more sensitive than ZN smear examination and LJ medium culture for the diagnosis of TB in pulmonary and extra-pulmonary clinical samples

  14. Subcutaneous emphysema in cavitary pulmonary tuberculosis without pneumothorax or pneumomediastinum

    Ramakant Dixit

    2012-01-01

    Full Text Available Extra-alveolar air in the form of subcutaneous tissue emphysema is observed in a variety of clinical settings. Spontaneous subcutaneous emphysema in the absence of pneumothorax or pneumomediastinum is very rare. We report a case of spontaneous subcutaneous emphysema secondary to cavitary pulmonary tuberculosis in the absence of pneumothorax or pneumomediastinum.

  15. Subcutaneous emphysema in cavitary pulmonary tuberculosis without pneumothorax or pneumomediastinum

    Ramakant Dixit; Jacob George

    2012-01-01

    Extra-alveolar air in the form of subcutaneous tissue emphysema is observed in a variety of clinical settings. Spontaneous subcutaneous emphysema in the absence of pneumothorax or pneumomediastinum is very rare. We report a case of spontaneous subcutaneous emphysema secondary to cavitary pulmonary tuberculosis in the absence of pneumothorax or pneumomediastinum.

  16. Tip of nose tuberculosis: A rare presentation of extra pulmonary tuberculosis.

    Bajaj, Darshan K; Verma, Ajay K; Jaiswal, Riddhi; Kant, Surya; Patel, Anand; Asnani, Mona

    2016-05-01

    Tuberculosis is notorious that it affects various sites of the human body and presents in different ways. One of the uncommon or rather rare presentation of extra pulmonary tuberculosis is nasal tuberculosis. The nose apart from its physiological functions also contributes to facial aesthetics and gives a defined appearance and its deformity imparts cosmetic disfigurement and unsightly appearance. Both primary and secondary forms of nasal tuberculosis are rare but should be considered in the differential diagnosis of ulcerative or crusting lesions of the nose. Here we report such a case of nasal tuberculosis, which presented as an ulcerative and crusting lesion over the tip of the nose in a female child. The patient was given antituberculous chemotherapy after establishing the diagnosis and responded well to treatment. PMID:27195200

  17. Prevalence of nutritional deficiency in patients with pulmonary tuberculosis

    Silvana Gomes Nunes Piva

    2013-06-01

    Full Text Available OBJECTIVE: To determine the prevalence of nutritional deficiency among patients with pulmonary tuberculosis. METHODS: This was a cross-sectional study using data obtained from the Brazilian Case Registry Database and from the medical records of patients diagnosed with pulmonary tuberculosis (15-59 years of age residing in one of the municipalities that make up the 16th Regional Health District of the state of Bahia. We calculated the incidence, lethality, and mortality rates, as well as the prevalence of nutritional deficiency, as evaluated by body mass index. Demographic, social, clinical, and epidemiological data were collected. RESULTS: Of the 72 confirmed cases of tuberculosis, 59 (81.9% were in males, and 21 (29.2% of the patients were in the 40-49 year age bracket. The majority (85.3% described themselves as Mulatto or Black; 55.2% reported using alcohol; and approximately 90% were treated as outpatients. In the district and age bracket studied, the incidence of pulmonary tuberculosis was 30.6/100,000 population. Among the 72 patients, data regarding nutritional status was available for 34. Of those, 50% and 25%, respectively, presented nutritional deficiency at the beginning and at the end of treatment. No statistically significant differences were found between normal-weight and malnourished patients regarding the characteristics studied. CONCLUSIONS: The prevalence of nutritional deficiency was high among our sample of patients with pulmonary tuberculosis. This underscores the importance of nutritional follow-up for the assessment of tuberculosis treatment in the decision-making process regarding therapeutic interventions.

  18. Fluorescent analysis of lymphocytes at pulmonary tuberculosis patients exposed to irradiation

    On the territory of Belarus, damaging from the Chernobyl NPP accident, was scheduled negative pathological changes of a tuberculosis, which are displayed in heavier current of disease, decrease of an immunological reactivity and increase of a morbidity and mortality. For understanding and the interpretations of those changes were investigated lymphocytes of a peripheral blood of the pulmonary tuberculosis patients. 45 patients with the first time revealed widespread forms of a pulmonary tuberculosis, living on contaminated territories, with individual absorbed dozes of an external and internal irradiation 2 - 8 rem (at 9 patients - more than 8 rem), were investigated. Also 27 pulmonary tuberculosis patients and 25 healthy persons, which were not irradiated, were investigated too. The biophysical methods of research were used - proper and probe fluorescence, photosensitive death of cells. At the tuberculosis disease revealed changes in cells, indicating about increase of a metabolic processes level, decrease of an antioxidant system activity, a lipid bilayer viscosity and negative charge of cell membranes. The patients from contaminated territories had more expressed character of such changes. 8 refs., 1 tab

  19. A rare cause of pulmonary tuberculosis.

    Chan, Heidi H Y; Mpe, John

    2015-10-16

    We present a case of bovine tuberculosis in a 50-year-old Māori female. She had worked for approximately 7 years at a local freezing works where animal organs were cleaned and packed. The diagnosis was established 4 weeks after commencement of first-line anti-TB therapy. While human zoonotic tuberculosis may be uncommon in developed countries, its diagnosis still has important public health and treatment implications. PMID:26645759

  20. Non-Adherence of New Pulmonary Tuberculosis Patients to Anti-Tuberculosis Treatment

    Kulkarni, PY; Akarte, SV; Mankeshwar, RM; Bhawalkar, JS; A. Banerjee; Kulkarni, AD

    2013-01-01

    Background: Non-adherence to anti-tuberculosis (TB) treatment adversely affects treatment success rate. It increases disease morbidity and mortality. Also, it contributes significantly to the development of drug resistance. Aim: To identify risk factors for non-adherence to anti-TB treatment by new pulmonary TB patients. Subjects and Methods: It is a prospective cohort study at 21 TB treatment centres in E ward of Mumbai Municipal Corporation. All sputum smear positive new pulmonary TB patien...

  1. [Commemorative lecture of receiving Imamura Memorial Prize. NK cell in pulmonary tuberculosis from basic and clinical point of view].

    Yoneda, T

    1996-11-01

    Although natural killer (NK) cells, which lyse certain tumors in vitro, have been shown to provide early defense mechanism against cancer growth and viral infection, possible role in the host defense against pulmonary tuberculosis remains undefined. A series of my studies have recently provided several evidence supporting the involvement of NK cells in the immunopathology of pulmonary tuberculosis. NK cell activity in patients with active pulmonary tuberculosis was significantly augmented compared with that in age-, sex- matched healthy controls, which suggests NK cells are activated in vivo in pulmonary tuberculosis. Lung NK cells from BCG-infected mice also are shown to be activated. Asialo GM 1 was demonstrated to be a novel surface marker of mice NK cells, which inhibited activation of NK cells by interferon. Chronic intractable tuberculosis was classified with a combination of NK cell activity and delayed-type hypersensitivity reaction to 2, 4-dinitrochrolbenzene. Subgroup defined with high NK cell activity and normal delayed-type hypersensitivity was characterized with moderate radiographical lesions and stable clinical course, suggesting the immune-spectrum classification was associated with clinical manifestations. Malnutrition has been suggested to be a risk factor associated with the development and reactivation of pulmonary tuberculosis. NK cell activity was significantly correlated with visceral proteins. IL-2 producing capability was significantly decreased in patients with serum albumin less than 3.5 g/dl. More recently, I established an in vitro system evaluating quantitative capability for intracellular killing by human monocytes, in which monocyte phagocytize Mycobacterium tuberculosis and subsequently inhibit intracellular replication of the organisms by adding some cytokines or cells. Purified NK cells by using discontinuous gradient centrifugation and magnetic separation technique were added to M. tuberculosis-infected monocytes monolayer

  2. Commercial serological antibody detection tests for the diagnosis of pulmonary tuberculosis: a systematic review.

    Karen R Steingart

    2007-06-01

    commercial tests in smear microscopy-negative patients, as well as their performance in children or persons with HIV infection. CONCLUSIONS: None of the commercial tests evaluated perform well enough to replace sputum smear microscopy. Thus, these tests have little or no role in the diagnosis of pulmonary tuberculosis. Lack of methodological rigor in these studies was identified as a concern. It will be important to review the basic science literature evaluating serological tests for the diagnosis of pulmonary tuberculosis to determine whether useful antigens have been described but their potential has not been fully exploited. Activities leading to the discovery of new antigens with immunodiagnostic potential need to be intensified.

  3. Tomographic findings of lobar consolidation in primary pulmonary tuberculosis

    Objective: To describe tomographic findings of lobar consolidation as early manifestation of primary pulmonary tuberculosis. Materials and methods: The present study was developed at Hospital Municipal Jesus, Rio de Janeiro, RJ, Brazil, in the period between 2002 and 2006, retrospectively evaluating tomographic findings in four children aged from 3 to 14 months with lobar consolidation as an early manifestation of primary pulmonary tuberculosis. Results: The most frequently found radiological pattern was lobar consolidation with calcifications, cavitation and intermingle necrotic areas, associated with bulging fissure. Signs of bronchogenic dissemination and lymph node enlargement were observed in all of the four children. Consolidation with a pseudotumor aspect and masslike effect was observed in one case. Conclusion: The cases included in the present study have demonstrated that primary pulmonary tuberculosis manifested as lobar consolidation presents typical tomographic images such as cavitation, hypodense areas and calcifications intermingled with consolidation. The association with lymph node enlargement with central necrosis and signs of bronchogenic dissemination reinforce the diagnosis of tuberculosis. (author)

  4. Tratamiento de la tuberculosis pulmonar Treatment of pulmonary tuberculosis

    J. Boldú

    2007-01-01

    Full Text Available El tratamiento de la tuberculosis es importante tanto para preservar la salud del paciente como para prevenir la propagación de la enfermedad entre la población. Sus bases bacteriológicas estriban en el elevado número de bacilos que existen en la mayor parte de lesiones humanas de la TB y en la capacidad de mutar que tiene el M. tuberculosis cuando alcanza un número elevado de divisiones; ello hace imprescindible la asociación de fármacos que eviten la selección de mutantes resistentes. En nuestro medio la terapia farmacológica que se ha demostrado más eficaz consiste en la asociación durante dos meses de isoniacida, rifampicina y piracinamida seguida durante cuatro meses más con los dos primeros fármacos. En general los tuberculostáticos de primera elección son bien tolerados, pero pueden producir efectos secundarios potencialmente graves que conviene conocer y saber manejar. En el presente trabajo describimos también cómo se debe actuar desde el punto de vista terapéutico ante determinadas situaciones especiales y cuando los tratamientos iniciales se han abandonado o han fracasado. En los últimos cinco años en Navarra, se ha incrementado de forma importante la presencia de inmigrantes procedentes de países en vías de desarrollo con altas tasas de tuberculosis y de resistencias primarias. Este colectivo genera con frecuencia, como consecuencia de sus particulares condiciones socioeconómicas y su idiosincrasia cultural, dificultades respecto al cumplimiento del tratamiento, así como en los seguimientos y controles. El tratamiento de la tuberculosis siempre debe ser realizado por médicos expertos en el tema.The treatment of tuberculosis is important both to preserve the health of the patient and to prevent the spread of the disease amongst the population. Its bacteriological bases are found in the high number of bacillae existing in the majority of human TB lesions and the capacity to mutate of Mycobacterium tuberculosis

  5. Research on the significance of TSPOT.TB test in diagnosing the atypical pulmonary tuberculosis

    Jin Li; Qi-Huang Chen; Yan-Yu Pan; Wei-Zheng Chen; Wen-Feng Lin; Sai-Li Zeng

    2015-01-01

    Objective:To investigate the sensitivity and specificity of the TSPOT.TB test in diagnosing the atypical pulmonary tuberculosis.Methods:A total of 100 patients with suspected pulmonary tuberculosis were diagnosed by TSPOT.TB test and TST, and the difference between the two detection methods was compared.Results:The positive detection rate in the atypical pulmonary tuberculosis was significantly higher than that in the pulmonary tuberculosis group. The sensitivity (94.21), specificity (94.50), PPV (74.20), NPV (94.17), and LR+ (6.14) in the atypical pulmonary tuberculosis group by TSPOT.TB test were significantly higher than those by TST, while LR-(0.13) was significantly lower than that by TST.Conclusions:When compared with TST, TSPOT. TB test has a higher clinical application value, possesses advantages of rapidness and sensitivity, and plays a vital role in diagnosing atypical pulmonary tuberculosis.

  6. A Dual Lung Scan for the Evaluation of Pulmonary Function in Patients with Pulmonary Tuberculosis before and after Treatment

    In 20 normal cases and 39 pulmonary tuberculosis cases, regional pulmonary arterial blood flow measurement and lung perfusion scans by 131I-Macroaggregated albumin, lung inhalation scans by colloidal 198Au and spirometries by respirometer were done at the Radiological Research Institute. The measured lung function tests were compared and the results were as the following: 1) The normal distribution of pulmonary blood flow was found to be 54.5±2.82% to the right lung and 45.5±2.39% to the left lung. The difference between the right and left pulmonary arterial blood flow was significant statistically (p131I-MAA in patients with pulmonary tuberculosis was as follows: a) In the pretreated minimal pulmonary tuberculosis, the decreased area of pulmonary arterial blood flow was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive than had been expected from the chest roentgenogram in the apparently healed minimal pulmonary tuberculosis. b) In the pretreated moderately advanced pulmonary tuberculosis, the decrease of pulmonary arterial blood flow to the diseased area was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive in the treated moderately advanced pulmonary tuberculosis as in the treated minimal pulmonary tuberculosis. c) Pulmonary arterial blood flow in the patients with far advanced pulmonary tuberculosis both before and after chemotherapy were almost similar to the chest roentgenogram. Especially the decrease of pulmonary arterial blood flow to the cavity was usually greater than had been expected from the chest roentgenogram. 3) Lung inhalation scan by colloidal 198Au in patients with pulmonary tuberculosis was as follows: a) In the minimal pulmonary tuberculosis, lung inhalation scan showed almost similar decrease of radioactivity corresponding to the chest roentgenogram. b) In the moderately advanced pulmonary tuberculosis the decrease of

  7. Awareness Regarding Pulmonary Tuberculosis - A Study Among Patient Taking Treatment of Tuberculosis in Rural Surat, Gujarat

    Madhu Vidhani

    2012-08-01

    Full Text Available Background: Pulmonary tuberculosis (PTB is one of the most grave public health problem and account for four fifth of all tuberculosis cases. PTB is the key source of spread of mycobacterium. Revised National Tuberculosis Control Programme (RNTCP adopted passive surveillance strategy of the chest symptomatic for identification of cases of PTB. Therefore, it is utmost important that the basic information about PTB and services provided under the program is clear in community. Methodology: A cross sectional observational study was conducted among 176 patient taking treatment of PTB from Health Centers of Surat District. Results: More than 80 percent of the respondents were aware of symptomatology of PTB. Almost all (96.7% of patient were aware about one person to other person mode of transmission of tuberculosis. Almost half were aware about the infective organism as cause of disease and more than one third patients were aware of diagnostic investigations of PTB. However only 9% of patients were know about BCG immunization as means of prevention for tuberculosis. Most of the respondents 95% believed that tuberculosis is curable. Conclusion: The current study revealed that although awareness regarding certain basic aspect of tuberculosis was adequate; however there is a great need to improve awareness in illiterate individuals and females. Importance of BCG vaccination needs to be appreciated in community through continuation and innovations in IEC. [Natl J of Med Res 2012; 2(4.000: 452-455

  8. Pulmonary alveolar proteinosis and superinfection with pulmonary tuberculosis in a case

    Tekgül, Serpil; Bilaceroglu, Semra; Ozkaya, Sevket; Coskun, Ayse; Komurcuoglu, Berna; Cirak, Ali Kadri

    2011-01-01

    Pulmonary alveolar proteinosis (PAP) is a rare and diffuse lung process, characterized by the presence of alveolar spaces filled with amorphous eosinophilic material. Impaired macrophage function and impaired host defence due to abnormalities of surfactant proteins may favor the growth of microorganisms. The association of alveolar proteinosis with mycobacterial infections is rarely reported. The PAP and superinfection with pulmonary tuberculosis is defined by radiologic and histopathologic i...

  9. Computed tomography in predicting smear-negative pulmonary tuberculosis in AIDS patients

    FENG Feng; SHI Yu-xin; XIA Gan-lin; ZHU Ying; LU Hong-zhou; ZHANG Zhi-yong

    2013-01-01

    Background The correct diagnosis of sputum smear-negative pulmonary tuberculosis in AIDS patients is very important to their therapy.We aimed to assess the value of the computed tomography (CT) and clinical findings in predicting smearnegative pulmonary tuberculosis in AIDS patients.Methods A total of 121 AIDS patients suspected of smear-negative pulmonary tuberculosis by clinical and radiographic findings were recruited.Pulmonary tuberculosis was diagnosed in 57 (47.1%) patients.The CT and clinical predictors were selected to diagnose AIDS-related pulmonary tuberculosis through univariate and multivariate Logistic analysis.Results Multivariate analysis showed that five variables,including weight loss,presence of miliary nodules,necrotic lymph node,Iobular consolidation,tree-in-bud sign,were independent predictors of pulmonary tuberculosis in AIDS patients.Predicted scores based on the five variables were used to identify pulmonary tuberculosis.If the predicted score of 3 was taken as the ideal cut-off point in the diagnosis of AIDS-related smear-negative pulmonary tuberculosis,the sensitivity,specificity,positive predictive value,negative predictive value,and accuracy were 84.2%,81.2%,80.0%,85.2%,and 82.6%,respectively.Conclusion The prediction method based on five key factors of clinical and CT findings are useful in guiding the diagnosis of smear-negative pulmonary tuberculosis in AIDS patients.

  10. Pleuropulmonary Paragonimiasis mimicking Pulmonary Tuberculosis - A Report of Three Cases

    Singh T

    2005-01-01

    Full Text Available Paragonimiasis is an important cause of pulmonary disease worldwide. Infection in humans mainly occurs by ingestion of raw or undercooked freshwater crabs or crayfishes. The disease is well known in endemic regions of Asian countries, where culturally based methods of food preparation foster human transmission. Three patients with clinical and radiological features compatible with pulmonary tuberculosis had been treated for tuberculosis without remedy despite an inability to demonstrate acid fast bacilli in sputum smears. All patients had history of ingestion of raw crabs and crayfishes. The confirmed diagnosis of pleuropulmonary paragonimiasis was made based on the demonstration of Paragonimus eggs in the sputum, and high absolute eosinophilia in their peripheral blood and pleural fluid. All the patients had been treated with praziquantel successfully.

  11. Prevalence of pulmonary tuberculosis among HIV positive patients attending antiretroviral therapy clinic

    Purushottam A Giri

    2013-01-01

    Full Text Available Background: Tuberculosis (TB is the most common serious opportunistic infection in HIV positive patients and is the manifestation of AIDS in more than 50% of cases in developing countries. TB can occur at any time during the course of HIV infection. Aim: To describe the socio-demographic profile and prevalence of pulmonary tuberculosis (HIV/TB co-infection among HIV positive patients been attended at the antiretroviral therapy clinic (ART clinic at tertiary care teaching hospital of western Maharashtra, India. Materials and Methods: A cross-sectional study was carried out at the ART clinic of Pravara Rural Hospital, Loni, from June 2011 to May 2012. A total of 1012 HIV positive patients, who attended ART clinic, receiving ART treatment during the study period, were included in the analysis. The statistical analysis was performed using SPSS software (Version 17.0. Results: This study showed 1012/172 (17% prevalence of pulmonary tuberculosis among HIV positive patients, of which 87 (50.58% were males and 85 (48.42% were females. Low CD4 count (< 50/μl had statistically significant association with HIV/TB co-infection as compared to HIV infection only ( P < 0.0001. Conclusion: The study showed that 17% of HIV infected persons had tuberculosis co-infection. More strategic preventive measures that enhance body immunity among HIV patients are highly needed as early as possible before they develop active tuberculosis.

  12. Pulmonary impairment after tuberculosis and its contribution to TB burden

    Munguia Guadalupe

    2010-05-01

    Full Text Available Abstract Background The health impacts of pulmonary impairment after tuberculosis (TB treatment have not been included in assessments of TB burden. Therefore, previous global and national TB burden estimates do not reflect the full consequences of surviving TB. We assessed the burden of TB including pulmonary impairment after tuberculosis in Tarrant County, Texas using Disability-adjusted Life Years (DALYs. Methods TB burden was calculated for all culture-confirmed TB patients treated at Tarrant County Public Health between January 2005 and December 2006 using identical methods and life tables as the Global Burden of Disease Study. Years of life-lost were calculated as the difference between life expectancy using standardized life tables and age-at-death from TB. Years lived-with-disability were calculated from age and gender-specific TB disease incidence using published disability weights. Non-fatal health impacts of TB were divided into years lived-with-disability-acute and years lived-with-disability-chronic. Years lived-with-disability-acute was defined as TB burden resulting from illness prior to completion of treatment including the burden from treatment-related side effects. Years lived-with-disability-chronic was defined as TB burden from disability resulting from pulmonary impairment after tuberculosis. Results There were 224 TB cases in the time period, of these 177 were culture confirmed. These 177 subjects lost a total of 1189 DALYs. Of these 1189 DALYs 23% were from years of life-lost, 2% were from years lived-with-disability-acute and 75% were from years lived-with-disability-chronic. Conclusions Our findings demonstrate that the disease burden from TB is greater than previously estimated. Pulmonary impairment after tuberculosis was responsible for the majority of the burden. These data demonstrate that successful TB control efforts may reduce the health burden more than previously recognized.

  13. Pulmonary tuberculosis as differential diagnosis of lung cancer

    MLB Bhatt; Surya Kant; Ravi Bhaskar

    2012-01-01

    Patients with lung cancer are often misdiagnosed as pulmonary tuberculosis leading to delay in the correct diagnosis as well as exposure to inappropriate medication. Several factors are responsible for this situation in developing countries, including lack of awareness, inadequate infrastructure and socio-economic factors. This article outlines the differences between the two diseases as well as features that would make a clinician suspect the right diagnosis early.

  14. Directly Observed Therapy in Pulmonary Tuberculosis

    GÜNEN, Hakan; Kızkın, Özkan

    2000-01-01

    Prevalence of tuberculosis (TB), persistently having a downward trend until the beginning of 1980s in developed countries, re-surged with the appearance of AIDS, decrease of funding for health due to economical reasons in governmental policies, unequal distribution of the general capital, increase in dimensions of alcoholism, homelessness and illicit drug use. At the end of 1990s, these countries mainly the USA, one by one, declared to the world that they had lost the war against TB and immed...

  15. Chromoblastomycosis due to Fonsecaea monophora misdiagnosed as sporotrichosis and cutaneous tuberculosis in a pulmonary tuberculosis patient

    Dongmei Shi

    2016-03-01

    Full Text Available Chromoblastomycosis is caused by dematiaceous fungi. It develops after inoculation of the organism into the skin. We report a case of chromoblastomycosis in a pulmonary tuberculosis patient without known history of trauma. The lesions were initially diagnosed as sporotrichosis and skin tuberculosis. Histopathology of scales and skin biopsy specimen revealed sclerotic bodies, the hallmark of chromoblastomycosis. The causative organism was identified as Fonsecaea monophora by rDNA ITS sequencing. The lesions recovered markedly after two month treatment with oral terbinafine 250 mg daily according to drug sensitive test in vitro in combination with local thermotherapy

  16. Tuberculosis associated pulmonary hypertension: The revelation of a clinical observation

    Parthasarathi Bhattacharyya

    2016-01-01

    Full Text Available Background: Pulmonary tuberculosis is not listed as a cause of pulmonary hypertension (PH. Scanty information is available in the literature regarding this issue. Methods: A group of patients with a history of pulmonary tuberculosis were diagnosed to have PH on the basis of a novel clinico-radio-echocardiographic criteria. Subdivided into two groups on the basis of the history of smoking, we looked for their demographic, spirometric, radiological characteristics along with the quality of life assessment. Results: A total of 40 patients (21 smokers and 19 nonsmokers were found to have PH with history of pulmonary tuberculosis. The two groups were similar radiologically including the extent of fibrosis. The nonsmoker group had lower age range (52.16 ± 14.81 vs. 63.1 ± 10.05, P = 0.01, worse chronic obstructive pulmonary disease (COPD assessment test score (16.11 ± 6.24 vs. 13.9 ± 5.6, P = 0.25 and higher pulmonary artery (PA pressure (46.39 ± 7.44 vs. 44.55 ± 8.04, P = 0.46 compared to the smokers. Overall and for the smoker group, in particular, the spirometric pictures were favoring obstruction without reversibility as in COPD (forced expiratory volume in 1 second [FEV1] % as 64.26 ± 18.38 and 58.85 ± 14.61 with % of predicted FEV1being 43.74 ± 17.26 and 42.38 ± 16.64 respectively. However, those with no history of smoking had restrictive changes as in diffuse parenchymal lung disease (DPLD in their spirometry (FEV1/forced vital capacity [FVC] of 79.33 ± 19.93 and FVC as 49.67 ± 11.54% of predicted. The smoker group had far more obvious involvement of the small airways in terms of change in FEF25-75compared to nonsmokers (FEF25-75 = 22.85 ± 19.68 vs. 63.83 ± 48.61. Conclusion: PH appears associated with the history of pulmonary tuberculosis. With or without a history of smoking, they pose two distinct phenotypes in spirometry as COPD and DPLD. The DPLD phenotype had worse quality of life.

  17. An Unusual Radiologic Manifestation of Pulmonary Tuberculosis with Bilateral Multiple Lung Nodules and Diffuse Alveolar Hemorrhage: A Case Report

    Pulmonary tuberculosis presenting as bilateral multiple lung nodules or diffuse alveolar hemorrhage is very rare. Here, we report a case of pulmonary tuberculosis presenting as bilateral multiple lung nodules and diffuse alveolar hemorrhage mimicking granulomatous vasculitis, such as Wegener's granulomatosis.

  18. Pleural tuberculosis: is radiological evidence of pulmonary-associated disease related to the exacerbation of the inflammatory response?

    Leila Antonangelo

    2012-11-01

    Full Text Available OBJECTIVE: Pleural tuberculosis is the most frequently occurring form of extra pulmonary disease in adults. In up to 40% of cases, the lung parenchyma is concomitantly involved, which can have an epidemiological impact. This study aims to evaluate the pleural and systemic inflammatory response of patients with pleural or pleuropulmonary tuberculosis. METHODS: A prospective study of 39 patients with confirmed pleural tuberculosis. After thoracentesis, a high resolution chest tomography was performed to evaluate the pulmonary involvement. Of the 39 patients, 20 exhibited only pleural effusion, and high resolution chest tomography revealed active associated-pulmonary disease in 19 patients. The total protein, lactic dehydrogenase, adenosine deaminase, vascular endothelial growth factor, interleukin-8, tumor necrosis factor-α, and transforming growth factor-β1 levels were quantified in the patient serum and pleural fluid. RESULTS: All of the effusions were exudates with high levels of adenosine deaminase. The levels of vascular endothelial growth factor and transforming growth factor-β1 were increased in the blood and pleural fluid of all of the patients with pleural tuberculosis, with no differences between the two forms of tuberculosis. The tumor necrosis factor-α levels were significantly higher in the pleural fluid of the patients with the pleuropulmonary form of tuberculosis. The interleukin-8 levels were high in the pleural fluid of all of the patients, without any differences between the forms of tuberculosis. CONCLUSION: Tumor necrosis factor-α was the single cytokine that significantly increased in the pleural fluid of the patients with pulmonary involvement. However, an overlap in the results does not permit us to suggest that cytokine is a biological marker of concomitant parenchymal involvement. Although high resolution chest tomography can be useful in identifying these patients, the investigation of fast acid bacilli and cultures

  19. Arginine Adjunctive Therapy in Active Tuberculosis

    Aliasghar Farazi

    2015-01-01

    Full Text Available Background. Dietary supplementation has been used as a mechanism to augment the immune system. Adjunctive therapy with L-arginine has the potential to improve outcomes in active tuberculosis. Methods. In a randomized clinical trial 63 participants with smear-positive pulmonary tuberculosis in Markazi Province of Iran were given arginine or placebo for 4 weeks in addition to conventional chemotherapy. The final treatment success, sputum conversion, weight gain, and clinical symptoms after one and two months were considered as primary outcomes and secondary outcomes were ESR, CRP, and Hg. Data were collected and analyzed with SPSS software (ver. 18. Results. Arginine supplementation reduced constitutional symptoms (P=0.032 in patients with smear-positive TB at the end of the first month of treatment. Arginine treated patients had significantly increased BMI at the end of the first and second months of treatment (P=0.032 and P=0.04 and a reduced CRP at the end of the first month of treatment (P=0.03 versus placebo group. Conclusion. Arginine is useful as an adjunctive therapy in patients with active tuberculosis, in which the effects are more likely mediated by the increased production of nitric oxide and improved constitutional symptoms and weight gain. This trial is registered with Clinical Trials Registry of Iran: IRCT201211179855N2.

  20. The similar hexheimer reaction during initial treatment of pulmonary tuberculosis: CT appearances

    Objective: To investigate CT features of similar Hexheimer's reaction during initial treatment of active pulmonary tuberculosis. Methods: The similar Hexheimer's reaction in 44 patients diagnosed by clinic and follow-up CT scans were retrospectively reviewed by three radiologists. Results: During initial treatment of active pulmonary tuberculosis, development of radiographic progression were observed in 57 foci, including 28 pulmonary lesions increased at the site of their original lesion or new opacities elsewhere, ipsilateral or contralateral to the original lesion or both, 10 lesions related to the pleura (pleural effusion, pleural tuberculoma), 15 lymphadenectasis, 3 thymus reactions, and 1 cardiac pericardium thickening, respectively. These reactions appeared from the 20 days to 3.5 months, then with continuation of the initial chemotherapy for 1.0-3.0 months, the radiographic response was excellent with the areas of progression and the original lesions demonstrating resolution or improvement. Conclusion: The CT appearances of similar Hexheimer's reaction during initial treatment of active tuberculosis are specific to a certainty. (authors)

  1. Cost implications of delays to tuberculosis diagnosis among pulmonary tuberculosis patients in Ethiopia

    Kifle Yohannes T

    2010-03-01

    Full Text Available Abstract Background Delays seeking care worsen the burden of tuberculosis and cost of care for patients, families and the public health system. This study investigates costs of tuberculosis diagnosis incurred by patients, escorts and the public health system in 10 districts of Ethiopia. Methods New pulmonary tuberculosis patients ≥ 15 years old were interviewed regarding their health care seeking behaviour at the time of diagnosis. Using a structured questionnaire patients were interviewed about the duration of delay at alternative care providers and the public health system prior to diagnosis. Costs incurred by patients, escorts and the public health system were quantified through patient interview and review of medical records. Results Interviews were held with 537 (58% smear positive patients and 387 (42% smear negative pulmonary patients. Of these, 413 (45% were female; 451 (49% were rural residents; and the median age was 34 years. The mean (median days elapsed for consultation at alternative care providers and public health facilities prior to tuberculosis diagnosis was 5 days (0 days and 3 (3 days respectively. The total median cost incurred from first consultation to diagnosis was $27 per patient (mean = $59. The median costs per patient incurred by patient, escort and the public health system were $16 (mean = $29, $3 (mean = $23 and $3 (mean = $7 respectively. The total cost per patient diagnosed was higher for women, rural residents; those who received government food for work support, patients with smear negative pulmonary tuberculosis and patients who were not screened for TB in at least one district diagnostic centers. Conclusions The costs of tuberculosis diagnosis incurred by patients and escorts represent a significant portion of their monthly income. The costs arising from time lost in seeking care comprised a major portion of the total cost of diagnosis, and may worsen the economic position of patients and their families

  2. Peculiarities of the hormone regulation in patients with pulmonary tuberculosis living in the unfavourable radioecological conditions

    The hormone regulation indices are studies in 83 patients with the pulmonary tuberculosis of the frequent forms living on contamination territories with gamma-background more 10 Ci/sq.km, as well as 60 patients with the same diseases and 35 practically healthy people living in clear territories. It is stated that in patients who were exposed to irradiation, particularly in those with the disease unfavourable run, the thyroid functional activity as well as the insulin and sex hormones secretion and adrenal gland and pituitary body stress reaction are decreased. The prognostic value of the blood plasma thyrotropin, thyroxine and testosterone content study in patients with primarily revealed pulmonary tuberculosis is determined. No significant dependence of the studied parameters on the calculated irradiation dose was found. (author). 8 refs., 1 tab

  3. Pulmonary Disease due to Mycobacterium tuberculosis in a Horse: Zoonotic Concerns and Limitations of Antemortem Testing

    Lyashchenko, Konstantin P.; Rena Greenwald; Javan Esfandiari; Alexis Lecu; W. Ray Waters; Horst Posthaus; Thomas Bodmer; Jean-Paul Janssens; Fabio Aloisio; Claudia Graubner; Eléonore Grosclaude; Alessandra Piersigilli; Irene Schiller

    2012-01-01

    A case of pulmonary tuberculosis caused by Mycobacterium tuberculosis was diagnosed in a horse. Clinical evaluation performed prior to euthanasia did not suggest tuberculosis, but postmortem examination provided pathological and bacteriological evidence of mycobacteriosis. In the lungs, multiple tuberculoid granulomas communicating with the bronchiolar lumen, pleural effusion, and a granulomatous lymphadenitis involving mediastinal and tracheobronchial lymph nodes were found. Serologic respon...

  4. Pulmonary Disease due to Mycobacterium tuberculosis in a Horse: Zoonotic Concerns and Limitations of Antemortem Testing.

    Lyashchenko, Konstantin P.; Greenwald, Rena; Esfandiari, Javan; Lecu, Alexis; Waters, W. Ray; Posthaus, Horst; Bodmer, Thomas; Janssens, Jean-Paul; Aloisio, Fabio; Graubner, Claudia; Grosclaude, Eléonore; Piersigilli, Alessandra; Schiller, Irene

    2012-01-01

    A case of pulmonary tuberculosis caused by Mycobacterium tuberculosis was diagnosed in a horse. Clinical evaluation performed prior to euthanasia did not suggest tuberculosis, but postmortem examination provided pathological and bacteriological evidence of mycobacteriosis. In the lungs, multiple tuberculoid granulomas communicating with the bronchiolar lumen, pleural effusion, and a granulomatous lymphadenitis involving mediastinal and tracheobronchial lymph nodes were found. Serologic respon...

  5. Diffuse Pulmonary Uptake of Tc-99m Methylene Diphosphonate in a Patient with Non-tuberculosis Mycobacterial Infection

    Kwon, Hyun Woo; Chung, June Key; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Ab-Aziz, Aini [University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, (Morocco)

    2010-06-15

    Extra-osseous uptake of bone-seeking radiopharmaceuticals has been reported at various sites and it is known to be induced by various causes. Diffuse pulmonary infection, such as tuberculosis, can be a cause of lung uptake of bone-scan agent. Here we report on a patient with non-tuberculosis mycobacterial infection (NTM) who demonstrated diffuse pulmonary uptake on Tc-99m MDP bone scan. After medical treatment for NTM, the patient's lung lesions improved. Estra skeletal lung Tc-99m MDP uptake on bone scan may suggest lung parenchymal damage associated with disease activity.

  6. Diffuse Pulmonary Uptake of Tc-99m Methylene Diphosphonate in a Patient with Non-tuberculosis Mycobacterial Infection

    Extra-osseous uptake of bone-seeking radiopharmaceuticals has been reported at various sites and it is known to be induced by various causes. Diffuse pulmonary infection, such as tuberculosis, can be a cause of lung uptake of bone-scan agent. Here we report on a patient with non-tuberculosis mycobacterial infection (NTM) who demonstrated diffuse pulmonary uptake on Tc-99m MDP bone scan. After medical treatment for NTM, the patient's lung lesions improved. Estra skeletal lung Tc-99m MDP uptake on bone scan may suggest lung parenchymal damage associated with disease activity.

  7. Markers of acute-phase response in the treatment of pulmonary tuberculosis

    Cristiane Martins; Antônio Carlos de Castro Gama; Daniela Valcarenghi; Anna Paula de Borba Batschauer

    2014-01-01

    Introduction:Tuberculosis promotes an acute phase response with an increase of blood reactants, such as C-reactive protein (CRP), among others, which are associated with increased erythrocyte sedimentation rate (ESR).Objective:Evaluate the ESR and the CRP as markers for diagnosis and monitoring cases of pulmonary tuberculosis.Method:Research on patients with clinical, laboratory, and imaging diagnosis of pulmonary tuberculosis, from Itajaí-SC; in which CRP and ESR were analyzed in three diffe...

  8. Incremental yield of bronchial washing for diagnosing smear-negative pulmonary tuberculosis

    2013-01-01

    OBJECTIVE: To assess the increased diagnostic yield for pulmonary tuberculosis using bronchial washing cultures compared with sputum cultures. METHODS: Study conducted with 61 adults in Lima, Peru, from January 2006 to December 2007. The yield of sputum cultures was compared with the yield of acid-fast bacilli smears and cultures of bronchial washing for diagnosing pulmonary tuberculosis in suspected cases of clinical tuberculosis with negative acid fast bacilli sputum smears. RESULTS: ...

  9. Pulmonary impairment after tuberculosis in a South African population

    Gibwa Cole

    2016-02-01

    Full Text Available Background: In South Africa, pulmonary tuberculosis (PTB remains a problem of epidemic proportions. Despite evidence demonstrating persistent lung impairment after PTB cure, few population-based South African studies have investigated this finding. Pulmonary rehabilitation post-cure is not routinely received.Objectives: To determine the effects of PTB on lung function in adults with current or past PTB. To determine any association between PTB and chronic obstructive pulmonary disease (COPD. Methods: This study was observational and cross-sectional in design. Participants (n = 55 were included if they were HIV positive on treatment, had current PTB and were on treatment, and/or had previous PTB and completed treatment or if they were healthy adult subjects with no history of PTB. A sample of convenience was used with participants coming from a similar socio-economic background and undergoing spirometry testing. Multiple regression analyses were conducted on each lung function variable.Results: Compared to normal percentage-predicted values, forced expiratory volume in 1 second (FEV1 , forced vital capacity (FVC and FEV1 :FVC were significantly reduced in those with current PTB by 23.39%, 15.99% and 6.4%, respectively. Both FEV1 and FVC were significantly reduced in those with past PTB by 11.76% and 10.79%, respectively. There was no association between PTB and COPD – those with previous PTB having a reduced FEV1 :FVC (4.88% less than the norm, which was just short of significance (p = 0.059.Conclusions: Lung function is reduced both during and after treatment for PTB and these deficits may persist. This has implications regarding the need for pulmonary rehabilitation even after medical cure.Keywords: Lung function, pulmonary, tuberculosis

  10. Increasing pathomorphism of pulmonary tuberculosis: an observational study of slow clinical, microbiological and imaging response of lung tuberculosis to specific treatment. Which role for linezolid?

    Roberto Manfredi

    2009-08-01

    Full Text Available During recent years, a progressive emerging of tuberculosis occurred, related to the overall increased age of general population, primary and secondary (iatrogenic immunodeficiencies, the availability of invasive procedures, surgical interventions and intensive care supports, bone marrow and solid organ transplantation, and especially the recent immigration flows of people often coming from areas endemic for tuberculosis, and living with evident social-economical disadvantages, and with a reduced access to health care facilities. Since January 2006, at our reference centre we followed 81 consecutive cases of pulmonary tuberculosis, with 65 of them which remained evaluable for the absence of extrapulmonary complications, and a continuative and effective clinical and therapeutic follow-up. The majority of episodes of evaluable pulmonary tuberculosis (49 cases out of 65: 75,4% occurred in patients who immigrated from developing countries. In two patients multiresistant (MDR Mycobacterium tuberculosis strains were found, while two more subjects (both immigrated from Eastern Europe suffered from a disease due to extremely resistant (XDR M. tuberculosis strains. Although enforcing all possible measures to increase patients' adherence to treatment (empowerment, delivery of oral drugs under direct control, use of i.v. formulation whenever possible, over 72% of evaluable patients had a very slow clinical, microbiological, and imaging ameliorement (1-6 months, with persistance of sputum and/or bronchoalveolar lavage (BAL fluid positive for M.tuberculosis microscopy and/or culture for over 1-4 months (mean 9.2±3.2 weeks, during an apparently adequate treatment. When excluding patients suffering from XDR and MDR tuberculosis, in four subjects we observed that off-label linezolid adjunct together with at least three drugs with residual activity against tuberculosis, led to a significantly more rapid clinical-radiological improvement and negative

  11. A rare case of co-infection with pulmonary tuberculosis and oronasal actinomycosis Caso raro de coinfecção tuberculose pulmonar e actinomicose oronasal

    Vitor Alexandre Oliveira Fonseca; Gustavo Reis; Carlos Alves; Maria José Simões; Elvira Camacho; António Pinto Saraiva

    2009-01-01

    Oronasal actinomycosis is an infection seldom described in the literature, especially in the form of a co-infection with pulmonary tuberculosis. We report the case of a 48-year-old male admitted to the isolation ward due to active pulmonary tuberculosis, with a history of diabetes and alcohol abuse. While hospitalized, the patient complained of dysphagia and nasal regurgitation of food. The examination of the oral cavity revealed an oronasal fistula. The infecting agent was identified, and th...

  12. Psychiatric morbidity in patients of pulmonary tuberculosis-an observational study

    Lalit Singh

    2015-01-01

    Full Text Available Background: A lot of stigma and misconceptions about pulmonary tuberculosis still persist, in spite of the advances in treatment. Thus, a mere diagnosis of pulmonary tuberculosis can be a psychological trauma to an individual. The situation has aggravated with the association of tuberculosis with HIV infection. Aim: To study the psychiatric morbidity due to the various psychological stresses faced by a patient of pulmonary tuberculosis. Materials and Methods: The study group consisted of 100 inpatients admitted to pulmonary ward with diagnosis of pulmonary tuberculosis. The control group consisted of 100 inpatients admitted to pulmonary ward with nontuberculous pulmonary diseases. Psychiatric history and mental status were recorded on a specially designed proforma and diagnosis of any psychiatric illness, if present, arrived at as per International Classification of Diseases (ICD-10. The psychiatric tests applied were beck's depression inventory (BDI and Taylor's Manifest Anxiety Scale (TMAS. Results: Of the patients of pulmonary tuberculosis, 24% could be given a diagnostic category, as per ICD-10, as compared to only 8% of the controls (P < 0.005. On BDI, 44% of patients of pulmonary tuberculosis showed depression as compared to 27% of the controls (P < 0.02. On TMAS, 38% of patients of pulmonary tuberculosis showed anxiety as compared to 24% of controls (P < 0.05. A greater incidence of depression (on BDI and anxiety (on TMAS was seen in those with longer duration of illness (P < 0.02 and in those with greater severity of illness (P < 0.02. Conclusion: In view of the high psychiatric morbidity associated with pulmonary tuberculosis, there is enough scope for psychiatric services to be made available to these patients. In addition, personnel involved in the treatment of these patients should be trained for early detection of psychiatric symptoms.

  13. Radioiodinated DPA-713 Imaging Correlates with Bactericidal Activity of Tuberculosis Treatments in Mice

    Ordonez, Alvaro A.; Pokkali, Supriya; DeMarco, Vincent P.; Klunk, Mariah; Mease, Ronnie C.; Foss, Catherine A.; Pomper, Martin G.; Jain, Sanjay K.

    2014-01-01

    Current tools for monitoring response to tuberculosis treatments have several limitations. Noninvasive biomarkers could accelerate tuberculosis drug development and clinical studies, but to date little progress has been made in developing new imaging technologies for this application. In this study, we developed pulmonary single-photon emission computed tomography (SPECT) using radioiodinated DPA-713 to serially monitor the activity of tuberculosis treatments in live mice, which develop necro...

  14. Andrographis Paniculata (Burm. F.) Nees Induces Clinical and Sputum Conversion in Pulmonary Tuberculosis Patients

    Widhawati, Riswahyuni; Hanani, Endang; Zaini, Jamal

    2015-01-01

    AbstractThe aim of this study was to determine whether Andrographus paniculata capsule induces clinical and sputum conversion in pulmonary tuberculosis (TB) patients. Randomized, placebo-controlled, double-blind pilot study was conducted to pulmonary tuberculosis patient who admitted to Pulmonology Polyclinic of Persahabatan Central General Hospital, Jakarta. A total of 44 pulmonary TB patients were randomly divided into two groups including one group received standard antituberculosis drugs ...

  15. Pulmonary Impairment in Tuberculosis Survivors: The Korean National Health and Nutrition Examination Survey 2008-2012.

    Jae-Woo Jung

    Full Text Available Pulmonary tuberculosis (TB can affect lung function, but studies regarding long-term follow-up in patients with no sequelae on chest X-ray (CXR have not been performed. We evaluated lung functional impairment and persistent respiratory symptoms in those with prior pulmonary TB and those with prior pulmonary TB with no residual sequelae on CXR, and determined risk factors for airflow obstruction.We used data from adults aged ≥ 40 years from the annual Korean National Health and Nutrition Examination Surveys conducted between 2008 and 2012. P values for comparisons were adjusted for age, sex, and smoking status.In total of 14,967 adults, 822 subjects (5.5% had diagnosed and treated pulmonary TB (mean 29.0 years ago. The FVC% (84.9 vs. 92.6, FEV1% (83.4 vs. 92.4, and FEV1/FVC% (73.4 vs. 77.9 were significantly decreased in subjects with prior pulmonary TB compared to those without (p < 0.001, each. In 12,885 subjects with no sequalae on CXR, those with prior pulmonary TB (296, 2.3% had significantly lower FEV1% (90.9 vs. 93.4, p = 0.001 and FEV1/FVC% (76.6 vs. 78.4, p < 0.001 than those without. Subjects with prior pulmonary TB as well as subjects with no sequalae on CXR were more likely to experience cough and physical activity limitations due to pulmonary symptoms than those without prior pulmonary TB (p < 0.001, each. In total subjects, prior pulmonary TB (OR, 2.314; 95% CI, 1.922-2.785, along with age, male, asthma, and smoking mount was risk factor for airflow obstruction. In subjects with prior pulmonary tuberculosis, inactive TB lesion on chest x-ray (OR, 2.300; 95% CI, 1.606-3.294 were risk factors of airflow obstruction.In addition to subjects with inactive TB lesion on CXR, subjects with no sequelae on CXR can show impaired pulmonary function and respiratory symptoms. Prior TB is a risk factor for airflow obstruction and that the risk is more important when they have inactive lesions on chest X-ray. Hence, the patients with treated TB

  16. Ayurvedic management of Pulmonary Tuberculosis (PTB: A systematic review

    Janmejaya Samal

    2016-03-01

    Full Text Available Background: Tuberculosis is a global public health crisis. 25% of world's TB cases are found in India. Ayurveda, an ancient medical science may offer some solution to this problem hence a systematic review was carried out to assess the role of Ayurveda for the management of Tuberculosis. Methodology: A systematic review was carried out using published literature obtained through and ldquo;PUBMED and rdquo; till April 2015. The key words used for literature search include and ldquo;Ayurveda, role and Tuberculosis and rdquo;. Results and Discussion: It was observed that a couple of single and compound drugs have been used for the management of tuberculosis. However none of the studies could reflect the true anti-tubercular activities of any drug, both single and compound. Two of the studies revealed in vitro anti-tubercular properties of some herbs which can potentially be brought in to the realm of clinical trial to test their efficacy in human subject. Most of these Ayurvedic therapeutic preparations studied at different clinical settings primarily reflected their adjunct properties for the management of Tuberculosis. These studies revealed that Ayurvedic therapeutics were able to reduce associated symptoms and the adverse drug effects of ATDs (Antitubercular Drugs. Furthermore some of the preparations showed potential hepato-protective properties that can be simultaneously administered with ATDs. Conclusion: Distressingly research on the role of Ayurveda in the management of Tuberculosis is very scanty and mostly limited to adjunct or supportive therapy. Being a global public health crisis, it is highly recommended to carry out clinical trials on Tuberculosis patients by using Ayurvedic drugs and therapeutic regimens. [J Intercult Ethnopharmacol 2016; 5(1.000: 86-91

  17. Pulmonary tuberculosis with neuromyelitis optica: an uncommon association of a common disease

    Systemic tuberculosis has been reported with varying neurological manifestations like meningitis, tuberculomas, myositis and neuropathy. Neuromyelitis optica (NMO) is a well known neurological entity which has been described in association with several systemic disorders like systemic lupus erythematosis, diabetes mellitus, hypothyroidism, exposure to Mycobacterium tuberculosis. insecticides etc. However, only a few cases of NMO have been reported in association with Here, we report a case of pulmonary tuberculosis in association with NMO to highlight the under-reported association of NMO with pulmonary tuberculosis presenting in a peculiar anatomical fashion i.e. longitudinal myelitis with predominant posterior column involvement. (author)

  18. Delay in DOTS for new pulmonary tuberculosis patient from rural area of Wardha District, India

    Shilpa Bawankule

    2010-07-01

    Full Text Available Vast majority of active tuberculosis patients seeks treatment, do so promptly, still many patients spend a great deal of time and money “shopping for health” and too often they do not receive either accurate diagnosis or effective treatment, despite spending considerable resources. Objective: To find out the time taken to, for diagnosis of tuberculosis and to put patient on DOTS from the onset of symptoms and pattern of health seeking behavior of new pulmonary tuberculosis patients. A cross-sectional rapid assessment using qualitative (FGD and quantitative (Interview methods conducted at DOTS center of tertiary care hospital from rural Wardha. Participants: 53 pulmonary tuberculosis patients already on DOTS, in intensive phase. Main outcome measure: Delay in initiation of DOTS & health seeking behavior Results: Median total delay for starting DOTS was 111 days, (range: 10 to 321 days. Patient delay was more than provider delay. Patients delay was more in patients above 60 years, illiterate, per-capita income below 650 Rupees and HIV TB co-infection. Pattern of health seeking behavior was complex. Family physician was the preferred health care provider. Patient visited on an average four providers and spent around 1450 rupees (only direct cost before DOTS begin. Time taken from the onset of symptoms and start of DOT is a cause of concern for the tuberculosis control program. Early case detection is important rather than mere achieving target of 70% new case detection. Program manager needs to implement locally relevant & focused strategies for early case detection to improve the treatment success, especially in rural area of India.

  19. Drug resistance pattern in multidrug resistance pulmonary tuberculosis patients

    To evaluate the frequency of drug resistance profiles of multidrug resistant tuberculosis (MDR-TB) isolates of pulmonary tuberculosis patients, against both the first and the second line drugs. Study Design: An observational study. Place and Duration of Study: The multidrug resistant tuberculosis (MDR-TB) ward of Ojha Institute of Chest Diseases (OICD), Karachi, from 1996 to 2006. Methodology: Culture proven MDR-TB cases (resistant to both isoniazid and Rifampicin) were retrospectively reviewed. Susceptibility testing was performed at the clinical laboratory of the Aga Khan University. Sensitivity against both first and second line anti-tuberculosis drugs was done. Susceptibility testing was performed using Agar proportion method on enriched middle brook 7H10 medium (BBL) for Rifampicin, Isoniazid, Streptomycin, Ethambutol, Ethionamide, Capreomycin and Ciprofloxacin. Pyrazinamide sensitivity was carried out using the BACTEC 7H12 medium. During the study period MTB H37Rv was used as control. Results: Out of total 577 patients, all were resistant to both Rifampicin and Isoniazid (INH). 56.5% isolates were resistant to all five first line drugs. Resistances against other first line drugs was 76.60% for Pyrazinamide, 73% for Ethambutol and 68.11% for Streptomycin. Five hundred and ten (88%) cases were MDR plus resistant to one more first line drug. Forty (07%) isolates were MDR plus Quinolone-resistant. They were sensitive to Capreomycin but sensitivity against Amikacin and Kanamycin were not tested. Conclusion: There were high resistance rates in MDR-TB to remaining first line and second line drugs. Continuous monitoring of drug resistance pattern especially of MDR isolates and treatment in specialized centers is a crucial need for future TB control in Pakistan. (author)

  20. Transcatheter arterial embolization for control of hemoptysis in pulmonary tuberculosis: analysis of prognostic factors

    To evaluate the effectiveness of transcatheter arterial embolization(TAE) and the relationship between therapeutic effect and prognostic factors after this procedure. Fifty-five patients with hemoptysis caused by pulmonary tuberculosis (TB) underwent TAE. We reviewed medical records of the history and activity of pulmonary TB, and the extent of treatment, and assessed plain chest PA for the extent of lesions;we also evaluated the angiographic findings of embolized arteries, and embolic agents. The initial success rate, as shown by immediate response, and recurrence during follow-up, were then observed. Using the Chi-square test, differences in these findings were analysed. Immediate control of hemoptysis was achieved in 46 of 55 patients(84%);24 of 46(52.2%), experienced recurrence. Initial failure and partial response rates were higher in patients with active pulmonary TB(p<0.05) than in those in whom the condition was inactive. The recurrence rate was higher among those who had pulmonary TB for between one and ten years (p<0.05). There was, however, no significant correlation between therapeutic effect and the extent of anti-TB treatment, the extent of lesions seen on plain chest PA, angiographic findings, embolized arteries, and embolic agents. The initial success rate of TAE was 84% and the recurrence rate was as high as 52.2%. Both activity and duration of pulmonary TB were prognostic factors in immediate response and recurrence.=20

  1. Surgical Treatment of Complications of Pulmonary Tuberculosis, including Drug-Resistant Tuberculosis

    Rajhmun Madansein

    2015-03-01

    Full Text Available Surgery for drug-resistant tuberculosis has been shown to be safe and effective, with similar level of mortalities associated with surgical intervention observed with that for lung cancer. While surgery has been an option to treat TB in the pre-antibiotic era, it is now increasingly used to treat complications of pulmonary TB, particularly in patients with drug-resistant TB who do not respond to medical treatment. The two most frequent indications for lung resection in drug- resistant TB, are i failed medical treatment with persistent sputum positivity or ii patients who have had medical treatment and are sputum negative, but with persistent localized cavitary disease or bronchiectasis. Massive hemoptysis is a potentially life-threatening complication of TB. Lung resection is potentially curative in patients with massive hemoptysis and cavitary or bronchiectatic disease. Bronchial artery embolization in these patients has a high success rate but bears also the risk of recurrence. Lung resection can be safely undertaken in selected patients with HIV co-infection and pulmonary complications of TB. Ambulatory drainage is a novel, safe, affordable and effective method of draining a chronic TB associated empyema thoracis. We review here the current surgical treatment of the complications of pulmonary TB and discuss the experience from the Durban Cardiothoracic Surgery Unit for the surgical treatment of patients with complicated pulmonary TB.

  2. Vitamin D status of patients with type 2 diabetes and sputum positive pulmonary tuberculosis

    Sandeep Chaudhary; Anubhav Thukral; Shalbha Tiwari; Daliparthy D Pratyush; Surya Kumar Singh

    2013-01-01

    Introduction: Vitamin D deficiency is expected to be higher in patients with diabetes and pulmonary tuberculosis (TB). Studies estimating prevalence in the subset of patients with both diabetes and pulmonary TB are scarce. Materials and Methods: A total of 155 subjects were recruited; 46 patients with type 2 diabetes, 39 non-diabetic healthy controls, 30 patients of pulmonary TB and 40 patients with both pulmonary TB and type 2 diabetes. Vitamin D level (25 OH vitamin D) levels were done for ...

  3. [Lupus vulgaris as a complication of pulmonary tuberculosis--case report].

    Owczarek, Witold; Targowski, Tomasz; Kozera-Zywczyk, Anna; Paluchowska, Elwira; Patera, Janusz

    2009-10-01

    Tuberculosis is a contagious disease induced by Mycobacterium species, acid-fast bacilli. These are mostly human type--Mycobacterium tuberculosis, less often cattle type--mycobacterium bovis or other: mycobacterium avium, kansasii, marinom, scrofulaceum, heamophilium, gordonae. The infection can affect all organs, but pulmonary tuberculosis is the most common form. The importance of tuberculosis is definitely rising in the context of massive population migrations in regions affected by its higher incidence, increased HIV infections and AIDS development. Cutaneous tuberculosis is a particular tuberculosis form with differentiated clinical picture. Non-typicalness of skin changes and oligobacilleous course of extrapulmonary tuberculosis forms are repeatedly causing difficulties in adequate diagnosis and early treatment. In differential diagnostics of cutaneous tuberculosis one must take leishmaniasis, actinomycosis, leprosy, syphilis and deep mycosis (among others) into consideration. The study is presenting a case of lupus vulgaris as a complication of past pulmonary tuberculosis. In bacteriological diagnostics of skin changes bioptates, no tuberculosis mycobacteria were found. The disease was diagnosed based on specific granulation presence in histopathology test, tuberculin hypersensivity, bacilli DNA presence in polymerase chain reaction (PCR) test and skin changes regression after anti-mycobacterium treatment. According to authors of the study, the described case confirms the usefulness of PCR nucleonic acids amplification test in cutaneous tuberculosis diagnosis. PMID:19928663

  4. Prevalence of patients with respiratory symptoms through active case finding and diagnosis of pulmonary tuberculosis among prisoners and related predictors in a jail in the city of Carapicuíba, Brazil Prevalência de sintomáticos respiratórios através da busca ativa, diagnóstico de tuberculose pulmonar entre pessoas privadas de liberdade e fatores associados em uma cadeia pública no município de Carapicuíba, Brasil

    Vieira, Amadeu A.; Sandra A. Ribeiro; Ana M. de Siqueira; Galesi, Vera M. N.; Laedi A. R. dos Santos; Jonathan E. Golub

    2010-01-01

    BACKGROUND: Prisons offer a fertile setting for the transmission of tuberculosis due to the presence of many classic risk factors for both infection and disease: overcrowding, poor ventilation, and little sunlight. Prisoners are often malnourished and have poor hygiene and are more likely to have a background of alcohol and drug abuse. OBJECTIVES: To determine the prevalence of prisoners with respiratory symptoms and pulmonary tuberculosis (PTB) through active case finding in a prisoner popul...

  5. Pulmonary Alveolar Proteinosis and tuberculosis in a diabetic patient: a rare or a seldom diagnosed association

    Pereira-Silva J.L.; Marinho M.M.M.A.; Veloso T.V.B.; Coelho Filho J.C.

    2002-01-01

    A case of Pulmonary Alveolar Proteinosis (PAP), in association with tuberculosis, is described in a 35-year-old diabetic patient. Lung biopsy showed an intra-alveolar accumulation of PAS-positive material, and multifocal granulomas compatible with tuberculosis. The bronchoalveolar culture was positive for Mycobacterium tuberculosis. PAP results from an imbalance of the mechanisms that regulate the homeostasis of the surfactant, where specific proteins are involved, especially SP-A and SP-D, t...

  6. [The interpretation of pulmonary tuberculosis in the 18th century].

    Bernier, Jacques

    2005-01-01

    Pulmonary tuberculosis took on alarming proportions in the 18th-century Europe. This study examines the ways learned medical practitioners presented the causes of the malady in Great Britain and France, by analyzing 12 medical treatises. Four etiological models appears to have dominated medical thinking in this context: theories that emphasize contagion; those which attribute the cause to physiological disorders; those which find the origin in hereditary predispositions; and those theories which observe a link with behaviour and lifestyles. The study also shows how one of these theories - the hereditary theory - eventually triumphed over the others and became the dominant for the better part of the 19th century, and will be examined within the context of the growth of liberal and individualist ideology. PMID:15977379

  7. Pulmonary tuberculosis in a patient with cystic fibrosis

    Naveen Patil

    2015-01-01

    Full Text Available Context: Mycobacterium tuberculosis (MTB infection is rarely seen in cystic fibrosis (CF patients. Case Report: We report a 24-year-old CF patient with fever, cough, hemoptysis, and weight loss of 1week duration prior to admission. Past sputum cultures grew methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa. The patient was treated with broad spectrum antibiotics based on previous culture data, but failed to improve. Chest radiograph and computed tomography (CT chest revealed chronic collapse of the anterior subsegment of right upper lobe and multiple bilateral cavitary lesions which were worse compared to prior films. MTB was suspected and was confirmed by positive acid-fast bacilli (AFB smears and cultures. After receiving first-line antituberculous drugs, the patient′s condition markedly improved. Conclusion: MTB is an infrequent finding, but considered a potential pathogen in CF patients, and may lead to serious pulmonary complications if there is a delay in diagnosis and treatment.

  8. Wegener′s granulomatosis disease mimicking pulmonary tuberculosis

    Naveen Pandhi

    2015-01-01

    Full Text Available Wegener′s granulomatosis (WG is an uncommon autoimmune disease with multi-system involvement that manifests as vasculitis, granulomatosis, and necrosis. While its standard form involves the upper and lower respiratory tracts and kidneys, it may essentially involve any organ. We present a case in a young female patient presenting with symptoms of cough with expectoration, fever, dyspnea and chest discomfort, having cavitating lesion in right upper lobe and nodule in left upper lobe with bilateral paranasal sinus involvement on computed tomography. Allergic rhino-sinusitis with pulmonary tuberculosis was suspected, and patient was investigated further. Upon further investigation, renal involvement was detected, and serology revealed cytoplasmic antineutrophil cytoplasmic antibody. WG was suspected and was proven by histopathology of nasal tissue which revealed necrotizing granulomas.

  9. Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil

    Liberato Isabella Ramos de Oliveira; Albuquerque Maria de Fatima P. Militão de; Campelo Antônio Roberto Leite; Melo Heloísa Ramos Lacerda de

    2004-01-01

    The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV) and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001), showed a higher frequency of weight loss >10 kilos (p

  10. Medialisation thyroplasty for unilateral vocal fold paralysis associated with chronic pulmonary tuberculosis

    Lam, PKY; Wei, WI

    2007-01-01

    Improved hygiene and public awareness have led to a steady decline in the incidence of pulmonary tuberculosis in developed countries. Nonetheless, long-term sequelae like unilateral vocal fold paralysis should not be underestimated in a modern society. We report three patients with chronic lung fibrosis following pulmonary tuberculosis leading to unilateral vocal fold paralysis. All three patients had hoarseness and chronic aspiration on swallowing. Early diagnosis and prompt surgical interve...

  11. Primary pulmonary tuberculosis in infancy: A resurgent disease in the urban United States

    Primary pulmonary tuberculosis in infancy still exists in the urban United States, reflecting new immigrations from less developed areas. The clinical diagnosis may be difficult and routine chest radiographs may be confusing. We found magnification high KV filtered radiography to be very useful in delineating the primary complex and its effect on the tracheobronchial tree. Twelve infants and small children with primary pulmonary tuberculosis were seen in the years 1978-1984. (orig.)

  12. Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study

    Kritski Afrânio; Chaisson Richard E; Conde Marcus; Rezende Valéria MC; Soares Sérgio; Bastos Luiz; Mello Fernanda; Ruffino-Netto Antonio; Werneck Guilherme

    2006-01-01

    Abstract Background Smear negative pulmonary tuberculosis (SNPT) accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. Methods The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs ...

  13. Delayed consultation among pulmonary tuberculosis patients: a cross sectional study of 10 DOTS districts of Ethiopia

    Gessessew Amanuel; Walley John D; Newell James N; Mesfin Mengiste M; Madeley Richard J

    2009-01-01

    Abstract Background Delays seeking care increase transmission of pulmonary tuberculosis and hence the burden of tuberculosis, which remains high in developing countries. This study investigates patterns of health seeking behavior and determines risk factors for delayed patient consultation at public health facilities in 10 districts of Ethiopia. Methods New pulmonary TB patients ≥ 15 years old were recruited at 18 diagnostic centres. Patients were asked about their health care seeking behavio...

  14. Relationship between Toll-Like Receptor 8 Gene Polymorphisms and Pediatric Pulmonary Tuberculosis

    Nazan Dalgic

    2011-01-01

    Full Text Available Objectives: Genetic variants in Toll-like receptors (TLRs are considered a potential indicator for host susceptibility to and outcome of several infectious diseases including tuberculosis. The aim of this study was to determine whether −129 C/G and Met1Val polymorphisms of TLR8 were associated with pediatric pulmonary tuberculosis in Turkish population.

  15. Long-term mortality in patients with pulmonary and extrapulmonary tuberculosis

    Christensen, Anne-Sophie Halkjær; Roed, Casper; Andersen, Peter H;

    2014-01-01

    BACKGROUND: Long-term mortality and causes of death in patients with pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) are poorly documented. In this study, long-term mortality and causes of death in PTB and EPTB patients were compared with the background population and it was...

  16. Evaluation of Smear Negative and Pozitive Pulmonary Tuberculosis Cases

    Fulsen Bozkus

    2014-04-01

    Full Text Available Aim: To determine the relation between radiographic involvement and tuberculin skin test (TST and Bacillus Calmette Guerin (BCG results in patients with pulmonary tuberculosis (PTB. Material and Method: In 210 patients (%42,7 female, %57,6 male, mean age:40,5 ± 16,1 with smear positive and negative PTB we retrospectively analyzed the relation between radiographic findings, TST and BCG. We separated the patients into three groups as mild, moderate and severe according to their radiologic involvement and compared the radiologic extension with tuberculin skin test results. We also compared the degree of sputum smear positivity with tuberculin skin test results. Results: According to the evaluation of radiological findings of the patients, high risk is detected in 58(67,4% patients in smear-positive group and 28(32,6% patients in smear-negative group and statistically valuable relation between smear positivity and radiological findings of the patients is seen (p:0,001. According to the results of TST of the patients, high risk is detected radiologically in 53(61,6% cases of TST-negative group, 33(38,4% cases of TST-positive group and statistically valuable relation between TST results and radiological findings of the patients is seen (p:0,001. A valuable difference between BCG results and radiological findings is not seen. Discussion: It is concluded that radiology is beneficial for diagnosis especially in cases which are without bacilli and suspicious for tuberculosis and TST is shown that it can be beneficial for determining the immunity against to mycobacterium tuberculosis.

  17. Lung abscess due to Streptococcus pneumoniae simulating pulmonary tuberculosis: presentation of two cases

    Alessandro Perazzo

    2014-03-01

    Full Text Available In the past, anaerobes were the most common cause of community-acquired lung abscess; Streptococcus species were the second most common cause. In recent years, this has changed. Klebsiella pneumoniae is now most common cause of community- acquired lung abscess, although Streptococcus species remain pathogen of major importance. We present two cases of pulmonary cavitation due to Streptococcus pneumoniae which resembled pulmonary tuberculosis with regards to their history and radiological findings. These are examples of a common diagnosis presenting in an uncommon way. Our cases had some peculiarities: they had a clinical picture strongly suggestive of pulmonary tuberculosis or lung cancer rather than necrotizing infectious pneumonia in patients with no comorbidities or underlying diseases (including oral or dental pathologies. Radiological findings did not help the clinicians: pulmonary tuberculosis was the first diagnostic hypothesis in both cases. An underlying lung cancer was excluded in the first case only after invasive pulmonary procedures.

  18. Cavitating pulmonary tuberculosis in children: correlating radiology with pathogenesis

    Griffith-Richards, S.B.; Andronikou, Savvas; Przybojewski, Stefan J.; Strachan, Melanie; Vadachia, Yousuf; Kathan, David L. [Tygerberg Hospital and University of Stellenbosch, Department of Radiology (South Africa); Goussard, Pierre; Gie, Robert P. [Tygerberg Children' s Hospital and University of Stellenbosch, Department of Paediatrics, Tygerberg (South Africa)

    2007-08-15

    Cavitating pulmonary tuberculosis (PTB) is generally known as a disease of adults, with children typically having features of primary PTB. To group children with PTB and cavities according to possible pathogenesis by evaluating the clinical and radiological findings. The clinical and radiological findings in ten randomly selected children with PTB and cavitations on chest radiographs were retrospectively reviewed and evaluated. Three groups emerged: group 1 (four children) had cavities, usually single and unilateral in the classic upper lobe distribution of postprimary PTB; group 2 (three children) developed progressive primary spread of disease with extensive and bilateral pulmonary cavities; and group 3 (three children) developed cavities secondary to airway obstruction by mediastinal lymph nodes with consequent distal collapse and consolidation. Children in group 1 responded well to treatment and had unremarkable recoveries. Children in group 2 were all below 2 years of age with complicated recoveries. Children in group 3 had frequent complications resulting in one fatality. Cavities in PTB in children may arise by one of three possible mechanisms with a relatively equal incidence. A study is underway to determine the incidence of cavity formation associated with mediastinal lymphadenopathy and airway obstruction. (orig.)

  19. Cavitating pulmonary tuberculosis in children: correlating radiology with pathogenesis

    Cavitating pulmonary tuberculosis (PTB) is generally known as a disease of adults, with children typically having features of primary PTB. To group children with PTB and cavities according to possible pathogenesis by evaluating the clinical and radiological findings. The clinical and radiological findings in ten randomly selected children with PTB and cavitations on chest radiographs were retrospectively reviewed and evaluated. Three groups emerged: group 1 (four children) had cavities, usually single and unilateral in the classic upper lobe distribution of postprimary PTB; group 2 (three children) developed progressive primary spread of disease with extensive and bilateral pulmonary cavities; and group 3 (three children) developed cavities secondary to airway obstruction by mediastinal lymph nodes with consequent distal collapse and consolidation. Children in group 1 responded well to treatment and had unremarkable recoveries. Children in group 2 were all below 2 years of age with complicated recoveries. Children in group 3 had frequent complications resulting in one fatality. Cavities in PTB in children may arise by one of three possible mechanisms with a relatively equal incidence. A study is underway to determine the incidence of cavity formation associated with mediastinal lymphadenopathy and airway obstruction. (orig.)

  20. Pulmonary Tuberculosis in Humanized Mice Infected with HIV-1

    Nusbaum, Rebecca J.; Calderon, Veronica E.; Huante, Matthew B.; Sutjita, Putri; Vijayakumar, Sudhamathi; Lancaster, Katrina L.; Hunter, Robert L.; Actor, Jeffrey K.; Cirillo, Jeffrey D.; Aronson, Judith; Gelman, Benjamin B.; Lisinicchia, Joshua G.; Valbuena, Gustavo; Endsley, Janice J.

    2016-01-01

    Co-infection with HIV increases the morbidity and mortality associated with tuberculosis due to multiple factors including a poorly understood microbial synergy. We developed a novel small animal model of co-infection in the humanized mouse to investigate how HIV infection disrupts pulmonary containment of Mtb. Following dual infection, HIV-infected cells were localized to sites of Mtb-driven inflammation and mycobacterial replication in the lung. Consistent with disease in human subjects, we observed increased mycobacterial burden, loss of granuloma structure, and increased progression of TB disease, due to HIV co-infection. Importantly, we observed an HIV-dependent pro-inflammatory cytokine signature (IL-1β, IL-6, TNFα, and IL-8), neutrophil accumulation, and greater lung pathology in the Mtb-co-infected lung. These results suggest that in the early stages of acute co-infection in the humanized mouse, infection with HIV exacerbates the pro-inflammatory response to pulmonary Mtb, leading to poorly formed granulomas, more severe lung pathology, and increased mycobacterial burden and dissemination. PMID:26908312

  1. Population Pharmacokinetics of Rifampicin in Chinese Patients With Pulmonary Tuberculosis.

    Jing, Ying; Zhu, Li Qin; Yang, Jian Wei; Huang, Shu Ping; Wang, Qian; Zhang, Jie

    2016-05-01

    Rifampicin (RIF) induces cytochrome P450, which in turn catalyzes drug metabolism; however, pharmacokinetic studies on this phenomenon in the Chinese population, especially in the context of disease, are limited. Therefore, we sought to establish population-based pharmacokinetic models of RIF in a Chinese population with pulmonary tuberculosis (TB). Clinical data were retrospectively collected from 54 patients with pulmonary TB and analyzed alongside RIF blood levels from 95 samples collected prior to RIF administration and between 2 and 12 hours after treatment. HPLC was used to measure serum RIF concentrations. A nonlinear mixed model used to characterize RIF pharmacokinetics and the data generated from the present study were validated using a bootstrap method. Covariates, including demographics, as well as hematological and biological indicators were analyzed. We observed a 1-compartment model with first-order absorption. Typical population values of apparent clearance (CL/F) and apparent volume of distribution (VD /F) were 4.02 L/h and 57.8 L, respectively. No covariate significantly changed the parameters of CL/F and VD . The present study may serve as a foundation for individualized therapy and offer a basis for pharmacokinetic-pharmacodynamic (PK-PD) analysis. PMID:26387492

  2. Whole Blood Interferon-γ Release Assay Is Insufficient for the Diagnosis of Sputum Smear Negative Pulmonary Tuberculosis

    Park, Heejin; Shin, Jung Ar; Kim, Hyung Jung; Ahn, Chul Min; CHANG, YOON SOO

    2014-01-01

    Purpose We investigated the value of an interferon-γ release assay (IGRA) for the diagnosis of active pulmonary tuberculosis (PTB) among sputum smear negative PTB suspects in an environment with intermediate burden of PTB and high Bacillus Calmette-Guérin (BCG) vaccination rate. Materials and Methods We retrospectively reviewed IGRA, medical records, chest PA and CT scan of PTB suspects seen at Gangnam Severance Hospital, Seoul, Korea from Oct. 2007 to Apr. 2013. "Active PTB" was diagnosed wh...

  3. The radiological spectrum of pulmonary multidrug-resistant tuberculosis: in HIV-Negative patients

    Background: Multidrug-resistant tuberculosis is a major worldwide health problem. In countries where tuberculosis is of moderate to high prevalence, the issue of Multidrug-resistant tuberculosis carries significant importance. Multidrug-resistant tuberculosis, similar to drug-sensitive tuberculosis, is contagious. Meanwhile its treatment is not only more difficult but also more expensive with lower success rates. Regarding clinical findings, there is no significant difference between Multidrug-resistant tuberculosis and drug-sensitive tuberculosis. Therefore determination of characteristic radiological findings in cases of Multidrug-resistant tuberculosis might be of help in early detection, and hence appropriate management of this disease condition. Objective: To explain the radiological spectrum of pulmonary Multidrug-resistant tuberculosis. Patients and methods: We retrospectively evaluated the radiographic images of 35 patients with clinically-and microbiologically- proven Multidrug-resistant tuberculosis admitted to our tertiary-care tuberculosis unit over a period of 13 months. The latest chest x-ray of all patients and the conventional chest CT scan without contrast of 15 patients were reviewed by three expert radiologists who rendered consensus opinion. Results: Of the 35 patients with imaging studies, 23 (66%) were male and 12 (34%) were female. The mean±SD age of participants was 38.2±17.3 (range: 16-20) years. 33 patients were known as secondary and only 2 had primary Multidrug-resistant tuberculosis. Chest radiography revealed cavitary lesion in 80% pulmonary infiltration in 89% and nodules in 80% of the cases. Pleurisy was the rarest finding observed in only 5 (14%) patients. All of 15 chest CT scans revealed cavitation, 93% of which were bilateral and multiple. Pleural involvement was seen in 93% of patients. Conclusion: Presence of multiple cavities, especially in both lungs, nodular and infiltrative lesions, and pleural effusion are main features

  4. Seasonality in pulmonary tuberculosis among migrant workers entering Kuwait

    Mohammad Hameed GHH

    2008-01-01

    Full Text Available Abstract Background There is paucity of data on seasonal variation in pulmonary tuberculosis (TB in developing countries contrary to recognized seasonality in the TB notification in western societies. This study examined the seasonal pattern in TB diagnosis among migrant workers from developing countries entering Kuwait. Methods Monthly aggregates of TB diagnosis results for consecutive migrants tested between January I, 1997 and December 31, 2006 were analyzed. We assessed the amplitude (α of the sinusoidal oscillation and the time at which maximum (θ° TB cases were detected using Edwards' test. The adequacy of the hypothesized sinusoidal curve was assessed by χ2 goodness-of-fit test. Results During the 10 year study period, the proportion (per 100,000 of pulmonary TB cases among the migrants was 198 (4608/2328582, (95% confidence interval: 192 – 204. The adjusted mean monthly number of pulmonary TB cases was 384. Based on the observed seasonal pattern in the data, the maximum number of TB cases was expected during the last week of April (θ° = 112°; P α = 0.204 ± 0.04 of simple harmonic curve showed 20.4% difference from the mean to maximum TB cases. The peak to low ratio of adjusted number of TB cases was 1.51 (95% CI: 1.39 – 1.65. The χ2 goodness-of-test revealed that there was no significant (P > 0.1 departure of observed frequencies from the fitted simple harmonic curve. Seasonal component explained 55% of the total variation in the proportions of TB cases (100,000 among the migrants. Conclusion This regularity of peak seasonality in TB case detection may prove useful to institute measures that warrant a better attendance of migrants. Public health authorities may consider re-allocation of resources in the period of peak seasonality to minimize the risk of Mycobacterium tuberculosis infection to close contacts in this and comparable settings in the region having similar influx of immigrants from high TB burden countries

  5. The Clinical Analysis on 80 patients with Pulmonary Tuberculosis Associated with Diabetes%肺结核合并糖尿病80例分析

    曹蕾; 吴纪明

    2012-01-01

    目的 探讨两种疾病合并存在的相关规律.方法 对2006~2008年来在市结核病防治所完成规则全疗程的肺结核合并糖尿病患者80例相关临床资料进行分析.结果 肺结核病情严重程度治疗效果控制水平有关.结论 肺结核合并糖尿病患者有病变范围广、痰菌涂阳率、空洞率高,其预后通常较差;通过积极控制血糖水平,早期合理抗结核药物治疗,能提高肺结核治愈率.%Objective To study the relationships of pulmonary tuberculosis and diabetes in order to provide effective measures for its prevention, control and treatment. Methods The data of 80 patients suffering from pulmonary tuberculosis with diabetes were analyzed , focusing on the interaction of pulmonary tuberculosis and diabetes. Results The severity of pulmonary tuberculosis closely related with the control of blood glucose. The higher of blood glucose, the higher detection rate of smear-positive and the higher cavitation rate. The treatment effect of pulmonary tuberculosis was closely related to the control of blood glucose. Conclusion Pulmonary tuberculosis with diabetes was characterized by wide extent of disease, high rates of smear-positive and cavity and bad prognosis. The control of blood glucose was the key to its care. Actively contolling blood glucose and reasonably using antituberculosis drugs can improve recovery rate Pulmonary tuberculosis.

  6. Association of the FCN2 Gene Single Nucleotide Polymorphisms with Susceptibility to Pulmonary Tuberculosis.

    Dan-Dan Xu

    Full Text Available Ficolin-2 (FCN2 is an innate immune pattern recognition molecule that can activate the complement pathway, opsonophagocytosis, and elimination of the pathogens. The present study aimed to investigate the association of the FCN2 gene single nucleotide polymorphisms (SNPs with susceptibility to pulmonary tuberculosis (TB. A total of seven SNPs in exon 8 (+6359 C>T and +6424 G>T and in the promoter region (-986 G>A, -602 G>A, -557 A>G, -64 A>C and -4 A>G of the FCN2 gene were genotyped using the PCR amplification and DNA sequencing methods in the healthy controls group (n = 254 and the pulmonary TB group (n = 282. The correlation between SNPs and pulmonary TB was analyzed using the logistic regression method. The results showed that there were no significant differences in the distribution of allelic frequencies of seven SNPs between the pulmonary TB group and the healthy controls group. However, the frequency of the variant homozygous genotype (P = 0.037, -557 A>G; P = 0.038, -64 A>C; P = 0.024, +6424 G>T in the TB group was significantly lower than the control group. After adjustment for age and gender, these variant homozygous genotypes were found to be recessive models in association with pulmonary TB. In addition, -64 A>C (P = 0.047 and +6424 G>T (P = 0.03 were found to be codominant models in association with pulmonary TB. There was strong linkage disequilibrium (r2 > 0.80, P A site. Therefore, -557 A>G, -64 A>C and +6424 G>T SNPs of the FCN2 gene were correlated with pulmonary TB, and may be protective factors for TB. This study provides a novel idea for the prevention and control of TB transmission from a genetics perspective.

  7. Patterns of pulmonary tuberculosis on FDG-PET/CT

    Objective: This study aims to describe patterns of pulmonary tuberculosis (TB) on FDG-PET/CT. Methods: All patients with a diagnosis of TB and who underwent FDG-PET/CT between January 2009 and June 2010 were included. Clinical, biological and imaging data were reviewed. TB was proven either on bacteriological or histopathological studies (n = 13) or on a clinical and imaging basis (n = 3). Results: Sixteen patients (11 men; median age 56, range 22–84 years) were included. Two distinct patterns were identified. In the lung pattern (9/16), patients had predominantly pulmonary symptoms (6/9 patients, 67%) with a parenchymal involvement: uptakes on lung consolidation ± cavitation surrounded by micronodules. Mediastino-hilar lymph nodes were slightly enlarged (15 mm, 10–27) with moderate uptake (3.9, 2.5–13.4). In the lymphatic pattern (7/16), patients had predominantly systemic symptoms (5/7 cases, 71%) and all had extra-thoracic involvement. Mediastino-hilar lymph nodes were more enlarged (30 mm, 18–35, p = 0.03) and with higher uptake (6.8, 5.7–16.8, p = 0.034) than in the lung pattern. Conclusion: We identified two distinct patterns of pulmonary TB on FDG-PET/CT. The lung pattern related to a restricted and slight hypermetabolic infection and the lymphatic pattern related to a systemic and intense infection. Combined interpretation of PET and CT findings improves the specificity of images, especially for the lung pattern

  8. A Multi-Country Non-Inferiority Cluster Randomized Trial of Frontloaded Smear Microscopy for the Diagnosis of Pulmonary Tuberculosis

    Cuevas, Luis Eduardo; Al-Sonboli, Najla; Lawson, Lovett; Yassin, Mohammed Ahmed; Arbide, Isabel; Al-Aghbari, Nasher; Bahadur Sherchand, Jeevan; Al-Absi, Amin; Emenyonu, Emmanuel Nnamdi; Merid, Yared; Okobi, Mosis Ifenyi; Onuoha, Juliana Olubunmi; Aschalew, Melkamsew; Aseffa, Abraham; Harper, Greg

    2011-01-01

    Editors' Summary Background Tuberculosis is a global public health problem. Every year, about 1.7 million people die from this contagious bacterial infection, and about 9 million new cases occur, mainly in low- and middle-income countries. Mycobacterium tuberculosis, which causes tuberculosis, is spread in airborne droplets when people with the disease cough or sneeze, and usually infects the lungs (pulmonary tuberculosis). Symptoms of tuberculosis include a persistent cough, weight loss, and...

  9. A study of the role of IL-12 in pulmonary tuberculosis using the whole blood flowcytometry technique.

    Zahran, Wafaa A; Ghonaim, Mabrouk M; Koura, Bothina A; El-Banna, Hassan; Ali, Sahar M; El-Sheikh, Nabila

    2006-01-01

    Pulmonary tuberculosis remains a major health problem. It is caused by Mycobacterium tuberculosis, which elicits a T-cell dependent immune response, initiated by monocytes through a large number of cytokines of which interleukin-12 is thought to play a critical role in initiation and regulation of T-helper (Th-1) like responses. To better understand the role of IL-12 in pulmonary tuberculosis patients, intracellular IL-12 in peripheral blood-derived monocytes was examined by flowcytometery. The percentage of monocytes producing IL-12 was measured after invitro stimulation of heparinized whole blood with mycobacterial protein antigens (culture filtrate). Of the 22 active tuberculosis patients, 17 were recent cases and 5 recurrent cases. Healthy controls were 14 individuals with detectable reaction to purified protein derivative (PPD+) and 14 without detectable reaction to PPD. The role of different factors affecting disease outcome such as treatment, age, gender, smoking, severity of disease and presence of other complications on the percentage of monocytes producing IL-12 was studied. Recurrent TB patients had a higher number of monocytes producing IL-12 in unstimulated cultures compared to other groups (P 0.05). It is concluded that IL-12 plays a prominent regulatory role in tuberculosis. PMID:17974150

  10. Detection of Mycobacterium tuberculosis complex by nested polymerase chain reaction in pulmonary and extrapulmonary specimens

    Adriana Antônia da Cruz Furini

    2013-12-01

    Full Text Available OBJECTIVE: To compare the performance of nested polymerase chain reaction (NPCR with that of cultures in the detection of the Mycobacterium tuberculosis complex in pulmonary and extrapulmonary specimens.METHODS: We analyzed 20 and 78 pulmonary and extrapulmonary specimens, respectively, of 67 hospitalized patients suspected of having tuberculosis. An automated microbial system was used for the identification of Mycobacterium spp. cultures, and M. tuberculosis IS6110 was used as the target sequence in the NPCR. The kappa statistic was used in order to assess the level of agreement among the results.RESULTS: Among the 67 patients, 6 and 5, respectively, were diagnosed with pulmonary and extrapulmonary tuberculosis, and the NPCR was positive in all of the cases. Among the 98 clinical specimens, smear microscopy, culture, and NPCR were positive in 6.00%, 8.16%, and 13.26%, respectively. Comparing the results of NPCR with those of cultures (the gold standard, we found that NPCR had a sensitivity and specificity of 100% and 83%, respectively, in pulmonary specimens, compared with 83% and 96%, respectively, in extrapulmonary specimens, with good concordance between the tests (kappa, 0.50 and 0.6867, respectively.CONCLUSIONS: Although NPCR proved to be a very useful tool for the detection of M. tuberculosis complex, clinical, epidemiological, and other laboratory data should also be considered in the diagnosis and treatment of pulmonary and extrapulmonary tuberculosis.

  11. Incremental yield of bronchial washing for diagnosing smear-negative pulmonary tuberculosis

    Alonso Soto

    2013-08-01

    Full Text Available OBJECTIVE To assess the increased diagnostic yield for pulmonary tuberculosis using bronchial washing cultures compared with sputum cultures. METHODS Study conducted with 61 adults in Lima, Peru, from January 2006 to December 2007. The yield of sputum cultures was compared with the yield of acid-fast bacilli smears and cultures of bronchial washing for diagnosing pulmonary tuberculosis in suspected cases of clinical tuberculosis with negative acid fast bacilli sputum smears. RESULTS Twenty seven (95%CI 32;58 of the cases were eventually diagnosed with smear-negative pulmonary tuberculosis. Bronchial washing samples detected 23 (95%CI 72;99 of the smear-negative pulmonary tuberculosis cases compared with 15 (95%CI 37;74 for sputum cultures (p = 0.02. The incremental diagnostic yield of acid fast bacilli smear and culture of bronchial washing specimens over sputum culture was 44% (95%CI 25;65. CONCLUSIONS In function of the epidemiological context and the resources available, bronchoscopy should be deployed as part of a comprehensive work up that optimizes smear-negative pulmonary tuberculosis diagnosis and minimizes risk and costs.

  12. Pulmonary Tuberculosis Presenting as Surgical Emphysema without Pneumothorax and/or

    Mayank Vats, M. L. Gupta, Deepa Vats*, Rakesh C. Gupta, Neeraj Gupta

    2007-01-01

    Surgical emphysema as a presenting manifestation of pulmonary tuberculosis in the absence ofpneumothorax and/or pneumomediastinum is not yet known. We report one such case in which surgicalemphysema was probably the result of rupture of a pulmonary cavity into subcutaneous tissue resultingfrom caverno-pleuro-cutaneous fistula.

  13. Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil.

    Liberato, Isabella Ramos de Oliveira; de Albuquerque, Maria de Fatima P Militão; Campelo, Antônio Roberto Leite; de Melo, Heloísa Ramos Lacerda

    2004-01-01

    The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV) and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001), showed a higher frequency of weight loss >10 kilos (p tuberculosis (p = 0.001). Treatment failure was more common in those who were HIV positive (p extrapulmonary and pulmonary tuberculosis was more frequent in those seropositive to HIV than those without HIV virus, 30% and 1.6% respectively. These findings showed a predominance of atypical clinical laboratory features in co-infected patients, and suggest that health care personnel should consider the possibility this diagnosis. PMID:15042183

  14. Radiological profile of pulmonary tuberculosis in HIV: concerning 171 observations in Kinshasa

    This prospective descriptive study was conducted in Depistage center of the Tuberculosis treatment of Kabinda during a period of three months, had as objectives to study the radiological profile of pulmonary tuberculosis in HIV and HIV- patients, then to compare the frequency of different radiological abnormalities between the two groups to determine some characteristics of co-infection HIV/TP+. Among 171 patients with contagious pulmonary tuberculosis, 50 patients had positive serology for HIV, a prevalence of 29,2%. The intrathoracic lymph nodes, localized lesions only in the lower field were more observed in HIV, as well as pleurisy and the absence of radiological abnormality. The only one case of miliary was HIV positive. By contrast, excavations and localized lesions in the upper field were predominant in HIV-. Atypical radiological manifestations of pulmonary tuberculosis were more common in patients with HIV infection.

  15. Influence of levofloxacin on soluble selection, interleukin, adhesion molecule and pulmonary surfactant protein of patients with pulmonary tuberculosis

    Qing-Zhou He; Qian-Shu Hu

    2016-01-01

    Objective:To observe the influence of levofloxacin on soluble selection, interleukin, adhesion molecule and pulmonary surfactant protein of patients with pulmonary tuberculosis. Methods:A total of 50 patients with pulmonary tuberculosis who had been treated in our hospital from March 2014 to April 2015 were randomly divided into the control group (conventional treatment) and the observation group (conventional treatment plus levofloxacin). Each group had 25 cases. Then, the soluble selection,interleukin,adhesion molecule and pulmonary surfactant protein levels of the two groups at the second, fourth and sixth months before and after treatment were compared. Results:Before treatment, the differencess of the levels of the soluble selection, interleukin, adhesion molecule and pulmonary surfactant protein of the two groups were significant (P>0.05), while the detection levels of all the aspects of the observation group at the second, fourth and sixth months after treatment were all significantly lower than those of the control group (P<0.05). The detection results of the two groups at the second, fourth and sixth months after treatment showed significant differences. Conclusions:Lvofloxacin has significant effect on the soluble selection, interleukin, adhesion molecule and pulmonary surfactant protein of patients with pulmonary tuberculosis.

  16. Patho-TB test for the rapid diagnosis of pulmonary tuberculosis

    Roya Alavi-Naini

    2009-09-01

    Full Text Available

    • BACKGROUND: Despite recent technologic improvements in identifying mycobacterium tuberculosis, we are still facing problems in rapid diagnosis of tuberculosis. The objective of this study is to determine the diagnostic value of a new rapid screening test (Patho-TB™ for diagnosis of pulmonary tuberculosis.
    • METHODS: Between September 2006 to August 2007, 178 patients were enrolled in the study who were finally classified into two groups; a group of documented pulmonary tuberculosis (n = 67 and a group of non-tuberculous pulmonary infection (n = 111. Patho-TB™ test, Ziehl-Neelsen staining and culture were done on all specimens.
    • RESULTS: Of all, 43 patients with pulmonary tuberculosis were sputum smear positive for acid fast bacilli and the rest were smear negative. Mean age of the patients was 59.8 ± 16.1 years and 44% of them were men. The results of Patho- TB™ test were positive in 40 of smear positive and 20 of smear negative tuberculous patients and 33 cases of nontuberculous control group. The sensitivity, specificity, positive and negative predictive values and accuracy of Patho- TB™ test were estimated 89.5%, 70.2%, 64.5%, 91.7% and 77.5%, respectively.
    • CONCLUSIONS: According to the present study it would be suggested that Patho-TB™ test could be a rapid and inexpensive method for diagnosis of pulmonary tuberculosis, given by its high sensitivity and negative predictive value. Concerning the high number of false positive results, using a confirmatory diagnostic procedure is mandatory.
    • KEYWORDS: Pulmonary Tuberculosis, Rapid Diagnosis, Mycobacterium Tuberculosis Antigens, Iran

  17. Strain diversity of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Afar pastoral region of Ethiopia.

    Belay, Mulugeta; Ameni, Gobena; Bjune, Gunnar; Couvin, David; Rastogi, Nalin; Abebe, Fekadu

    2014-01-01

    Data on genotypic diversity of Mycobacterium tuberculosis complex (MTBC) is important to understand its epidemiology, human adaptation, clinical phenotypes, and drug resistance. This study aimed to characterize MTBC clinical isolates circulating in a predominantly pastoralist area in Ethiopia, a country where tuberculosis is the second leading cause of mortality. Culture of sputum samples collected from a total of 325 pulmonary TB suspects was done to isolate MTBC. Spoligotyping was used to characterize 105 isolates from culture positive slopes and the result was compared with an international database. Forty-four spoligotype patterns were observed to correspond to 35 shared-types (SITs) containing 96 isolates and 9 orphan patterns; 27 SITs containing 83 isolates matched a preexisting shared-type in the database, whereas 8 SITs (n = 13 isolates) were newly created. A total of 19 SITs containing 80 isolates were clustered within this study (overall clustering of 76.19%). Three dominant lineages (T, CAS, and Manu) accounted for 76.19% of the isolates. SIT149/T3-ETH was one of the two most dominant sublineages. Unlike previous reports, we show that Manu lineage strains not only constitute a dominant lineage, but are also associated with HIV infection in Afar region of Ethiopia. The high level of clustering suggests the presence of recent transmission that should be further studied using additional genotyping markers. PMID:24734230

  18. Altered serum microRNAs as biomarkers for the early diagnosis of pulmonary tuberculosis infection

    Qi Yuhua

    2012-12-01

    Full Text Available Abstract Background Pulmonary tuberculosis (TB is a highly lethal infectious disease and early diagnosis of TB is critical for the control of disease progression. The objective of this study was to profile a panel of serum microRNAs (miRNAs as potential biomarkers for the early diagnosis of pulmonary TB infection. Methods Using TaqMan Low-Density Array (TLDA analysis followed by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR validation, expression levels of miRNAs in serum samples from 30 patients with active tuberculosis and 60 patients with Bordetella pertussis (BP, varicella-zoster virus (VZV and enterovirus (EV were analyzed. Results The Low-Density Array data showed that 97 miRNAs were differentially expressed in pulmonary TB patient sera compared with healthy controls (90 up-regulated and 7 down-regulated. Following qRT-PCR confirmation and receiver operational curve (ROC analysis, three miRNAs (miR-361-5p, miR-889 and miR-576-3p were shown to distinguish TB infected patients from healthy controls and other microbial infections with moderate sensitivity and specificity (area under curve (AUC value range, 0.711-0.848. Multiple logistic regression analysis of a combination of these three miRNAs showed an enhanced ability to discriminate between these two groups with an AUC value of 0.863. Conclusions Our study suggests that altered levels of serum miRNAs have great potential to serve as non-invasive biomarkers for early detection of pulmonary TB infection.

  19. Arterial embolization for management of hemoptysis in pulmonary tuberculosis : factors of rebleeding

    To evaluate the effectiveness of arterial embolization in reducing hemoptysis in pulmonary tuberculosis, and rebleeding factors after embolization. Fifty-nine patients with massive or recurrent hemoptysis from pulmonary tuberculosis were underwent percutaneous transcatheter embolotherapy and thirteen were subsequently operated on. In 46 patients, we retrospectively analyzed on plain chest PA the extent of pulmonary tuberculosis lesions, the period from initial diagnosis to embolization, and angiographic findings. The extent of lesions shown on plain chest PA were classified into minimal, moderately advanced, and far advanced. If there was no evidence of rebleeding after the first embolization,this was regarded as initial success in the control of hemoptysis. Angiographic findings were classified into hypervascularity, shunt, aneurysmal dilatation, and extravasation. Using the chi-square test, differences in these findings between rebleedig and non-rebleeding cases were anlysed. Immediate control of hemoptysis was achieved in 27 (58.7%) of 46 patients. Hemoptysis recurred in 19 (41.3%) of 46 patients followed up. Rebleeding cases showed more nonbronchial systemic collateral vessels and shunt than non-rebleeding cases (p<0.05). More advanced lesions of pulmonary tuberculosis on plain chest PA showed an increased rebleeding rate after embolization, but this was not statistically significant. There was no correlation between the period from initial diagnosis of pulmonary tuberculosis to embolization and the rate of rebleeding. But the longer the period, the greater the number of nonbronchial systemic collateral vessels. In cases with more advanced lesions of pulmonary tuberculosis on plain chese PA and a long period from initial diagnosis of pulmonary tuberculosis to embolization, angiographic findings showed numerous nonbronchial systemic collateral vessels but increases in the rebleeding rate were statistically not significant. The greater the number of nonbronchial

  20. Pulmonary Disease due to Mycobacterium tuberculosis in a Horse: Zoonotic Concerns and Limitations of Antemortem Testing

    Konstantin P. Lyashchenko

    2012-01-01

    Full Text Available A case of pulmonary tuberculosis caused by Mycobacterium tuberculosis was diagnosed in a horse. Clinical evaluation performed prior to euthanasia did not suggest tuberculosis, but postmortem examination provided pathological and bacteriological evidence of mycobacteriosis. In the lungs, multiple tuberculoid granulomas communicating with the bronchiolar lumen, pleural effusion, and a granulomatous lymphadenitis involving mediastinal and tracheobronchial lymph nodes were found. Serologic response to M. tuberculosis antigens was detected in the infected horse, but not in the group of 42 potentially exposed animals (18 horses, 14 alpacas, 6 donkeys, and 4 dogs which showed no signs of disease. Diagnosis of tuberculosis in live horses remains extremely difficult. Four of 20 animal handlers at the farm were positive for tuberculous infection upon follow-up testing by interferon-gamma release assay, indicating a possibility of interspecies transmission of M. tuberculosis.

  1. Pulmonary Disease due to Mycobacterium tuberculosis in a Horse: Zoonotic Concerns and Limitations of Antemortem Testing.

    Lyashchenko, Konstantin P; Greenwald, Rena; Esfandiari, Javan; Lecu, Alexis; Waters, W Ray; Posthaus, Horst; Bodmer, Thomas; Janssens, Jean-Paul; Aloisio, Fabio; Graubner, Claudia; Grosclaude, Eléonore; Piersigilli, Alessandra; Schiller, Irene

    2012-01-01

    A case of pulmonary tuberculosis caused by Mycobacterium tuberculosis was diagnosed in a horse. Clinical evaluation performed prior to euthanasia did not suggest tuberculosis, but postmortem examination provided pathological and bacteriological evidence of mycobacteriosis. In the lungs, multiple tuberculoid granulomas communicating with the bronchiolar lumen, pleural effusion, and a granulomatous lymphadenitis involving mediastinal and tracheobronchial lymph nodes were found. Serologic response to M. tuberculosis antigens was detected in the infected horse, but not in the group of 42 potentially exposed animals (18 horses, 14 alpacas, 6 donkeys, and 4 dogs) which showed no signs of disease. Diagnosis of tuberculosis in live horses remains extremely difficult. Four of 20 animal handlers at the farm were positive for tuberculous infection upon follow-up testing by interferon-gamma release assay, indicating a possibility of interspecies transmission of M. tuberculosis. PMID:22567544

  2. CT and pathologic correlation acute miliary pulmonary tuberculosis

    Objective: To elucidate the CT characteristics and pathology of acute miliary pulmonary tuberculosis (AMPT). Methods: The CT features of AMPT in 25 cases were analyzed retrospectively, and the CT features in HIV-seronegative and HIV-seropositive patients were compared by 2-sided exact probability Chi-square test. Two lung specimens were inflated and fixed by Heitzman's method. HRCT scans, gross specimen section (80-150 μm) and histologic section (5 μm) were performed on dry lung specimens and CT-pathologic correlation was conducted. The distribution of micronodules in the secondary lobule on HRCT and pathology in one specimen was evaluated by Chi-square test. Results: Twenty five patients with AMPT were included in this study, including 11 HIV-seropositive patients and 14 HIV- seronegative patients. HRCT showed diffuse micronodules randomly distributed throughout both lungs in 25 patients, and ground-glass opacity (17 patients) was the predominant complicated finding. Coalescence of nodules and consolidation in HIV-seropositive patients (5 and 6 patients) were markedly higher than that in HIV-seronegative patients (none). In lung specimens, most nodules located in the lung parenchyma between the central bronchovascular bundle and the perilobular structures (792 and 560 nodules), which located in the interlobular septum pathologically. The distribution of micronodules in the secondary lobule showed on HRCT (1060 nodules) and pathology (864 nodules) was not significantly difference (χ2=2.814, P>0.05) . HRCT showed ground-glass opacities when ARDS occurred, which were pulmonary edema, inflammation and hyaline membrane on alveolar wall pathologically. Conclusions: The HRCT characteristic of nodule distribution in AMPT is random. ARDS should be suspected when diffuse ground-glass opacities appear on HRCT. (authors)

  3. Pulmonary spheral tuberculosis: features and clinical significance of spiral dynamic CT

    Objective: To assess the features and clinical significance of spiral dynamic CT in patients with pulmonary spheral tuberculosis. Methods: The 54 foci in 42 patients with pulmonary spheral tuberculosis were studied. Thin-sections at 2 mm thickness and 2 mm interval through the nodular center were obtained before and after administration of contrast material. Results: In 54 pulmonary spheral tuberculosis, maximum enhanced CT value in 51 (94.4%, 51/54) foci was less than 20 HU, and more than 20 HU in the other 3(5.6%, 3/54) foci. 27(50.0%, 27/54) foci showed no any enhancement, 24, (44%, 24/54) foci showed capsular enhancement, 1(1.9%, 1/54) focus showed peripheral enhancement and 2(3.7%, 2/54) foci showed extensive enhancement. The accuracy of the correct diagnosis was 25.9% in terms of plain CT and 94.4% in terms of enhanced CT scanning. The difference was significant (x2 = 50.1, P < 0.05). The curative effect of extensive enhanced foci and peripheral enhanced foci was optimal, capsular enhanced foci was second, and non-enhanced foci was barely satisfactory. Conclusion: Spiral dynamic CT technique may improve the accuracy of diagnosing pulmonary spheral tuberculosis. No enhancement and/or capsular enhancement were suggestive of tuberculosis. The enhancing character of foci might contribute to assess the curative effect of anti-tuberculosis

  4. Comparison of sputum acid-fast culture and chest radiography in pulmonary tuberculosis

    While it is still a common practice of some clinicians to rely on chest radiography examination alone for the diagnosis of pulmonary tuberculosis, others still claim that absolute diagnosis of tuberculosis can firmly be established by bacteriological examination from secretions or tissues of the infected host. This study will evaluate the relationship between radiographic findings (CXR) and the likelihood of finding tubercle bacilli on sputum acid-fast bacilli (AFB) culture in pulmonary tuberculosis at Lung Center of the Philippines. Of 41 individuals who submitted their sputum for AFB culture, tubercle bacilli in the sputum was shown in 25 (60%) of cases and no growth of tubercle bacilli in 16 (40%) of cases. Chest radiography reading revealed tuberculosis in 100% of cases, of which when classified further, 22 (54%) has fibrohazed or hazy infiltrates on their CXR, 7 (17%) has cavitations or interpreted as moderate or far advanced TB, 12 (29%) has fibroid, nodular infiltrates or densities. In patients radiologically diagnosed as PTB minimal, sputum culture revealed tubercle bacilli in 15 (57%) among moderate, far advanced tuberculosis, and 6 (50%) among those with inactive or old tuberculosis. Therefore, the probability of detecting tubercle bacilli in pulmonary tuberculosis is not greatly influenced by radiographic findings. (auth.). 11 refs.; 2 figs.; 2 tabs

  5. The experience of college students with pulmonary tuberculosis in Shaanxi, China: a qualitative study

    Zhang Tian-Hua

    2010-06-01

    Full Text Available Abstract Background The prevalence of pulmonary tuberculosis among college students in Shaanxi is high. Although tuberculosis leaves much psychological and social impact on patients, little is known about its impact on college students. The objective of this study is to explore the experiences and psychological process of college students with pulmonary tuberculosis in Shaanxi, China. Methods 17 college students with pulmonary tuberculosis were recruited purposively from 9 colleges in Shaanxi. In-depth interviews were conducted to collect data and a thematic framework analysis was used. Results The participants reported that pulmonary tuberculosis deeply influenced their mental health. They were fearful to the nature of pulmonary tuberculosis at the stage of diagnosis, anxious about the illness before the period of diagnosis and the early week of the treatment, excessive worry immediately before the first recheck. They expected an early full recovery, bored on tedious treatment life and worried about future heath and prospects during the whole treatment phase. Their daily life was also influenced, namely discontinued studies, isolation and increased financial burden. They also reported that they could get strong supports from family members, while little supports from healthcare workers and their friends. Conclusions The participants' psychological pressure was significant during the treatment. In addition, there was serious conflict between treatment and study; social support provided for them was insufficient. Healthcare workers should provide psychological support for college students with pulmonary tuberculosis according to the psychological characteristics and offer social support through strengthening communication with them. Colleges should follow governmental policies on TB exactly and provide opportunities for the patients to continue their studies.

  6. Radiological patterns of childhood pulmonary tuberculosis in Khartoum state

    This hospital based study was undertaken to determine the commonest radiological features of childhood pulmonary tuberculosis in Khartoum, and to correlate these features with the clinical symptoms and laboratory investigations. A total of hundred patients were selected from referred clinics and the paediatric wards (inpatients) of three teaching hospitals in Khartoum, during the period february 95 to april 96. Almost all the families were from low socio economic status. The peak age incidence was at (7, 8, 10) years; 50% of children had received BCG vaccination and history of contact with TB was positive in 35%. Mantoux test was positive in 79% and four cases had smear-positive sputum for AAFB. The most frequent lesion on chest radiography was lemphadenopathy in 67% of cases followed by multiple lesions which were present in 65% of cases. Consolidation was present in 49 cases , 38 showed unilateral changes, while 11 showed bilateral changes. The right and particularly the right middle and lower lobes were more frequently affected. Seven patients had pleural effusion which was sided in five, left sided in one and bilateral in one. Cavitation was present in eight cases, broncho-pneumonic changes in three and only one case had miliary mottling. Positive mantoux test and chest x-ray were present in 72 patients, while all cases with negative mantoux and negative sputum smear showed significant radiological findings. (Author)

  7. Microbiome diversity in the sputum of patients with pulmonary tuberculosis.

    Krishna, P; Jain, A; Bisen, P S

    2016-07-01

    TB is a worldwide pandemic. India has the highest burden of TB, with WHO statistics for 2013 giving an estimated incidence figure of 2.1 million cases for India out of a global incidence of 9 million. Microbiota have been shown to be associated with many disease conditions; however, only few studies have been reported for microbiota associated with TB infection. For the first time, we characterized the composition of microbiota of TB patients of India, using high-throughput 16S rRNA gene sequencing and compared it with healthy controls. Phylum-level analysis showed that the relative abundance of Firmicutes and Actinobacteria was significantly higher in TB samples and Neisseria and Veillonella were two dominant genera after Streptococcus. In our study, significantly different core genera in TB and normal population were found as compared with the reported studies. Also, the presence of diverse opportunistic pathogenic microbiota in TB patients increases the complexity and diversity of sputum microbiota. Characterization of the sputum microbiome is likely to provide important pathogenic insights into pulmonary tuberculosis. PMID:27142586

  8. Low level nitrogen laser therapy in pulmonary tuberculosis

    Bhagwanani, NS; Bhatia, C.C.; Sharma, N.; Hemvani, N.; Chitnis, D.S.

    2015-01-01

    Background and aims: WHO estimated 9 million new Tuberculosis cases and 1.5 million TB deaths in 2013. Globally 480000 Multi drug resistant tuberculosis cases were noted and majority of them were in India, China and Russian federation. Multi drug resistant tuberculosis cases are difficult to treat and have high mortality. Presently, it was aimed to assess prevalence of drug resistance in M. tuberculosis isolates in Central India, to check the in-vitro effect of N2 Laser on M. tuberculosis and...

  9. The Role of Foxp3-Expressing Regulatory T Cells and T Helpers in Immunopathogenesis of Multidrug Resistant Pulmonary Tuberculosis

    E. G. Churina; Urazova, O. I.; V. V. Novitskiy

    2012-01-01

    Subpopulation structure of regulatory T cells and T helpers of peripheral blood in patients with newly diagnosed pulmonary tuberculosis depending on the clinical form of disease and sensitivity of Mycobacterium tuberculosis to antituberculosis drugs has been analyzed in this work. It has been shown that the leading part in immune suppression at infiltrative, dissemination, and fibrosis-cavity pulmonary tuberculosis is played by natural regulatory CD4+CD25+Foxp3+-T lymphocytes. Thus we estimat...

  10. Adjunctive Phosphodiesterase-4 Inhibitor Therapy Improves Antibiotic Response to Pulmonary Tuberculosis in a Rabbit Model

    Subbian, Selvakumar; Tsenova, Liana; Holloway, Jennifer; Peixoto, Blas; O'Brien, Paul; Dartois, Véronique; Khetani, Vikram; Zeldis, Jerome B.; Kaplan, Gilla

    2016-01-01

    Objectives Adjunctive host-directed therapy is emerging as a new potential approach to improve the outcome of conventional antimicrobial treatment for tuberculosis (TB). We tested the ability of a phosphodiesterase-4 inhibitor (PDE4i) CC-11050, co-administered with the first-line anti-TB drug isoniazid (INH), to accelerate bacillary killing and reduce chronic inflammation in the lungs of rabbits with experimental Mycobacterium tuberculosis (Mtb) infection. Methods A rabbit model of pulmonary TB that recapitulates the pathologic manifestations seen in humans was used. Rabbits were infected with virulent Mtb by aerosol exposure and treated for eight weeks with INH with or without CC-11050, starting at four weeks post infection. The effect of CC-11050 treatment on disease severity, pathology, bacillary load, T cell proliferation and global lung transcriptome profiles were analyzed. Results Significant improvement in bacillary clearance and reduced lung pathology and fibrosis were noted in the rabbits treated for eight weeks with INH + CC-11050, compared to those treated with INH or CC-11050 only. In addition, expression of host genes associated with tissue remodeling, tumor necrosis factor alpha (TNF-α) regulation, macrophage activation and lung inflammation networks was dampened in CC-11050-treated, compared to the untreated rabbits. Conclusions Adjunctive CC-11050 therapy significantly improves the response of rabbits with experimental pulmonary TB to INH treatment. We propose that CC-11050 may be a promising candidate for host directed therapy of patients with pulmonary TB, reducing the duration and improving clinical outcome of antibiotic treatment. PMID:26981575

  11. Mycobacterium tuberculosis Zinc Metalloprotease-1 Elicits Tuberculosis-specific Humoral Immune Response Independent of Mycobacterial Load in Pulmonary and Extra-Pulmonary Tuberculosis Patients

    Mani Harika eVemula

    2016-03-01

    Full Text Available Conventionally, facultative intracellular pathogen, Mycobacterium tuberculosis (M.tb, the tuberculosis (TB causing bacilli in human is cleared by cell-mediated immunity (CMI with CD4+ T cells playing instrumental role in protective immunity, while antibody-mediated immunity (AMI is considered non-protective. This longstanding convention has been challenged with recent evidences of increased susceptibility of hosts with compromised AMI and monoclonal antibodies conferring passive protection against TB and other intracellular pathogens. Therefore, novel approaches towards vaccine development include strategies aiming at induction of humoral response along with CMI. This necessitates the identification of mycobacterial proteins with properties of immunomodulation and strong immunogenicity. In this study, we determined the immunogenic potential of M.tb Zinc metalloprotease-1 (Zmp1, a secretory protein essential for intracellular survival and pathogenesis of M.tb. We observed that Zmp1 was secreted by in vitro grown M.tb under granuloma-like stress conditions (acidic, oxidative, iron deficiency and nutrient deprivation and generated Th2 cytokine microenvironment upon exogenous treatment of Peripheral Blood Mononulear Cells (PBMCs with recombinant Zmp1 (rZmp1. This was supported by recording specific and robust humoral response in TB patients in a cohort of 295. The anti-Zmp1 titers were significantly higher in TB patients (n=121 as against healthy control (n=62, household contacts (n=89 and non-specific infection controls (n=23. A significant observation of the study is the presence of equally high titers of anti-Zmp1 antibodies in a range of patients with high bacilli load (sputum bacilli load of 300+ per mL to paucibacillary smear-negative pulmonary tuberculosis (PTB cases. This clearly indicated the potential of Zmp1 to evoke an effective humoral response independent of mycobacterial load. Such mycobacterial proteins can be explored as antigen

  12. Effect of Yogic Breathing Techniques in New Sputum Positive Pulmonary Tuberculosis

    A Mooventhan; Vitthal Khode; L Nivethitha

    2014-01-01

    A 24-year-old, unmarried woman diagnosed of pulmonary tuberculosis (PTB) visited our hospital out-patient department in the month of August-2013. Patient came with the complaint of sever cough with expectoration; evening raise of temperature; gradual loss of appetite and weight since 2-weeks. We referred the patient to our hospital′s Revised National Tuberculosis Program, direct observed treatment short-course center for sputum fluorescence microscopic examination (FME). FME report suggested ...

  13. Chronic symptoms and pulmonary dysfunction in post-tuberculosis Brazilian patients

    Simone de Sousa Elias Nihues; Eliane Viana Mancuzo; Nara Sulmonetti; Flávia Patussi Correia Sacchi; Vanessa de Souza Viana; Eduardo Martins Netto; Silvana Spindola de Miranda; Julio Croda

    2015-01-01

    ABSTRACTBACKGROUND: Questionnaire and spirometry were applied to post-tuberculosis indigenous and non-indigenous individuals from Dourados, Brazil, to investigate the prevalence of chronic respiratory symptoms and pulmonary dysfunction.METHODS:This was a cross-sectional study in cured tuberculosis individuals as reported in the National System on Reportable Diseases (SINAN) from 2002 to 2012.RESULTS:One hundred and twenty individuals were included in the study and the prevalence of chronic re...

  14. Antimycobacterial Drugs Modulate Immunopathogenic Matrix Metalloproteinases in a Cellular Model of Pulmonary Tuberculosis

    Singh, Shivani; Kubler, Andre; Singh, Utpal K.; Singh, Ajay; Gardiner, Harriet; Prasad, Rajniti; Elkington, Paul T.; Friedland, Jon S.

    2014-01-01

    Tuberculosis is characterized by extensive destruction and remodelling of the pulmonary extracellular matrix. Stromal cell-derived matrix metalloproteinases (MMPs) are implicated in this process and may be a target for adjunctive immunotherapy. We hypothesized that MMPs are elevated in bronchoalveolar lavage fluid of tuberculosis patients and that antimycobacterial agents may have a modulatory effect on MMP secretion. Concentrations of MMP-1, -2, -3, -7, -8, and -9 were elevated in the bronch...

  15. Rapid Diagnosis of Childhood Pulmonary Tuberculosis by Xpert MTB/RIF Assay Using Bronchoalveolar Lavage Fluid

    Qing-Qin Yin; Wei-Wei Jiao; Rui Han; An-Xia Jiao; Lin Sun; Jian-Ling Tian; Yu-Yan Ma; Xiao-Chun Rao; Chen Shen; Qin-Jing Li; A-Dong Shen

    2014-01-01

    In order to evaluate the diagnostic accuracy of the Xpert MTB/RIF assay on childhood pulmonary tuberculosis (PTB) using bronchoalveolar lavage fluid (BALF), we evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of Xpert MTB/RIF assay using BALF in comparison with acid-fast bacilli (AFB) microscopy and Mycobacterium tuberculosis (MTB) culture for diagnosing childhood PTB using Chinese “composite clinical reference standard” (CCRS) as reference stan...

  16. Application of a geographical information system for information management on pulmonary tuberculosis

    José Danilo Pacheco González

    2010-12-01

    Full Text Available Background: tuberculosis program is a priority for the National Health System in Cuba. The difficulties encountered in dealing with the disease are associated, directly or indirectly, to a restricted knowledge management by the health system. Objective: to implement a geographical information system to manage information on pulmonary tuberculosis. Methods: retrospective, descriptive and correlational study conducted between January 1, 1996 and December 31, 2007. It included the 155 new cases of pulmonary tuberculosis in 15 years old patients and on in the province of Cienfuegos. MapInfo 8.5 software was used to design the geographical information system. Theoretical, empirical and statistical methods were combined. Results: the elimination of the geographical aspect as an obstacle for carrying out preventive actions established in the program and for the stratification of pulmonary tuberculosis according to its incidence in districts and neighbourhoods of the city. Conclusions: the designed geographical information system is an auxiliary technological tool that improves information management on pulmonary tuberculosis in Cienfuegos as the basis for a variety of analysis and the generation of new knowledge.

  17. LED Fluorescence Microscopy for the Diagnosis of Pulmonary Tuberculosis: A Multi-Country Cross-Sectional Evaluation

    Cuevas, Luis Eduardo; Yassin, Mohammed Ahmed; Al-Sonboli, Najla; Lawson, Lovett; Arbide, Isabel; Al-Aghbari, Nasher; Bahadur Sherchand, Jeevan; Al-Absi, Amin; Emenyonu, Emmanuel Nnamdi; Merid, Yared; Okobi, Mosis Ifenyi; Onuoha, Juliana Olubunmi; Aschalew, Melkamsew; Aseffa, Abraham; Harper, Greg

    2011-01-01

    Editors' Summary Background Every year, nearly 10 million people develop tuberculosis—a contagious bacterial infection that usually affects the lungs (pulmonary tuberculosis)—and about 1.7 million people die from the disease. Mycobacterium tuberculosis, which causes tuberculosis, is spread in airborne droplets when people with the disease cough or sneeze. Thus, to control tuberculosis, it is essential that infected individuals are rapidly identified and treated. The “gold standard” diagnostic...

  18. Bilateral multiple pulmonary tuberculous nodules mimicking metastatic disease

    We present CT findings of a young woman who has bilateral pulmonary nodules mimicking metastases. Clinical presentation with active multiple pulmonary macronodules without cavitation responsive to treatment is an atypical manifestation of pulmonary tuberculosis. We reviewed the causes of multiple pulmonary nodules, role of radiological findings in differential diagnosis and parenchymal manifestations of pulmonary tuberculosis in this report

  19. Pulmonary Alveolar Proteinosis and tuberculosis in a diabetic patient: a rare or a seldom diagnosed association

    Pereira-Silva J.L.

    2002-01-01

    Full Text Available A case of Pulmonary Alveolar Proteinosis (PAP, in association with tuberculosis, is described in a 35-year-old diabetic patient. Lung biopsy showed an intra-alveolar accumulation of PAS-positive material, and multifocal granulomas compatible with tuberculosis. The bronchoalveolar culture was positive for Mycobacterium tuberculosis. PAP results from an imbalance of the mechanisms that regulate the homeostasis of the surfactant, where specific proteins are involved, especially SP-A and SP-D, the cytokines, IL-10 and GM-CSF, in addition to alveolar macrophages and type-II pneumocytes. Chemotaxis and phagocytic capacity are reduced. PAP and diabetes share several immunological disfunctions that may increase the risk for tuberculosis. Although there are no controlled studies, the diagnosis of PAP in diabetic patients with tuberculosis must be considered.

  20. Association of Pulmonary Tuberculosis and Diabetes in Mexico: Analysis of the National Tuberculosis Registry 2000-2012.

    Guadalupe Delgado-Sánchez

    Full Text Available Tuberculosis (TB remains a public health problem in Mexico while the incidence of diabetes mellitus type 2 (DM has increased rapidly in recent years.To describe the trends of incidence rates of pulmonary TB associated with DM and not associated with DM and to compare the results of treatment outcomes in patients with and without DM.We analysed the National Tuberculosis Registry from 2000 to 2012 including patients with pulmonary TB among individuals older than 20 years of age. The association between DM and treatment failure was analysed using logistic regression, accounting for clustering due to regional distribution.In Mexico from 2000 to 2012, the incidence rates of pulmonary TB associated to DM increased by 82.64%, (p<0.001 in contrast to rates of pulmonary TB rate without DM, which decreased by 26.77%, (p<0.001. Patients with a prior diagnosis of DM had a greater likelihood of failing treatment (adjusted odds ratio, 1.34 (1.11-1.61 p<0.002 compared with patients who did not have DM. There was statistical evidence of interaction between DM and sex. The odds of treatment failure were increased in both sexes.Our data suggest that the growing DM epidemic has an impact on the rates of pulmonary TB. In addition, patients who suffer from both diseases have a greater probability of treatment failure.

  1. The evaluation of the clinical and laboratory characteristics of children with pulmonary tuberculosis

    Velat Şen

    2014-09-01

    Full Text Available Objective: Pulmonary tuberculosis is an important health problem in pediatric patients. The aim of this study is to evaluate the epidemiological and clinical signs and treatment results of the children with pulmonary tuberculosis. Methods:Hospital records of 85 children with pulmonary tuberculosis which were diagnosis in Dicle University Medical Faculty, Pediatric Pulmonology Department, between the period of January 2008 and December 2013,were retrospectively reviewed. Results: Of 85 patients, 51.7% were girls with a mean age of 9.84±4.66 years (6 months-18 years.Ratio of patients that aged less than 5 years was 22.3%. The most prominent complaints were cough (81.2%, fever (55.2%, inappetence (47.1%, night sweats (38.8%, and weight lost (32.9 %. Sixty five of the patients (76.4 % had a history of contact with adult patients with tuberculosis. BCG vaccine scarring was present in 70.6% of patients. Tuberculin skin test reactivity was present in 75.3%. Hilar lympadenomegaly (58.8%, primary focuscalsification (37.6%, and parenchymal infiltration (32.9% were the most common radiographic findings. Conclusion: Pulmonary tuberculous is not a rare entity and remains an important infectious disease in children in our country. Early diagnosis and treatment of children with pulmonary uberculosis is important to protect late symptoms and to prevent contamination of healthy people.

  2. Chronic symptoms and pulmonary dysfunction in post-tuberculosis Brazilian patients

    Simone de Sousa Elias Nihues

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND: Questionnaire and spirometry were applied to post-tuberculosis indigenous and non-indigenous individuals from Dourados, Brazil, to investigate the prevalence of chronic respiratory symptoms and pulmonary dysfunction.METHODS:This was a cross-sectional study in cured tuberculosis individuals as reported in the National System on Reportable Diseases (SINAN from 2002 to 2012.RESULTS:One hundred and twenty individuals were included in the study and the prevalence of chronic respiratory symptoms was 45% (95% CI, 34-59%. Respiratory symptoms included cough (28%, sputum (23%, wheezing (22% and dyspnea (8%. These symptoms were associated with alcoholism, AOR: 3.1 (1.2-8.4; less than 4 years of schooling, AOR: 5.0 (1.4-17.7; and previous pulmonary diseases, AOR: 5.4 (1.7-17.3. Forty-one percent (95% CI, 29-56 had pulmonary disorders, of which the most prevalent were obstructive disorders (49%, followed by obstructive disorder with reduced forced vital capacity disorders (46% and restrictive disorders (5%. The lifestyle difference could not explain differences in chronic symptoms and/or the prevalence of pulmonary dysfunction.CONCLUSION:The high prevalence of chronic respiratory symptoms and pulmonary dysfunction in post-tuberculosis patients indicates a need for further interventions to reduce social vulnerability of patients successfully treated for tuberculosis.

  3. Trace elements status of pulmonary tuberculosis patients compared with healthy voluntaries

    Trace elements have important contribution to immune function. The objective of this study was to compare the Iron, Copper and Zinc levels of patients with active Pulmonary Tuberculosis (TB) and healthy subjects using X-ray Total Reflection Fluorescence Spectrometry. The study group was formed by men with active TB hospitalized on the Ary Parreiras State Institute of diseases of the chest and on the Santa Maria State Hospital, Rio de Janeiro, Brazil. The control group was formed by healthy men of Military Academy Fire Dom Pedro II, Rio de Janeiro, Brazil. The measurements of trace elements were performed at XRF beam line at Brazilian Synchrotron Light, Campinas, Sao Paulo. The results show that serum iron concentration was higher in control group than in study group. Besides that, serum copper concentration was higher in control group than in study group. According to the literature higher levels of copper are observed in infectious diseases like tuberculosis. In the case of the serum zinc concentration no statistical difference was observed between the two groups studied. (author)

  4. Trace elements status of pulmonary tuberculosis patients compared with healthy voluntaries

    Moraes, Milena L. de; Ramalho, Daniela M.P.; Delogo, Karina N.; Miranda, Pryscila F.C.; Mesquita, Eliene D.D.; Kritski, Afranio L.; Oliveira, Martha M. [Centro de Pesquisa em Tuberculose, Hospital Universitario Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, RJ (Brazil); Canellas, Catarine G.L.; Lopes, Ricardo T., E-mail: ricardo@lin.ufrj.br [Laboratorio de Instrumentacao Nuclear, Programa de Engenharia Nuclear/COPPE UFRJ, RJ (Brazil); Anjos, Marcelino J., E-mail: marcelin@uerj.br [Departamento de Fisica Aplicada e Termodinamica - Instituto de Fisica Armando Dias Tavares. Universidade do Estado do Rio de Janeiro, RJ (Brazil)

    2011-07-01

    Trace elements have important contribution to immune function. The objective of this study was to compare the Iron, Copper and Zinc levels of patients with active Pulmonary Tuberculosis (TB) and healthy subjects using X-ray Total Reflection Fluorescence Spectrometry. The study group was formed by men with active TB hospitalized on the Ary Parreiras State Institute of diseases of the chest and on the Santa Maria State Hospital, Rio de Janeiro, Brazil. The control group was formed by healthy men of Military Academy Fire Dom Pedro II, Rio de Janeiro, Brazil. The measurements of trace elements were performed at XRF beam line at Brazilian Synchrotron Light, Campinas, Sao Paulo. The results show that serum iron concentration was higher in control group than in study group. Besides that, serum copper concentration was higher in control group than in study group. According to the literature higher levels of copper are observed in infectious diseases like tuberculosis. In the case of the serum zinc concentration no statistical difference was observed between the two groups studied. (author)

  5. Determination of Urinary Neopterin/Creatinine Ratio to Distinguish Active Tuberculosis from Latent Mycobacterium tuberculosis Infection

    Michael Eisenhut

    2016-01-01

    Full Text Available Background. Biomarkers to distinguish latent from active Mycobacterium (M. tuberculosis infection in clinical practice are lacking. The urinary neopterin/creatinine ratio can quantify the systemic interferon-gamma effect in patients with M. tuberculosis infection. Methods. In a prospective observational study, urinary neopterin levels were measured by enzyme linked immunosorbent assay in patients with active tuberculosis, in people with latent M. tuberculosis infection, and in healthy controls and the urinary neopterin/creatinine ratio was calculated. Results. We included a total of 44 patients with M. tuberculosis infection and nine controls. 12 patients had active tuberculosis (8 of them culture-confirmed. The median age was 15 years (range 4.5 to 49. Median urinary neopterin/creatinine ratio in patients with active tuberculosis was 374.1 micromol/mol (129.0 to 1072.3, in patients with latent M. tuberculosis infection it was 142.1 (28.0 to 384.1, and in controls it was 146.0 (40.3 to 200.0, with significantly higher levels in patients with active tuberculosis (p<0.01. The receiver operating characteristics curve had an area under the curve of 0.84 (95% CI 0.70 to 0.97 (p<0.01. Conclusions. Urinary neopterin/creatinine ratios are significantly higher in patients with active tuberculosis compared to patients with latent infection and may be a significant predictor of active tuberculosis in patients with M. tuberculosis infection.

  6. Mouse model of pulmonary cavitary tuberculosis and expression of matrix metalloproteinase-9

    Alvaro A. Ordonez

    2016-07-01

    Full Text Available Cavitation is a key pathological feature of human tuberculosis (TB, and is a well-recognized risk factor for transmission of infection, relapse after treatment and the emergence of drug resistance. Despite intense interest in the mechanisms underlying cavitation and its negative impact on treatment outcomes, there has been limited study of this phenomenon, owing in large part to the limitations of existing animal models. Although cavitation does not occur in conventional mouse strains after infection with Mycobacterium tuberculosis, cavitary lung lesions have occasionally been observed in C3HeB/FeJ mice. However, to date, there has been no demonstration that cavitation can be produced consistently enough to support C3HeB/FeJ mice as a new and useful model of cavitary TB. We utilized serial computed tomography (CT imaging to detect pulmonary cavitation in C3HeB/FeJ mice after aerosol infection with M. tuberculosis. Post-mortem analyses were performed to characterize lung lesions and to localize matrix metalloproteinases (MMPs previously implicated in cavitary TB in situ. A total of 47-61% of infected mice developed cavities during primary disease or relapse after non-curative treatments. Key pathological features of human TB, including simultaneous presence of multiple pathologies, were noted in lung tissues. Optical imaging demonstrated increased MMP activity in TB lesions and MMP-9 was significantly expressed in cavitary lesions. Tissue MMP-9 activity could be abrogated by specific inhibitors. In situ, three-dimensional analyses of cavitary lesions demonstrated that 22.06% of CD11b+ signal colocalized with MMP-9. C3HeB/FeJ mice represent a reliable, economical and tractable model of cavitary TB, with key similarities to human TB. This model should provide an excellent tool to better understand the pathogenesis of cavitation and its effects on TB treatments.

  7. Computed Tomography in the study of pulmonary tuberculosis

    The authors carried out a retrospective study on 4 years' work on a series of patients with proved active tuberculosis examined in the Departments of Bronchopneumology and Infectious Disease of the Arezzo Civil Hospital. The population was heterogenerous from the immunologic viewpoint. This paper compared the effectiveness of Computed Tomography (CT) with that of conventional chest radiography (CR) in the diagnosis and prognosis of tuberculosis. All patients underwent chest CR in double projection and conventional CT studies of the chest; 16 patients were also submitted to high resolution CT (HRCT). Consolidation was the most frequent parenchymal lesion in immunocompetent patients; it was often associated with cavitation, with no clear topographic prevalence in the upper lobes. Pleural effusion, as the only sign of disease and with empyema features, was found in 10 immunocompetent patients. No predominant pattern was found in the other two groups, even though intrathoracic adenopathies were relatively more common in the immigrants while micronodular images and cavitations were more common in the immunodeficient subjects. Finally, chest CR always depicted the signs of pneumopathy in progress. Conventional CT was more accurate in the spatial definition of pleuroparenchymal lesions and demonstrated more nodular lesions and/or infiltrating lesions which were often masked by scars, bymassive pleural effusions or by calcific fibrothorax. Ct also demonstrated adenophatic mediastinal involvement, showed empyemic pleural collections and confirmed fistulas in calcific fibrothorax subjects. Moreover, HRCT depicted centrilobular micronodular images which are often ill-defined and poorly or not recognizable at CR but are signs of tuberculous infection spread along the distal airways. Posttreatment follow-up confirmed clinical recovery showing markedly and progressively fewer nodular densities

  8. IMPACT OF CIGARETTE SMOKING ON RATES AND CLINICAL PROGNOSIS OF PULMONARY TUBERCULOSIS IN SOUTHERN MEXICO

    Bonacci, Robert A.; Cruz-Hervert, Luis Pablo; García-García, Lourdes; Reynales-Shigematsu, Luz Myriam; Ferreyra-Reyes, Leticia; Bobadilla-del-Valle, Miriam; Canizales-Quintero, Sergio; Ferreira-Guerrero, Elizabeth; Báez-Saldaña, Renata; Téllez-Vázquez, Norma; Mongua-Rodríguez, Norma; Montero-Campos, Rogelio; Delgado-Sánchez, Guadalupe; Martínez-Gamboa, Rosa Areli; Cano-Arellano, Bulmaro; Sifuentes-Osornio, José; de León, Alfredo Ponce

    2012-01-01

    Objectives To examine the relationship between cigarette smoking and incidence and mortality rates of pulmonary tuberculosis (TB) and treatment outcomes. Materials From 1995-2010, we analyzed data from 1062 patients with TB and from 2001-2004, 2951 contacts in Southern Mexico. Patients with acid-fast bacilli or Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and mycobacteriological evaluation and received treatment by the local DOTS program. Results Consumers of 1-10 (LS) or 11 or more (HS) cigarettes per day incidence (1.75 and 11.79) and mortality (HS,17.74) smoker-nonsmoker rate ratios were significantly higher for smokers. Smoker population was more likely to experience unfavorable treatment outcomes (HS, adjusted OR 2.36) and retreatment (LS and HS, adjusted hazard ratio (HR) 2.14 and 2.37). Contacts that smoked had a higher probability of developing active TB (HR 2.38) during follow up. Conclusions Results indicate the need of incorporating smoking prevention and cessation, especially among men, into international TB control strategies. PMID:22982014

  9. Prevalence of smear positive pulmonary tuberculosis in Gondar prisoners, North West Ethiopia

    Zelalem Addis; Emebet Adem; Abebe Alemu; Wubet Birhan; Biniam Mathewos; Belaynesh Tachebele; Yegnasew Takele

    2015-01-01

    Objective:To assess the prevalence and risk factors of smear positive pulmonary tuberculosis amongGondar town prisoners,NorthWestEthiopia.Methods:A cross sectional study was conducted fromFebruary toJuly,2008 inGondarPrison.Prisoners with cough duration of more than two weeks were involved in the study by giving three sputum samples and filling the questionnaires prepared for risk factor assessment.Acid fast staining technique was employed to detect the presence of theMycobacterium tuberculosis bacilli in the sputum samples.Data was analyzed usingSPSS version13 computer software and presented in table.Chi-square test was used to assess associations and aP-value less than0.05 was taken as significant.Results:A total of384 prisoners,349 male and35 females, with a mean age of33.3 years were involved in the study.The prevalence of smear positive pulmonary tuberculosis among those prisoners with cough duration of more than two weeks was8.59%.Only the length of imprisonment had a significant association(χ²=18.82,P-value<0.0001) with the prevalence of tuberculosis. Conclusions:This study indicated that tuberculosis among prisoners with cough duration of more than two weeks inGondar prison is very high.ThereforePeriodic screening of the prisoners and screening of newly introduced prisoners should be practiced so as to minimize the burden of tuberculosis in prisoners.

  10. Pulmonary tuberculosis and mucormycosis co-infection in a diabetic patient

    Deepak Aggarwal

    2015-01-01

    Full Text Available Uncontrolled diabetes mellitus is associated with a variety of infections which pose management difficulties. Herein, we report a case of diabetic patient who developed combined pulmonary tuberculosis and mucormycosis. The case illustrates management of this rare co-infection which despite being potentially fatal was treated successfully.

  11. Pulmonary cavitation and skin lesions mimicking tuberculosis in a HIV negative patient caused by Sporothrix brasiliensis

    Orofino-Costa, Rosane; Unterstell, Natasha; Carlos Gripp, Alexandre; de Macedo, Priscila Marques; Brota, Arles; Dias, Emylli; de Melo Teixeira, Marcus; Felipe, Maria Sueli; Bernardes-Engemann, Andréa R; Lopes-Bezerra, Leila Maria

    2013-01-01

    A 32-year-old HIV negative male presented with multiple pulmonary cavitation and skin abscesses up to 15 cm in diameter mimicking tuberculosis. Sporothrix brasiliensis was isolated and patient responded well to amphotericin B followed by itraconazole, except the skin lesions that had to be surgical drained to obtain cure.

  12. Delay in the Diagnosis and Treatment of Pulmonary Tuberculosis in Uzbekistan: A Cross-Sectional Study

    Belkina, T.V.; Khojiev, D.S.; Tillyashaykhov, M.N.; Tigay, Z.N.; Kudenov, M.U.; Duintjer Tebbens, Jurjen; Vlček, J.

    2014-01-01

    Roč. 14, November (2014), article 624. ISSN 1471-2334 Grant ostatní: SVV UK(CZ) 260 066 Institutional support: RVO:67985807 Keywords : cross-sectional study * pulmonary tuberculosis * self-medication * Uzbekistan Subject RIV: FR - Pharmacology ; Medidal Chemistry Impact factor: 2.613, year: 2014

  13. Spinal cord glioma after multiple fluoroscopies during artificial pneumothorax treatment of pulmonary tuberculosis: case report

    A patient is reported who developed multiple basal-cell carcinomas of the skin, a breast carcinoma, and astrocytoma of the spinal cord, and a bronchial carcinoid tumor following multiple fluoroscopies during artificial pneumothorax treatment for pulmonary tuberculosis. A review of the literature revealed no previously documented cases of radiation-induced gliomas of the spinal cord

  14. PREVALENCE OF PULMONARY TUBERCULOSIS IN HIV POSITIVE INDIVIDUALS AND ITS ASSOCIATION WITH CD 4 COUNT

    Sudha; Meena; Atul R.; Kurhade

    2015-01-01

    PURPOSE: There is grave concern regarding increase in HIV associated Tuberculosis (TB) and emergence of Multi Drug Resistant (MDR) and Extremely Drug Resistant (XDR) TB. It is essential to know prevalence of TB in HIV patients and its association with CD 4 count. MATERIAL & METHODS: A total of 362 patients were screened for Pulmonary ...

  15. Broncho pleuro subcutaneous fistula with subcutaneous emphysema: A rare presentation of pulmonary tuberculosis

    Saxena, Mukul; Shameem, Mohammad; Bhargava, Rakesh; Baneen, Ummul; Alam, Mohd Mazhar; Fatima, Nazish

    2012-01-01

    Subcutaneous tissue emphysema is observed in a several clinical settings but spontaneous subcutaneous emphysema in the absence of pneumothorax with broncho pleuro subcutaneous fistula is rare. We report a case of spontaneous subcutaneous emphysema secondary to cavitary pulmonary tuberculosis in the absence of pneumothorax.

  16. Herpes generalisata associated with diabetes mellitus and pulmonary tuberculosis (A case report

    Panwar R

    1979-01-01

    Full Text Available An unusual case of Herpes Generalisata with diabetes mellitus and pulmonary tuberculosis is reported. This condition has beer, regularly reported in various immunologically suppressed states like Hodgkin′s disease, other lymphomas and leukaemias, but its occur-rence with diabetes mellitus has been described for the first time in our case.

  17. Sputum Conversion Among Patients With Smear Positive Pulmonary Tuberculosis

    Soudbakhsh A R

    2003-06-01

    Full Text Available Introduction: In the patients with smear-positive pulmonary tuberculosis (TB bacteriologic assessment of sputum for detection of acid bacilli (AFB Has essential role. This evaluation is accomplished by direct sputum smear & sputum culture. These examinations must be done in regular and preferably monthly after beginning of treatment. These tests have two important aims, including, determining of treatment efficacy & duration of isolation."nMethods and Materials: Most of the studies have that classic six month regimen led to sputum smear conversion & negative sputum culture in 85% of patient. This treatment regimen has two phases, including, attack phase and maintenance phase. In the attack phase we use four drugs, including, Isoniazid (INH, Rifampin (RMP, Pyrazinamide (PZA and Ethambutol (EMB for the first 2 months and if necessary until the end of third month. In the maintenance phase we use INH and Rif for the remaining of treatment course. The main objectives of this study were to determine the time needed for smear conversion and assessment of probable factors which may influence the smear conversion until 4 months after beginning of therapy. The factors that were assessed, were, Age, nationality, sex, clinical symptoms, underlying diseases, chest radiography (number of cavities, smoking, drug abuse and concentration of AF13 in the sputum Generally, we did this cross sectional study on the patient's records, who had been observed in Imam Khomeni Hospital, west health service center and masih daneshvary hospital between."nResults: This study showed that from totally 218 patients, 138(74.6% patients had sputum conversion at the first 2 months of treatment and until the end of 3rd & 4th month this rate reached to 83.3% respectively. So in the end of fourth month only 32(14.7% patients did not show sputum smear conversion. On the other hand this study showed that two factors including presence of cavities in chest radiography

  18. Treatment outcome of new culture positive pulmonary tuberculosis in Norway

    Heldal Einar

    2005-02-01

    Full Text Available Abstract Background The key elements in tuberculosis (TB control are to cure the individual patient, interrupt transmission of TB to others and prevent the tubercle bacilli from becoming drug resistant. Incomplete treatment may result in excretion of bacteria that may also acquire drug resistance and cause increased morbidity and mortality. Treatment outcome results serves as a tool to control the quality of TB treatment provided by the health care system. The aims of this study were to evaluate the treatment outcome for new cases of culture positive pulmonary TB registered in Norway during the period 1996–2002 and to identify factors associated with non-successful treatment. Methods This was a register-based cohort study. Treatment outcome was assessed according to sex, birthplace, age group, isoniazid (INH susceptibility, mode of detection and treatment periods (1996–1997, 1998–1999 and 2000–2002. Logistic regression was also used to estimate the odds ratio for treatment success vs. non-success with 95% confidence interval (CI, taking the above variables into account. Results Among the 655 patients included, the total treatment success rate was 83% (95% CI 80%–86%. The success rates for those born in Norway and abroad were 79% (95% CI 74%–84% and 86% (95% CI 83%–89% respectively. There was no difference in success rates by sex and treatment periods. Twenty-two patients (3% defaulted treatment, 58 (9% died and 26 (4% transferred out. The default rate was higher among foreign-born and male patients, whereas almost all who died were born in Norway. The majority of the transferred out group left the country, but seven were expelled from the country. In the multivariate analysis, only high age and initial INH resistance remained as significant risk factors for non-successful treatment. Conclusion Although the TB treatment success rate in Norway has increased compared to previous studies and although it has reached a reasonable target

  19. Pulmonary tuberculosis in severely-malnourished or HIV-infected children with pneumonia: a review.

    Chisti, Mohammod Jobayer; Ahmed, Tahmeed; Pietroni, Mark A C; Faruque, Abu S G; Ashraf, Hasan; Bardhan, Pradip K; Hossain, Iqbal; Das, Sumon Kumar; Salam, Mohammed Abdus

    2013-09-01

    Presentation of pulmonary tuberculosis (PTB) as acute pneumonia in severely-malnourished and HIV-positive children has received very little attention, although this is very important in the management of pneumonia in children living in communities where TB is highly endemic. Our aim was to identify confirmed TB in children with acute pneumonia and HIV infection and/or severe acute malnutrition (SAM) (weight-for-length/height or weight-for-age z score Web of Science in April 2013 for the period from January 1974 through April 2013. We included only those studies that reported confirmed TB identified by acid fast bacilli (AFB) through smear microscopy, or by culture-positive specimens from children with acute pneumonia and SAM and/or HIV infection. The specimens were collected either from induced sputum (IS), or gastric lavage (GL), or broncho-alveolar lavage (BAL), or percutaneous lung aspirates (LA). Pneumonia was defined as the radiological evidence of lobar or patchy consolidation and/or clinical evidence of severe/ very severe pneumonia according to the WHO criteria of acute respiratory infection. A total of 17 studies met our search criteria but 6 were relevant for our review. Eleven studies were excluded as those did not assess the HIV status of the children or specify the nutritional status of the children with acute pneumonia and TB. We identified only 747 under-five children from the six relevant studies that determined a tubercular aetiology of acute pneumonia in children with SAM and/or positive HIV status. Three studies were reported from South Africa and one each from the Gambia, Ethiopia, and Thailand where 610, 90, 35, and 12 children were enrolled and 64 (10%), 23 (26%), 5 (14%), and 1 (8%) children were identified with active TB respectively, with a total of 93 (12%) children with active TB. Among 610 HIV-infected children in three studies from South Africa and 137 SAM children from other studies, 64 (10%) and 29 (21%) isolates of M. tuberculosis

  20. Pulmonary tuberculosis with airspace consolidation vs mycoplasma pneumonia in adults: high-resolution CT findings

    To analyse and compare high-resolution CT findings of pulmonary tuberculosis with consolidation and mycoplasma pneumonia. Twenty patients with pulmonary tuberculosis [confirmed by sputum culture (n=9) and bronchoscopic biopsy (n=11)] and airspace consolidation on high-resolution CT and 17 patients with mycoplasma pneumonia, confirmed by serologic test, were included in this study. High-resolution CT findings were analyzed in terms of ground-glass opacities, distribution of consolidation, type of nodules, cavities, interlobular septal thickening, bronchial dilatations, bronchial wall thickening and pleural effusion. In patients with tuberculosis, average age was 33.5 years (range, 20-67); in those with mycoplasma pneumonia it was 32.5 years (range, 17-74). Segmental and subsegmental distributions were most common in both diseases; the preferred site of consolidation was different, however; for tuberculosis it was the upper lobes (13 cases, 65%; bilateral involvement, 7 cases); for mycoplasma pneumonia it was the lower lobes (11 cases, 64.7%). Non-segmental (diffuse and random) distribution of ground-glass opacities were seen in two patients(11.8%) with mycoplasma pneumonia. Centrilobular nodules, branching linear opacities and alveolar nodules were not different in both diseases, but there were nodules above 10mm in 14 cases of tuberculosis and in only one case of mycoplasma pneumonia. Tree-in-bud appearances were seen in five cases of tuberculosis. Cavities without air-fluid level were noted in ten cases of tuberculosis. Other interlobular septal thickening, bronchial wall thickening, bronchial dilatation and pleural effusion were not different in both diseases. There was considerable overlap between high resolution CT findings of tuberculosis with airspace consolidation and those of mycoplasma pneumonia. The location of consolidation, type of nodules, and the presence of tree-in-bud appearance and cavities help in the differentiation of the two diseases, however

  1. Tonsillar tuberculosis, with primary pulmonary focus: A Case Report

    Juan Antonio Lugo Machado

    2015-09-01

    Full Text Available Tuberculosis is an infectious disease that affects various organs and tissues, with greater tropism for lung disease, gastrointestinal and central nervous system tissue and even bone. However isolated cases of affection to other structures have been reported, just like this patient who came with symptoms in the tonsils and subsequently, lung involvement became apparent. The tonsillar infection in this case was considered a secondary tuberculosis with primary focus in the lungs.

  2. Computed tomographic assessment of the surgical risks associated with fibrocavernous pulmonary tuberculosis

    We evaluated the surgical risks associated with fibrocavernous pulmonary tuberculosis by retrospectively examining chest computed tomography (CT) scans. We reviewed the records of 40 patients who underwent pulmonary resection for fibrocavernous pulmonary tuberculosis, for whom preoperative CT scans were available. The disease was categorized as class I, defined as a cavity within one lobe without remarkable pleural thickness, in 21 patients; class II, defined as a cavity extending beyond one lobe or within one lobe with remarkable pleural thickness, in 10 patients; and class III, defined as bilateral cavities, in 9 patients. Four of the nine patients with bilateral cavities underwent bilateral pulmonary resection and five underwent unilateral pulmonary resection. The study parameters were intraoperative blood loss, operative time, hospital stay, major operative morbidity, and hospital death. Intraoperative blood loss and operative time were significantly greater and hospital stay was significantly longer in patients with advanced disease (P=0.046, P=0.000, and P=0.143, respectively). Major surgical morbidity mainly occurred in association with advanced disease (P=0.028) at the following incidences: class I, 5%; class II, 30%; class III, 44.4%. Two hospital deaths occurred, both following bilateral pulmonary resection for class III disease, accounting for an overall 5% mortality rate. The surgical risks associated with fibrocavernous pulmonary tuberculosis were well correlated with anatomic involvement, according to the extent of cavitation and the severity of pleural thickness, as depicted by CT. Staged pulmonary resection or the combination of one-sided resection with other modalities is recommended for the treatment of bilateral cavities. (author)

  3. -592 and -1082 interleukin-10 polymorphisms in pulmonary tuberculosis with type 2 diabetes

    Guadalupe Garca-Elorriaga; Leila Vera-Ramrez; Guillermo del Rey-Pineda; Csar Gonzlez-Bonilla

    2013-01-01

    Objective: To determine the polymorphisms of Interleukin-10 (IL-10) (-592, -1082) in pulmonary tuberculosis (PTB) with and without type 2 diabetes (T2D). Methods: We studied a Mexican mestizo population of 37 patients with TB in remission (TBr) and 40 with active pulmonary TB (PTB), 21 patients with TB + T2D, 47 blood donors accepted, and 13 healthy health-care workers with tuberculin skin test positive. Determination of IL-10 polymorphisms was performed by real-time Polymerase chain reaction. Results: IL-10-592C/A presented in a greater proportion in healthy individuals than in patients with type 2 diabetes and TB in a not quite significant statistically manner. IL-10-1082A/A presented more frequently in the group of patients with both diseases, not being statistically significant in comparison with the group of healthy subjects. Conclusions: This study describes two important new findings. First, it reveals that the IL-10 (-592 A/A and -592 C/C) polymorphisms were found in a greater proportion in a group of patients with T2D and TB than in healthy subjects. Second, the study provides evidence that the (-1082 G/G) polymorphism presented with greater frequency in healthy individuals than in patients with both of these diseases.

  4. Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil

    Liberato Isabella Ramos de Oliveira

    2004-01-01

    Full Text Available The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001, showed a higher frequency of weight loss >10 kilos (p <0.001, had a higher rate of non-reaction result to the tuberculin skin test (p <0.001, a higher frequency of negative sputum smear examination for acid-fast bacilli (p = 0.001 and negative sputum culture for Mycobacterium tuberculosis (p = 0.001. Treatment failure was more common in those who were HIV positive (p <0.000. No higher frequency of resistance to antituberculosis drugs was found to be associated with TB/HIV coinfection (p = 0.407. Association between extrapulmonary and pulmonary tuberculosis was more frequent in those seropositive to HIV than those without HIV virus, 30% and 1.6% respectively. These findings showed a predominance of atypical clinical laboratory features in co-infected patients, and suggest that health care personnel should consider the possibility this diagnosis.

  5. Reliability of urinary tests for antibody to Helicobacter pylori in patients with pulmonary tuberculosis

    Takatsugu Yamamoto; Taro Ishii; Tomotaka Kawakami; Yoko Sase; Chiaki Horikawa; Nozomu Aoki; Masaki Sanaka; Yasushi Kuvama

    2005-01-01

    AIM: Although the quality of currently available urinary tests for detecting antibody to Helicobacter pylori (H pylori)have been proved in some populations, the accuracy has not been studied regarding patients who suffer from pulmonary tuberculosis with multi-drug treatments. The present study was conducted to evaluate the accuracy of these urinary tests for antibody to H pylori in these patients.METHODS: Serum samples from 61 inpatients with pulmonary tuberculosis were tested using enzyme immunoassay, and urine samples were assayed by enzyme-linked immunosorbent assay method (URINELISA) and immunochromatography method (RAPIRAN). Medicines prescribed to the patients were recorded for medical charts, to evaluate the influences on the results of urinary tests.RESULTS: The sensitivity, specificity, and consistency of URINELISA against the serum test were 93.1%, 65.6%, and 78.6% respectively, and those of RAPIRAN were 86.2%,93.7%, and 90.1% respectively, which were almost equal to the data previously reported. Prescribed medicines had little influence on the results.CONCLUSION: The two urinary tests for detecting H pylori antibody have a diagnostic accuracy in patients with pulmonary tuberculosis given multiple anti-tuberculosis drugs.

  6. Mycobacterium sherrisii Lung Infection in a Brazilian Patient with Silicosis and a History of Pulmonary Tuberculosis

    Carolina de Oliveira Abrão

    2015-01-01

    Full Text Available Nontuberculous mycobacteria (NTM diseases became relevant with the emergence and spread of HIV and are also related to lung infection in non-HIV individuals with structural lung diseases. Mycobacterium sherrisii is a NTM first characterized in 2004. Only a few cases have been reported. The aim of this case report is to describe the first detailed case of infection with M. sherrisii in a patient with silicosis and history of pulmonary tuberculosis. A 50-year-old HIV-negative white male, previous smoker, with silicosis and a history of treated pulmonary tuberculosis developed a worsening of cough and expectoration pattern, and two sputum samples were positive for acid-fast bacilli. Presumptive treatment for pulmonary tuberculosis was initiated with rifampin, isoniazid, pyrazinamide, and ethambutol, but, at month 5 of treatment, despite correct medication intake and slight improvement of symptoms, sputum bacilloscopy remained positive. Sputum cultures were positive Mycobacterium sherrisii. Treatment regimen was altered to streptomycin (for 2 months, ethambutol, clarithromycin, rifabutin, and trimethoprim-sulfamethoxazole. M. sherrisii should be considered a possible etiological agent of lung infections in patients with pneumoconiosis and history of tuberculosis.

  7. Changes in respiratory function impairment following the treatment of severe pulmonary tuberculosis – limitations for the underlying COPD detection

    Radovic M.; Ristic L; Ciric Z; Dinic-Radovic V; Stankovic I; Pejcic T.; Rancic M; Bogdanovic D

    2016-01-01

    Milan Radovic,1,2 Lidija Ristic,1,2 Zorica Ciric,1,2 Violeta Dinic-Radovic,3 Ivana Stankovic,1,2 Tatjana Pejcic,1,2 Milan Rancic,1,2 Dragan Bogdanovic4 1Department of Internal Medicine, Faculty of Medicine, University of Nis, 2Clinic for Lung Diseases, 3Clinic for Gastroenterology and Hepatology, Clinical Centre of Nis, 4Public Health Institute Nis, Nis, Republic of Serbia Background: During the treatment phase of active pulmonary tuberculosis (PTB), respiratory function impairment is usual...

  8. Changes in respiratory function impairment following the treatment of severe pulmonary tuberculosis – limitations for the underlying COPD detection

    Radovic, Milan

    2016-01-01

    Milan Radovic,1,2 Lidija Ristic,1,2 Zorica Ciric,1,2 Violeta Dinic-Radovic,3 Ivana Stankovic,1,2 Tatjana Pejcic,1,2 Milan Rancic,1,2 Dragan Bogdanovic4 1Department of Internal Medicine, Faculty of Medicine, University of Nis, 2Clinic for Lung Diseases, 3Clinic for Gastroenterology and Hepatology, Clinical Centre of Nis, 4Public Health Institute Nis, Nis, Republic of Serbia Background: During the treatment phase of active pulmonary tuberculosis (PTB), respiratory function impairment is usual...

  9. Frequency of a typical radiological pattern of pulmonary tuberculosis in adults and elderly (dissertation based article)

    Tuberculosis is one of the oldest diseases and one third of the world's population is affected. Typical pattern (infiltration and or nodules with or without cavitations involving upper zone lung field) of pulmonary tuberculosis is the most common mode of radiological presentation in adults. There is a trend towards a relative increase in the unusual radiological presentations. This study was conducted to determine the frequency of atypical radiological trend of pulmonary tuberculosis in adults and elderly. Subjects and Methods: The objective of the study was to determine frequency of a typical radiological pattern of pulmonary tuberculosis in adults and elderly. It was a descriptive (case series) study and was conducted in the Department of Pulmonology, Nishtar Hospital Multan. The study duration was six months from 24 May 2006 to 23 November 2006. 300 patients presenting with pulmonary tuberculosis were selected. History and clinical examination was done. Relevant investigations and x-ray chest were carried out. Lesions like infiltration with or without cavitation were localized in upper, middle and lower zones. Groups of patients with their x-ray findings in different zones were made and analyzed accordingly, data collected were entered in specific proforma. Results: 205 (97.6%) adults and 85 (94.4%) elderly presented with cough while 205 (97.6%) adults and 75 (83.3%) elderly presented with fever. Out of 300 cases infiltration was found in 141 (46.19% vs 48.88%) young adult and elderly cases. There were 99 cases with nodule (35.71% vs 26.66%) and 60 cases had cavitation (18.09% vs 24.44%). Conclusion: There is a trend towards a relative increase in the frequency of unusual radiological presentations which is more common in elderly. (author)

  10. Pleural tuberculosis: is radiological evidence of pulmonary-associated disease related to the exacerbation of the inflammatory response?

    Leila Antonangelo; Vargas, Francisco S.; Juliana Puka; Márcia Seiscento; Acencio, Milena M P; LISETE R. TEIXEIRA; Ricardo M. TERRA; Sales, Roberta K B

    2012-01-01

    OBJECTIVE: Pleural tuberculosis is the most frequently occurring form of extra pulmonary disease in adults. In up to 40% of cases, the lung parenchyma is concomitantly involved, which can have an epidemiological impact. This study aims to evaluate the pleural and systemic inflammatory response of patients with pleural or pleuropulmonary tuberculosis. METHODS: A prospective study of 39 patients with confirmed pleural tuberculosis. After thoracentesis, a high resolution chest tomography was per...

  11. Delayed Treatment of Diagnosed Pulmonary Tuberculosis in Taiwan

    Chen Duan-Rung

    2008-07-01

    Full Text Available Abstract Background Mycobacterium tuberculosis infection is an ongoing public health problem in Taiwan. The National Tuberculosis Registry Campaign, a case management system, was implemented in 1997. This study examined this monitoring system to identify and characterize delayed treatment of TB patients. Methods Records of all tuberculosis cases treated in Taiwan from 2002 through 2005 were obtained from the National Tuberculosis Registry Campaign. Initiation of treatment more than 7 days after diagnosis was considered a long treatment delay. Results The study included 31,937 patients. The mean day of delayed treatment was 3.6 days. Most patients were treated immediately after diagnosis. The relationship between number of TB patients and days of delayed treatment after diagnosis exhibited a Power-law distribution. The long tail of the power-law distribution indicated that an extreme number occur cannot be neglected. Tuberculosis patients treated after an unusually long delay require close observation and follow up. Conclusion This study found that TB control is generally acceptabl in Taiwan; however, delayed treatment increases the risk of transmission. Improving the protocol for managing confirmed TB cases can minimize disease transmission.

  12. Coinfections in Intensive Care Unit with pulmonary tuberculosis and mucormycosis: A clinical dilemma

    Pratibha Dube

    2016-01-01

    Full Text Available Herein, we present the case report of an adult male diabetic patient who had coinfection with Mycobacterium tuberculosis and mucormycosis, which otherwise is a rare clinical entity. Diabetes mellitus may predispose a patient to tuberculosis (TB infection which further weakens immune system thus making him susceptible to other fungal or bacterial infections which may pose various treatment difficulties. Therefore, there is a need for mycological and bacteriological investigations in patients with pulmonary TB to rule out secondary coinfections thus contributing to better management.

  13. Coinfections in Intensive Care Unit with pulmonary tuberculosis and mucormycosis: A clinical dilemma.

    Dube, Pratibha; Saroa, Richa; Palta, Sanjeev

    2016-03-01

    Herein, we present the case report of an adult male diabetic patient who had coinfection with Mycobacterium tuberculosis and mucormycosis, which otherwise is a rare clinical entity. Diabetes mellitus may predispose a patient to tuberculosis (TB) infection which further weakens immune system thus making him susceptible to other fungal or bacterial infections which may pose various treatment difficulties. Therefore, there is a need for mycological and bacteriological investigations in patients with pulmonary TB to rule out secondary coinfections thus contributing to better management. PMID:27076735

  14. Association of SP-D, MBL and I-NOS genetic variants with pulmonary tuberculosis

    Vaid Mudit

    2006-01-01

    Full Text Available Background : Pulmonary tuberculosis is caused by Mycobacterium tuberculosis . It is a multifactorial disease with both host as well as pathogen factors contributing to susceptibility and protection from the disease. Various reports have highlighted important roles of lung surfactant protein D (SP-D, mannan-binding lectin (MBL and I-NOS in innate immune defense against M. tuberculosis Aims : The present study investigated the role of polymorphisms in three candidate genes encoding Lung surfactant protein D, Mannan binding lectin and Inducible Nitric oxide synthase, in susceptibility and protection to pulmonary tuberculosis. Settings and Design : A case-control association study of SNP′s in lung surfactant protein D (SP-D, mannan-binding lectin (MBL and I-NOS with pulmonary tuberculosis in Indian population was carried out. This involved sequencing of all the coding exons of lung surfactant protein D (SP-D , while, exon 1 (collagen region and exon 4 (carbohydrate recognition domain of mannan-binding lectin (MBL and exons 2, 8 and 16 of I-NOS and their flanking intronic regions for single nucleotide polymorphisms in DNA samples isolated from 30 pulmonary tuberculosis patients and 30 controls of Indian population. Statistical analysis: Various allele frequencies were calculated using online two by two table (home.clara.net/sisa/. Odds ratio and P values were calculated at 95% confidence interval (CI. Results : A total of fourteen single nucleotide polymorphisms (5 in SP-D , 5 in MBL and 4 in I-NOS were observed of which four (G459A SP-D , G274T I-NOS , G1011A and T357G MBL have not been reported earlier. Four single nucleotide polymorphisms viz. G459A of exon 7 of SP-D ( P =0.00, odds ratio (OR = 4.96, 2.18 P = 0.00 or= 3.85 1.66 P =0.00 or=4.04, 2.20< OR< 7.42 and G274T of intron 16 of I-NOS ( P =0.00 or=4.46, 2.40 Conclusion: The present study has led to identification of 4 SNP′s in SP-D , MBL and I-NOS associated with pulmonary tuberculosis

  15. High prevalence and upward trend of pulmonary tuberculosis in leukemia, lymphoma and lung cancer patients

    Objective: To document the prevalence and any increasing or decreasing trend of tuberculosis in cancer patients. Design: An analysis and comparison of patients suffering from cancers along with tuberculosis for years 1976, 1987 and 1999. Place and Duration of study: The record of all these patients was collected from different hospitals of Lahore, specially Mayo Hospital, Services Hospital and patients managed privately by the authors of this study. Subjects and Methods: In the years 1976, 1987 and 1999, total cancer patients were 1100, 1481 and 1628 respectively. Patients were diagnosed on the basis of history, physical examination, sputum for AFB, culture for AFB tuberculin skin test and x ray chest. In few difficult cases, Mycodot blood test was also performed. Results: in patients with head and neck cancers, 3.6 %, 3.9% and 4.4% had tuberculosis in the years 1976, 1987 and 1999 respectively. In lung cancer patient the prevalen of tuberculosis was 6.5%, 4.9% and 6.9% for each respective year. In case of leukemia and lymphoma, the prevalence of tuberculosis was 9.8%, 11.25% and 11.21% for the years 1976, 1987 and 1999 respectively. Conclusion: A statistically significant difference was seen in leukemia, lymphoma and lung cancer cases for prevalence of pulmonary tuberculosis as compared to all other cancers combined over respective years. (author)

  16. Determination of serum TNF for pulmonary tuberculosis patients

    Adopting radioimmunoassay, the serum TNF of 33 normal persons and 62 pulmonary TB patierlts are determined. The results are as follows: the serum TNF content of normal persons is 14.80 +- 0.72 fmol/l, while the serum TNF of pulmonary TB patients is 16.60 +- 1.11 fmol/l before treatment. Obviously, the value is higher than that of normal persons. The serum TNF content of pulmonary TB patients is 13.90 +- 1.12 fmol/l after treatment and the value is obviously lower than that of normal persons. Furthermore, after two month treatment the serum TNF content of progressive-stage pulmonary TB patients is 14.70 +- 1.81 fmol/l. The value is obviously higher than that of resolving-stage pulmonary TB patients 13.40 +- 1.03 fmol/l after two month treatment (P<0.01). It shows that TNF is concerned with the condition and pathogeny of pulmonary TB patients. So the determination of serum TNF has clinical significance to pathogeny, judgement and curative effect observation of pulmonary TB

  17. USING KRIGING FOR STATISTICAL DISEASE MAPPING OF PULMONARY TUBERCULOSIS

    M MOHAMMAD ZADE

    2003-06-01

    Full Text Available Introduction: The map of diseases is usually constructed using the information from diseases incidnce in some regions. Some factors, such as measurment error and rapid variation of diseases rates in different regions make maps so wiggly that their interpretation becomes difficult. Therefore these maps must be smoothed using statisical methods. Methods: Since disease rates of different regions reflect an spatial correlation structure, in this paper the spatial correlation structure of data is specified by fitting a variogram model, then kriging as a best linear unbiased prediction method is used to make a smooth map of diseases. Results: The tuberculosis incidence rates of 262 counties of Iran are used to demonstrate the application and accuracy of the diseases mapping method presented in this paper. The smoothing map of tuberculosis disease, obtained by kriging method shows the geographical trend of the disease in Iran. In this map, central and western regions of Iran have minimum incidence rates, and it gradually increases toward the eastern boundaries. Discussion: The object of this article is introducing kriging method for disease mapping and tuberculosis disease is used to demonstrate the application of this method. There is on dubt that the numerical results of prediction and mapping can be affected by undercount in the smir positive (S + tuberculosis data, which are gathered by the office for campaigning against diseases. However this method has a wide application in different areas of medical sciences. such as geographical epidemiology of diseases, environmental health and environmental engineering.

  18. Study of clinical profile of childhood extra pulmonary tuberculosis

    Dhara K. Gosai

    2014-04-01

    Conclusion: Childhood EPTB is commonly seen in children age more than 1 year, lower socioeconomic class and in severely malnourished. CNS tuberculosis commonly present with fever, altered sensorium, convulsion, abnormal movements while abdominal TB present with fever, anorexia, weight loss and abdominal pain. [Int J Res Med Sci 2014; 2(2.000: 501-505

  19. A Bayesian Nonlinear Mixed-Effects Regression Model for the Characterization of Early Bactericidal Activity of Tuberculosis Drugs

    Burger, Divan Aristo; Schall, Robert

    2014-01-01

    Trials of the early bactericidal activity (EBA) of tuberculosis (TB) treatments assess the decline, during the first few days to weeks of treatment, in colony forming unit (CFU) count of Mycobacterium tuberculosis in the sputum of patients with smear-microscopy-positive pulmonary TB. Profiles over time of CFU data have conventionally been modeled using linear, bilinear, or bi-exponential regression. We propose a new biphasic nonlinear regression model for CFU data that comprises linear and bi...

  20. DIAGNOSTIC TEST OF SPUTUM GENEXPERT MTB/RIF FOR SMEAR NEGATIVE PULMONARY TUBERCULOSIS.

    Reechaipichitkul, Wipa; Phetsuriyawong, Attawoot; Chaimanee, Prajuab; Ananta, Pimjai

    2016-05-01

    The objective of this study was to evaluate the performance of the Gene-Xpert MTB/RIF sputum test for diagnosing pulmonary tuberculosis (TB) among patients sputum acid-fast bacillus (AFB) smear negative results in Thailand, a country with a high prevalence of pulmonary tuberculosis. We studied 151 patients who presented to Srinagarind Hospital, Khon Kaen, Thailand with a 2 week or more history of fever and/or cough and an abnormal chest radiograph between 2010 and 2014; these patients had at least 2 negative sputum AFB smear results. Of these, 76 were diagnosed as having either confirmed or probable pulmonary TB: the 32 confirmed cases were those with a positive sputum culture for Mycobacterium tuberculosis (MTB) and the 44 probable case were those with clinical and radiographic findings consistent with TB and who had a response to anti-TB therapy. Seventy-five cases were diagnosed as not having pulmonary TB. Of the 32 patients with a positive sputum culture for MTB, 26 had a positive GeneXpert MTB/RIF sputum test. Compared to sputum culture for MTB the GeneXpert MTB/ RIF test gave a sensitivity of 83.9% (95% CI: 66.3-94.5) and a specificity of 92.1% (95% CI: 83.6-97), a positive predictive value (PPV) of 81.3% (95% CI: 63.6-92.8) and a negative predictive value (NPV) of 93.3% (95% CI: 85.1-97.8). The GeneXpert MTB/RIF test had a fair sensitivity and specificity for diagnosing smear negative pulmonary TB. It may be useful for diagnosing pulmonary TB in patients with a negative sputum AFB smear. The assay is faster than culture and can detect rifampicin resistant strains of MTB. PMID:27405129

  1. Rapid Screening of MDR-TB in Cases of Extra Pulmonary Tuberculosis Using Geno Type MTBDRplus.

    Richa Kumari

    Full Text Available Drug resistance in tuberculosis is a major public health challenge in developing countries. The limited data available on drug resistance in extra pulmonary tuberculosis stimulated us to design our study on anti-tuberculosis drug resistance pattern in cases of extra pulmonary tuberculosis in a tertiary referral hospital of North India. We performed Geno Type MTBDRplus assay in comparison with conventional drug susceptibility testing by proportion method to study the mutation patterns in rpoB, katG and inhA genes.A total of 510 extra pulmonary samples were included in this study. After the smear microscopy, all the specimens were subjected for culture on Lowenstein Jensen (LJ media. Phenotypic drug susceptibility testing (DST was performed on LJ media for all the MTB isolates and compared with the results of Geno Type MTBDRplus assay which was performed with the DNA isolated from the culture by conventional method.Of 510 specimens cultured, the total culture positivity obtained was 11.8% (60 encompassing 54 (10.6% Mycobacterium tuberculosis and 6 (1.2% non-tubercular mycobacteria (NTM. DST results by Geno Type MTBDRplus assay and solid culture methods were compared in 51 MTB isolates excluding the two Rif indeterminate and one invalid test. Geno Type MTBDRplus accurately identified 13 of 14 rifampicin-resistant strains, 14 of 15 isoniazid-resistant strains and 13 of 14 as multi drug resistant tuberculosis (MDR-TB in comparison with conventional method. Sensitivity and specificity were 92.86% and 97.30% respectively for detection of RIF resistance, 93.33% and 94.44% respectively for detection of INH resistance, 92.86% and 97.30% respectively for detection of MDR-TB, while the overall concordance of Geno Type MTBDRplus assay with conventional DST was 94.11%. The turn-around time for performing Geno Type MTBDRplus assay test was 48 hours.The problem of MDR in extra pulmonary tuberculosis (EPTB cannot be overlooked and due attention on patients

  2. Dynamic analysis of active pulmonary tuberculosis among employees in food trades and public places in Changping district of Beijing%北京市昌平区食品和公共场所从业人员活动性肺结核动态分析

    王秀云

    2012-01-01

    [Objective]To study the epidemic status of pulmonary tuberculosis among employees in food trades and public places in Changping district of Beijing, provide a scientific basis for making decisions. [ Methods] The health examination data of employees in food trades and public places in Changping district from 2006 to 2010 were analyzed statistically ( x2 test). [ Results ] During 2006-2010, the detection rate of active pulmonary tuberculosis of employees in food trades and public places in Changping district increased year by year( 0.002% , 0.042% , 0.153% , 0. 124% and 0.228% ), and the difference was significant (x2 =210.64, P <0.01). The detection rate of active pulmonary tuberculosis among local employees (0.000% , 0.044% , 0. 155% , 0.048% and 0.265% ) and migrant employees (0.002% , 0. 041% , 0. 152% , 0. 149% and 0. 216% ) increased year by year, and the differences were significant (local employees x2 = 82.08, P < 0.01; migrant employees x2 = 145. 99, P < 0.01). [ Conclusion ] In order to ensure the public health security in Changping district, the annual health examination among employees in food trades and public places should be strengthened, the education of pulmonary tuberculosis should be improved among migrant employees, so as to early detect the tuberculosis patients and control the spread of tuberculosis.%目的 了解北京市昌平区食品、公共场所从业人员肺结核的流行状况,为制定决策提供科学依据.方法 对2006-2010年间昌平区食品、公共场所从业人员健康检查资料进行统计学分析(x2检验).结果 2006-2010年昌平区食品及公共场所从业人员活动性肺结核病检出率(0.002%、0.042%、0.153%、0.124%、0.228%)呈逐年上升趋势,差异有统计学意义(x2 =210.64,P<0.01);该地从业人员活动性肺结核病的检出率(0.000%、0.044%、0.155%、0.048%、0.265%)与外埠从业人员活动性肺结核病的检出率(0.002%、0.041%、0.152%、0.149

  3. Pneumoconiosis and liver cirrhosis are not risk factors for tuberculosis in patients with pulmonary infection

    Wu, H.P.; Pan, Y.H.; Hua, C.C.; Shieh, H.B.; Jiang, B.Y.; Yu, T.J. [Chang Gung Memorial Hospital, Chilung (Taiwan)

    2007-05-15

    It is unclear whether patients with liver cirrhosis and coal miners with pneumoconiosis are at increased risk of developing pulmonary tuberculosis (TB). Furthermore, little is known of the likelihood of pneumonia in patients with bronchiectasis, haemodialysis, diabetes mellitus or advanced lung cancer being due to TB. To answer these questions, patients with these clinical comorbidities were analysed. The study was retrospective and included 264 TB patients, 478 non-TB pneumonia patients, and as negative controls, 438 subjects without pneumonia. The parameters analysed were age, gender and the presence of pneumoconiosis, bronchiectasis, liver cirrhosis, haemodialysis, diabetes mellitus and advanced lung cancer. Male gender was the only significant factor increasing the risk of pulmonary TB. When compared with non-TB pneumonia and control patients, the odds ratios were 1.862 and 2.182, respectively. Patients with liver cirrhosis did not show an increased risk of pulmonary TB after regression analysis. Pneumoconiosis resulted in a 2.260 (P = 0.003) odds ratio for pulmonary TB, compared with the controls. However, there was no difference in pneurmoconiosis between TB and non-TB pneumonia patients. Patients with bronchiectasis, lung cancer and those receiving haemodialysis had a lower risk for pulmonary TB in lower respiratory tract infection, with odds ratios of 0.342, 0.311 and 0.182, respectively. Physicians should first consider non-TB bacterial infection rather than Mycobacterium tuberculosis infection in pneumonia in patients with bronchiectasis, lung cancer or those receiving haemodialysis.

  4. Mini-invasive resection and collapse therapy in patients with bilateral pulmonary tuberculosis

    Korpusenko I.V.

    2015-06-01

    Full Text Available Objective. Improve the effectiveness of surgical treatment in patients with bilateral destructive pulmonary tuberculosis by mini-invasive resection and collapse therapy. Materials and Methods: Retrospective analysis of 222 patients’ cards with bilateral destructive pulmonary tuberculosis who were treated in the period from 1995 to 2014 in the thoracic department of Dnepropetrovsk regional clinical therapeutic and prophylactic association "Phthisiology". Patients were divided into 2 groups: basic (111 patients who underwent mini-invasive surgery and control (111 patients, who underwent standard surgical approach. The distribution of patients in investigated groups was representative by the majority of parameters. Results and discussion. The average duration of simultaneous bilateral VATS lung resections was 1,90 ± 0,12 hour, standard thoracotomies - 2,13 ± 0,19 per hour, estimated blood loss was 234±5,20ml and 433±3,70ml respectively. The average postoperative time in-patient was 52,40±2,63 days in basic and 80,10±3,58 days in the control group. Number of postoperative complications after lung resection with VATS was significantly lower (1.6 times, as compared with standard surgical approach. Volume of blood loss less than 400 ml was 93,40±3,20% in basic and 72,60±4,80% in the control group, the amount of intraoperative complications reduced by 2.2 times. Complete clinical response (decontamination and closing of cavities have been achieved in patients of the basic group by 1.6 times more often. Conclusions: For patients with bilateral pulmonary tuberculosis to perform mini-invasive surgical approach is the best option. Mini-invasive interventions with VATS due to its good abilities to visualize tissues and anatomical structures may significantly decrease the amount of intraoperative blood and plasma loss in the first postoperative day. It leads to the stabilization of tuberculosis process in the contralateral lung, responsible for

  5. Massive hemoptysis due to pulmonary tuberculosis: management with bronchial artery embolization

    Objective: To evaluate the clinical effects of interventional bronchial artery embolization in the management of massive hemoptysis as a complication of pulmonary tuberculosis. Methods: Interventional bronchial arterial embolization was performed in 26 cases with secondary pulmonary tuberculosis and massive hemoptysis. Tuberculosis was found in bilateral lung in 20 cases out of 26. Unilateral lung was evolved in the rest 6. The dose of hemoptysis was 200 ml/d-1200 ml/d. Bronchial arteriography was undertaken and the target blood vessel was confirmed in all patients. Then PVA grain or silk segment (1-2 mm) were injected into bronchial artery until blood flow was blocked. The procedures were guided under the fluoroscopy. Gelfoam particles were used in 2 cases when tortuous feeding arteries were revealed in angiogram. Results: Bleeding was demonstrated in 58 branches of bronchial artery in all cases. 19 cases were bilateral and 7 unilateral. After the primary intervention, hemoptysis was controlled completely in 23 patients, slight hemoptysis was noted in 2 patients, and no improvement was obtained in one patient. The short term efficiency was 96.1%. No serious complication occurred. In a post-interventional follow up of 6 months to 6 years, 3 patients had relapse after 6 months and reembolization with silk segments was done. The other 23 patients were in stable condition. Long-term efficiency was 88.4%. Conclusion: Embolization of bronchial artery with PVA grain or with silk segments is an effective and safe method in the management of hemoptysis as a complication of pulmonary tuberculosis, especially in patients with severe hemoptysis. The anti-tuberculosis chemotherapy is helpful in preventing the relapse. (authors)

  6. The pathogen recognition sensor, NOD2, is variably expressed in patients with pulmonary tuberculosis

    Johnson Margaret A

    2007-08-01

    Full Text Available Abstract Background NOD2, an intracellular pathogen recognition sensor, modulates innate defences to muropeptides derived from various bacterial species, including Mycobacterium tuberculosis (MTB. Experimentally, NOD2 attenuates two key putative mycobactericidal mechanisms. TNF-α synthesis is markedly reduced in MTB-antigen stimulated-mononuclear cells expressing mutant NOD2 proteins. NOD2 agonists also induce resistance to apoptosis, and may thus facilitate the survival of MTB in infected macrophages. To further define a role for NOD2 in disease pathogenesis, we analysed NOD2 transcriptional responses in pulmonary leucocytes and mononuclear cells harvested from patients with pulmonary tuberculosis (PTB. Methods We analysed NOD2 mRNA expression by real-time polymerase chain-reaction in alveolar lavage cells obtained from 15 patients with pulmonary tuberculosis and their matched controls. We compared NOD2 transcriptional responses, in peripheral leucocytes, before and after anti-tuberculous treatment in 10 patients. In vitro, we measured NOD2 mRNA levels in MTB-antigen stimulated-mononuclear cells. Results No significant differences in NOD2 transcriptional responses were detected in patients and controls. In some patients, however, NOD2 expression was markedly increased and correlated with toll-like-receptor 2 and 4 expression. In whole blood, NOD2 mRNA levels increased significantly after completion of anti-tuberculosis treatment. NOD2 expression levels did not change significantly in mononuclear cells stimulated with mycobacterial antigens in vitro. Conclusion There are no characteristic NOD2 transcriptional responses in PTB. Nonetheless, the increased levels of NOD2 expression in some patients with severe tuberculosis, and the increases in expression levels within peripheral leucocytes following treatment merit further studies in selected patient and control populations.

  7. Assessment of knowledge and attitude towards pulmonary tuberculosis in undergraduate nursing students of Applied University in Greece.

    Vassilopoulos A.

    2010-04-01

    Full Text Available Background: Tuberculosis constitutes a diachronic problem of Public Health that in the past years received bigger epidemic dimensions, stirring interesting many researchers in all levels. Aim: The aim of our study was to assess the knowledge and attitude of students of Nursing departments in Applied University in Greece, towards the transmission and the prevention of pulmonary tuberculosis. Materials and Methods: The sample consisted of 275 students (12.1% male και 87,9% female of Nursing Departments. The anonymous questionnaire was used in order to collect our data. The study was conducted from May 19, 2008 to June 20, 2009. Each participant completed two questionnaires which included demographic data, questions regarding their knowledge to this infection and questions regarding their attitude toward it. The research took place at the Applied University of Athens, Lamia and Larissa. Statistical analyze was done with statistical methods SPSS version 15. Results: The founding of present study show that the 55,6% of the students had average knowledge concerning tuberculosis while only 2% of them had excellent knowledge, fact that affects indirectly in their attitude towards the disease. 59,1% of them knows the ways of transmission of disease but only the 52,2% the vaccine at tuberculosis. In case of a fellow student being infected from active tuberculosis 86% of the subjects would follow the advise and instructions of the Professional Health Bodies, while the 52,6% would ask medical advices if their fellow student suffered. 90.2 % of them could come into contact with patients while on clinical education placement but taking all personal precautions. Conclusions: The systematic teaching of preventing infectious diseases the evaluation of preventing programs as well as the concretisation of Educating Health Programs can contribute in overall complete education of students on issues in Public Health.

  8. Cellular immune responses to ESAT-6 discriminate between patients with pulmonary disease due to Mycobacterium avium complex and those with pulmonary disease due to Mycobacterium tuberculosis

    Lein, A D; von Reyn, C F; Ravn, P;

    1999-01-01

    disease due to either Mycobacterium avium complex (MAC) or Mycobacterium tuberculosis with those in healthy, skin test-negative, control subjects. Significant IFN-gamma responses to ESAT-6 were detected in 16 (59%) of 27 M. tuberculosis pulmonary disease patients, 0 (0%) of 8 MAC disease patients, and 0...... (0%) of 8 controls. Significant IFN-gamma responses to M. tuberculosis purified protein derivative were detected in 23 (85%) of 27 M. tuberculosis disease patients, 2 (25%) of 8 MAC disease patients, and 5 (63%) of 8 healthy controls. M. avium sensitin was recognized in 24 (89%) of 27 M. tuberculosis...... disease patients, 4 (50%) of 8 MAC disease patients, and 1 (13%) of 8 controls. IFN-gamma responses to ESAT-6 are specificfor disease due to M. tuberculosis and are not observed in patients with MAC disease or in healthy controls....

  9. Cellular immune responses to ESAT-6 discriminate between patients with pulmonary disease due to Mycobacterium avium complex and those with pulmonary disease due to Mycobacterium tuberculosis

    Lein, A D; von Reyn, C F; Ravn, P;

    1999-01-01

    disease due to either Mycobacterium avium complex (MAC) or Mycobacterium tuberculosis with those in healthy, skin test-negative, control subjects. Significant IFN-gamma responses to ESAT-6 were detected in 16 (59%) of 27 M. tuberculosis pulmonary disease patients, 0 (0%) of 8 MAC disease patients, and 0...... (0%) of 8 controls. Significant IFN-gamma responses to M. tuberculosis purified protein derivative were detected in 23 (85%) of 27 M. tuberculosis disease patients, 2 (25%) of 8 MAC disease patients, and 5 (63%) of 8 healthy controls. M. avium sensitin was recognized in 24 (89%) of 27 M. tuberculosis...... disease patients, 4 (50%) of 8 MAC disease patients, and 1 (13%) of 8 controls. IFN-gamma responses to ESAT-6 are specific for disease due to M. tuberculosis and are not observed in patients with MAC disease or in healthy controls....

  10. Diagnosis of pulmonary tuberculosis among asymptomatic HIV+ patients in Guangxi, China

    ZHANG Yao; ZHANG Fu-jie; YU Lan; TANG Zhi-rong; HUANG Shao-biao; ZHENG Yuan-jia; MENG Zhi-hao; SUN Kai; WANG Li-ming; Ray Y.CHEN

    2010-01-01

    Background Pulmonary tuberculosis (PTB) among asymptomatic Chinese patients with HIV infection has not been investigated despite high tuberculosis burden in China. This study was aimed to evaluate the prevalence, risk factors and clinical outcomes of PTB among asymptomatic patients with HIV/AIDS in Guangxi to facilitate the development of diagnostic and treatment strategies.Methods All asymptomatic adult HIV-infected patients with CD4 <350 cells/μl who attended four HIV clinics in Guangxi between August 2006 and March 2008 were evaluated for active PTB with physical examination, chest X-ray (CXR),sputum smear and/or sputum liquid culture. Data were described using median (interquartile range, IQR) and frequencies.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with PTB.Results Among 340 asymptomatic subjects, 15 (4%) were diagnosed with PTB, with 4 (27%) sputum smear positive and 8 (53%) sputum culture positive. CXR has higher diagnostic sensitivity (87%) than sputum smear (25%) and sputum culture (67%), but lower specificity (56%) compared with sputum smear (99%) and culture (100%). In univariate analysis,injection drug user, body mass index (BMI) <18 kg/m2, CD4 <50 cells/μl and presence of peripheral lymphadenopathy were associated with an increased risk of asymptomatic PTB, while in multivariate analysis only peripheral lymphadenopathy maintained statistical significance (OR=7.6, 95% CI 1.4-40). Patients with negative smear and minor or no abnormalities on CXR had longer interval between screening and TB treatment.Conclusions PTB was relatively common in this group of HIV+ asymptomatic Chinese patients. Diagnosis is challenging especially where sputum culture is unavailable. These findings suggest that an enhanced evaluation for PTB needs to be integrated with HIV care in China and transmission prevention in China to control at both households and health care facilities, especially for patients

  11. Is diagnostic protocol a cause of overestimation of extra-pulmonary tuberculosis in Himachal Pradesh? A report from a high-prevalence tuberculosis unit

    Vishav Chander; Raina, S. K.; Bhardwaj, A. K.; KASHYAP, S.; Anmol K Gupta; Abhilash Sood

    2013-01-01

    Aims and Objectives: To study the diagnostic practices for diagnosis of extra-pulmonary tuberculosis (EPTB) in a high-prevalence tuberculosis unit (TU). Material and Methods: It was a cross-sectional study using a pre-designed and pre-tested structured questionnaire. The information was collected from new EPTB cases registered in Rampur TU between 1 July 2007 and 31 March 2008. Diagnostic practices of the medical practitioners for establishing the diagnosis of different types of EPTB were stu...

  12. Paradoxical Tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) in HIV Patients with Culture Confirmed Pulmonary Tuberculosis in India and the Potential Role of IL-6 in Prediction

    Narendran, Gopalan; Andrade, Bruno B; Porter, Brian O.; Chandrasekhar, Chockalingam; Venkatesan, Perumal; Menon, Pradeep A.; Subramanian, Sudha; Anbalagan, Selvaraj; Bhavani, Kannabiran P.; Sekar, Sathiyavelu; Padmapriyadarshini, Chandrasekaran; Kumar, Satagopan; Ravichandran, Narayanan; Raja, Krishnaraj; Bhanu, Kesavamurthy

    2013-01-01

    Background The incidence, manifestations, outcome and clinical predictors of paradoxical TB-IRIS in patients with HIV and culture confirmed pulmonary tuberculosis (PTB) in India have not been studied prospectively. Methods HIV+ patients with culture confirmed PTB started on anti-tuberculosis therapy (ATT) were followed prospectively after anti-retroviral therapy (ART) initiation. Established criteria for IRIS diagnosis were used including decline in plasma HIV RNA at IRIS event. Pre-ART plasm...

  13. A New Vaccine against Tuberculosis Affords Greater Survival after Challenge than the Current Vaccine in the Guinea Pig Model of Pulmonary Tuberculosis

    Horwitz, Marcus A.; Harth, Guenter

    2003-01-01

    Tuberculosis (TB) remains an enormous global health problem, and a new vaccine against TB more potent than the current inadequate vaccine, Mycobacterium bovis BCG, is urgently needed. We describe a recombinant BCG vaccine (rBCG30) expressing and secreting the 30-kDa major secretory protein of Mycobacterium tuberculosis, the primary causative agent of TB, that affords greater survival after challenge than parental BCG in the highly demanding guinea pig model of pulmonary TB. Animals immunized ...

  14. Multidrug Resistant Pulmonary Tuberculosis Treatment Regimens and Patient Outcomes: An Individual Patient Data Meta-analysis of 9,153 Patients

    Ahuja, Shama D.; Ashkin, David; Avendano, Monika; Banerjee, Rita; Bauer, Melissa; Bayona, Jamie N.; Becerra, Mercedes C.; Benedetti, Andrea; Burgos, Marcos; Centis, Rosella; Chan, Eward D.; Chiang, Chen-Yuan; Cox, Helen; D'Ambrosio, Lia; DeRiemer, Kathy

    2012-01-01

    Editors' Summary Background In 2010, 8.8 million people developed tuberculosis—a contagious bacterial infection—and 1.4 million people died from the disease. Mycobacterium tuberculosis, the bacterium that causes tuberculosis, is spread in airborne droplets when people with the disease cough or sneeze and usually infects the lungs (pulmonary tuberculosis). The characteristic symptoms of tuberculosis are a persistent cough, weight loss, and night sweats. Tuberculosis can be cured by taking seve...

  15. Pulmonary tuberculosis among migrants in Shandong, China: factors associated with treatment delay

    Zhou, Chengchao; Chu, Jie; Geng, Hong; Wang, Xingzhou; Xu, Lingzhong

    2014-01-01

    Objective A timely initiation of treatment is crucial to better control tuberculosis (TB). The aim of this study is to describe treatment delay among migrant patients with TB and to identify factors associated with treatment delay, so as to provide evidence for strategy development and improvement of TB control among migrants in China. Design A cross-sectional study was conducted in Shandong province of China. A total of 314 confirmed smear positive migrant patients with pulmonary TB were inc...

  16. SIGNIFICANCE OF ADENOSINE DEAMINASE SERUM CONCENTRATIONS IN THE DIAGNOSIS OF EXTRA-PULMONARY TUBERCULOSIS

    Stevanovic G.; Pelemis M.; Pavlovic M.; Lavadinovic L,; Dakic Z,; Milosevic I,; Milosevic B.

    2011-01-01

    Extra pulmonary tuberculosis (EPTB) is a growing problem worldwide. Due to the nature of the disease, the diversity of clinical pictures as well as its minor epidemiological importance, the diagnosis is difficult and often late.In addition to standard TB diagnostic techniques use of new biochemical (surrogate markers) are increased. With this work we wanted to examine the usefulness of serum adenosine deaminase levels as a diagnostic parameter for EPTB.The work included 116 patients with feve...

  17. The Risk of Contracting Drug-Induced Pancreatitis during Treatment for Pulmonary Tuberculosis

    Natalya Gubergrits

    2015-05-01

    Full Text Available Context Pulmonary tuberculosis and especially multi-drug-resistant tuberculosis remain a pressing health problem. Objective The aim of this study was to establish how often standard preparations for the treatment of tuberculosis, such as isoniazid and rifampicin, lead to acute pancreatitis. Methods Two hundred and eighty patients with pulmonary tuberculosis were investigated by clinical chemistry and ultrasonography to determine in how many cases the use of isoniazid and rifampicin was followed by elevation of pancreatic isoamylase or lipase or by sonographic signs of acute pancreatitis with and without occurrence of acute upper abdominal symptoms. Results Acute pancreatitis definitely occurred in 22 (8% and probably in 36 (13% of the patients. In 21 (8% there was merely an asymptomatic serum elevation of pancreatic enzymes and no pathologic sonographic signs in the pancreas. Conclusions Acute pancreatitis is a frequent occurrence after administration of isoniazid and rifampicin and must be considered whenever upper abdominal symptoms are found in patients treated with these drugs.

  18. Comparative study between CT findings of pulmonary tuberculosis in immunocompromised and immuned normal patients

    Objective: To evaluate the CT features of pulmonary tuberculosis between immunocompromised patients compared with immuned normal patients. Methods: The complete data, including chest CT scanning and laboratory results of 213 patients with pulmonary tuberculosis from 2006 to 2009 were retrospectively studied. The patients were classified as immunocompromised group (18 cases ) and immuned normal group (195 cases) and the CT features of these two group were compared. Results: CT features of tuberculosis in immunocompromised group included larger confluent consolidation (77.8%), multiple small cavities within any given lesion (66.7%), nodular opacities (38.39%), tree-in-bud (50.0%), pleural effusion (61.1%) and enlarged mediastinal lymph nodes (55.56%). CT findings of tuberculosis in immuned normal group included larger confluent consolidation (24.62%), multiple small cavities within any given lesion (9.23%), nodular opacities (42.05%), tree-in-bud (45.64%), pleural effusion (50.26%) and enlarged mediastinal lymph nodes (29.78%). There were significantly differences (P0.05) in the findings of nodular opacities, tree-in-bud, pleural effusion. Conclusion: Immunocompromised patients have a higher prevalence of larger confluent consolidation, multiple small cavities within a given lesion and enlarged mediastinal lymph nodes than immuned normal patients. (authors)

  19. Hypertrophic osteoarthropathy in association with pulmonary tuberculosis: a case report; Osteoartropatia hipertrofica associada a tuberculose pulmonar: relato de caso

    Moreira, Luiza Beatriz Melo; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]. E-mail: edmarchiori@zipmail.com.br; Melo, Alessandro Severo Alves de [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Servico de Radiologia; Pinto, Ana Lucia de Araujo [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Servico de Pneumologia; Monteiro, Nicolau Pedro [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Medicina Clinica

    2002-02-01

    In this article the authors report a case of a patient with hypertrophic osteoarthropathy associated with pulmonary tuberculosis. This disorder is a rare complication of tuberculosis and may be associated with severe and fulminant disease. The imaging methods used in the diagnosis of this disease included lower limbs radiographs that showed bilateral periosteal reaction, and chest radiographs and computed tomography that revealed a mass in the upper lobe of the right lung. Although a fine needle aspiration was suggestive of tuberculosis, the definitive diagnosis was made after thoracotomy and histopathological examination of the mass. The patient presented symptomatic and radiological improvement after treatment of tuberculosis. (author)

  20. Association of Positive History of Pulmonary Tuberculosis with Female Infertility

    Babak Eshrati; Koorosh Houlakooei; Mohammad Kamali; Jafar Hassanzadeh; Fahimeh Kashfi; Farshad Pourmalek

    2007-01-01

    Background: The etiology of infertility has direct influence on the plan and outcome of its management.In this paper we showed the effect of history of tuberculosis (TB) on female infertility among infertilecouples admitted to Royan infertility management center.Material and Methods: This case control study was performed on cases that were diagnosed withfemale infertility (308 women). Controls were women whose husbands were infertile due to some malefactor (314 women). Those who had both fema...

  1. Respiratory Review of 2014: Tuberculosis and Nontuberculous Mycobacterial Pulmonary Disease

    Park, Cheol Kyu; Kwon, Yong Soo

    2014-01-01

    Since tuberculosis (TB) remains a major global health concern and the incidence of multi-drug resistant (MDR)-TB is increasing globally, new modalities for the detection of TB and drug resistant TB are needed to improve TB control. The Xpert MTB/RIF test can be a valuable new tool for early detection of TB and rifampicin resistance, with a high sensitivity and specificity. Late-generation fluoroquinolones, levofloxacin, and moxifloxacin, which are the principal drugs for the treatment of MDR-...

  2. Pulmonary Tuberculosis in a Patient with Cystic Fibrosis

    Naveen Patil; Asween Marco; Maria Theresa Montales; Nutan Bhaskar; Penchala Mittadodla; Mukasa, Leonard N.

    2015-01-01

    Context: Mycobacterium tuberculosis (MTB) infection is rarely seen in cystic fibrosis (CF) patients. Case Report: We report a 24-year-old CF patient with fever, cough, hemoptysis, and weight loss of 1week duration prior to admission. Past sputum cultures grew methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa. The patient was treated with broad spectrum antibiotics based on previous culture data, but failed to improve. Chest radiograph and computed tomography (CT) chest re...

  3. CT-Guided Transthoracic Core Biopsy for Pulmonary Tuberculosis: Diagnostic Value of the Histopathological Findings in the Specimen

    We evaluated the value of CT-guided transthoracic core biopsy for the diagnosis of mycobacterial pulmonary nodules. The 30 subjects in this study had pulmonary nodules that had been either diagnosed histopathologically as tuberculosis or were suspected as tuberculosis based on a specimen obtained by CT-guided transthoracic core biopsy. The histopathological findings, the existence of acid-fast bacilli in the biopsy specimens, and the clinical course of the patients after the biopsy were reviewed retrospectively. Two of the three histological findings for tuberculosis that included epithelioid cells, multinucleated giant cells and caseous necrosis were observed in 21 of the nodules which were therefore diagnosed as histological tuberculosis. Six of these 21 nodules were positive for acid-fast bacilli, confirming the diagnosis of tuberculosis. Thirteen of the 21 nodules did not contain acid-fast bacilli but decreased in size in response to antituberculous treatment and were therefore diagnosed as clinical tuberculosis. Seven nodules with only caseous necrosis were diagnosed as suspected tuberculosis, with a final diagnosis of tuberculosis being made in 4 of the nodules and a diagnosis of old tuberculosis in 2 nodules. Two nodules with only multinucleated giant cells were diagnosed as suspected tuberculosis with 1 of these nodules being diagnosed finally as tuberculosis and the other nodule as a nonspecific granuloma. When any two of the three following histopathological findings - epithelioid cells, multinucleated giant cells or caseous necrosis - are observed in a specimen obtained by CT-guided transthoracic core biopsy, the diagnosis of tuberculosis can be established without the detection of acid-fast bacilli or Mycobacterium tuberculosis

  4. Prevalence of national treatment algorithm defined smear positive pulmonary tuberculosis in HIV positive patients in Brazzaville, Republic of Congo

    Linguissi, Laure Stella Ghoma; Mayengue, Pembe Issamou; Sidibé, Anissa; Vouvoungui, Jeannhey C; Missontsa, Mitawa; Madzou-Laboum, Igor Kevin; Essassa, Gaston Bango; Oyakhirome, Sunny; Frank, Matthias; Penlap, Veronique; Ntoumi, Francine

    2014-01-01

    Background In the Republic in Congo, the national algorithm for the diagnosis of pulmonary tuberculosis (TB) relies on Ziehl-Neelsen (ZN) sputum smear microscopy, chest X-ray radiography (CXR) and clinical symptoms. Microscopy positive pulmonary TB (MPT+) is defined as symptoms of TB and a positive ZN smear. Microscopy negative pulmonary TB (MPT-) is defined as symptoms of TB, a negative ZN smear but CXR changes consistent with TB. The present cross-sectional study was designed to determine t...

  5. CT findings of the pulmonary tuberculosis in patients with diabetes mellitus

    Yang, Chang Kyu; Hong, Deok Hwa; Kim, Yeong Tong; Kim, Hyung Lyul; Lee, Jong Myeong; Kim, Jong Kun; Lee, So Hyun; Jeong, Gun Young [Taejon Sun General Hospital, Taejon (Korea, Republic of)

    1998-07-01

    To evaluate the CT findings of pulmonary tuberculosis in patients with diabetes mellitus (MD),according to the diabetic control state. Materials and Methods: We retrospectively studied 34 cases of pulmonary tuberculosis accompanied by DM. We divided the right lung three lobes and ten segments and the left into two lobes and eight segments and analyzed CT findings of bronchogenic spread, cavitary lesion, ill-defined nodule, lobular consolidation, lobar and segmental consolidation, atelectasis, interlobular septal thickening, fibrotic band, and associated findings such as lymph node enlargement, pleural effusion and empyema. We also tried to determine the typical CT findings of pulmonary tuberculosis according to diabetic duration and controlled state of DM focusing by FBS 160 and HbA1C 8.0. Results: Among 34 CT scans, bronchogenic spread was seen on 29 (85.3%), cavitary lesion on 26 (76.5%), ill-defined nodules on 11 (32.4%), lobular consolidation on 14 (41.2%), lobar and segmental consolidation on 12 (35.3%), atelectasis on four (14.7%), and fibrotic band on eight (23.5%). Multiple cavities were present in 76.9% of total cavitary lesions, and consolidation with bronchogenic spread in 75%; associated findings were as follows: lymph node enlargement (n=1), pleural effusion (n=10), empyema (n=2), and pericardial effusion (n=2). In 46.7% of cases, general tubercular lesions were in an unusual location, but among cases of secondary pulmonary tuberculosis, 73.9% of lesions were in the usual location. More lobular consolidation was seen in patients with less than FBS 160 on admission, and this result was statistically significant (p<0.05); CT findings did not, however, differ according to diabetic duration and HbA1C. Conclusion: In patients with DM,general fubercular lesions were found infrequently, but in secondary tubereulosis, multiple cavitary lesions-in the usual location-were very frequent. In patients with DM, CT findings of pulmonary tuberculosis did not vary

  6. CT findings of the pulmonary tuberculosis in patients with diabetes mellitus

    To evaluate the CT findings of pulmonary tuberculosis in patients with diabetes mellitus (MD),according to the diabetic control state. Materials and Methods: We retrospectively studied 34 cases of pulmonary tuberculosis accompanied by DM. We divided the right lung three lobes and ten segments and the left into two lobes and eight segments and analyzed CT findings of bronchogenic spread, cavitary lesion, ill-defined nodule, lobular consolidation, lobar and segmental consolidation, atelectasis, interlobular septal thickening, fibrotic band, and associated findings such as lymph node enlargement, pleural effusion and empyema. We also tried to determine the typical CT findings of pulmonary tuberculosis according to diabetic duration and controlled state of DM focusing by FBS 160 and HbA1C 8.0. Results: Among 34 CT scans, bronchogenic spread was seen on 29 (85.3%), cavitary lesion on 26 (76.5%), ill-defined nodules on 11 (32.4%), lobular consolidation on 14 (41.2%), lobar and segmental consolidation on 12 (35.3%), atelectasis on four (14.7%), and fibrotic band on eight (23.5%). Multiple cavities were present in 76.9% of total cavitary lesions, and consolidation with bronchogenic spread in 75%; associated findings were as follows: lymph node enlargement (n=1), pleural effusion (n=10), empyema (n=2), and pericardial effusion (n=2). In 46.7% of cases, general tubercular lesions were in an unusual location, but among cases of secondary pulmonary tuberculosis, 73.9% of lesions were in the usual location. More lobular consolidation was seen in patients with less than FBS 160 on admission, and this result was statistically significant (p<0.05); CT findings did not, however, differ according to diabetic duration and HbA1C. Conclusion: In patients with DM,general fubercular lesions were found infrequently, but in secondary tubereulosis, multiple cavitary lesions-in the usual location-were very frequent. In patients with DM, CT findings of pulmonary tuberculosis did not vary

  7. A Phase 2 Randomized Trial of a Rifapentine plus Moxifloxacin-Based Regimen for Treatment of Pulmonary Tuberculosis.

    Marcus B Conde

    Full Text Available The combination of rifapentine and moxifloxacin administered daily with other anti-tuberculosis drugs is highly active in mouse models of tuberculosis chemotherapy. The objective of this phase 2 clinical trial was to determine the bactericidal activity, safety, and tolerability of a regimen comprised of rifapentine, moxifloxacin, isoniazid, and pyrazinamide administered daily during the first 8 weeks of pulmonary tuberculosis treatment.Adults with sputum smear-positive pulmonary tuberculosis were randomized to receive either rifapentine (approximately 7.5 mg/kg plus moxifloxacin (investigational arm, or rifampin (approximately 10 mg/kg plus ethambutol (control daily for 8 weeks, along with isoniazid and pyrazinamide. The primary endpoint was sputum culture status at completion of 8 weeks of treatment.121 participants (56% of accrual target were enrolled. At completion of 8 weeks of treatment, negative cultures using Löwenstein-Jensen (LJ medium occurred in 47/60 (78% participants in the investigational arm vs. 43/51 (84%, p = 0.47 in the control arm; negative cultures using liquid medium occurred in 37/47 (79% in the investigational arm vs. 27/41 (66%, p = 0.23 in the control arm. Time to stable culture conversion was shorter for the investigational arm vs. the control arm using liquid culture medium (p = 0.03, but there was no difference using LJ medium. Median rifapentine area under the concentration-time curve (AUC0-24 was 313 mcg*h/mL, similar to recent studies of rifapentine dosed at 450-600 mg daily. Median moxifloxacin AUC0-24 was 28.0 mcg*h/mL, much lower than in trials where rifapentine was given only intermittently with moxifloxacin. The proportion of participants discontinuing assigned treatment for reasons other than microbiological ineligibility was higher in the investigational arm vs. the control arm (11/62 [18%] vs. 3/59 [5%], p = 0.04 although the proportions of grade 3 or higher adverse events were similar (5/62 [8%] in the

  8. PREVALENCE OF PULMONARY TUBERCULOSIS IN HIV POSITIVE INDIVIDUALS AND ITS ASSOCIATION WITH CD 4 COUNT

    Sudha

    2015-02-01

    Full Text Available PURPOSE: There is grave concern regarding increase in HIV associated Tuberculosis (TB and emergence of Multi Drug Resistant (MDR and Extremely Drug Resistant (XDR TB. It is essential to know prevalence of TB in HIV patients and its association with CD 4 count. MATERIAL & METHODS: A total of 362 patients were screened for Pulmonary TB of which 85 (23.48% were diagnosed as Pulmonary TB by radiology, Ziehl Neelson (ZN smear and culture. Results: It was commoner in males (28.76%, almost equal in urban (23.64% & rural (22.45% people and more frequent in laborers (34.12%. Culture was positive in 34 (40% out of 85 Pulmonary TB patients of which 33 were M. tuberculosis and one was Rapid grower. The results of the study emphasize that co - infection of TB in HIV/AIDS patients is a concern. There is direct correlation between CD 4 counts depletion and Pulmonary TB in HIV/AIDS patient. Hence, regular monitoring of these patients is warranted.

  9. Knowledge and practice regarding pulmonary tuberculosis among private practitioners

    M Basu

    2013-12-01

    Full Text Available Background: India leads the world in its burden of tuberculosis (TB. General practitioners are the backbone of health care system. Objective: To assess the knowledge and practice of the allopathic private practitioners regarding TB. Method: In June 2012– October 2012, a cross-sectional study was conducted in West Bengal, India among 180 private practitioners who treat TB patients; using a self-administered semi-structured questionnaire. Results: About 58.3 % and 56.7 % study population knew full form of RNTCP (Revised National Tuberculosis Control Program and DOTS (Directly Observed Treatment Short Course respectively. The correct modes of transmission were expressed by 75.0 % of them. The most common symptom of TB was rightly answered by 46.7 %. About 43.3 % and 33.3 % replied correctly about number of sputum samples collected and timing of collection. More than half participants knew number of categories and 8.3 % knew categorisation correctly. About 66.7 % could correctly state the names of recommended 1st line anti-TB drugs; frequency of drug administration told correctly by 68.3 %. Very few Private Practitioners (PPs knew treatment regimens correctly for each category. Almost all participants knew that treatment under DOTS was given supervised. About 78.3 % PPs expressed correctly that treatment for TB was given in two phases; the duration of treatment of 6-8 months was stated by 53.3 %. Conclusion: Many gaps were found in the knowledge and practices of PPs regarding Tuberculosis. PPs should be properly trained and sensitized to use RNTCP guidelines.

  10. Weight, body composition and handgrip strength among pulmonary tuberculosis patients

    Praygod, George; Range, Nyagosya; Faurholt-Jepsen, Daniel;

    2011-01-01

    This study aimed to estimate deficits in weight, arm fat area (AFA), arm muscle area (AMA) and handgrip strength among smear-positive pulmonary TB (PTB+) patients starting treatment. We conducted a cross-sectional study among PTB+ patients and age- and sex-matched neighborhood controls. HIV statu...

  11. Biomarkers of Oxidative Stress and Personalized Treatment of Pulmonary Tuberculosis: Emerging Role of Gamma-Glutamyltransferase

    Etienne Mokondjimobe

    2012-01-01

    Full Text Available Background. The objectives were (i to evaluate the impact of acute pulmonary tuberculosis (PTB and anti-TB therapy on the relationship between AST, ALT, and GGT levels in absence of conditions related to hepatotoxicity; (ii to evaluate the rate and the time of alterations of AST, ALT, and GGT. Design and Methods. A prospective followup of 40 adults (21 males; mean age of 34.7±5.8 years with active PTB on initial phase and continuation phase anti-TB. Results. Only 3% (n=1 developed a transient and benign ADR at day 30 without interruption of anti-TB treatment. Within normal ranges, GGT decreased significantly from day 0 to day 60, while AST and ALT increased significantly and respectively. During day 0–day 60, there was a significant, negative, and independent association between GGT and AST. Conclusion. The initial two months led to significant improvement of oxidative stress. Values of oxidative markers in normal ranges might predict low rate of ADR.

  12. Secondary renal amyloidosis in a patient of pulmonary tuberculosis and common variable immunodeficiency

    Balwani Manish R

    2015-04-01

    Full Text Available Common variable immunodeficiency (CVID usually manifests in the second or third decade of life with recurrent bacterial infections and hypoglobulinemia. Secondary renal amyloidosis with history of pulmonary tuberculosis is rare in CVID, although T cell dysfunction has been reported in few CVID patients. A 40-year-old male was admitted to our hospital with a 3-month history of recurrent respiratory infections and persistent pitting pedal edema. His past history revealed 3 to 5 episodes of recurrent respiratory tract infections and diarrhoea each year since last 20 years. He had been successfully treated for sputum positive pulmonary tuberculosis 8 years back. Laboratory studies disclosed high erythrocyte sedimentation rate (ESR, hypoalbuminemia and nephrotic range proteinuria. Serum immunoglobulin levels were low. CD4/CD8 ratio and CD3 level was normal. C3 and C4 complement levels were normal. Biopsy revealed amyloid A (AA positive secondary renal amyloidosis. Glomeruli showed variable widening of mesangial regions with deposition of periodic schiff stain (PAS pale positive of pink matrix showing apple green birefringence on Congo-red staining. Immunohistochemistry was AA stain positive. Immunofluorescence microscopy revealed no staining with anti-human IgG, IgM, IgA, C3, C1q, kappa and lambda light chains antisera. Patient was treated symptomatically for respiratory tract infection and was discharged with low dose angiotensin receptor blocker. An old treated tuberculosis and chronic inflammation due to recurrent respiratory tract infections were thought to be responsible for AA amyloidosis. Thus pulmonary tuberculosis should be considered in differential diagnosis of secondary causes of AA renal amyloidosis in patients of CVID especially in endemic settings.

  13. Co-endemicity of Pulmonary Tuberculosis and Intestinal Helminth Infection in the People's Republic of China.

    Xin-Xu Li

    2016-03-01

    Full Text Available Both pulmonary tuberculosis (PTB and intestinal helminth infection (IHI affect millions of individuals every year in China. However, the national-scale estimation of prevalence predictors and prevalence maps for these diseases, as well as co-endemic relative risk (RR maps of both diseases' prevalence are not well developed. There are co-endemic, high prevalence areas of both diseases, whose delimitation is essential for devising effective control strategies. Bayesian geostatistical logistic regression models including socio-economic, climatic, geographical and environmental predictors were fitted separately for active PTB and IHI based on data from the national surveys for PTB and major human parasitic diseases that were completed in 2010 and 2004, respectively. Prevalence maps and co-endemic RR maps were constructed for both diseases by means of Bayesian Kriging model and Bayesian shared component model capable of appraising the fraction of variance of spatial RRs shared by both diseases, and those specific for each one, under an assumption that there are unobserved covariates common to both diseases. Our results indicate that gross domestic product (GDP per capita had a negative association, while rural regions, the arid and polar zones and elevation had positive association with active PTB prevalence; for the IHI prevalence, GDP per capita and distance to water bodies had a negative association, the equatorial and warm zones and the normalized difference vegetation index had a positive association. Moderate to high prevalence of active PTB and low prevalence of IHI were predicted in western regions, low to moderate prevalence of active PTB and low prevalence of IHI were predicted in north-central regions and the southeast coastal regions, and moderate to high prevalence of active PTB and high prevalence of IHI were predicted in the south-western regions. Thus, co-endemic areas of active PTB and IHI were located in the south-western regions of

  14. Co-endemicity of Pulmonary Tuberculosis and Intestinal Helminth Infection in the People's Republic of China.

    Li, Xin-Xu; Ren, Zhou-Peng; Wang, Li-Xia; Zhang, Hui; Jiang, Shi-Wen; Chen, Jia-Xu; Wang, Jin-Feng; Zhou, Xiao-Nong

    2016-03-01

    Both pulmonary tuberculosis (PTB) and intestinal helminth infection (IHI) affect millions of individuals every year in China. However, the national-scale estimation of prevalence predictors and prevalence maps for these diseases, as well as co-endemic relative risk (RR) maps of both diseases' prevalence are not well developed. There are co-endemic, high prevalence areas of both diseases, whose delimitation is essential for devising effective control strategies. Bayesian geostatistical logistic regression models including socio-economic, climatic, geographical and environmental predictors were fitted separately for active PTB and IHI based on data from the national surveys for PTB and major human parasitic diseases that were completed in 2010 and 2004, respectively. Prevalence maps and co-endemic RR maps were constructed for both diseases by means of Bayesian Kriging model and Bayesian shared component model capable of appraising the fraction of variance of spatial RRs shared by both diseases, and those specific for each one, under an assumption that there are unobserved covariates common to both diseases. Our results indicate that gross domestic product (GDP) per capita had a negative association, while rural regions, the arid and polar zones and elevation had positive association with active PTB prevalence; for the IHI prevalence, GDP per capita and distance to water bodies had a negative association, the equatorial and warm zones and the normalized difference vegetation index had a positive association. Moderate to high prevalence of active PTB and low prevalence of IHI were predicted in western regions, low to moderate prevalence of active PTB and low prevalence of IHI were predicted in north-central regions and the southeast coastal regions, and moderate to high prevalence of active PTB and high prevalence of IHI were predicted in the south-western regions. Thus, co-endemic areas of active PTB and IHI were located in the south-western regions of China, which

  15. Mannose-binding lectin promoter polymorphisms and gene variants in pulmonary tuberculosis patients from cantabria (northern Spain).

    Ocejo-Vinyals, J-Gonzalo; Lavín-Alconero, Lucía; Sánchez-Velasco, Pablo; Guerrero-Alonso, M-Ángeles; Ausín, Fernando; Fariñas, M-Carmen; Leyva-Cobián, Francisco

    2012-01-01

    Mannose-binding lectin is a central molecule of the innate immune system. Mannose-binding lectin 2 promoter polymorphisms and structural variants have been associated with susceptibility to tuberculosis. However, contradictory results among different populations have been reported, resulting in no convincing evidence of association between mannose-binding lectin 2 and susceptibility to tuberculosis. For this reason, we conducted a study in a well genetically conserved Spanish population in order to shed light on this controversial association. We analysed the six promoter and structural mannose-binding lectin 2 gene variants in 107 patients with pulmonary tuberculosis and 441 healthy controls. Only D variant and HYPD haplotype were significantly more frequents in controls which would indicate that this allele could confer protection against pulmonary tuberculosis, but this difference disappeared after statistical correction. Neither the rest of alleles nor the haplotypes were significantly associated with the disease. These results would indicate that mannose-binding lectin promoter polymorphisms and gene variants would not be associated with an increased risk to pulmonary tuberculosis. Despite the slight trend of the D allele and HYPD haplotype in conferring protection against pulmonary tuberculosis, susceptibility to this disease would probably be due to other genetic factors, at least in our population. PMID:23304495

  16. Mannose-Binding Lectin Promoter Polymorphisms and Gene Variants in Pulmonary Tuberculosis Patients from Cantabria (Northern Spain

    J.-Gonzalo Ocejo-Vinyals

    2012-01-01

    Full Text Available Mannose-binding lectin is a central molecule of the innate immune system. Mannose-binding lectin 2 promoter polymorphisms and structural variants have been associated with susceptibility to tuberculosis. However, contradictory results among different populations have been reported, resulting in no convincing evidence of association between mannose-binding lectin 2 and susceptibility to tuberculosis. For this reason, we conducted a study in a well genetically conserved Spanish population in order to shed light on this controversial association. We analysed the six promoter and structural mannose-binding lectin 2 gene variants in 107 patients with pulmonary tuberculosis and 441 healthy controls. Only D variant and HYPD haplotype were significantly more frequents in controls which would indicate that this allele could confer protection against pulmonary tuberculosis, but this difference disappeared after statistical correction. Neither the rest of alleles nor the haplotypes were significantly associated with the disease. These results would indicate that mannose-binding lectin promoter polymorphisms and gene variants would not be associated with an increased risk to pulmonary tuberculosis. Despite the slight trend of the D allele and HYPD haplotype in conferring protection against pulmonary tuberculosis, susceptibility to this disease would probably be due to other genetic factors, at least in our population.

  17. Pulmonary tuberculosis and delay in anti-tuberculous treatment are important risk factors for chronic obstructive pulmonary disease.

    Chih-Hsin Lee

    Full Text Available OBJECTIVE: Tuberculosis (TB remains the leading cause of death among infectious diseases worldwide. It has been suggested as an important risk factor of chronic obstructive pulmonary disease (COPD, which is also a major cause of morbidity and mortality. This study investigated the impact of pulmonary TB and anti-TB treatment on the risk of developing COPD. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used the National Health Insurance Database of Taiwan, particularly the Longitudinal Health Insurance Database 2005 to obtain 3,176 pulmonary TB cases and 15,880 control subjects matched in age, sex, and timing of entering the database. MAIN OUTCOME MEASURES: Hazard ratios of potential risk factors of COPD, especially pulmonary TB and anti-TB treatment. RESULTS: The mean age of pulmonary TB cases was 51.9±19.2. The interval between the initial study date and commencement of anti-TB treatment (delay in anti-TB treatment was 75.8±65.4 days. Independent risk factors for developing COPD were age, male, low income, and history of pulmonary TB (hazard ratio 2.054 [1.768-2.387], while diabetes mellitus was protective. The impact of TB persisted for six years after TB diagnosis and was significant in women and subjects aged >70 years. Among TB patients, delay in anti-TB treatment had a dose-response relationship with the risk of developing COPD. CONCLUSIONS: Some cases of COPD may be preventable by controlling the TB epidemic, early TB diagnosis, and prompt initiation of appropriate anti-TB treatment. Follow-up care and early intervention for COPD may be necessary for treated TB patients.

  18. Cytokine and Antibody Based Diagnostic Algorithms for Sputum Culture-Positive Pulmonary Tuberculosis.

    Tao Chen

    Full Text Available Tuberculosis (TB is one of the most serious infectious diseases globally and has high mortality rates. A variety of diagnostic tests are available, yet none are wholly reliable. Serum cytokines, although significantly and frequently induced by different diseases and thus good biomarkers for disease diagnosis and prognosis, are not sufficiently disease-specific. TB-specific antibody detection, on the other hand, has been reported to be highly specific but not sufficiently sensitive. In this study, our aim was to improve the sensitivity and specificity of TB diagnosis by combining detection of TB-related cytokines and TB-specific antibodies in peripheral blood samples.TB-related serum cytokines were screened using a human cytokine array. TB-related cytokines and TB-specific antibodies were detected in parallel with microarray technology. The diagnostic performance of the new protocol for active TB was systematically compared with other traditional methods.Here, we show that cytokines I-309, IL-8 and MIG are capable of distinguishing patients with active TB from healthy controls, patients with latent TB infection, and those with a range of other pulmonary diseases, and that these cytokines, and their presence alongside antibodies for TB-specific antigens Ag14-16kDa, Ag32kDa, Ag38kDa and Ag85B, are specific markers for active TB. The diagnostic protocol for active TB developed here, which combines the detection of three TB-related cytokines and TB-specific antibodies, is highly sensitive (91.03%, specific (90.77% and accurate (90.87%.Our results show that combining detection of TB-related cytokines and TB-specific antibodies significantly enhances diagnostic accuracy for active TB, providing greater accuracy than conventional diagnostic methods such as interferon gamma release assays (IGRAs, TB antibody Colloidal Gold Assays and microbiological culture, and suggest that this diagnostic protocol has potential for clinical application.

  19. Frequency of sputum positive AFB cases among patients of pulmonary tuberculosis in tertiary care hospitals of northern Pakistan

    Objective: This study was aimed to find out the frequency of sputum positive Acid Fast Bacilli (AFB) cases among pulmonary tuberculosis patients and to determine those patients who are the potential source of transmitting infection. Methods: This study was conducted in four medical units of Khyber Teaching Hospital, Peshawar and Chest Unit, Ayub Teaching Hospital, Abbottabad in collaboration with the pathology unit of Khyber Teaching Hospital, Peshawar, and Kohat Institute of Medical Sciences, Kohat. Three specimens of sputum were collected for three consecutive days in the morning and were transported immediately to the laboratory along with full details of the patients. Results: Out of two hundred total patients studied, 104 patients (52%) were sputum AFB positive. Among the 104 patients 60 patients (57.4%) were females. Sixty-four (61.52%) individuals were between 20-50 years. Majority of the patients were from poor, deprived and lower social class. Fifty-two (50%) patients had monthly income of less than Rs. 4,000; only 8 patients (7.67%) had monthly income of more than Rs. 12,000). Forty-eight patients <46.12% were house wives, 10 patients (9.61%) were unemployed. Most of the patients were under weight for their age and height. 24 patients (23.06%) were below 42 kg. The maximum (53.84%) number of patients was in weight range of 43-50 kg. Conclusion: Sputum AFB positive pulmonary tuberculosis is more in individuals of low socioeconomic group and in females. The patients put their children and family members at risk of tuberculosis infection. For the control of this disease early diagnosis of active disease and their treatment under supervision is important. (author)

  20. Effect of Yogic Breathing Techniques in New Sputum Positive Pulmonary Tuberculosis

    A Mooventhan

    2014-01-01

    Full Text Available A 24-year-old, unmarried woman diagnosed of pulmonary tuberculosis (PTB visited our hospital out-patient department in the month of August-2013. Patient came with the complaint of sever cough with expectoration; evening raise of temperature; gradual loss of appetite and weight since 2-weeks. We referred the patient to our hospital′s Revised National Tuberculosis Program, direct observed treatment short-course center for sputum fluorescence microscopic examination (FME. FME report suggested the new smear positive, 2+ PTB. Our patient received yogic breathing techniques (YBT for 45-min daily under the supervision for three alternate-days/week with anti-tuberculosis treatment (ATT for the period of 8-weeks. After intervention our result showed better improvement in weight gain, body mass index, symptom scores, pulmonary function and health related quality of life with conversion of positive to negative FME for acid fast bacilli. It suggests YBT with ATT are effective in treating PTB and further studies required to warrant this effect.

  1. Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study

    Kritski Afrânio

    2006-02-01

    Full Text Available Abstract Background Smear negative pulmonary tuberculosis (SNPT accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. Methods The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs and chest X-rays were used for constructing logistic regression and classification and regression tree models. From the logistic regression, we generated a clinical and radiological prediction score. The area under the receiver operator characteristic curve, sensitivity, and specificity were used to evaluate the model's performance in both generation and validation samples. Results It was possible to generate predictive models for SNPT with sensitivity ranging from 64% to 71% and specificity ranging from 58% to 76%. Conclusion The results suggest that those models might be useful as screening tools for estimating the risk of SNPT, optimizing the utilization of more expensive tests, and avoiding costs of unnecessary anti-tuberculosis treatment. Those models might be cost-effective tools in a health care network with hierarchical distribution of scarce resources.

  2. Correlation of immunologic status with high-resolution CT and distributions of pulmonary tuberculosis

    Purpose: To investigate the correlation of cluster of differentiation (CD)4 lymphocyte counts with high-resolution CT (HRCT) findings and distribution of pulmonary tuberculosis. Material and Methods: Thirty-seven bacteriologically proven pulmonary tuberculosis, clinically non-AIDS, patients underwent HRCT and CD4 lymphocyte counts in peripheral blood cells were obtained within 3 days after the CT examinations. Patients were categorized into four groups according to CD4 lymphocyte counts (A >800; B 800-500; C 500-200; D <200). HRCT findings analyzed were as follows: typical, atypical, and mixed findings of post-primary tuberculosis, common, uncommon, and mixed distribution, and number of lobes involved. Results: CD4 lymphocyte counts correlated with the degree of the mixture of atypical CT findings (=0.565, p<0.001) and the degree of the mixture of uncommon distribution (=0.431, p<0.01). Number of involved lobes showed no statistically significant correlation (=0.209, p=0.21). Conclusion: In patients with low CD4 levels, atypical HRCT findings co-exist with typical findings, and uncommon sites are involved in addition to common sites

  3. Consultations of health service providers amongst patients of pulmonary tuberculosis from an urban area

    Geeta S. Pardeshi

    2008-11-01

    Full Text Available Aims: To describe the number, types and reasons of consultations amongst patients of pulmonary tuberculosis from an urban area. Settings and Design Cross sectional study was conducted amongst new patients of pulmonary tuberculosis initiated on DOTS at District Tuberculosis Centre (DTC, Yavatmal from January to June 2006. Material and Methods: The data regarding consultations were collected along a time line. The reasons for consultations were studied by in-depth interviews. Statistical analysis: Logistic regression analysis and transcripts of interviews. Results and Conclusions A total of 55 patients were studied in whom median duration between first consultation to treatment initiation was 15 days. A majority of cases (87.27% had first consulted a private practitioner. A total of 32 patients reported more than two consultations and 19 had consulted more than two private health service providers. Amongst the movements between consultations, a majority were from private to government. Only four patients had come to DTC without any prior consultation. Many patients came to government health service provider on their own when the symptomatic treatment prescribed by the private practitioners did not relieve their symptoms.

  4. Prevalence of Pulmonary Tuberculosis among Prison Inmates in Ethiopia, a Cross-Sectional Study

    Ali, Solomon; Haileamlak, Abraham; Wieser, Andreas; Pritsch, Michael; Heinrich, Norbert; Loscher, Thomas; Hoelscher, Michael; Rachow, Andrea

    2015-01-01

    Setting Tuberculosis (TB) is one of the major health problems in prisons. Objective This study was done to assess the prevalence and determinants of active tuberculosis in Ethiopian prisons. Design A cross-sectional study was conducted from January 2013 to December 2013 in 13 zonal prisons. All incarcerated inmates underwent TB symptom screening according to WHO criteria. From identified TB-suspects two sputum samples were analyzed using smear microscopy and solid culture. A standardized ques...

  5. Active case finding of tuberculosis in Europe: a Tuberculosis Network European Trials Group (TBNET) survey

    Bothamley, G.H.; Ditiu, L.; Migliori, G.B.;

    2008-01-01

    Tuberculosis control depends on successful case finding and treatment of individuals infected with Mycobacterium tuberculosis. Passive case finding is widely practised: the present study aims to ascertain the consensus and possible improvements in active case finding across Europe. Recommendations...... from national guidelines were collected from 50 countries of the World Health Organization European region using a standard questionnaire. Contacts are universally screened for active tuberculosis and latent tuberculosis infection (LTBI). Most countries (>70%) screen those with HIV infection, prisoners...... and in-patient contacts. Screening of immigrants is related to their contribution to national rates of tuberculosis. Only 25 (50%) out of 50 advise a request for symptoms in their guidelines. A total of 36 (72%) out of 50 countries recommend sputum examination for those with a persistent cough; 13...

  6. Radioiodinated DPA-713 imaging correlates with bactericidal activity of tuberculosis treatments in mice.

    Ordonez, Alvaro A; Pokkali, Supriya; DeMarco, Vincent P; Klunk, Mariah; Mease, Ronnie C; Foss, Catherine A; Pomper, Martin G; Jain, Sanjay K

    2015-01-01

    Current tools for monitoring response to tuberculosis treatments have several limitations. Noninvasive biomarkers could accelerate tuberculosis drug development and clinical studies, but to date little progress has been made in developing new imaging technologies for this application. In this study, we developed pulmonary single-photon emission computed tomography (SPECT) using radioiodinated DPA-713 to serially monitor the activity of tuberculosis treatments in live mice, which develop necrotic granulomas and cavitary lesions. C3HeB/FeJ mice were aerosol infected with Mycobacterium tuberculosis and administered either a standard or a highly active bedaquiline-containing drug regimen. Serial (125)I-DPA-713 SPECT imaging was compared with (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and standard microbiology. Ex vivo studies were performed to characterize and correlate DPA-713 imaging with cellular and cytokine responses. Pulmonary (125)I-DPA-713 SPECT, but not (18)F-FDG PET, was able to correctly identify the bactericidal activities of the two tuberculosis treatments as early as 4 weeks after the start of treatment (P < 0.03). DPA-713 readily penetrated the fibrotic rims of necrotic and cavitary lesions. A time-dependent decrease in both tumor necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) levels was observed with treatments, with (125)I-DPA-713 SPECT correlating best with tissue TNF-α levels (ρ = 0.94; P < 0.01). (124)I-DPA-713 was also evaluated as a PET probe and demonstrated a 4.0-fold-higher signal intensity in the infected tuberculous lesions than uninfected controls (P = 0.03). These studies provide proof of concept for application of a novel noninvasive imaging biomarker to monitor tuberculosis treatments, with the potential for application for humans. PMID:25403669

  7. Clinical manifestations and image analysis of senile pulmonary tuberculosis%老年性肺结核的临床表现与影像分析

    胡宗泉; 黎尚诗

    2015-01-01

    目的探讨老年性肺结核临床表现与影像特征。方法回顾性分析2008—2013年280例老年性肺结核好发部位、临床表现特点及影像学特征。结果280例继发性肺结核合并慢性支气管炎肺气肿168例,单发或多发肺大泡78例;右肺结核98例,左肺结核114例,双上肺结核46例,中下肺发病22例;单纯斑片状磨玻璃样渗出影55例,渗出影、增殖性结节合并纤维化索状影113例,颗粒状播散灶32例,空洞29例,钙化18例,胸部CT显示树芽征33例。结论渗出性病灶、树芽征、厚壁空洞伴周围炎是活动性肺结核的征象,增殖性病灶是非活动性肺结核的征象,颗粒状结节是继发性肺结核支气管播散的特点,钙化是肺结核好转和稳定的影像表现。%Objective Clinical manifestations and imaging features of senile pulmonary tuberculosis are dis-cussed. Methods From 2008 to 2013, 280 cases of senile pulmonary tuberculosis good location, clinical features and imaging characteristics were retrospectively analyzed. Results Two hundred and eighty cases with secondary pul-monary tuberculosis, 168 cases of chronic bronchitis, emphysema, single or multiple pulmonary bullae 78 cases; Right pulmonary tuberculosis in 98 cases, left 114 cases of tuberculosis, double the 46 cases of pulmonary tuberculosis, the middle and lower lung disease 22 cases; Simple patchy ground glass sample effusion shadows 55 cases, seepage, in-cremental nodal merger in 113 cases of fibrosis funicular shade, granular spread focal 32 cases, empty 29 cases, 18 cases calcification, tree-in-bud chest CT shows 33 cases. Conclusion Tree-in-bud exudative lesions, and thick wall around the hole with inflammation is a sign of active tuberculosis, hyperplastic lesions is a sign of active tuberculosis, granular nodules is secondary characteristics of endobronchial spread of tuberculosis, calcification is tuberculosis im-proved performance and stability of the

  8. Prediction of delayed treatment response in pulmonary tuberculosis: use of time to positivity values of Bactec cultures.

    Carroll, N M; Uys, P; Hesseling, A; Lawrence, K; Pheiffer, C; Salker, F; Duncan, K; Beyers, N; van Helden, P D

    2008-11-01

    New drugs that can shorten tuberculosis (TB) treatment and target drug resistant strains are urgently needed. A test which could predict patients at risk of a delayed response to treatment would facilitate clinical trials of new anti-tuberculosis drugs. A widely-used test for the assessment of response to treatment is sputum smear examination. Patients who are smear positive after 2 and 3 months of treatment are said to have delayed and significantly delayed treatment responses respectively. Time to positivity (TTP) values of Bactec cultures, from the first 2 weeks of treatment were used to predict delayed and significantly delayed treatment responses in patients with first time pulmonary tuberculosis. Changes in TTP values early in treatment were transformed to a response ratio (r). Values of r that were less than a threshold value (r(c)) indicated patients who were at risk of having delayed or significantly delayed response to treatment. Accuracy of prediction was sensitive to the timing of sputum sampling and adherence to therapy in the first 2 weeks. Based on TTP data from the first 2 weeks of treatment, significantly delayed treatment response could be predicted with a sensitivity of 75% and a specificity of 62% while the positive (PPV) and negative predictive values (NPV) were 14% and 97% respectively. While the high NPV indicates that a large proportion of patients with a satisfactory response to treatment can be reliably identified, the low PPV value underlines the need to use TTP in conjunction with other markers of disease activity to predict unfavourable treatment response in tuberculosis treatment. PMID:18456556

  9. Epidemiological aspects of pulmonary tuberculosis in Mato Grosso do Sul, Brazil

    Antonio Flavio Ferraz

    2014-03-01

    Full Text Available OBJECTIVE: To describe the profile and analyze the cases of pulmonary tuberculosis reported in the state of Mato Grosso do Sul from 2001 to 2009, according to the chosen variable categories (gender, age, ethnicity, education, residing in the border area, indigenous population and individuals deprived of liberty. METHODS: An ecological study was conducted from data of reported cases of TB. RESULTS: Estimates of risk higher than the general population, and even extremely high, were obtained in three specific populations, which certainly requires priority attention from health policies and health network professionals to keep the transmission of tuberculosis under control, including in the population residing in the borders with Bolivia and Paraguay, the indigenous population and individuals deprived of liberty. CONCLUSIONS: This study sought to show the importance of discussing territoriality more adequately in Brazil. A continuous reevaluation of all health programs is needed for populations in each of the areas where they live. Then, it will be possible to correct the incidence rate of tuberculosis for specific populations in the state, taking into account populations in each place of residence and considering their specificities and differences. In conclusion, in the light of the present study, it is necessary to discuss more efficient strategies to control tuberculosis in the various territories of the state of Mato Grosso do Sul if we actually want to minimize this endemic to acceptable levels in our environment.

  10. Rare congenital hearth disease as a cause of tuberculosis activation

    Radović Milan

    2010-01-01

    Full Text Available Introduction. Patients with congenital cyanotic heart defects and the left-to-right shunt are at a three times higher risk of getting tuberculosis than acyanotic ones. No TB cases have been recorded in adult patients with the right-to-left shunt having cyanosis since their birth. Case report. A 34-year-old man was referred to our Clinic with the discomforts such as chronic cough, hemoptysis and insomnia. At the admission he was pale, cyanotic, with a partial manifest respiratory insufficiency and characteristic TB pulmonary lesions detected by x-rays and tomography. After the sputum positive TB recidivism had been diagnosed, the antituberculotics treatment was introduced resulting in the successful smear and culture conversion and radiological regression of pulmonary lesions, but associated with non-explicable deterioration of cyanosis and chronic respiratory insufficiency until Doppler-echocardiographic examination verified the presence of tetralogy of Fallot. Conclusion. Congenital cyanotic heart defects are extremely rare in adults. Nevertheless, it is necessary to maintain a very high level of clinical suspicion regarding TB activation even in the cases of defects with the right-to-left shunt.

  11. Significance of measurement of serum fibrosis markers (HA, LN, P III P, IV C) in patients with pulmonary tuberculosis

    Objective: To study the clinical significance of determination of serum fibrosis markers in patients with pulmonary tuberculosis. Methods: Serum hyaluronic acid (HA), laminin (LN), procollagen III peptide (P III P) and Type IV collagen (IV C) contents were determined with RIA in 128 patients with pulmonary tuberculosis both before and after treatment as well as in 40 controls. Results: Before treatment, the serum contents of the four markers in the patients were significantly higher than those in the controls (P0.05). Decreases of the levels in treatment failures were not significant and the levels remained significantly higher than those in controls (P<0.01 or P<0.05). Conclusion: Determination of serum fibrosis markers levels in patients with pulmonary tuberculosis is valuable for early diagnosis as well as for evaluation of the effect of chemotherapy. (authors)

  12. Nontuberculous mycobacteria in respiratory samples from patients with pulmonary tuberculosis in the state of Rondonia, Brazil

    Cleoni Alves Mendes de Lima

    2013-06-01

    Full Text Available The main cause of pulmonary tuberculosis (TB is infection with Mycobacterium tuberculosis (MTB. We aimed to evaluate the contribution of nontuberculous mycobacteria (NTM to pulmonary disease in patients from the state of Rondônia using respiratory samples and epidemiological data from TB cases. Mycobacterium isolates were identified using a combination of conventional tests, polymerase chain reaction-based restriction enzyme analysis of hsp65 gene and hsp65 gene sequencing. Among the 1,812 cases suspected of having pulmonary TB, 444 yielded bacterial cultures, including 369 cases positive for MTB and 75 cases positive for NTM. Within the latter group, 14 species were identified as Mycobacterium abscessus, Mycobacterium avium, Mycobacterium fortuitum, Mycobacterium intracellulare, Mycobacterium gilvum, Mycobacterium gordonae, Mycobacterium asiaticum, Mycobacterium tusciae, Mycobacterium porcinum, Mycobacterium novocastrense, Mycobacterium simiae, Mycobacterium szulgai, Mycobacterium phlei and Mycobacterium holsaticum and 13 isolates could not be identified at the species level. The majority of NTM cases were observed in Porto Velho and the relative frequency of NTM compared with MTB was highest in Ji-Paraná. In approximately half of the TB subjects with NTM, a second sample containing NTM was obtained, confirming this as the disease-causing agent. The most frequently observed NTM species were M. abscessus and M. avium and because the former species is resistant to many antibiotics and displays unsatisfactory cure rates, the implementation of rapid identification of mycobacterium species is of considerable importance.

  13. Assessment of knowledge and attitude towards pulmonary tuberculosis in undergraduate nursing students of Applied University in Greece.

    Vassilopoulos A.; Roupa Z.; Wozniak G.; Rekliti M.; Tsaras K.; Papathanasiou I.; Gourgoulianis K

    2010-01-01

    Background: Tuberculosis constitutes a diachronic problem of Public Health that in the past years received bigger epidemic dimensions, stirring interesting many researchers in all levels. Aim: The aim of our study was to assess the knowledge and attitude of students of Nursing departments in Applied University in Greece, towards the transmission and the prevention of pulmonary tuberculosis. Materials and Methods: The sample consisted of 275 students (12.1% male και 87,9% female) of Nursing De...

  14. Evaluation of an In-House-Developed Radioassay Kit for Antibody Detection in Cases of Pulmonary Tuberculosis and Tuberculous Meningitis

    Kameswaran, M.; Shetty, K.; Ray, M. K.; Jaleel, M. A.; Kadival, G. V.

    2002-01-01

    A radioassay for the detection of antitubercular antibody has been developed. The technique involves the addition of 125I-labeled Mycobacterium tuberculosis antigen as a tracer, diluted clinical sample (serum or cerebrospinal fluid [CSF]), and heat-inactivated Staphylococcus aureus to capture the antibody, incubation for 4 h, and quantitation of the amount of antibody present in the sample. A total of 330 serum samples from patients with pulmonary tuberculosis and 138 control serum samples fr...

  15. The Assessment of Socio-Economic inequalities in Extra-Pulmonary Tuberculosis Patients undergoing DOTS Therapy in Chitradurga Region

    SHASHANK S HOSUR; ABUBAKER SIDDIQ; MOULYA M V; NATARAJ G R; BHARATHI D R

    2014-01-01

    India is highest tuberculosis (TB) burden country globally, accounting for more than one-fifth of the global incidence. The impact of TB on individuals is often all encompassing, affecting not only physical health, but also social, economic, and psychological well-being. The aim of our study was to assess the socio-economic inequalities of the patients having Extra-pulmonary Tuberculosis (EPTB) in Chitradurga region. The ambispective analysis was carried out, by collecting the data of one yea...

  16. The Role of Video-Assisted Thoracoscopic Therapeutic Resection for Medically Failed Pulmonary Tuberculosis

    Tseng, Yau-Lin; Chang, Jia-Ming; Liu, Yi-Sheng; Cheng, Lili; Chen, Ying-Yuan; Wu, Ming-Ho; Lu, Chung-Lan; Yen, Yi-Ting

    2016-01-01

    Abstract There are few reports regarding video-assisted thoracoscopic therapeutic resection for medically failed pulmonary tuberculosis (TB). We reviewed our surgical results of video-assisted thoracoscopic surgery (VATS) therapeutic resection for pulmonary TB with medical failure, and its correlation with image characteristics on chest computed tomography (CT) scan. Between January 2007 and December 2012, among the 203 patients who had surgery for TB, the medical records of 89 patients undergoing therapeutic resection for medically failed pulmonary TB were reviewed. Clinical information and the image characteristics of CT scan were investigated and analyzed. Forty-six of the 89 patients undergoing successful VATS therapeutic resection had significantly lower grading in pleural thickening (P the 38 patients with multi-drug resistant pulmonary tuberculosis (MDRTB) who successfully underwent VATS had significantly lower grading in pleural thickening (P = 0.001), peribronchial lymph node calcification (P = 0.019), and cavity (P = 0.017). They were preoperatively medicated for a shorter period of time (221.6 ± 90.8 vs 596.1 ± 432.5 days; P = 0.001), and had more sublobar resection (44.4% vs 10%), less blood loss (165.3 ± 148.3 vs 468.0 ± 439.9 mL; P = 0.009), and shorter hospital stay (5.4 ± 2.6 vs 11.8 ± 6.9 days; P = 0.001). Without multiple cavities, peribronchial lymph node calcification, and extensive pleural thickening, VATS therapeutic resection could be safely performed in selected patients with medically failed pulmonary TB as an effective adjunct with satisfactory results. PMID:27149451

  17. Effectiveness of embolization for management of hemoptysis pulmonary tuberculosis: comparison of chest radiographic study and angiography

    To compare the effectiveness of embolization of the bronchial artery embolization for the management of hemoptysis in pulmonary tuberculosis cases with the severity of lung parenchymal injury and pleural infiltration, as seen on plain chest radiographs, and with the findings of angiography of the branchial artery. Among 265 patients with hemoptysis due to pulmonary tuberculosis, the findings of plain chest radiography and angiography of the bronchial artery were comparatively analyzed in the 206 for whom the results of follow up were available. The chest radiographin findings were classified as follows: Type I refers to simple pulmonary tuberculosis; Type II includes cases in which pulmonary tuberculosis is complicated by bronchiectasis, aspergillosis, or cavitation; Type III si either Types I or II acompainted by pleural in filtrates limited to the lung apex, and Type IV includes cases in which pleural infiltrates have extended beyond the apex in the whole the lung. Bronchial angiographic findings were divided into four groups: Group I consists of cases which show abnormalities of only the bronchial artery; Group II includes those in which abnormalities are seen in the bronchial artery and either the internal mammary or an intercostal artery; Group III comprises cases which belong to Group I or II and which a bronch of the subclavian artery is abnormal, and Group IV includes those in which abnormalities occur in at least two branches of the subclavian artery, or there is direct visualization of hypervascularity of this vessel. The initial post-embolic hemostatic effect and the results of follow up were studied over a six-month period. As compared with simple pulmonary tuberculosis (Type I), we found that as the severity of pleural infiltration and complications revealed by plain chest radiographs increased (Type II, III, IV), so did the severity of the manifestation of systemic collateral arteries other than the bronchial artery, as depicted by increased on

  18. IS6110 restriction fragment length polymorphism of Mycobacterium tuberculosis isolated from patients with pulmonary tuberculosis in Campinas, Brazil: evidence of intercontinental distribution of strains

    Ana Lucia Roscani Calusni

    2003-07-01

    Full Text Available Tuberculosis (TB is a major concern in developing countries. In Brazil, few genotyping studies have been conducted to verify the number of IS6110 copies present in local prevalent strains of Mycobacterium tuberculosis, the distribution and clustering of strains. IS6110 DNA fingerprinting was performed on a sample of M. tuberculosis isolates from patients with AFB smear-positive pulmonary TB, at a hospital in Brazil. The IS6110 profiles were analyzed and compared to a M. tuberculosis database of the Houston Tuberculosis Initiative, Houston, US. Seventy-six fingerprints were obtained from 98 patients. All M. tuberculosis strains had an IS6110 copy number between 5-21 allowing for differentiation of the isolates. Human immunodeficiency virus infection was confirmed in nearly half the patients of whom data was available. Fifty-eight strains had unique patterns, while 17 strains were grouped in 7 clusters (2 to 6 strains. When compared to the HTI database, 6 strains matched isolates from El Paso, Ciudad de Juarez, Houston, and New York. Recently acquired infections were documented in 19% of cases. The community transmission of infection is intense, since some clustered strains were recovered during the four-year study period. The intercontinental dissemination of M. tuberculosis strains is suspected by demonstration of identical fingerprints in a distant country.

  19. Nearest patch matching for color image segmentation supporting neural network classification in pulmonary tuberculosis identification

    Rulaningtyas, Riries; Suksmono, Andriyan B.; Mengko, Tati L. R.; Saptawati, Putri

    2016-03-01

    Pulmonary tuberculosis is a deadly infectious disease which occurs in many countries in Asia and Africa. In Indonesia, many people with tuberculosis disease are examined in the community health center. Examination of pulmonary tuberculosis is done through sputum smear with Ziehl - Neelsen staining using conventional light microscope. The results of Ziehl - Neelsen staining will give effect to the appearance of tuberculosis (TB) bacteria in red color and sputum background in blue color. The first examination is to detect the presence of TB bacteria from its color, then from the morphology of the TB bacteria itself. The results of Ziehl - Neelsen staining in sputum smear give the complex color images, so that the clinicians have difficulty when doing slide examination manually because it is time consuming and needs highly training to detect the presence of TB bacteria accurately. The clinicians have heavy workload to examine many sputum smear slides from the patients. To assist the clinicians when reading the sputum smear slide, this research built computer aided diagnose with color image segmentation, feature extraction, and classification method. This research used K-means clustering with patch technique to segment digital sputum smear images which separated the TB bacteria images from the background images. This segmentation method gave the good accuracy 97.68%. Then, feature extraction based on geometrical shape of TB bacteria was applied to this research. The last step, this research used neural network with back propagation method to classify TB bacteria and non TB bacteria images in sputum slides. The classification result of neural network back propagation are learning time (42.69±0.02) second, the number of epoch 5000, error rate of learning 15%, learning accuracy (98.58±0.01)%, and test accuracy (96.54±0.02)%.

  20. Diagnostic value of symptom screening for pulmonary tuberculosis in China.

    Jun Cheng

    Full Text Available To evaluate the diagnostic value of symptom screening for tuberculosis (TB case finding defined in National Tuberculosis Control Program in China (China NTP among elderly people(≥65 years and younger people(<65 years.We made a secondary analysis in a population-based TB prevalence survey in China in 2010. Questionnaire including information for cough and haemoptysis was completed by face to face interview, and then chest radiography was conducted in all eligible participants. Sputum smear and culture were followed for all TB suspects. We calculated the odds ratios (OR, sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV and the area under the receiver operating characteristic curve (AUC of using different symptoms for screening to detect bacteriologically positive TB in subpopulations stratified by age 65, to evaluate the performance of symptom screening for TB.Of 315 newly diagnosed bacteriologically positive TB, 131 patients (41.59% were elderly, and 48.57% of TB patients were asymptomatic. Nearly 50% patients did not present cough of any duration, and less than half present cough more than 2 weeks, a defined suspected symptom in China NTP. Cough of any duration was reported more in patients aged under 65 than those in elderly, especially for the acute cough (9.78% vs 6.87%. Those symptoms defined by China NTP were reported by less than half participants in two subpopulations. Acute cough (<2 weeks was an independent predictor of TB in people aged under 65 (adjusted OR: 3.3, 95% CI: 2.0-5.5, but not in those aged 65 and above (adjusted OR: 1.4, 95% CI: 0.7-2.9. The specificity for each symptom was significantly higher in participants aged under 65 (P<0.01, and sensitivities of most symptoms were significantly higher among elderly (P<0.05 or P<0.01. When compared with cough for 2 weeks and more, using cough of any duration for symptom screening increased the sensitivity from 42.9% to 51. % for all

  1. Chest CT findings in patients with non-cardiovascular causes of chest pain: Focusing on pulmonary tuberculosis in a tuberculosis endemic country

    Lee, So Won; Shim, Sung Shine; Kim, Yoo Kyung; Ryu, Yon Ju [Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2015-10-15

    To review the common causes of non-cardiovascular chest pain (NCCP) according to the location and lesion type as seen on chest CT, and to evaluate CT findings in tuberculosis (TB) as a cause of NCCP. In the period 2009 to 2012, patients having NCCP without definitive evidence of acute myocardial infarction, pulmonary thromboembolism, and aortic dissection, were included. In total, 162 patients (60.5% male; 39.5% female), with a mean age of 51 years, were enrolled. CT images were evaluated by location and lesion type, for causes of NCCP. Chest CT revealed that the most common location for the cause of NCCP was the pleura (45.1%), followed by the subpleural lung parenchyma (30.2%). The most common lesion causing NCCP was TB (33.3%), followed by pneumonia (19.1%). Of the 54 TB cases, 40 (74.1%) were stable TB and 14 (25.9%) were active TB; among these 54 patients, NCCP was most commonly the result of fibrotic pleural thickening (55.6%), followed by subpleural stable pulmonary TB (14.8%). Results of chest CT revealed that TB was a major cause of NCCP in a TB endemic area. Among the TB patients, fibrotic pleural thickening in patients with stable TB was the most common cause of NCCP.

  2. Chest CT findings in patients with non-cardiovascular causes of chest pain: Focusing on pulmonary tuberculosis in a tuberculosis endemic country

    To review the common causes of non-cardiovascular chest pain (NCCP) according to the location and lesion type as seen on chest CT, and to evaluate CT findings in tuberculosis (TB) as a cause of NCCP. In the period 2009 to 2012, patients having NCCP without definitive evidence of acute myocardial infarction, pulmonary thromboembolism, and aortic dissection, were included. In total, 162 patients (60.5% male; 39.5% female), with a mean age of 51 years, were enrolled. CT images were evaluated by location and lesion type, for causes of NCCP. Chest CT revealed that the most common location for the cause of NCCP was the pleura (45.1%), followed by the subpleural lung parenchyma (30.2%). The most common lesion causing NCCP was TB (33.3%), followed by pneumonia (19.1%). Of the 54 TB cases, 40 (74.1%) were stable TB and 14 (25.9%) were active TB; among these 54 patients, NCCP was most commonly the result of fibrotic pleural thickening (55.6%), followed by subpleural stable pulmonary TB (14.8%). Results of chest CT revealed that TB was a major cause of NCCP in a TB endemic area. Among the TB patients, fibrotic pleural thickening in patients with stable TB was the most common cause of NCCP

  3. Radiological patterns in HIV-associated pulmonary tuberculosis: Comparison between HAART-treated and non-HAART-treated patients

    AIM: To evaluate whether highly active antiretroviral therapy (HAART) modifies radiographic appearances of pulmonary tuberculosis (TB), in terms of patterns and their relative frequencies, among patients with human immunodeficiency virus (HIV) infection. MATERIALS AND METHODS: Chest radiographs were obtained in 209 HIV-infected patients with culture confirmed pulmonary TB. Computed tomography (CT) images were also reviewed for 42 patients whose chest radiographs were normal or showed questionable abnormalities. Imaging was evaluated for the presence and distribution of consolidation, cavitation, interstitial changes, pleural disease, adenopathy, and were classified as a primary or post-primary pattern. RESULTS: A post-primary pattern was more frequent after 1996 when HAART came into clinical use. Forty-four percent (77/176) of patients not on HAART had a post-primary pattern in comparison with 82% (27/33) of patients receiving HAART (p3). CONCLUSION: HIV patients receiving HAART with pulmonary TB, had a post-primary pattern more frequently than those not receiving this treatment. This observation is consistent with the partial restoration of cell-mediated immunity that can be induced by HAART

  4. [Diabetes among new cases of pulmonary tuberculosis in Hanoï, Vietnam].

    Thanh, Nguyen Phuong; Khue, Pham Minh; Sy, Dinh Ngoc; Strobel, M

    2015-12-01

    The aim of this study was to analyze all new pulmonary tuberculosis cases and to assess the frequency and consequences of associated diabetes mellitus. Although apparently distinct, these two diseases could be linked, as suspected since decades. The context is the persistent endemicity of tuberculosis and the recent emergence of diabetes, two major health events for developing countries. The study was conducted at National TB hospital in Hanoï, Vietnam, and retrospectively included tuberculosis patients, cases with diabetes and controls without diabetes, collected during a three-year period 2006-2008. Cases associated with HIV infection or other comorbidities potentially affecting mortality were excluded. Among 2867 new pulmonary TB cases, 254 (8.8%) had associated diabetes. Eighty-six cases and 86 matched controls were included. Among cases mean blood glucose at admission was 14.4 mmol/dl, and patients were mostly urban (50% cases vs 32.5% controls, p=0.03). Clinical symptoms were similar in both groups. However, chest X-Ray cavitary images were significantly more frequent among cases (38.3% vs 16.3%, p=0.002, OR=4.1), as did infiltrative images (78% vs 62%, p=0.017, OR=2.55) and positive sputum smears (67.4% vs 47.8%, p=0.014, OR=2.21). In Vietnam, DM is found in quasi 9% of patients with a new diagnosis of primary pulmonary TB. The diabetes-TB patients may have more severe radiologic findings and a higher smear positivity rate. We suggest that in addition to the systematic HIV screening, all new TB patients should also be screened for diabetes. PMID:26490764

  5. Radiographic Findings of Pulmonary Tuberculosis in Tehran in Comparison with Other Institutional Studies

    A. Jamzad

    2009-11-01

    Full Text Available Background/Objective: Tuberculosis (TB is one of the most common worldwide infections, especially in developing countries. Early diagnosis is very important for prevention of the chronic form of the disease and sequel formation. Chest x-ray (CXR is an easy, feasible, non-expensive and quick tool for the diagnosis of pulmonary tuberculosis. "nPatients and Methods: We retrospectively evaluated 200 chest x-rays of secondary pulmonary TB cases in university-affiliated hospitals. These cases were all proved by a positive sputum smear or culture for mycobacterium tuberculosis. "nResults: In this study, we correlated CXR findings of 100 male and 100 female patients. The peak age of involvement in both groups was 61-80 years. None of the chest x-rays were normal. The main radiographic findings were consolidation-infiltration, fibrosis, pleural effusion, cavitation, pleural thickening and bronchiectasis. Mediastinal lymphadenopathy was detected in 9% of the cases. Pulmonary infiltration with consolidation was the most common finding (55%. Miliary shadowing, atelectasis and pneumomediastinum were the least common presentations. Lymphadenopathy was more common in 40 to 60-year-old women. Right lung involvement was more common than the left side and the upper zones were involved in most cases. The most common underlying diseases were hypertension and diabetes mellitus. Infiltration in diabetic patients and fibrotic appearances in hypertensive patients were common findings. "nConclusion: There was no significant difference between our data and the other studies carried out in Iran. The patients were younger in the studies from other countries. However, cavitary lesions were more common in other studies than this study, which seems to be due to the higher prevalence of underlying diseases such as HIV or diabetes.

  6. Isolation of Mycobacterium kumamotonense from a patient with pulmonary infection and latent tuberculosis.

    Kontos, Fanourios; Mavromanolakis, Dimitrios Nikitas; Zande, Marina Chari; Gitti, Zoe Georgios

    2016-01-01

    Mycobacterium kumamotonense is a novel, slow-growing non-chromogenic nontuberculous mycobacterium, which belongs to Mycobacterium terrae complex. We report, for the first time in Greece, the isolation of M. kumamotonense from an immunocompetent patient with pulmonary infection and latent tuberculosis. M. kumamotonense was identified by sequencing analysis of 16S rDNA and 65-kDa heat shock protein genes while by commercial molecular assays it was misidentified as Mycobacterium celatum. Antibiotic susceptibility testing was performed by the reference broth microdilution method. The strain was susceptible to amikacin, clarithromycin, rifampin, ciprofloxacin, moxifloxacin, rifabutin, ethambutol and linezolid. PMID:27080783

  7. Pulmonary sarcoidosis and latent tuberculosis in a patient with psoriasis treated with adalimumab.

    Korta, Dorota Z; Ochieng, Pius; Fishman, Donald; Katz, Susan E

    2015-01-01

    Tumor necrosis factor (TNF) inhibitors are powerful biologic medications that have been used successfully in the treatment of a variety of inflammatory conditions, including psoriasis. Although TNF inhibitors are generally well tolerated, their use increases the risk of infections such as tuberculosis (TB), and paradoxically, they have been associated with development of sarcoidosis. We report the case of a 54-year old man with plaque psoriasis who developed a positive TB test and pulmonary sarcoidosis after 12 months of adalimumab treatment. After stopping adalimumab, his psoriasis worsened and he was started on ustekinumab and narrowband UVB, with improvement in symptoms. We provide a review of the literature and discuss treatment challenges. PMID:25612132

  8. The effectiveness study of the physiotherapy techniques with infiltrative pulmonary tuberculosis using external respiration indicators

    Kalmykova Y.S.

    2012-02-01

    Full Text Available The results of the study of respiratory function of patients with infiltrative pulmonary tuberculosis to assess the ventilation ability of the lungs, as well as the presence and degree of ventilation violations. Indicated the need to examine the results of studies of lung function in these patients in order to timely correction of violations. It is established that therapeutic exercises with financial astrophysical exercises with elements of yoga postures, combined with yogic breathing exercises, as well as regulated breathing exercises, taking into account the tone of the sympathetic and parasympathetic nervous systems and measured distance is an effective and significantly improves functional indices of external respiration.

  9. Successful diagnosis of hyperpyrexia induced by isoniazid in a child with suspected extra-pulmonary tuberculosis

    Qu, Caihong; Li, Xiaoyan; Zheng, Zhenda; Zhu, Jieming

    2015-01-01

    A 9-year-old boy received a rifampicin-isoniazid-ethambutol regimen for suspected extra-pulmonary tuberculosis, and glucurolactone and vitamin B6 to provide liver protection and decrease neurotoxicity associated with isoniazid. Baseline serum aminotransferase and total bilirubin levels were within normal limits before anti-tubercular treatment. After 4 days of treatment, the patient’s body temperature increased (from 38.0°C to 40.1°C) and on the 11th day of treatment, serum chemistry results ...

  10. Validation of a clinical-radiographic score to assess the probability of pulmonary tuberculosis in suspect patients with negative sputum smears

    Soto, A.; Solari, L.; Díaz, J.; Mantilla, A.; Matthys, F.; Van der Stuyft, P.

    2011-01-01

    Background: Clinical suspects of pulmonary tuberculosis in which the sputum smears are negative for acid fast bacilli represent a diagnostic challenge in resource constrained settings. Our objective was to validate an existing clinical-radiographic score that assessed the probability of smear-negative pulmonary tuberculosis (SNPT) in high incidence settings in Peru. Methodology/Principal Findings: We included in two referral hospitals in Lima patients with clinical suspicion of pulmonary ...

  11. The role of diabetes on the clinical manifestations of pulmonary tuberculosis

    Faurholt-Jepsen, Daniel; Range, Nyagosya; PrayGod, George Amani;

    2012-01-01

    Objective: Diabetes is associated with pulmonary tuberculosis (TB), possibly due to impaired immunity, and diabetes may exacerbate the clinical manifestations of TB. Our aim was to assess the role of diabetes in the clinical manifestations of TB. Methods: We studied 1250 patients with pulmonary TB...... in an urban population in a cross-sectional study in Tanzania. All participants were tested for diabetes and HIV co-infection, and TB culture intensity was assessed. Levels of white blood cells, haemoglobin, acute phase reactants, CD4 count and HIV viral load were measured, and a qualitative morbidity.......001) and alpha-1-acid glycoprotein (B 0.2 g / l, CI 95% 0.03; 0.3, P = 0.02) were similarly higher in patients with diabetes. Diabetes did not affect culture intensity or HIV status, but selfreported fever was three times higher among participants with diabetes than in those without diabetes (OR 2.9, CI 95% 1...

  12. The presence of old pulmonary tuberculosis is an independent prognostic factor for squamous cell lung cancer survival

    Zhou, Yiming; Cui, Zhenling; Zhou, Xiao; Chen, Chang; Jiang, Sen; Hu, Zhongyi; Jiang, Gening

    2013-01-01

    Background Pulmonary tuberculosis (TB) is associated with an increased risk of lung cancer. Our study investigated whether the coexistence of an old pulmonary TB lesion is an independent prognostic factor for lung cancer survival in Chinese non-small cell lung cancer patients. Methods We performed a retrospective review of 782 non-small cell lung cancer patients who underwent surgical resection as their primary treatment in 2006 and were followed for 5 years. The associations between lung can...

  13. Pulmonary but Not Subcutaneous Delivery of BCG Vaccine Confers Protection to Tuberculosis-Susceptible Mice by an Interleukin 17-Dependent Mechanism.

    Aguilo, Nacho; Alvarez-Arguedas, Samuel; Uranga, Santiago; Marinova, Dessislava; Monzón, Marta; Badiola, Juan; Martin, Carlos

    2016-03-01

    Some of the most promising novel tuberculosis vaccine strategies currently under development are based on respiratory vaccination, mimicking the natural route of infection. In this work, we have compared pulmonary and subcutaneous delivery of BCG vaccine in the tuberculosis-susceptible DBA/2 mouse strain, a model in which parenterally administered BCG vaccine does not protect against tuberculosis. Our data show that intranasally but not subcutaneously administered BCG confers robust protection against pulmonary tuberculosis challenge. In addition, our results indicate that pulmonary vaccination triggers a Mycobacterium tuberculosis-specific mucosal immune response orchestrated by interleukin 17A (IL-17A). Thus, IL-17A neutralization in vivo reduces protection and abrogates M. tuberculosis-specific immunoglobulin A (IgA) secretion to respiratory airways and lung expression of polymeric immunoglobulin receptor induced following intranasal vaccination. Together, our results demonstrate that pulmonary delivery of BCG can overcome the lack of protection observed when BCG is given parenterally, suggesting that respiratory tuberculosis vaccines could have an advantage in tuberculosis-endemic countries, where intradermally administered BCG has inefficient effectiveness against pulmonary tuberculosis. PMID:26494773

  14. 肺结核患者的MDR-TB知识知晓率调查%PulmonaryTuberculosisPatientswithMulti-drugResistantTuberculosisAwarenessSurvey

    钟红苗; 黄图华; 叶朝红

    2013-01-01

    Objective Pulmonary tuberculosis patients with multi-drug resistant tuberculosis knowledge and awareness of the situation, in order to provide reference to carry out health education work. Methods On pulmonary outpatient follow-up treatment management of patients with pulmonary tuberculosis questionnaire was conducted. Result In 159 cases of patients with pulmonary tuberculosis were investigated, and the primary school education accounted for 67.2%,"what is MDR-TB"witting rate of 55.9%,"chronic discharging bacteria/initial treatment failure/recurrence in patients with MDR-TB/close contacts of patients with smear-positive pulmonary tuberculosis patients should be suspected MDR-TB"witting rate was 13.8%, MDR-TB"causes of"the awareness rate of 26.4%,"how to treat the awareness rate of 15.1%MDR-TB","MDR-TB can administer well what"the awareness rate of 30.2%,"how to prevent MDR-TB"rate was 23.9%.Conclusion Pulmonary tuberculosis in patients with MDR-TB knowledge awareness rate is low, should strengthen the publicity and education of MDR-TB.%  目的了解肺结核患者的MDR-TB知识知晓率情况,为有针对性开展健康教育工作提供参考。方法对肺科门诊跟踪治疗管理的肺结核患者进行询问式问卷调查。结果共调查159例肺结核患者,小学及以下学历占67.2%,“什么是MDR-TB”的知晓率为55.9%,“慢性排菌者/初治失败者/复发患者/密切接触MDR-TB患者的涂阳肺结核患者应怀疑得了MDR-TB”的知晓率为13.8%,“产生MDR-TB的原因”的知晓率为26.4%,“如何治疗MDR-TB”的知晓率为15.1%,“MDR-TB能治好吗”的知晓率为30.2%,“如何预防MDR-TB”的知晓率为23.9%。结论肺结核患者的MDR-TB知识知晓率低,应加强MDR-TB的宣传教育。

  15. SIGNIFICANCE OF ADENOSINE DEAMINASE SERUM CONCENTRATIONS IN THE DIAGNOSIS OF EXTRA-PULMONARY TUBERCULOSIS

    Stevanovic G,

    2011-06-01

    Full Text Available Extra pulmonary tuberculosis (EPTB is a growing problem worldwide. Due to the nature of the disease, the diversity of clinical pictures as well as its minor epidemiological importance, the diagnosis is difficult and often late.In addition to standard TB diagnostic techniques use of new biochemical (surrogate markers are increased. With this work we wanted to examine the usefulness of serum adenosine deaminase levels as a diagnostic parameter for EPTB.The work included 116 patients with fever of unknown origin in which tuberculosis or infectious mononucleosis was not proven and 51 person who had proven EPTB. Correlated adenosine deaminase levels between these two groups we obtained significantly higher values ​​in patients with EPTB. The calculated sensitivity was 0.56, specificity 0.89, positive predictive value 0.80 and negative predictive value 0.72. Certain reducing of the values observed during anti TB therapy. In previous studies the diagnostic importance of adenosine deaminase in the diagnosis of tuberculosis serosityes was demonstrated. The significance of serum levels in diagnosis is rarely evaluated during EPTB. Our findings are similar to the results of authors who have conducted such testing in the pediatric population.Increased concentrations of serum adenosine deaminase have shown the potential of usable screening test and can be used as an indicative EPTB parameter. To fully assess its diagnostic significance require future clinical research.

  16. Tuberculosis and HIV infection among pulmonary tuberculosis suspects in a predominantly pastoralist area, Northeast Ethiopia

    2015-01-01

    Background: TB-HIV co-infection is one of the biggest public health challenges in sub-Saharan Africa. Although there is a wealth of information on TB-HIV co-infection among settled populations in Africa and elsewhere, to our knowledge, there are no published reports on TB-HIV co-infection from pastoral communities. In this study, we report the prevalence of TB, HIV and TB-HIV co-infection among pulmonary TB suspects in the Afar Regional State of Ethiopia. Design: In a cross-sectional study...

  17. Neutrophil-Derived MMP-8 Drives AMPK-Dependent Matrix Destruction in Human Pulmonary Tuberculosis.

    Catherine W M Ong

    2015-05-01

    Full Text Available Pulmonary cavities, the hallmark of tuberculosis (TB, are characterized by high mycobacterial load and perpetuate the spread of M. tuberculosis. The mechanism of matrix destruction resulting in cavitation is not well defined. Neutrophils are emerging as key mediators of TB immunopathology and their influx are associated with poor outcomes. We investigated neutrophil-dependent mechanisms involved in TB-associated matrix destruction using a cellular model, a cohort of 108 patients, and in separate patient lung biopsies. Neutrophil-derived NF-kB-dependent matrix metalloproteinase-8 (MMP-8 secretion was up-regulated in TB and caused matrix destruction both in vitro and in respiratory samples of TB patients. Collagen destruction induced by TB infection was abolished by doxycycline, a licensed MMP inhibitor. Neutrophil extracellular traps (NETs contain MMP-8 and are increased in samples from TB patients. Neutrophils lined the circumference of human pulmonary TB cavities and sputum MMP-8 concentrations reflected TB radiological and clinical disease severity. AMPK, a central regulator of catabolism, drove neutrophil MMP-8 secretion and neutrophils from AMPK-deficient patients secrete lower MMP-8 concentrations. AMPK-expressing neutrophils are present in human TB lung biopsies with phospho-AMPK detected in nuclei. These data demonstrate that neutrophil-derived MMP-8 has a key role in the immunopathology of TB and is a potential target for host-directed therapy in this infectious disease.

  18. Tool for objective quantification of pulmonary sequelae in monitoring of patients with tuberculosis

    Tuberculosis (TB), caused by Mycobacterium tuberculosis, is an ancient infectious disease that remains a global health problem. Chest radiography is the method commonly employed in assessing the evolution of TB. However, lung damage quantification methods are usually performed on a computerized tomography (CT). This objective quantification is important in the radiological monitoring of the patient by assessing the progression and treatment of TB. However, precise quantification is not feasible by the number of CT examinations necessary due to the high dose subjected to the patient and high cost to the institution. The purpose of this work is to develop a tool to quantify pulmonary sequelae caused by TB through chest X-rays. Aiming the proposed objective, a computational algorithm was developed, creating a three-dimensional representation of the lungs, with regions of dilated sequelae inside. It also made the quantification of pulmonary sequelae of these patients through CT scans performed in upcoming dates, minimizing the differences in disease progression. The measurements from the two methods were compared with results suggest that the effectiveness and applicability of the developed tool, allowing lower doses radiological monitoring of the patient during treatment

  19. Improved sensitivity, safety and laboratory turnaround time in the diagnosis of pulmonary tuberculosis by use of bleach sedimentation

    Ameh James

    2015-05-01

    Full Text Available Background: Inadequate diagnostic processes and human resources in laboratories contribute to a high burden of tuberculosis (TB in low- and middle-income countries. Direct smear microscopy is relied on for TB diagnosis; however, sensitivity rates vary. To improve sensitivity of direct microscopy, the researchers employed several approaches, including sputum digestion and concentration of acid-fast bacilli (AFB, a technique which uses commercial bleach.Objectives: This study compared methods used to diagnose active Mycobacterium tuberculosis infections.Methods: Three sputum specimens were collected from each of 340 participants in Abuja, Nigeria, over two consecutive days. Direct microscopy was performed on all specimens; following microscopy, one specimen from each patient was selected randomly for bleach sedimentation and one for Lowenstein-Jensen culture.Results: Direct microscopy produced 28.8% AFB-positive results, whilst bleach sedimentation resulted in 30.3%. When compared with the cultures, 26.5% were AFB true positive using direct microscopy and 27.1% using bleach sedimentation. Whilst the specificity rate between these two methods was not statistically significant (P = 0.548, the sensitivity rate was significant (P = 0.004.Conclusion: Based on these results, bleach increases the sensitivity of microscopy compared with direct smear and has similar specificity. When diagnosing new cases of pulmonary TB, one bleach-digested smear is as sensitive as three direct smears, reducing waiting times for patients and ensuring the safety of laboratory technicians.

  20. Micronutrient malnutrition and wasting in adults with pulmonary tuberculosis with and without HIV co-infection in Malawi

    Clark Tamara D

    2004-12-01

    Full Text Available Abstract Background Wasting and micronutrient malnutrition have not been well characterized in adults with pulmonary tuberculosis. We hypothesized that micronutrient malnutrition is associated with wasting and higher plasma human immunodeficiency virus (HIV load in adults with pulmonary tuberculosis. Methods In a cross-sectional study involving 579 HIV-positive and 222 HIV-negative adults with pulmonary tuberculosis in Zomba, Malawi, anthropometry, plasma HIV load and plasma micronutrient concentrations (retinol, α-tocopherol, carotenoids, zinc, and selenium were measured. The risk of micronutrient deficiencies was examined at different severity levels of wasting. Results Body mass index (BMI, plasma retinol, carotenoid and selenium concentrations significantly decreased by increasing tertile of plasma HIV load. There were no significant differences in plasma micronutrient concentrations between HIV-negative individuals and HIV-positive individuals who were in the lowest tertile of plasma HIV load. Plasma vitamin A concentrations Conclusions These data demonstrate that wasting and higher HIV load in pulmonary tuberculosis are associated with micronutrient malnutrition.

  1. MRI of the brain in patients with miliary pulmonary tuberculosis without symptoms or signs of central nervous system involvement

    MRI was performed on patients with miliary pulmonary tuberculosis to look for brain involvement and to study the features sequentially, during treatment. We studied seven patients with typical radiographic tuberculosis, and no symptoms or signs of central nervous system involvement. Conventional spin-echo (SE) imaging, including contrast enhanced images, was performed in all cases. All patients showed brain involvement: four patients showed lesions mainly less than 3 mm in diameter, better seen on contrast-enhanced images. These patients showed oedema around the lesions after 2 months of treatment, with subsequent regression on follow-up. The remaining three patients had multiple lesions, 3 mm or more in diameter, which showed a gradual decrease on follow-up. We conclude that the brain may commonly be involved in miliary pulmonary tuberculosis. The response to treatment depends on the stage of the granuloma and shows a definite pattern of healing on follow-up. (orig.). With 2 figs., 1 tab

  2. Status of HIV serology among pulmonary tuberculosis patients: the pattern of pulmonary tuberculosis and the characteristics of patients

    A Al-Ani

    2012-11-01

    Full Text Available Tuberculosis (TB is a leading cause of death among people with HIV. In 2009, there was an estimate of 380,000 deaths due to TB among HIV patients. 78% of TB/HIV co-infection cases reside in sub-Saharan Africa; HIV prevalence is as high as 80% in some countries. Therefore, the prevalence of HIV infection in the study population of TB was determined. Clinical, laboratory and radiological presentation of TB were analyzed and compared between HIV sero-ve and HIV sero + ve patients. Observational case-finding hospital-based study was done on 60 TB patients, performed in 3 hospitals in Sudan. Interview-based questionnaires and medical records were used for data collection. Prevalence of HIV-infected TB patients among the study population was 16.7%. The study revealed that 50% of the HIV+ve TB patients were younger than 30 years. There was no major sex difference between HIV+ve and −ve TB patients (P=0.905. However, males were predominant among the whole study population of TB patients. 60% of HIV+ve patients originated from the north, whereas the origins of the HIV-ve patients were more or less equally distributed (P=0.012. Clinical presentations of HIV+ve and −ve TB patients were similar and the differences were not statistically significant. When comparing the lab findings;+ve sputum smear was found more common among HIV+ve patients (70% vs. 54% and a+ve PPD test was also more common among HIV+ve patients (75% vs. 50%. A clear CXR was the only statistically significant difference between the two groups, being more common in HIV+ve (40% vs. 6% (P=0.002. The study concluded that the prevalence found was low in comparison to most of the countries in the region but high in comparison to developed countries. The main differences between HIV+ve and −ve was a+ve sputum smear, +ve PPD test, and a clear CXR, all of which were more common in HIV+ve TB patients. Therefore, the TB/HIV programme should be strengthened; starting by knowing the exact

  3. Fixed-dose combinations of drugs versus single-drug formulations for treating pulmonary tuberculosis

    Gallardo, Carmen R; Rigau Comas, David; Valderrama Rodríguez, Angélica; Roqué i Figuls, Marta; Parker, Lucy Anne; Caylà, Joan; Bonfill Cosp, Xavier

    2016-01-01

    Background People who are newly diagnosed with pulmonary tuberculosis (TB) typically receive a standard first-line treatment regimen that consists of two months of isoniazid, rifampicin, pyrazinamide, and ethambutol followed by four months of isoniazid and rifampicin. Fixed-dose combinations (FDCs) of these drugs are widely recommended. Objectives To compare the efficacy, safety, and acceptability of anti-tuberculosis regimens given as fixed-dose combinations compared to single-drug formulations for treating people with newly diagnosed pulmonary tuberculosis. Search methods We searched the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL, published in the Cochrane Library, Issue 11 2015); MEDLINE (1966 to 20 November 2015); EMBASE (1980 to 20 November 2015); LILACS (1982 to 20 November 2015); the metaRegister of Controlled Trials; and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), without language restrictions, up to 20 November 2015. Selection criteria Randomized controlled trials that compared the use of FDCs with single-drug formulations in adults (aged 15 years or more) newly diagnosed with pulmonary TB. Data collection and analysis Two review authors independently assessed studies for inclusion, and assessed the risk of bias and extracted data from the included trials. We used risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data with 95% confidence intervals (CIs). We attempted to assess the effect of treatment for time-to-event measures with hazard ratios and their 95% CIs. We used the Cochrane 'Risk of bias' assessment tool to determine the risk of bias in included trials. We used the fixed-effect model when there was little heterogeneity and the random-effects model with moderate heterogeneity. We used an I² statistic value of 75% or greater to denote significant heterogeneity, in which case we did not perform a

  4. Tuberculosis as a three-act play: A new paradigm for the pathogenesis of pulmonary tuberculosis.

    Hunter, Robert L

    2016-03-01

    Lack of access to human tissues with untreated tuberculosis (TB) has forced generations of researchers to use animal models and to adopt a paradigm that granulomas are the characteristic lesion of both primary and post primary TB. An extended search of studies of human lung tissues failed to find any reports that support this paradigm. We found scores of publications from gross pathology in 1804 through high resolution CT scans in 2015 that identify obstructive lobular pneumonia, not granulomas, as the characteristic lesion of developing post-primary TB. This paper reviews this literature together with other relevant observations to formulate a new paradigm of TB with three distinct stages: a three-act play. First, primary TB, a war of attrition, begins with infection that spreads via lymphatics and blood stream before inducing systemic immunity that contains and controls the organisms within granulomas. Second, post-primary TB, a sneak attack, develops during latent TB as an asymptomatic obstructive lobular pneumonia in persons with effective systemic immunity. It is a paucibacillary process with no granulomas that spreads via bronchi and accumulates mycobacterial antigens and host lipids for 1-2 years before suddenly undergoing caseous necrosis. Third, the fallout, is responsible for nearly all clinical post primary disease. It begins with caseous necrotic pneumonia that is either retained to become the focus of fibrocaseous disease or is coughed out to leave a cavity. This three-stage paradigm suggests testable hypotheses and plausible answers to long standing questions of immunity to TB. PMID:26980490

  5. Tuberculosis

    C. Robert Horsburgh, Jr

    2014-03-01

    Full Text Available This article reviews the published literature on tuberculosis from September 2012 to August 2013 and describes important advances in tuberculosis epidemiology, microbiology, pathology, clinical pharmacology, genetics, treatment and prevention.

  6. Potential and development of inhaled RNAi therapeutics for the treatment of pulmonary tuberculosis.

    Man, Dede K W; Chow, Michael Y T; Casettari, Luca; Gonzalez-Juarrero, Mercedes; Lam, Jenny K W

    2016-07-01

    Tuberculosis (TB), caused by the infection of Mycobacterium tuberculosis (Mtb), continues to pose a serious threat to public health, and the situation is worsening with the rapid emergence of multidrug resistant (MDR) TB. Current TB regimens require long duration of treatment, and their toxic side effects often lead to poor adherence and low success rates. There is an urgent need for shorter and more effective treatment for TB. In recent years, RNA interference (RNAi) has become a powerful tool for studying gene function by silencing the target genes. The survival of Mtb in host macrophages involves the attenuation of the antimicrobial responses mounted by the host cells. RNAi technology has helped to improve our understanding of how these bacilli interferes with the bactericidal effect and host immunity during TB infection. It has been suggested that the host-directed intervention by modulation of host pathways can be employed as a novel and effective therapy against TB. This therapeutic approach could be achieved by RNAi, which holds enormous potential beyond a laboratory to the clinic. RNAi therapy targeting TB is being investigated for enhancing host antibacterial capacity or improving drug efficacy on drug resistance strains while minimizing the associated adverse effects. One of the key challenges of RNAi therapeutics arises from the delivery of the RNAi molecules into the target cells, and inhalation could serve as a direct administration route for the treatment of pulmonary TB in a non-invasive manner. However, there are still major obstacles that need to be overcome. This review focuses on the RNAi candidates that are currently explored for the treatment of TB and discusses the major barriers of pulmonary RNAi delivery. From this, we hope to stimulate further studies of local RNAi therapeutics for pulmonary TB treatment. PMID:27108702

  7. Minimally invasive surgical treatment of patients with bilateral pulmonary tuberculosis complicated with pleural empyema

    Korpusenko I.V

    2015-03-01

    Full Text Available Objective of our study was to increase the effectiveness of surgical treatment of bilateral destructive pulmonary tuberculosis complicated by pleural empyema by using VTS-technologies. The study was done in Dnepropetrovsk regional clinical therapeutic and prophylactic association "Phthisiology" in the period from 2008 to 2013. A retrospective analysis of 43 cases of bilateral destructive pulmonary tuberculosis complicated by pleural empyema on one side and dissemination focus or limited destructive process on contralateral side has been performed. Selected cases were divided into 2 groups: main (eighteen cases where the following procedures were done: performed transsternal occlusion of the main bronchus, sanation of empyema cavity using videothoracosopy, in 30-45 days followed by pleuropneumectomy with usage of minithoracothomy and control (nineteen cases who had undergone drainage of the empyema cavity, sanation, in 45-60 days followed by pleuropmeumectomy with usage of anterolateral access. The distribution of main and control groups for analyzed parameters was representative. Sanation of pleural cavity with videothoracosopy usage compared with Bulau’s drainage provides better antibacterial effect, effective sanitation of the pleural cavity as evidenced by following changes: significant decrease in the number of microbial cells; normalization of total white blood cells count and rod-shaped granulocytes in the peripheral blood 10 days after treatment; normalization of leukocyte intoxication index. The use of minimally invasive surgical treatment allowed to reduce intraoperative complications by 2 times, amount of intraoperative blood loss and hemotrasfusions by 1.5 times, postoperative mortality by 2.5 times. Pleural cavity sanation with videothoracoscopy usage with following pneumoectomy leads to reduce in the incidence and severity of postoperative complications. The most promising is stage-by-stage surgical approach with consecutive use

  8. Antibacterial Activity of Medicinal Aqueous Plant Extracts against Mycobacterium tuberculosis

    Muna Mohammed Buzayan

    2012-09-01

    Full Text Available Tuberculosis (TB remains a serious health problem in many regions of the world, and the development of resistance to antibiotics by this microbe created the need for new drugs to replace those which have lost effectiveness. This study assesses the medicinal anti-Mycobacterium tuberculosis properties of natural products obtained from plants collected from Eastern Libya. In this study aqueous extracts of nine different plants were assayed for their Mycobacterium tuberculosis inhibitory activity using the BACTEC MGIT960 susceptibility test method. The aqueous extracts of Ceratonia siliqua L, Helichrysum stoechas (L. Moench and Thymus algeriensis did not show any activity against M. tuberculosis in different concentrations. The aqueous extract of Marrubium vulgare L. from Syria showed high activity against M. tuberculosis. Marrubium alysson L., Marrubium vulgare L., Pistacia lentiscus L, Quercus coccifera L, Thymus capitatus (L. Hoffm. & Link, showed varying degrees of activity against M. tuberculosis. The results of this study show that aqueous extracts from six different medicinal plants have different effects against M. tuberculosis in vitro.

  9. Non-adherence to anti-tuberculosis treatment among internal migrants with pulmonary tuberculosis in Shenzhen, China: a cross-sectional study

    Tang, Ying; Zhao, Meigui; Wang, Yunxia; Gong, Yanhong; Yin, Xiaoxv; Zhao, Angui; Zheng, Juanjuan; Liu, Zhenyang; Jian, Xiaofang; Wang, Wenxin; Wu, Chunmei; Lu, Zuxun

    2015-01-01

    Background Non-adherence to tuberculosis (TB) treatment threatens the success of treatment, increases the risk of TB spread, and leads to the development of drug resistance. The present study assessed non-adherence to anti-TB treatment among internal migrants with pulmonary TB living in Shenzhen, China, and examined risk factors for non-adherence in order to identify targets for intervention. Methods A total of 794 internal migrants with TB treated at Bao’an Hospital for Chronic Disease Preve...

  10. Detection and Quantification of Mycobacterium tuberculosis in the Sputum of Culture-Negative HIV-infected Pulmonary Tuberculosis Suspects: A Proof-of-Concept Study

    Madico, Guillermo; Mpeirwe, Moses; White, Laura; Vinhas, Solange; Orr, Beverley; Orikiriza, Patrick; Miller, Nancy S.; Gaeddert, Mary; Mwanga-Amumpaire, Juliet; Palaci, Moises; Kreiswirth, Barry; Straight, Joe; Dietze, Reynaldo; Boum, Yap; Jones-López, Edward C.

    2016-01-01

    Rationale Rapid diagnosis of pulmonary tuberculosis (TB) is critical for timely initiation of treatment and interruption of transmission. Yet, despite recent advances, many patients remain undiagnosed. Culture, usually considered the most sensitive diagnostic method, is sub-optimal for paucibacillary disease. Methods We evaluated the Totally Optimized PCR (TOP) TB assay, a new molecular test that we hypothesize is more sensitive than culture. After pre-clinical studies, we estimated TOP’s per-patient sensitivity and specificity in a convenience sample of 261 HIV-infected pulmonary TB suspects enrolled into a TB diagnostic study in Mbarara, Uganda against MGIT culture, Xpert MTB/RIF and a composite reference standard. We validated results with a confirmatory PCR used for sequencing M. tuberculosis. Measurements and Results Using culture as reference, TOP had 100% sensitivity but 35% specificity. Against a composite reference standard, the sensitivity of culture (27%) and Xpert MTB/RIF (27%) was lower than TOP (99%), with similar specificity (100%, 98% and 87%, respectively). In unadjusted analyses, culture-negative/TOP-positive patients were more likely to be older (PTB assay is accurately detecting M. tuberculosis DNA in the sputum of culture-negative tuberculosis suspects. Our results require prospective validation with clinical outcomes. If the operating characteristics of the TOP assay are confirmed in future studies, it will be justified as a “TB rule out” test. PMID:27391604

  11. Drug-sensitive tuberculosis, multidrug-resistant tuberculosis, and nontuberculous mycobacterial pulmonary disease in nonAIDS adults: comparisons of thin-section CT findings

    The aim of this work was to compare thin-section CT (TSCT) findings of drug-sensitive (DS) tuberculosis (TB), multidrug-resistant (MDR) TB, and nontuberculous mycobacterial (NTM) pulmonary disease in nonAIDS adults. During 2003, 216 (113 DS TB, 35 MDR TB, and 68 NTM) patients with smear-positive sputum for acid-fast bacilli (AFB), and who were subsequently confirmed to have mycobacterial pulmonary disease, underwent thoracic TSCT. The frequency of lung lesion patterns on TSCT and patients' demographic data were compared. The commonest TSCT findings were tree-in-bud opacities and nodules. On a per-person basis, significant differences were found in the frequency of multiple cavities and bronchiectasis (P<0.001, chi-square test and multiple logistic regression analysis). Multiple cavities were more frequent in MDR TB than in the other two groups and extensive bronchiectasis in NTM disease (multiple logistic regression analysis). Patients with MDR TB were younger than those with DS TB or NTM disease (P<0.001, multiple logistic regression analysis). Previous tuberculosis treatment history was significantly more frequent in patients with MDR TB or NTM disease (P<0.001, chi-square test and multiple logistic regression analysis). In patients with positive sputum AFB, multiple cavities, young age, and previous tuberculosis treatment history imply MDR TB, whereas extensive bronchiectasis, old age, and previous tuberculosis treatment history NTM disease. (orig.)

  12. Treatment of 9 cases of pulmonary atelectasis caused by endobronchial tuberculosis with intraluminal stent implantation

    Objective: To evaluate the effect and safety of intraluminal stent implantation in the treatment of complete airway obstruction with unilateral pulmonary atelectasis caused by endobronchial tuberculosis (EBTB). Methods: 9 cases of pulmonary atelectasis caused by EBTB were treated with high- frequency electricity/microwave, balloon dilation and endobronchial stent implantation. At the time of 1 week and 4-6 months after stenting ,the diameters of stenotic segment were measured. Results: All 9 cases with atelectasis of EBTB showed complete re-expansion within 3 days after the stent implantation. The mean diameter of the stenotic segments of 9 EBTB patients increased to 9.17 ± 1.24 mm at 7th day after stent implantation; 3 of 9 EBTB patients occured mild restenosis after implantation of tracheobronchial stents. However, combination therapy of cryotherapy and balloon dilation can effectively prevent the aggravation of restenosis. Conclusion: Comparing with traditional surgical treatment, the intraluminal stent implantation for atelectasis caused by EBTB is a new, effective, safe and microtraumatic method with reliable preservation of pulmonary function. (authors)

  13. Ethionamide activation and sensitivity in multidrug-resistant Mycobacterium tuberculosis

    DeBarber, Andrea E.; Mdluli, Khisimuzi; Bosman, Marlein; Bekker, Linda-Gail; Barry, Clifton E.

    2000-01-01

    Ethionamide (ETA) is an important component of second-line therapy for the treatment of multidrug-resistant tuberculosis. Synthesis of radiolabeled ETA and an examination of drug metabolites formed by whole cells of Mycobacterium tuberculosis (MTb) have allowed us to demonstrate that ETA is activated by S-oxidation before interacting with its cellular target. ETA is metabolized by MTb to a 4-pyridylmethanol product remarkably similar in structure to that formed by the activation of isoniazid ...

  14. Improvement in Plasma Drug Activity during the Early Treatment Interval among Tanzanian Patients with Multidrug-Resistant Tuberculosis

    Ndusilo, Norah D.; Scott K. Heysell; Mpagama, Stellah G.; Gratz, Jean; Segesela, Farida H.; Pazia, Saumu J.; Wang, Xin-Qun; Houpt, Eric R.; Kibiki, Gibson S

    2015-01-01

    Background Individual pharmacokinetic variability may be common in patients treated for multidrug-resistant tuberculosis (MDR-TB) but data are sparse from resource-limited settings and across the early treatment interval. Methods Plasma drug activity, as measured by the TB Drug Activity (TDA) assay at 2 and 4 weeks of treatment with a standardized MDR-TB regimen was performed in patients with pulmonary MDR-TB from Tanzania. TDA values were correlated with measures of early treatment outcome i...

  15. Alleles of HLA-DRB1*04 Associated with Pulmonary Tuberculosis in Amazon Brazilian Population

    Porto dos Santos, Maisa; de Melo Silva, Cláudia Maria; Alves de Almeida, Vanessa; Assumpção Antunes, Irineide

    2016-01-01

    Immunogenetic host factors are associated with susceptibility or protection to tuberculosis (TB). Strong associations of HLA class II genes with TB are reported. We analyzed the HLA-DRB1*04 alleles to identify subtypes associated with pulmonary TB and their interaction with risk factors such as alcohol, smoking, and gender in 316 pulmonary TB patients and 306 healthy individuals from the Brazilian Amazon. The HLA-DRB1*04 was prevalent in patients with pulmonary TB (p<0.0001; OR = 2.94; 95% CI = 2.12 to 4.08). Direct nucleotide sequencing of DRB1 exon 2 identified nine subtypes of HLA-DRB1*04. The subtype HLA-DRB1*04:11:01 (p = 0.0019; OR = 2.23; 95% CI = 1.34 to 3.70) was associated with susceptibility to pulmonary TB while DRB1*04:07:01 (p<0.0001; OR = 0.02; 95% CI = 0.001 to 0.33) to protection. Notably, the interaction between alcohol and HLA-DRB1*04:11:01 increased the risk for developing pulmonary TB (p = 0.0001; OR = 51.3; 95% CI = 6.81 to 386). Multibacillary pulmonary TB, the clinical presentation of disease transmission, was strongly associated with interaction to alcohol (p = 0.0026; OR = 11.1; 95% CI = 3.99 to 30.9), HLA-DRB1*04:11:01 (p = 0.0442; OR = 2.01; 95% CI = 1.03 to 3.93) and DRB1*04:92 (p = 0.0112; OR = 8.62; 95% CI = 1.63 to 45.5). These results show that HLA-DRB1*04 are associated with pulmonary TB. Interestingly, three subtypes, DRB1*04:07:01, DRB1*04:11:01 and DRB1*04:92 of the HLA-DRB1*04 could be potential immunogenetic markers that may help to explain mechanisms involved in disease development. PMID:26901036

  16. Tomographic findings of lobar consolidation in primary pulmonary tuberculosis; Aspectos tomograficos da consolidacao lobar na tuberculose pulmonar primaria

    Pereira, Bruno Alberto Falcao [Hopital Europeen Georges Pompidou, Paris (France); Macedo, Solange Goncalves David de [Hospital Municipal Jesus, Rio de Janeiro, RJ (Brazil). Setor de Pneumologia; Nogueira, Renata do Amaral [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil). Setor de Pediatria; Castiel, Lola Celeste Pantoja [Clinica Radiologica Dr. Samuel Castiel, Porto Velho, RO (Brazil); Penna, Claudia Renata Rezende [Hospital Municipal Jesus, Rio de Janeiro, RJ (Brazil). Servico de Radiologia Pediatrica], e-mail: cr-penna@uol.com.br

    2009-03-15

    Objective: To describe tomographic findings of lobar consolidation as early manifestation of primary pulmonary tuberculosis. Materials and methods: The present study was developed at Hospital Municipal Jesus, Rio de Janeiro, RJ, Brazil, in the period between 2002 and 2006, retrospectively evaluating tomographic findings in four children aged from 3 to 14 months with lobar consolidation as an early manifestation of primary pulmonary tuberculosis. Results: The most frequently found radiological pattern was lobar consolidation with calcifications, cavitation and intermingle necrotic areas, associated with bulging fissure. Signs of bronchogenic dissemination and lymph node enlargement were observed in all of the four children. Consolidation with a pseudotumor aspect and masslike effect was observed in one case. Conclusion: The cases included in the present study have demonstrated that primary pulmonary tuberculosis manifested as lobar consolidation presents typical tomographic images such as cavitation, hypodense areas and calcifications intermingled with consolidation. The association with lymph node enlargement with central necrosis and signs of bronchogenic dissemination reinforce the diagnosis of tuberculosis. (author)

  17. Clinico-pathological profile and treatment outcome in smear negative pulmonary tuberculosis patients at a teaching hospital

    Tuberculosis remains the single highest contributor to the world's morbidity and mortality. Early diagnosis and prompt treatment is essential to prevent its transmission. To see the treatment response of anti tuberculosis drugs in smear negative patients and study the predictors of culture positive among smear negative tuberculosis patients. Ninety four sputum smear negative patients clinically and radiologically suggestive of tuberculosis were selected. These patients were put on anti tuberculosis drugs without waiting for their culture results. They were then followed for 8 months to see their treatment outcome. A total of 94 smear negative patients were selected and given anti tuberculosis treatment. Of these 37(39%) were culture positive and 57(61%) were culture negative. Of the 37 culture positive patients 36(97%) showed clinical or radiological improvement as compared to 46(81%) out of 57 in culture negative cases. Symptoms of cough with sputum production was significantly associated with culture positivity. On x-ray chest moderate lesion with diffuse infiltration was more common finding in 64% while extensive and cavitatory lesion was seen in 24% of all cases. Association of extensive and cavitatory lesion were seen in culture positive group. Response to anti tuberculosis drugs in sputum smear negative tubercolosis suspects was found to be effective in majority of the patients. Cough, sputum and extensive cavitatory lung lesion were the predictors of culture positive cases. There is need to train physicians on the use of anti tuberculosis therapy in smear negative suspected pulmonary tuberculosis cases, especially if they have productive cough and cavitatory lung lesions. (author)

  18. A prospective study of pulmonary tuberculosis in rural geriatric population of South India

    Shaik KU

    2016-01-01

    Full Text Available Background: Sparse data are available documenting similarities and differences in the clinical, bacteriological and radiographic features of pulmonary tuberculosis (TB in persons aged over 60 years and those aged under 60 years. Materials and Methods: We prospectively studied 100 adult patients with pulmonary TB aged 18-59 years (n=50 and 60 years and above (n=50; elderly subjects who presented to the medicine out-patient service and were admitted in the medical wards at our medical college teaching hospital at Kuppam, Andhra Pradesh. Results: In both the groups, males were in the majority (72% in geriatric and 60% in adult group. Hemoptysis (26% in geriatric and 42% in adult and night sweats (12% in geriatric and 58% in adult were frequent in adults than geriatric patients. Chronic obstructive pulmonary disease(COPD,Hypertension and diabetes mellitus were more frequent in geriatric patients than 18-59 year old adults. Cavitations were more common in adults, whereas lower lobe involvement was more frequent in the geriatric group. In the geriatric patients 72% were completely cured compared to 92% in adult patients. Treatment failure was 20% in geriatric group compared to 6% in adults. Mortality was 8% in geriatric and 2% in adults. Adverse reactions were frequent in geriatric group (n=20 than 18-59 year old individuals. Conclusion: The present study documents important differences in clinical and radiological presentation of pulmonary TB in geriatric patients compared with adults aged 18-59 years. Geriatric patients also experienced more frequent occurrence of adverse reactions, failure of treatment and mortality.

  19. Multifactor dimensionality reduction reveals a three-locus epistatic interaction associated with susceptibility to pulmonary tuberculosis

    Collins, Ryan L; Hu, Ting; Wejse, Christian;

    2013-01-01

    problem. The goal of the present study was to apply MDR to mining high-order epistatic interactions in a population-based genetic study of tuberculosis (TB). Results The study used a previously published data set consisting of 19 candidate single-nucleotide polymorphisms (SNPs) in 321 pulmonary TB cases......Background Identifying high-order genetics associations with non-additive (i.e. epistatic) effects in population-based studies of common human diseases is a computational challenge. Multifactor dimensionality reduction (MDR) is a machine learning method that was designed specifically for this....... This study highlights the importance of using machine learning methods that are designed to embrace, rather than ignore, the complexity of common diseases such as TB. We recommend future studies of the genetic of TB take into account the possibility that high-order epistatic interactions might play an...

  20. A radiation-induced breast cancer following artificial pneumothorax therapy for pulmonary tuberculosis

    A case of radiation-induced breast cancer in a woman who had been fluoroscopied repeatedly for control of pneumothorax for pulmonary tuberculosis 35 years before is reported. The breast tissue presumably received about 136 rads or less in three and a half years. In Japan, both prospective and retrospective surveies following multiple fluoroscopies during artificial pneumothorax collaps therapy have failed to show an increase in the risk of subsequent development of primary breast cancer. The dose given to breast tissues in Japanese patients was generally far less than that in the MacKenzie's series. A radiation-induced breast cancer in Japanese literature has not yet been reported. It seems that the lesser doses may explain the reason of this fact. (auth.)

  1. Factors influencing quality of life and predictors of low quality of life scores in patients on treatment for pulmonary tuberculosis: a cross sectional study.

    Olufunke O Adeyeye; Ogunleye, Olayinka O; Ayodele Coker; Yetunde Kuyinu; Bamisile, Raymond T; Udeme Ekrikpo; Babatunde Onadeko

    2014-01-01

    There is paucity of information on the quality of life of patients with pulmonary tuberculosis in Nigeria. This study assessed the factors influencing their quality of life and the independent predictors of low quality of life scores. Two hundred and sixty consecutive patients with pulmonary tuberculosis seen at the Lagos University Teaching Hospital were evaluated for health related quality of life using the World Health Organization Quality of life instrument (WHOQoL-BREF). Sociodemographic...

  2. Bronchial artery embolization for the treatment of hemoptysis due to pulmonary tuberculosis: its clinical effect with an analysis of the causes of recurrence

    Objective: To investigate clinical effect of bronchial artery embolization (BAE) in treating massive hemoptysis due to pulmonary tuberculosis and to analyze the causes of recurrence in order to improve the therapeutic results. Methods: A total of 39 cases of patients with recurrent massive hemoptysis due to pulmonary tuberculosis, who were encountered during the period from Oct. 2007 to Sep. 2010, were enrolled in this study. The lesions included infiltrative pulmonary tuberculosis (n= 28) and chronic fibrocavitary pulmonary tuberculosis (n= 11). BAE with polyvinyl alcohol (PVA) particles only was performed in 14 cases (group A), while BAE with both PVA particles and coils was carried out in 25 cases (group B). All the patients were followed up for 12 - 48 months. The results were compared between the two groups. Results: Immediate hemostasis was obtained in 36 cases (92.3%), the clinical result was excellent in 3 cases. The complete cure or excellent result with single embolization procedure was achieved in 30 cases (76.9%). Recurrence was seen in 9 cases (23.1%). The difference in the recurrence rate between group A (42.9%) and group B (12.0%) was statistically significant (P < 0.05). The relapsing rate of patients with chronic fibrocavitary pulmonary tuberculosis was significantly higher than that of patients with infiltrative pulmonary tuberculosis (45.5% vs. 14.3%, P < 0.05). Conclusion: BAE has an instant effect of hemostasis and satisfactory clinical result. Nowadays BAE has already become the treatment of first choice for hemoptysis caused by pulmonary tuberculosis. The dual embolization technique with the combination use of PVA particles and coils can effectively reduce the recurrence of' pulmonary tuberculosis hemoptysis. (authors)

  3. Pulmonary Langerhans cell histiocytosis with cervical lymph node involvement, and coexistence with pulmonary tuberculosis and right pneumothorax: a case report and review of literature

    Gao, Limin; Li, Huifang; LI, GANDI; Liu, Weiping; Li, Jinnan; Zhang, Wenyan

    2015-01-01

    We report an uncommon 22-year-old male Pulmonary Langerhans Cell Histiocytosis (PLCH) case which co-existed with pulmonary tuberculosis (TB). Unlike the common PLCH cases, this PLCH case has cervical lymph node involvement and right pneumothorax. The diagnosis was established by the imaging of lung and the biopsies of the lung and left neck lymph node. Imaging of the chest showed characteristic small nodules and thin-walled cysts and right pneumothorax. The LCH cells in the lung and left neck...

  4. SOCIO - DEMOGRAPHIC PROFILE AND BASAL METABOLIC INDEX CHARACTERISTICS OF PATIENTS WITH PULMONARY TUBERCULOSIS AND THEIR TREATMENT OUTCOME IN MEDICAL COLLEGE HOSPITAL, AMRITSAR, INDIA

    Kajal De; Bharat; Rosy; Sandeep; Satish

    2015-01-01

    INTRODUCTION: Tuberculosis is an ancient disease associated with high degree of morbidity and mortality worldwide, more so in developing countries having overwhelming problems of poverty, poor living conditions, illiteracy, malnutrition, drug addiction. OBJECTIVES: To evaluate the socio - demographic profile and BMI characteristics of patients with pulmonary tuberculosis and their treatment outcome. MATERIAL & METHOD: This prospective study was conducted on 20...

  5. Relapse of pulmonary tuberculosis: a rare cause of false-positive of the scintigraphy with iodine 131

    The whole body scintigraphy with 131I is used in the follow up of the differentiated thyroid cancer. It is important to know the causes of false positive before decision of treatment by iodine 131. We present the case of a patient with a pulmonary fixation that was a false positive of 131I, of rare etiology. The after-effects of tuberculosis are able to fix iodine 131 and then to give false positive. scintigraphy. This etiology of false positive is rare and is worthy to be known because the lung is frequently an area of metastases in the thyroid cancer and the incidence of tuberculosis is increasing. (N.C.)

  6. Pulmonary Interleukin-23 Gene Delivery Increases Local T-Cell Immunity and Controls Growth of Mycobacterium tuberculosis in the Lungs

    Happel, Kyle I.; Lockhart, Euan A.; Mason, Carol M.; Porretta, Elizabeth; Keoshkerian, Elizabeth; Odden, Anthony R.; Nelson, Steve; Ramsay, Alistair J.

    2005-01-01

    Interleukin-23 (IL-23) is a heterodimeric cytokine that shares IL-12 p40 but contains a unique p19 subunit similar to IL-12 p35. Previous studies indicate a greater importance for intact IL-12/23 p40 expression than IL-12 p35 for immunity against Mycobacterium tuberculosis, suggesting a role for IL-23 in host defense. The effects of IL-23 on the outcome of pulmonary infection with M. tuberculosis have not been described. Here, we show that local delivery of replication-defective adenovirus ve...

  7. Pulmonary tuberculosis

    ... a high incidence of TB give people a vaccine called BCG to prevent TB. But, the effectiveness of this vaccine is limited and it is not usually used in the United States. People who have had BCG may still be skin tested for TB. Discuss ...

  8. Animal experiment and clinical preliminary application of percutaneous 70% ethanol injection therapy in multi-drug resistant pulmonary tuberculosis

    Objective: To evaluate the clinical value of percutaneous injection of 70% ethanol in the treatment of multidrug resistant pulmonary tuberculosis. Methods: Percutaneous and transcatheter absolute ethanol, 70% ethanol, and 60% meglucamine diatrizoate(or distilled water) injection into the lung (25 cases) and the bronchi (25 cases) of healthy rabbits were performed, respectively.All specimens were studied with pathology. On the base of animals experiment, thirty-five patients with multi-drug resistant pulmonary tuberculosis were treated with percutaneous 70% ethanol injection. Every patient was treated by the same way for 1-3 times. Results: Pathological findings of the specimens of pulmonary tissue showed nonspecific inflammation, necrosis, and fibrosis. The chief pathological changes with percutaneous or transcatheter 70% ethanol injection were slighter than those with absolute ethanol injection. Pathological findings of the specimens of bronchi showed slight mucosal edema, nonspecific inflammation, and focal cytonecrosis. Recovery of the damaged bronchial mucosa occurred within 14-30 days after the treatment. All patients with multi-drug resistant pulmonary tuberculosis were followed up for 6 to 33 months. The sputum bacterial conversion to negative rate was 100% within 6 months after the treatment. Cavity closing, shrinking, and no changing rate were 47.1% (16/34), 50.0% (17/34), and 2.9% (1/34), respectively. Radiographic improvement rate was 94.3 % (33/35). No severe complications and adverse reactions occurred. Conclusion: Percutaneous 70% ethanol injection is safe, effective, and easy to perform in the treatment of multi-drug resistant pulmonary tuberculosis. (authors)

  9. The impact of helminth infection in patients with active tuberculosis

    Abate, Ebba

    2013-01-01

    The geographic distribution of helminth infection and tuberculosis (TB) overlap substantially. Experimental animal models and limited data from humans have shown that intestinal helminths could subvert the host immune response towards a T-helper 2 (Th2)-type immune response and an increased regulatory T-cell activity (Tregs). This in turn affects the host's ability to mount an effective Th1 immune-mediated protection against Mycobacterium tuberculosis. However, evidence for this hypothesis in...

  10. Tuberculosis treatment outcome in a tertiary care setting

    The outcome of the chemotherapy for pulmonary, extraplumonary and disseminated tuberculosis is not well documented, especially in developing countries. This study assessed tuberculosis treatment outcome, cure-to-treatment ratio and mortality among all types of tuberculosis patients in a tertiary care setting in Saudi Arabia. All cases diagnosed and treated for active Mycobacterium tuberculosis infection between 1991 and 2000 were included retrospectively. Data collected included type of tuberculosis involvement, treatment outcome, relapse and co-morbidities. Over a ten-year period, 535 case of tuberculosis were diagnosed and treated. Isolated pulmonary tuberculosis was identified in 141 cases (26.4%), extrapulmonary tuberculosis in 339 cases (63.3%). Co-morbidities were noted in 277 (52%) patients. Immunosuppression was found in 181 (34%) cases. The cure rate was 82%. The cure-to-treatment ratio was 86% in extrapulmonary tuberculosis and 65% in disseminated tuberculosis. Overall mortality was 18%. Disseminated tuberculosis had the highest mortality (34.9%), followed by pulmonary (21.8%), the extrapulmonary tuberculosis (13.6%). Forty-seven percent of all mortalities were directly related to tuberculosis. Relapse was documented in 14 out of 349 patients (4%) who had 24 months of follow-up. Despite tertiary care support, complicated tuberculosis carries a high mortality. Earlier diagnosis and complete appropriate chemotherapy are essential for improved outcome. (author)

  11. Diagnóstico molecular da tuberculose pulmonar Molecular diagnosis of pulmonary tuberculosis

    Nelma Cristina Sousa de Assis

    2007-02-01

    Full Text Available A reação em cadeia da polimerase (PCR e suas variações, como a nested-PCR, têm sido destacadas como técnicas moleculares promissoras para o diagnóstico rápido da tuberculose (TB. No presente estudo avaliou-se a nested-PCR utilizando-se como marcadores moleculares a seqüência IS6110 e o antígeno b aplicados ao diagnóstico da TB. Foram submetidas a baciloscopia, cultura e nested-PCR 136 amostras clínicas de pacientes com suspeita de TB. O diagnóstico de tuberculose pulmonar foi atribuído a 116 pacientes e, desses, 97 foram multibacilares e 111 apresentaram cultura positiva para M. tuberculosis. As reações de nested-PCR identificaram 70% (antígeno b e 94% (IS6110 dos casos paucibacilares. Os valores de sensibilidade determinados para cultura, nested-PCR do IS6110 e antígeno b foram 95%, 98% e 86%, respectivamente. A especificidade foi de 100%, 15% e 45% para cultura, nested-PCR do IS6110 e antígeno b, respectivamente. O diagnóstico molecular da tuberculose deve estar fundamentado na análise conjunta de vários parâmetros, como baciloscopia, cultura, manifestações clínicas, prova terapêutica e história prévia de tuberculose.Chain reaction of polimerase (PCR and its variations such as the nested-PCR have been outstanding as promising molecular techniques for the fast diagnosis of the tuberculosis (TB. In the present study the nested-PCR was evaluated using as molecular markers the sequence IS6110 and the antigen b applied to the diagnosis of TB. One hundred and thirty six clinical samples of patients with suspicion of TB were submitted to the baciloscopia, culture and nested-PCR. The diagnosis of pulmonary tuberculosis was attributed to 116 patients, of these, 97 were multi-bacilli and 111 presented positive culture for M. tuberculosis. The nested-PCR reactions identified 70% (antigen b and 94% (IS6110 of the acid-fast smear negative cases of tuberculosis. The sensibility values determined for culture, and nested-PCR of

  12. Soluble Urokinase Plasminogen Activator Receptor Levels in Tuberculosis Patients at High Risk for Multidrug Resistance

    Tri Yudani Mardining Raras; Triwahju Astuti; Iin Noor Chozin

    2012-01-01

    The soluble urokinase plasminogen activator receptor (suPAR) has been shown to be a strong prognostic biomarker for tuberculosis (TB). In the present study, the profiles of plasma suPAR levels in pulmonary TB patients at high risk for multidrug resistance were analyzed and compared with those in multidrug resistant (MDR)-TB patients. Forty patients were prospectively included, consisting of 10 MDR-TB patients and 30 TB patients at high risk for MDR, underwent clinical assesment. Plasma suPAR ...

  13. Changes in respiratory function impairment following the treatment of severe pulmonary tuberculosis – limitations for the underlying COPD detection

    Radovic M

    2016-06-01

    Full Text Available Milan Radovic,1,2 Lidija Ristic,1,2 Zorica Ciric,1,2 Violeta Dinic-Radovic,3 Ivana Stankovic,1,2 Tatjana Pejcic,1,2 Milan Rancic,1,2 Dragan Bogdanovic4 1Department of Internal Medicine, Faculty of Medicine, University of Nis, 2Clinic for Lung Diseases, 3Clinic for Gastroenterology and Hepatology, Clinical Centre of Nis, 4Public Health Institute Nis, Nis, Republic of Serbia Background: During the treatment phase of active pulmonary tuberculosis (PTB, respiratory function impairment is usually restrictive. This may become obstructive, as a PTB-associated airflow obstruction (AFO or as a later manifestation of underlying COPD.Purpose: The aim of the study was to examine the potential causes and risks for AFO development in PTB by exploring the aspects of spirometry limitations and clinical implications for the underlying COPD detection, taking into account various confounding factors.Patients and methods: Prospective, nest case–control study on 40 new cases of PTB with initial restrictive respiratory function impairment, diagnosed and treated according to the directly observed treatment short course (DOTS strategy.Results: From all observed patients, 37.5% of them developed AFO upon the completion of PTB treatment, with significantly increased average of forced vital capacity (% (P<0.01. Their changes in forced expiratory volume in the first second (% during the PTB treatment were strongly associated with the air pollution exposure in living (0.474%–20.971% for 95% confidence interval [CI]; P=0.041 and working environments (3.928%–20.379% for 95% CI; P=0.005, initial radiological extent of PTB lesions (0.018%–0.700% for 95% CI; P=0.047, leukocyte count (0.020%–1.328% for 95% CI; P=0.043, and C-reactive protein serum level (0.046%–0.205% for 95% CI; P=0.003 compared to the other patients. The multivariate logistic regression analysis model shows initial radiological extent of pulmonary tuberculosis lesions (OR 1.01–1.05 for 95% CI; P=0

  14. Prevalence of smear positive pulmonary tuberculosis among prisoners in North Gondar Zone Prison, northwest Ethiopia

    Moges Beyene; Amare Bemnet; Asfaw Fanaye; Tesfaye Wogahta; Tiruneh Moges; Belyhun Yeshambel; Mulu Andargachew; Kassu Afework

    2012-01-01

    Abstract Background People concentrated in congregated systems, such as prisons, are important but often neglected reservoirs for TB transmission, and threaten those in the outside community. Therefore, this study was conducted to determine the prevalence of tuberculosis in a prison system of North Gondar Zone. Methods An active case-finding survey in North Gondar Prison was carried out from March to May 2011. All prison inmates who had history of cough for at least a week were included in th...

  15. X-ray chest mass screening for pulmonary tuberculosis in Friuli Venezia Giulia region, Italy

    Since 1980, the law which instituted the National Health Service (NHS) in Italy, attributing both the organization and the administration of all public health services to local government bodies referred to as 'Regioni', is being gradually enforced. One result is that the mass screening services are now set up on local basis, involving important practice and regulatory changes. These in particular concern chest X-ray mass screening centers, which were formerly organized as Provincial Antituberculosis Services, supervised by the Ministry of Health and dealing almost exclusively with pulmonary tuberculosis (PTB). Today, chest X-ray mass screening is carried on the 'Centri Sociali di Pneumologia', which in some case inherited the staff and diagnostic facilities of Provincial Antituberculosis Services, but are directed by the Councillorship of Health of the 'Regioni' and, in most cases, deal with the diagnosis and care of general pulmonary diseases. Therefore, regulations and practices of mass screening are eventually different in most Italian 'Regioni', depending on different economic and social situations. In this connection, this paper reports up-to-date information and data on frequency, effectiveness, cost and radiation risks of chest X-ray screening in the 'Regione Autonoma Friuli Venezia Giulia' (FVG), North-East Italy, population 1,300,000

  16. Prevalence of multidrug resistance among retreatment pulmonary tuberculosis cases in a tertiary care hospital, Hyderabad, India

    Subhakar Kandi

    2013-01-01

    Full Text Available Background: India is one of the high tuberculosis (TB burden countries in the world. India ranks second in harboring multi drug resistant (MDR-TB cases. About 50,000 of MDR cases are recorded in retreatment pulmonary TB cases. This study was conducted in a tertiary care facility (Government General and Chest Hospital in Hyderabad, India. Objectives: Toassess: Proportion of the TB patients having MDR-TB at the initiation of retreatment regimen; the prevalence of isoniazid (INH resistance in this geographical area. Materials and Methods: An analytical, observational, prospective cohort study of patients attending the out-patient department from December 2010 to March 2011. Results: Sputum samples from 100 patients were subjected to acid fast bacilli (AFB culture and drug sensitivity testing. Of these, 28 (28% were MDR-TB, 42 (42% were non-MDR-TB and 39% being INH resistance. Conclusions: In conclusion, one third of the retreatment pulmonary TB cases attending a tertiary care institute for TB will be MDR-TB at the initiation of treatment and there is a need to include ethambutol in the continuation phase of new TB case treatment in view of high INH resistance.

  17. Variations of care quality for infectious pulmonary tuberculosis in Taiwan: a population based cohort study

    Chang Ray-E

    2007-06-01

    Full Text Available Abstract Background Effective and efficient care is required to prevent the spread of infectious pulmonary tuberculosis (PTB. We attempted to compare care quality among different healthcare institutions in Southern Taiwan. Methods This study conducted population-based retrospective cohort design. One tuberculosis sanatorium, 2 medical centers, 11 regional hospitals, and 15 district hospitals and primary practitioners in the study area had reported tuberculosis cases, registered from January 1 to June 30 2003. Those cases with sputum positive PTB were followed 15 months after anti-tuberculosis treatment initiation. Meanwhile, Level of conformance with diagnostic guidelines, efficiency of diagnostic and treatment process, and treatment were measured as main outcome. Association was investigated using Chi-square tests, Kruskal Wallis tests, Mann-Whiteney U tests, and multiple logistic regression analysis to evaluate outcome differences among different levels of institutions. Results The analyses included 421 patients. In comparison with patients receiving treatment at medical centers, regional hospitals, and district hospitals/primary practitioners, patients at the Chest Specialty Hospital were more likely to provide at least three sputum specimens (74.1% vs. 48.2%, 36.8%, and 50.0%, shorter workdays examining sputum smears (2.4 ± 2.4 days vs. 2.6 ± 2.1, 4.5 ± 3.1, and 3.5 ± 2.6 days, shorter interval between the first consultation and treatment (10.1 ± 18.3 days vs. 31.0 ± 53.6, 31.2 ± 70.4, and 25.4 ± 37.6 days, and a higher successful treatment rate (92.6% vs. 65.2%, 63.9%, and 68.0%. Furthermore, after adjusting age and gender, the patients treated by the pulmonologists and treated at Chest Specialty Hospital had significantly more successful treatment rate, of which odds ratios were 1.74 and 4.58 respectively. Conclusion Differences in care quality exist among different types of healthcare institutions and among individual physicians

  18. Identifying the most infectious lesions in pulmonary tuberculosis by high-resolution multi-detector computed tomography

    This study aimed to determine whether characteristics detected by multi-detector computed tomography (MDCT) were predictive of highly infectious, smear-positive, active pulmonary tuberculosis (PTB). Among 124 patients with active PTB, 84 had positive (group 1) and 40 had negative (group 2) smear results for acid-fast bacilli. Multiplanar MDCT, axial conventional CT and chest X-ray images were analysed retrospectively for morphology, number, and segmental (lobe) distribution of lesions. By multivariate analysis, consolidation over any segment of the upper, middle, or lingual lobes, cavitations, and clusters of nodules were associated with group 1, while centrilobular nodules were predictive of group 2. Using five independent variables associated with risk in group 1, a prediction model was created to distinguish between group 1 and group 2. ROC curve analysis showed an area under the curve of 0.951 ± 0.021 for this prediction model. With the ideal cutoff point score of 1, the sensitivity, specificity, and positive predictive values were 84.5%, 97.5%, and 98.0%, respectively. A model to predict smear-positive active PTB on the basis of findings from MDCT may be a useful tool for clinical decisions about isolating patients pending sputum smear results. (orig.)

  19. Identifying the most infectious lesions in pulmonary tuberculosis by high-resolution multi-detector computed tomography

    Yeh, Jun Jun [Pingtung Christian Hospital, Pingtung (China); Mei-Ho Institute of Technology, Pingtung (China); China Medical University, Taichung (China); Chen, Solomon Chih-Cheng [Pingtung Christian Hospital, Pingtung (China); National Taiwan University, Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, Taipei (China); Teng, Wen-Bao; Chou, Chun-Hsiung; Hsieh, Shih-Peng; Lee, Tsung-Lung [Pingtung Christian Hospital, Pingtung (China); Wu, Ming-Ting [National Yang Ming University, Faculty of Medicine, School of Medicine, Taipei (China); Kaohsiung Veterans General Hospital, Section of Thoracic and Circulation Imaging, Department of Radiology, Kaohsiung (China)

    2010-09-15

    This study aimed to determine whether characteristics detected by multi-detector computed tomography (MDCT) were predictive of highly infectious, smear-positive, active pulmonary tuberculosis (PTB). Among 124 patients with active PTB, 84 had positive (group 1) and 40 had negative (group 2) smear results for acid-fast bacilli. Multiplanar MDCT, axial conventional CT and chest X-ray images were analysed retrospectively for morphology, number, and segmental (lobe) distribution of lesions. By multivariate analysis, consolidation over any segment of the upper, middle, or lingual lobes, cavitations, and clusters of nodules were associated with group 1, while centrilobular nodules were predictive of group 2. Using five independent variables associated with risk in group 1, a prediction model was created to distinguish between group 1 and group 2. ROC curve analysis showed an area under the curve of 0.951 {+-} 0.021 for this prediction model. With the ideal cutoff point score of 1, the sensitivity, specificity, and positive predictive values were 84.5%, 97.5%, and 98.0%, respectively. A model to predict smear-positive active PTB on the basis of findings from MDCT may be a useful tool for clinical decisions about isolating patients pending sputum smear results. (orig.)

  20. Cost Effectiveness of DOTS and Non-DOTS Strategies for Smear-positive Pulmonary Tuberculosis in Beijing

    2000-01-01

    The cost-effectiveness of DOTS (Directly Observed Treatment, short course) and non-DOTS strategies for smear-positive pulmonary tuberculosis in Beijing was evaluated. Cost calculation was based on the expenses of drugs, chest X-ray films, sputum smears and cultures for the patients. Effectiveness of the intervention was assessed in two aspects: direct benefits to the patients treated and indirect benefits to the others through reduced transmission of tuberculosis; disability adjusted life of year (DALY) was used as an index. The results showed that one DALY could be saved with 45.7 Yuan by DOTS and 471.4 Yuan by non-DOTS. DOTS is a good control strategy for smear-positive tuberculosis.

  1. Diagnostic Yield of Bronchoalveolar Lavage Gene Xpert in Smear-Negative and Sputum-Scarce Pulmonary Tuberculosis

    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. Methodology: BAL specimens of 93 patients with suspected pulmonary tuberculosis with smear-negative or sputumscarce disease, who presented to the Department of Pulmonology, FFH, Rawalpindi were inducted. A smear-negative case was one in whom three consecutive early morning sputum samples did not reveal acid fast bacilli when examined by microscopy with Zeihl Nelson (ZN) stain. Patients who had sputum amount less than 1 ml were defined to have sputumscarce disease. The same was evaluated with ZN stain, gene Xpert and mycobacterial cultures. Sensitivity analysis was carried out using culture as the gold standard. Results: The frequency of positive mycobacterial cultures was 85 (91.4%). The sensitivity, specificity, positive predictive value and negative predictive values of BAL gene Xpert to detect Mycobacterium tuberculosis were 91.86%, 71.42%, 97.53% and 41.66% respectively. Xpert MTB/RIF assay had a sensitivity and specificity of 83.33% and 100% to detect rifampicin resistance. Conclusion: Bronchoalveolar lavage gene Xpert had a superior diagnostic yield in patients with either smear-negative or sputum-scarce pulmonary tuberculosis. Hence a positive Xpert MTB/RIF assay may be a useful adjunct to diagnosis and detection of MDR-TB in bronchoalveolar lavage specimens. (author)

  2. Prevalence of latent tuberculosis infection among health care workers in a hospital for pulmonary diseases

    Diel Roland

    2009-01-01

    Full Text Available Abstract Background Little is known about the prevalence of latent tuberculosis infections (LTBI in health care workers (HCW in low-incidence countries especially in hospitals for pulmonary diseases. With Interferon-gamma release assays (IGRA, a new method for diagnosis of LTBI is available which is more specific than the tuberculin skin test (TST. Objectives The study was designed to estimate prevalence of LTBI among 270 HCW in a Hospital of Pulmonary Diseases routinely screened for TB. Methods LTBI was assessed by the QuantiFERON-Gold In Tube (QFT-IT. Information on gender, age, workplace, job title, BCG vaccination and history of both TB and TST were collected using a standardised questionnaire. Adjusted odds ratios for potential risk factors for LTBI were calculated. Results The prevalence of LTBI was 7.2%. In HCW younger than 30 years LTBI prevalence was 3.5% and in those older than 50 years 22%. Physicians and nurses showed a higher prevalence rate than other professions (10.8% to 4.5%. The putative risk factors for LTBI were age (>50 year OR 9.3, 95%CI 2.5–33.7, working as physicians/nurses (OR 3. 95%CI 1.2–10.4 and no previous TST in medical history (OR 4.4, 95%CI 1.01–18.9 when compared to those with a negative TST. Conclusion Prevalence of LTBI assessed by QFT-IT is low, this indicates a low infection risk even in hospitals for pulmonary diseases. No statement can be made regarding the occupational risk as compared to the general population because there are no LTBI prevalence data from Germany available. The higher LTBI prevalence rate in older HCWs might be due to the cohort effect or the longer time at risk.

  3. Oral Tolerance to Environmental Mycobacteria Interferes with Intradermal, but Not Pulmonary, Immunization against Tuberculosis.

    Dominique N Price

    2016-05-01

    Full Text Available Bacille Calmette-Guérin (BCG is currently the only approved vaccine against tuberculosis (TB and is administered in over 150 countries worldwide. Despite its widespread use, the vaccine has a variable protective efficacy of 0-80%, with the lowest efficacy rates in tropical regions where TB is most prevalent. This variability is partially due to ubiquitous environmental mycobacteria (EM found in soil and water sources, with high EM prevalence coinciding with areas of poor vaccine efficacy. In an effort to elucidate the mechanisms underlying EM interference with BCG vaccine efficacy, we exposed mice chronically to Mycobacterium avium (M. avium, a specific EM, by two different routes, the oral and intradermal route, to mimic human exposure. After intradermal BCG immunization in mice exposed to oral M. avium, we saw a significant decrease in the pro-inflammatory cytokine IFN-γ, and an increase in T regulatory cells and the immunosuppressive cytokine IL-10 compared to naïve BCG-vaccinated animals. To circumvent the immunosuppressive effect of oral M. avium exposure, we vaccinated mice by the pulmonary route with BCG. Inhaled BCG immunization rescued IFN-γ levels and increased CD4 and CD8 T cell recruitment into airways in M. avium-presensitized mice. In contrast, intradermal BCG vaccination was ineffective at T cell recruitment into the airway. Pulmonary BCG vaccination proved protective against Mtb infection regardless of previous oral M. avium exposure, compared to intradermal BCG immunization. In conclusion, our data indicate that vaccination against TB by the pulmonary route increases BCG vaccine efficacy by avoiding the immunosuppressive interference generated by chronic oral exposure to EM. This has implications in TB-burdened countries where drug resistance is on the rise and health care options are limited due to economic considerations. A successful vaccine against TB is necessary in these areas as it is both effective and economical.

  4. Oral Tolerance to Environmental Mycobacteria Interferes with Intradermal, but Not Pulmonary, Immunization against Tuberculosis.

    Price, Dominique N; Kusewitt, Donna F; Lino, Christopher A; McBride, Amber A; Muttil, Pavan

    2016-05-01

    Bacille Calmette-Guérin (BCG) is currently the only approved vaccine against tuberculosis (TB) and is administered in over 150 countries worldwide. Despite its widespread use, the vaccine has a variable protective efficacy of 0-80%, with the lowest efficacy rates in tropical regions where TB is most prevalent. This variability is partially due to ubiquitous environmental mycobacteria (EM) found in soil and water sources, with high EM prevalence coinciding with areas of poor vaccine efficacy. In an effort to elucidate the mechanisms underlying EM interference with BCG vaccine efficacy, we exposed mice chronically to Mycobacterium avium (M. avium), a specific EM, by two different routes, the oral and intradermal route, to mimic human exposure. After intradermal BCG immunization in mice exposed to oral M. avium, we saw a significant decrease in the pro-inflammatory cytokine IFN-γ, and an increase in T regulatory cells and the immunosuppressive cytokine IL-10 compared to naïve BCG-vaccinated animals. To circumvent the immunosuppressive effect of oral M. avium exposure, we vaccinated mice by the pulmonary route with BCG. Inhaled BCG immunization rescued IFN-γ levels and increased CD4 and CD8 T cell recruitment into airways in M. avium-presensitized mice. In contrast, intradermal BCG vaccination was ineffective at T cell recruitment into the airway. Pulmonary BCG vaccination proved protective against Mtb infection regardless of previous oral M. avium exposure, compared to intradermal BCG immunization. In conclusion, our data indicate that vaccination against TB by the pulmonary route increases BCG vaccine efficacy by avoiding the immunosuppressive interference generated by chronic oral exposure to EM. This has implications in TB-burdened countries where drug resistance is on the rise and health care options are limited due to economic considerations. A successful vaccine against TB is necessary in these areas as it is both effective and economical. PMID:27153120

  5. Chest Radiographic Findings in Primary Pulmonary Tuberculosis: Observations from High School Outbreaks

    Koh, Won Jung; Kwon, O Jung; Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Jeong, Yeon Joo [Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Kim, Hee Jin; Lew, Woo Jin [Korean Institute of Tuberculosis, Seoul (Korea, Republic of); Cho, En Hi [4Korea Centers for Disease Control and Prevention, Seoul (Korea, Republic of)

    2010-12-15

    To describe the radiographic findings of primary pulmonary tuberculosis (TB) in previously healthy adolescent patients. The Institutional Review Board approved this retrospective study, with a waiver of informed consent from the patients. TB outbreaks occurred in 15 senior high schools and chest radiographs from 58 students with identical strains of TB were analyzed by restriction fragment length polymorphism analysis by two independent observers. Lesions of nodule(s), consolidation, or cavitation in the upper lung zones were classified as typical TB. Mediastinal lymph node enlargement; lesions of nodule(s), consolidation, or cavitation in lower lung zones; or pleural effusion were classified as atypical TB. Inter-observer agreement for the presence of each radiographic finding was examined by kappa statistics. Of 58 patients, three (5%) had normal chest radiographs. Cavitary lesions were present in 25 (45%) of 55 students. Lesions with upper lung zone predominance were observed in 27 (49%) patients, whereas lower lung zone predominance was noted in 18 (33%) patients. The remaining 10 (18%) patients had lesions in both upper and lower lung zones. Pleural effusion was not observed in any patient, nor was the mediastinal lymph node enlargement. Hilar lymph node enlargement was seen in only one (2%) patient. Overall, 37 (67%) students had the typical form of TB, whereas 18 (33%) had TB lesions of the atypical form. The most common radiographic findings in primary pulmonary TB by recent infection in previously healthy adolescents are upper lung lesions, which were thought to be radiographic findings of reactivation pulmonary TB by remote infection

  6. Treatment delay among pulmonary tuberculosis patients in pastoralist communities in Bale Zone, Southeast Ethiopia

    Hussen Awol

    2012-06-01

    Full Text Available Abstract Background Tuberculosis (TB is a major public health problem in Africa with Ethiopia being the most affected. Treatment delay is an important indicator of access to TB diagnosis and treatment. However, little is known about factors associated with treatment delay of pulmonary TB among pastoralists. Health facility based cross sectional study was conducted on 129 pulmonary TB patients in pastoralist community. The study was conducted in three health centers and a hospital. Time between onset of TB symptoms and first visit to a professional health care provider (patient delay, and the time between first visits to the professional health care provider to the date of diagnosis (provider's delay were analyzed using SPSS 16.0 statistical software. Findings A total of 129 new smear positive pulmonary TB patients participated in the study. The median total delay was 97 days. The median patient and health provider delays were 63 and 34 days, respectively. Ninety six percent of the patients were delayed for more than the twenty one days cutoff point. Patient delay was positively associated with first visit to traditional healer/private clinic/drug shop, rural residence, being illiterate, living in more than 10 kilometers from health facility; severity of illness at first presentation to health facility. Provider delay was positively associated with rural residence, being illiterate, patient with good functional status, patients in contact with more than two health providers, and place of first visit being traditional healer/private clinic/drug shop. Conclusions This study showed that majority of smear positive patients delayed either for diagnosis or treatment, thus continue to serve as reservoirs of infection. This indicates that there is a need for intervention to decrease patient and provider delays. Effort to reduce delays in pastoralist communities should focus on improving access to services in rural communities, engaging traditional and

  7. Chest Radiographic Findings in Primary Pulmonary Tuberculosis: Observations from High School Outbreaks

    To describe the radiographic findings of primary pulmonary tuberculosis (TB) in previously healthy adolescent patients. The Institutional Review Board approved this retrospective study, with a waiver of informed consent from the patients. TB outbreaks occurred in 15 senior high schools and chest radiographs from 58 students with identical strains of TB were analyzed by restriction fragment length polymorphism analysis by two independent observers. Lesions of nodule(s), consolidation, or cavitation in the upper lung zones were classified as typical TB. Mediastinal lymph node enlargement; lesions of nodule(s), consolidation, or cavitation in lower lung zones; or pleural effusion were classified as atypical TB. Inter-observer agreement for the presence of each radiographic finding was examined by kappa statistics. Of 58 patients, three (5%) had normal chest radiographs. Cavitary lesions were present in 25 (45%) of 55 students. Lesions with upper lung zone predominance were observed in 27 (49%) patients, whereas lower lung zone predominance was noted in 18 (33%) patients. The remaining 10 (18%) patients had lesions in both upper and lower lung zones. Pleural effusion was not observed in any patient, nor was the mediastinal lymph node enlargement. Hilar lymph node enlargement was seen in only one (2%) patient. Overall, 37 (67%) students had the typical form of TB, whereas 18 (33%) had TB lesions of the atypical form. The most common radiographic findings in primary pulmonary TB by recent infection in previously healthy adolescents are upper lung lesions, which were thought to be radiographic findings of reactivation pulmonary TB by remote infection

  8. Seasonal variation of newly notified pulmonary tuberculosis cases from 2004 to 2013 in Wuhan, China.

    Xiaobing Yang

    Full Text Available BACKGROUND: Although there was a report about the seasonal variation in Wuhan city, it only analyzed the prevalence data of pulmonary tuberculosis (TB cases, and just studied the seasonality by subgroup of smear positive and negative from 2006 to 2010 by spectral analysis. In this study, we investigated the seasonality of the total newly notified pulmonary TB cases by subgroups such as time period, sex, age, occupation, district, and sputum smear result from 2004 to 2013 in Wuhan by a popular seasonal adjustment model (TRAMO-SEATS. METHODS: Monthly pulmonary TB cases from 2004 to 2013 in Wuhan were analyzed by the TRAMO-SEATS seasonal adjustment program. Seasonal amplitude was calculated and compared within the subgroups. RESULTS: From 2004 to 2013, there were 77.76 thousand newly notified pulmonary TB cases in Wuhan, China. There was a dominant peak spring peak (March with seasonal amplitude of 56.81% and a second summer peak (September of 43.40%, compared with the trough month (December. The spring seasonal amplitude in 2004-2008 was higher than that of 2009-2013(P0.05. However, there were significant differences in spring seasonal amplitude by occupation, with amplitude ranging from 59.37% to 113.22% (P0.05. There were significant differences in summer seasonal amplitude by age, with amplitude ranging from 36.05% to 100.09% (P<0.05. Also, there were significant differences in summer seasonal amplitude by occupation, with amplitude ranging from 43.40% to 109.88% (P<0.05. CONCLUSIONS: There was an apparent seasonal variation in pulmonary TB cases in Wuhan. We speculated that spring peak in our study was most likely caused by the increased reactivation of the latent TB due to vitamin D deficiency and high PM2.5 concentration, while the summer peak was mainly resulted from the enhanced winter transmission due to indoor crowding in winter, overcrowding of public transportation over the period of the Spring Festival and health care seeking delay in

  9. Pulmonary Langerhans cell histiocytosis with cervical lymph node involvement, and coexistence with pulmonary tuberculosis and right pneumothorax: a case report and review of literature.

    Gao, Limin; Li, Huifang; Li, Gandi; Liu, Weiping; Li, Jinnan; Zhang, Wenyan

    2015-01-01

    We report an uncommon 22-year-old male Pulmonary Langerhans Cell Histiocytosis (PLCH) case which co-existed with pulmonary tuberculosis (TB). Unlike the common PLCH cases, this PLCH case has cervical lymph node involvement and right pneumothorax. The diagnosis was established by the imaging of lung and the biopsies of the lung and left neck lymph node. Imaging of the chest showed characteristic small nodules and thin-walled cysts and right pneumothorax. The LCH cells in the lung and left neck lymph node were characterized by large convoluted nuclei with cerebriform indentations of the nuclear envelope and longitudinal grooves. The nuclei contained small eosinophilic nucleoli and moderate amount cytoplasm. Immunohistochemically, the histiocytoid cells were positive for Langerin, CD1a and S-100. Acid-fast bacilli were found in sputum and lung biopsy tissue. To the best of our knowledge, this is the first case of PLCH with cervical lymph node involvement, and coexisted with pulmonary tuberculosis, right pneumothorax. A contribution of this case and review three of the five cases of PLCH with extrapulmonary involvement to lymph nodes resolved spontaneously after smoking cessation constitute a novel addition that it is inappropriate to regard pulmonary/nodal LCH as multi-organ or disseminated disease, and the treatment methods are the same whether the PLCH patient with lymph node involvement or not. PMID:25973117

  10. Moxifloxacin Population Pharmacokinetics in Patients with Pulmonary Tuberculosis and the Effect of Intermittent High-Dose Rifapentine

    Zvada, Simbarashe P.; Denti, Paolo; Geldenhuys, Hennie; Meredith, Sandra; van As, Danelle; Hatherill, Mark; Hanekom, Willem; Wiesner, Lubbe; Simonsson, Ulrika S. H.; Jindani, Amina; Harrison, Thomas; McIlleron, Helen M.

    2012-01-01

    We described the population pharmacokinetics of moxifloxacin and the effect of high-dose intermittent rifapentine in patients with pulmonary tuberculosis who were randomized to a continuation-phase regimen of 400 mg moxifloxacin and 900 mg rifapentine twice weekly or 400 mg moxifloxacin and 1,200 mg rifapentine once weekly. A two-compartment model with transit absorption best described moxifloxacin pharmacokinetics. Although rifapentine increased the clearance of moxifloxacin by 8% during ant...

  11. Intranasal Boosting with an Adenovirus-Vectored Vaccine Markedly Enhances Protection by Parenteral Mycobacterium bovis BCG Immunization against Pulmonary Tuberculosis

    Santosuosso, Michael; McCormick, Sarah; Zhang, Xizhong; Zganiacz, Anna; Xing, Zhou

    2006-01-01

    Parenterally administered Mycobacterium bovis BCG vaccine confers only limited immune protection from pulmonary tuberculosis in humans. There is a need for developing effective boosting vaccination strategies. We examined a heterologous prime-boost regimen utilizing BCG as a prime vaccine and our recently described adenoviral vector expressing Ag85A (AdAg85A) as a boost vaccine. Since we recently demonstrated that a single intranasal but not intramuscular immunization with AdAg85A was able to...

  12. Prevalence of acute epiglottitis and its association with pulmonary tuberculosis in adults in a tertiary care hospital of Nepal

    Thapa, Narmaya

    2008-12-01

    Full Text Available Introduction: Acute epiglottitis is a relatively uncommon disease in both children and adults. It can be a serious life threatening disease because of its potential for sudden upper airway obstruction. Objective: To determine the prevalence of acute epiglottitis and to find out its association with Pulmonary Tuberculosis. Methods: All cases of acute epiglottitis admitted in ENT and Head and Neck Surgery ward of TUTH, Kathmandu, Nepal, from April 2001 to September 2007, were enrolled. Routine investigations including x-rays and blood cultures were done. The patients were further investigated to rule out the presence of Pulmonary Tuberculosis.The standard treatment protocol we used included Injection Ampicillin 500 mg intravenously six hourly for 72 hours followed by oral Ampicillin 500mg for 7 days, with analgesics and intravenous steroid (Hydrocortisone 200mg if required. Study Design: Prospective longitudinal study. Results: Majority of the patients presented with a history sore throat (83.3%, dysphagia (78.6% and odynophagia (78.6%. On examination all the patients were found to have swollen and congested epiglottis. Positive "Thumb sign" on plain X-ray soft tissue neck lateral view was found in almost all the patients (95.2%. Four patients presented with stridor and patient needed emergency tracheostomy. None of the investigations done to detect Pulmonary Tuberculosis was found to be positive. Conclusion: Acute epiglottitis is a rare disease which now occurs more commonly in adults. The annual prevalence of Acute Epiglottitis in adult in TUTH is 4.8 per 1000. This study did not find any association of acute epiglottitis with pulmonary tuberculosis.

  13. [The prevention of neurotoxic reactions during the treatment of pulmonary tuberculosis in middle-aged and elderly patients].

    Markova, E F

    1990-10-01

    To prevent and control neurotoxic reactions in the treatment of pulmonary tuberculosis in elderly and old patients the author used dipromonium (derivative of pangamic acid). Use of this agent at the beginning of the treatment course reduced the incidence of side-effects of neurotoxic character. In case of development of reactions of the central and peripheral nervous system dipromonium treatment resulted in their weakening or liquidation. PMID:2080583

  14. Predictors on Delay of Initial Health-Seeking in New Pulmonary Tuberculosis Cases among Migrants Population in East China

    Li, Xinxu; Jiang, Shiwen; Li, Xue; Mei, Jian; Zhong, Qiu; Xu, Weiguo; Li, Jun; Li, Weibin; Liu, Xiaoqiu; Zhang, Hui; Wang, Lixia

    2012-01-01

    Objectives To determine the length of delay in initial health-seeking in new pulmonary tuberculosis (PTB) cases among migrant population in the eastern part of China, and factors associated with it. Methods A cross-sectional study was conducted using a structured questionnaire in six counties in Shanghai, Guangdong and Jiangsu from May to October, 2008, to estimate the extent and factors responsible for delayed initial health-seeking of the new PTB cases. The interval between self-reported on...

  15. Genotype-independent association between profound vitamin D deficiency and delayed sputum smear conversion in pulmonary tuberculosis

    Junaid, Kashaf; Rehman, Abdul; Saeed, Tahir; Jolliffe, David A.; Wood, Kristie; Martineau, Adrian R

    2015-01-01

    Background Both vitamin D deficiency and genetic variants in the vitamin D receptor (VDR) have been reported to associate with delayed response to intensive-phase therapy for pulmonary tuberculosis. Studies investigating the influence of genetic variants in vitamin D binding protein (DBP) and vitamin D 25-hydroxylase (CYP2R1) on vitamin D status and response to antituberculous therapy are lacking. Methods We conducted a longitudinal study in 260 patients initiating treatment for smear-positiv...

  16. A review of Vitamin D effects on common respiratory diseases: Asthma, chronic obstructive pulmonary disease, and tuberculosis

    Hejazi, Mohammad Esmaeil; Modarresi-Ghazani, Faezeh; Entezari-Maleki, Taher

    2016-01-01

    Despite the classic role of Vitamin D in skeletal health, new aspects of Vitamin D have been discovered in tissues and organs other than bones. Epidemiological and observational studies demonstrate a link between Vitamin D deficiency and risk of developing respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD), and tuberculosis (TB). To review the literature, we searched the terms “Vitamin D” (using the set operator) and “asthma,” “COPD” and “TB” in electronic dat...

  17. Using radioisotopes compounds (99mTc-infecton and 99mTcHIG) in evaluating and examination of pulmonary tuberculosis patients

    This study examined 40 patients: 34 have pulmonary tuberculosis, 3 have pneumonitis, 2 have lung cancer, and one has bilharziasis. All patients have been imaged using radioisotopes compounds (99mTc-infecton and 99mTcHIG) and after 1 hour and 4 hours of patients injection.Using 99mTc-infecton gave positive results in 30 pulmonary tuberculosis patients out of 34, the 3 pneumonitis patients, while using 99mTcHIG gave positive results in 27 pulmonary tuberculosis patients including the 3 pneumonitis patients. Both 99mTc-infecton and 99mTcHIG gave negative results with the lung cancer patients and unreal positive results with the bilharziasis patient. It has been found that the sensitivity and accuracy in the examinations using 99mTc-infecton were 88%, 93%, and 85.7% respectively in comparison with using 99mTcHIG where the values were 70.6%, 91%, and 68.5% respectively. Continuing examination and monitoring of 18 tuberculosis patients for 2-18 months with anti-pulmonary tuberculosis treatment, showed complete response of 12 patients using 99mTc-infecton, and 8 by using 99mTcHIG. As a result, 99mTc-infecton can be used for examining pulmonary tuberculosis patients

  18. Tuberculosis.

    Dheda, Keertan; Barry, Clifton E; Maartens, Gary

    2016-03-19

    Although the worldwide incidence of tuberculosis has been slowly decreasing, the global disease burden remains substantial (∼9 million cases and ∼1·5 million deaths in 2013), and tuberculosis incidence and drug resistance are rising in some parts of the world such as Africa. The modest gains achieved thus far are threatened by high prevalence of HIV, persisting global poverty, and emergence of highly drug-resistant forms of tuberculosis. Tuberculosis is also a major problem in health-care workers in both low-burden and high-burden settings. Although the ideal preventive agent, an effective vaccine, is still some time away, several new diagnostic technologies have emerged, and two new tuberculosis drugs have been licensed after almost 50 years of no tuberculosis drugs being registered. Efforts towards an effective vaccine have been thwarted by poor understanding of what constitutes protective immunity. Although new interventions and investment in control programmes will enable control, eradication will only be possible through substantial reductions in poverty and overcrowding, political will and stability, and containing co-drivers of tuberculosis, such as HIV, smoking, and diabetes. PMID:26377143

  19. Value of the treatment of massive hemoptysis due to pulmonary tuberculosis by super elective bronchial artery embolization

    Objective: To investigate the value of the treatment of massive hemoptysis due to pulmonary tuberculosis by super elective bronchial artery embolization (SBAE), Methods: 41 cases with massive hemoptysis due to pulmonary tuberculosis underwent the treatment of SBAE. The follow-up time ranged from 4 to 52 months. The cases with recurrent massive hemoptysis underwent SBAE again. Results: SBAE resulted in an immediate cessation of hemoptysis in 35 of the primary 41 patients (85.3%), one time cure without recurrence in 26 cases (63.4%) and recurrent massive bleeding in 15 cases (36.6%). The recurrent rate of cases with hemoptysis more than 500 ml in 24 hours was higher than that of cases with hemoptysis less than 500 ml in 24 hours (P < 0.05). The recurrent rate of cases with cavity and/or extensive fibrosis was higher than that of cases without cavity and/or extensive fibrosis (P < 0.01). Conclusions: SBAE should be the first choice of massive hemoptysis due to pulmonary tuberculosis. Patients with cavity and/or extensive fibrosis or hemoptysis more than 500 ml in 24 hours are easy to recur. After SBAE for recurrent cases, the patients without cavity and/or extensive fibrosis can still be cured, but the patients with cavity and/or extensive fibrosis are easy to recur again, and they are best to be treated with selective lobectomy after immediate cessation of hemoptysis by SBAE

  20. Adjunctive micronutrient supplementation for pulmonary tuberculosis Suplementación con micronutrientes como tratamiento adjunto para tuberculosis pulmonar

    Rodrigo X Armijos

    2010-06-01

    Full Text Available OBJECTIVE: To assess the effect of micronutrient supplementation on tuberculosis (TB patient outcomes. MATERIAL AND METHODS: The randomized, double-blinded, placebo-controlled study was conducted in pulmonary TB patients undergoing directly observed treatment short course/ tratamiento acortado estrictamente supervisado (TAES/ DOTS at IMSS in Ciudad Juarez, Chihuahua, Mexico, who were recruited during August 2005-July 2006. Consecutive patients received zinc and vitamin A supplements or matched placebo for four months. Dietary intake, blood zinc and vitamin A, immune response (IFN-γ,TNF-α, and IL-10 mRNA, and sputum smear conversion were measured. RESULTS: The proportion of micronutrient compared to placebo group subjects with a negative sputum smear by month 3 was significantly increased (p= 0.03. This occurred subsequent to increased TNF-α and IFN-γ and decreased IL-'0 observed at month 2. Micronutrient supplementation appeared to accelerate the beneficial therapeutic effect of chemotherapy. CONCLUSIONS: The earlier elimination of bacilli from sputum was associated with improved zinc status and Th' immune response. The therapeutic effect of vitamin A was less evident.OBJETIVO: Determinar el efecto de la suplementación con zinc y vitamina A o placebo en pacientes tratados por tuberculosis (TB. MATERIAL Y MÉTODOS: Se realizó un ensayo aleatorizado en pacientes tuberculosos que iniciaron el tratamiento acortado estrictamente supervisado/ directly observed treatment short course (TAES/DOTS en las clínicas del IMSS, Ciudad Juárez, Chihuahua, México, reclutados durante agosto 2005-julio 2006. A cada paciente en forma aleatoria se le designó un código para recibir ya sea micronutrientes o placebo por cuatro meses, bajo el diseño doble ciego. Se evaluó la ingesta dietética, niveles de zinc y vitamina A en sangre, respuesta inmune (IFN-γ,TNF-α, IL-l0 mRNA en sangre y bacilo ácido alcohol resistente (BAAR en esputo. RESULTADOS: Al

  1. Tuberculose pulmonar: achados na tomografia computadorizada de alta resolução do tórax em pacientes com doença em atividade comprovada bacteriologicamente Pulmonary tuberculosis: findings on high resolution computerized tomography of active disease on patients with bacteriological confirmation

    CRISTIANE ALÓ CAMPOS

    2002-01-01

    Full Text Available Objetivo: Descrever os achados em pacientes com tuberculose pulmonar em atividade na tomografia computadorizada de alta resolução e o padrão de distribuição das lesões pelo parênquima pulmonar. Casuística e método: Foram analisadas retrospectivamente as tomografias de alta resolução de 42 pacientes com diagnóstico bacteriológico de tuberculose pulmonar ou forte suspeita clínica, com posterior confirmação bacteriológica. Resultados: Os principais sinais sugestivos de atividade encontrados foram nódulos do espaço aéreo (83%, nódulos centrolobulares (74%, aspecto de árvore em brotamento (67%, cavitações (67%, espessamento das paredes brônquicas (55%, consolidações (48%, opacidade em vidro fosco (21%, e espessamento do interstício pulmonar (9%. Conclusão: A tomografia computadorizada de alta resolução do tórax pode sugerir fortemente atividade da doença, sendo particularmente útil nos pacientes com baciloscopias negativas e/ou radiografias indeterminadas, permitindo a instituição de tratamento adequado, antes mesmo do crescimento da micobactéria em meio de cultura.Background: The aim of this study was to describe the signs of active tuberculosis in patients submitted to high resolution computerized tomography and the distribution of lesions along the pulmonary parenchyma. Material and methods: The high resolution CTs performed on 42 patients with tuberculosis either bacteriologically diagnosed or clinical suspected and later confirmed by bacteriological tests were studied. Results: The signs of disease activity observed were airspace nodule (83%, centrilobular nodule (74%, tree-in-bud pattern (67%, cavitations (67%, bronchial thickening (55%, parenchymal consolidations (48%, ground glass opacity (21% and thickening of the inter and intralobular septa (9%. Conclusion: High resolution computed tomography can be strongly suggestive of disease activity, is particularly helpful in patients with negative smear and

  2. Outbreak of pulmonary tuberculosis in which tuberculosis developed from QuantiFERON-TB second generation (QFT-2G) test negative persons

    The purpose of this study was to clarify the points to be considered when QuantiFERON-TB second generation (QFT-2G) tests are used in the contacts examination by public health center. We analyzed the results of contacts examination on 43 workplace colleagues (39 y/o and younger) of a pulmonary tuberculosis patient (bII2, Gaffky 9, cough for 1.5 months). After two months of the last contact with the index case, tuberculin skin tests, QFT-2G tests and chest X-rays were undertaken. After 6 months, chest X-rays were taken, and after 9 months, QFT-2G tests and chest CT scans were also undertaken. The tuberculin skin tests after two months showed a bimodal distribution, and 10 were QFT-2G positive and 2 showed doubtful reaction. The latter 12 persons underwent chemoprophylaxis. After 6 months, however, out of 31 QFT-2G negative persons, 2 developed pulmonary tuberculosis. Moreover, after 9 months, chest CT scans revealed 5 pulmonary tuberculosis patients. Three out of 7 new patients showed positive or doubtful reactions in QFT-2G tests undertaken after 9 months. The sensitivity of QFT-2G tests is reported to be 80 to 90%, and the possibility of false negative is not negligible. We propose measures for public health center to conduct the contacts examination as follows; In case of high QFT-2G positive (including doubtful reaction) rate and/or a bimodal distribution of tuberculin skin test result, many infected persons are likely to be included in the group; and the following measures are recommended; Necessity of chemoprophylaxis should be judged considering both tuberculin skin test results and the situation of contact with the index case, and not only by QFT-2G test results. QFT-2G negative persons also need to be followed with chest X-rays. (author)

  3. 糖尿病合并肺结核与单纯肺结核患者临床分析%Clinical Analysis of Pulmonary Tuberculosis Combines With Diabetes and Simple Pulmonary Tuberculosis

    王冰

    2015-01-01

    Objective To explore the clinical effect of pulmonary tuberculosis combines with diabetes and simple pulmonary tuberculosis. Methods Selected 54 cases with pulmonary tuberculosis patients with diabetes mellitus and 60 cases with simple pulmonary tuberculosis from April 2013 to May 2014 in our hospital, comparative analysis the clinical effect. Results The clinical manifestation of the 54 cases and the 60 cases in cough, fever and hemoptysis symptoms were 36 (66.6%), 26 (43.3%), 15 (27.8%), 31 (51.7%), 3 (5.6%), 13 (21.7%). Comared the data of the two groups, P<0.05, had difference statistically signiifcance. Conclusion Early diagnosis and early treatment for the pulmonary tuberculosis patients with diabetes mellitus are necessary, it can reduce patients pains and improve the quality of life.%目的:探究糖尿病合并肺结核与单纯肺结核患者的临床疗效。方法选取2013年4月~2014年5月我院收治的54例糖尿病和并肺结核与60例单纯肺结核患者的疗效进行对比分析。结果糖尿病并肺结核患者相比单纯肺结核患者在临床上表现出咳嗽36(66.6%)、26(43.3%)、发热15(27.8%)、31(51.7%)等方面对比,P<0.05,差异具有统计学意义。结论对糖尿病并肺结核患者需要早诊断、早治疗,能够减轻病痛,提高生活质量。

  4. The Role of Video-Assisted Thoracoscopic Therapeutic Resection for Medically Failed Pulmonary Tuberculosis.

    Tseng, Yau-Lin; Chang, Jia-Ming; Liu, Yi-Sheng; Cheng, Lili; Chen, Ying-Yuan; Wu, Ming-Ho; Lu, Chung-Lan; Yen, Yi-Ting

    2016-05-01

    There are few reports regarding video-assisted thoracoscopic therapeutic resection for medically failed pulmonary tuberculosis (TB). We reviewed our surgical results of video-assisted thoracoscopic surgery (VATS) therapeutic resection for pulmonary TB with medical failure, and its correlation with image characteristics on chest computed tomography (CT) scan.Between January 2007 and December 2012, among the 203 patients who had surgery for TB, the medical records of 89 patients undergoing therapeutic resection for medically failed pulmonary TB were reviewed. Clinical information and the image characteristics of CT scan were investigated and analyzed.Forty-six of the 89 patients undergoing successful VATS therapeutic resection had significantly lower grading in pleural thickening (P < 0.001), peribronchial lymph node calcification (P < 0.001), tuberculoma (P = 0.015), cavity (P = 0.006), and aspergilloma (P = 0.038); they had less operative blood loss (171.0 ± 218.7 vs 542.8 ± 622.8 mL; P < 0.001) and shorter hospital stay (5.2 ± 2.2 vs 15.6 ± 15.6 days; P < 0.001). They also had a lower percentage of anatomic resection (73.9% vs 93.0%; P = 0.016), a higher percentage of sublobar resection (56.5% vs 32.6%; P = 0.023), and a lower disease relapse rate (4.3% vs 23.3%; P = 0.009). Eighteen of the 38 patients with multi-drug resistant pulmonary tuberculosis (MDRTB) who successfully underwent VATS had significantly lower grading in pleural thickening (P = 0.001), peribronchial lymph node calcification (P = 0.019), and cavity (P = 0.017). They were preoperatively medicated for a shorter period of time (221.6 ± 90.8 vs 596.1 ± 432.5 days; P = 0.001), and had more sublobar resection (44.4% vs 10%), less blood loss (165.3 ± 148.3 vs 468.0 ± 439.9 mL; P = 0.009), and shorter hospital stay (5.4 ± 2.6 vs 11.8 ± 6.9 days; P = 0.001).Without multiple cavities

  5. TB-SA antibody test for diagnosis and monitoring treatment outcome of sputum smear negative pulmonary tuberculosis patients.

    Li, Xinxu; Xu, Hancheng; Jiang, Shiwen; Jing, Kuanhe; Wang, Li; Liu, Xiaoqiu; Li, Weibin; Zhang, Hui; Wang, Lixia

    2011-09-01

    The objectives of this study were to evaluate the suitability of the TB-SA antibody test to diagnose tuberculosis in sputum smear negative (SS-) pulmonary tuberculosis (TB) patients and its applicability for monitoring treatment outcomes in these patients. This study was conducted in three counties/districts in Chongqing Municipality, Liaoning Province, China between June 2005 and June 2007. A total of 432 SS suspected pulmonary TB patients were recruited and their blood was collected prior to treatment, at the end of 1 month of treatment, 2 months of treatment and 6 months of treatment (E6MT). The serum samples were analyzed with a TB-SA antibody test kit. Of the 432 SS suspected pulmonary TB patients, serum samples were obtained at all time points in 316 patients and analyzed. The 316 patients were divided into three groups according to sputum smear and sputum culture results and the chest X-ray results before treatment and at E6MT. Ten point four percent were SS-/culture positive (C+), 73.1% were SS-/culture negative (C-) with X-rays abnormalities, and 16.5% were SS-/C- without X-rays abnormalities. The positive rates for TB-SA antibody in the three groups were 57.6, 44.6 and 44.2%, respectively, before treatment, and 18.2, 19.1 and 26.9%, respectively, at E6MT. There was a significant decrease in TB-SA antibody positivity with treatment for all 3 groups. The TB-SA antibody test may be a useful adjunct to diagnose tuberculosis in SS- pulmonary TB patients, and may be useful for monitoring treatment outcomes of SS- pulmonary TB patients. PMID:22299440

  6. The prevention and treatment of isoniazid toxicity in the therapy of pulmonary tuberculosis

    1963-01-01

    A recent report from the Tuberculosis Chemotherapy Centre, Madras, showed that a vitamin-B-complex preparation containing a small amount of pyridoxine (as well as aneurine hydrochloride, riboflavine, nicotinamide, panthenol and cyanocobalamin) was effective in the treatment of peripheral neuropathy caused by daily high-dosage (12.5-15.2 mg/kg body-weight) isoniazid therapy of pulmonary tuberculosis. The present report gives results which show that the B-complex preparation is fully effective in preventing peripheral neuropathy in patients receiving the same high dosage of isoniazid, and that this is due to the small pyridoxine content of only 6 mg daily, and not to any of its other constituents. The low cost of this small dose of pyridoxine makes high-dosage isoniazid therapy, given in combination with other drugs or alone, a possible proposition in developing countries. Studies in the Centre have produced clear evidence that there is an increase in the frequency of peripheral neuropathy when the dosage of isoniazid is increased from 7.8-9.6 mg/kg body-weight to 12.5-15.6 mg/kg daily, and that its incidence is higher among slow than among rapid inactivators of isoniazid. The studies also show that increasing the dosage of isoniazid when given alone from a moderate daily dosage of 7.8-9.6 mg/kg to the high daily dosage of 12.5-15.6 mg/kg has not materially altered the radiographic or the bacteriological response to treatment. PMID:14099673

  7. Human Immunodeficiency Virus Infection-Associated Mortality during Pulmonary Tuberculosis Treatment in Six Provinces of China

    LAI Yu Ji; LIU Er Yong; WANG Li Ming; Jamie P MORANO; WANG Ning; Kaveh KHOSHNOOD; ZHOU Lin; CHENG Shi Ming

    2015-01-01

    Objective To investigate the risk factors attributable to tuberculosis-related deaths in areas with human immunodeficiency virus (HIV) infection epidemics. Methods A prospective cohort study of newly registered patients in tuberculosis (TB) dispensaries in six representative Chinese provinces was conducted from September 1, 2009 to August 31, 2011. Risk factors for TB-associated death were identified through logistic regression analysis. Results Of 19,103 newly registered pulmonary TB patients, 925 (4.8%) were found to be HIV-positive. Miliary TB and acid-fast bacillus smear-negative TB were more common among these patients. Out of a total of 322 (1.7%) deaths that occurred during TB treatment, 85 (26%) of the patients were co-infected with HIV. Multivariate analysis revealed that HIV infection was the strongest predictor of death [adjusted odds ratio (aOR) 7.86]. Other significant mortality risk factors included presentation with miliary TB (aOR 4.10; 95% confidence interval: 2.14-7.88), ≥35 years of age (aOR 3.04), non-Han ethnicity (aOR 1.67), and farming as an occupation (aOR 1.59). For patients with TB/HIV co-infection, miliary TB was the strongest risk factor for death (aOR 5.48). A low CD4 count (≤200 cells/µL) (aOR 3.27) at the time of TB treatment initiation and a lack of antiretroviral therapy (ART) administration (aOR 3.78) were also correlated with an increased risk of death. Conclusion Infection with HIV was independently associated with increased mortality during TB treatment. Offering HIV testing at the time of diagnosis with TB, early TB diagnosis among HIV/acquired immunodeficiency syndrome patients, and the timely provision of ART were identified as the key approaches that could reduce the number of HIV-associated TB deaths.

  8. 结核感染T细胞酶联免疫斑点试验在肺结核及肺外结核诊断中的价值%Diagnostic Value of T-cell Enzyme-linked Immunospot Assay for Pulmonary Tuberculosis and Extrapulmonary Tuberculosis

    陶学芳; 王建华; 李永兴; 王华钧

    2012-01-01

    Objective To investigate the diagnostic value of T - cell Enzyme - linked immunospot assay ( T - SPOT. TB ) in patients with pulmonary tuberculosis and extrapulmonary tuberculosis. Methods T - SPOT. TB was used to detect T - cell frequency in 55 patients with active tuberculosis, 14 case - controls with non - tuberculosis lung diseases, 9 case - controls with non - tuberculosis extrapulmonary diseases and 12 healthy controls. Results The positive rate of T - SPOT. TB was significantly higher in the patients with pulmonary tuberculosis and extrapulmonary tuberculosis than controls ( P 0. 05 ). Conclusion T - SPOT. TB assay possesse satisfactory sensitivity and specificity to diagnose tuberculosis infection and has an important clinical value in the diagnosis of extrapulmonary tuberculosis and sputum - negative pulmonary tuberculosis.%目的 探讨结核感染T细胞酶联免疫斑点试验(T-SPOT.TB)在肺结核及肺外结核诊断中的价值.方法 T-SPOT.TB检测55例活动性肺结核患者、30例肺外结核患者、14例肺部病变非肺结核者、9例肺外非结核性疾病者和12例健康体检者外周血结核抗原特异性的分泌IFN-γ的T细胞频率.结果 肺结核组T-SPOT.TB阳性率明显高于肺部病变非肺结核组和健康对照组,肺外结核组阳性率明显高于肺部病变非肺结核组和健康对照组,差异有统计学意义(P0.05);肺外结核组与菌阴肺结核和菌阳肺结核之间比较,T-SPOT.TB诊断效能差异均无统计学意义(P>0.05).结论 T-SPOT.TB诊断结核感染方面具有良好的敏感性和特异性,在肺外结核和菌阴肺结核的诊断与鉴别诊断方面有重要临床应用价值.

  9. Lung surfactant dysfunction in tuberculosis: effect of mycobacterial tubercular lipids on dipalmitoylphosphatidylcholine surface activity.

    Chimote, G; Banerjee, R

    2005-11-10

    In pulmonary tuberculosis, Mycobacterium tuberculosis bacteria reside in the alveoli and are in close proximity with the alveolar surfactant. Mycolic acid in its free form and as cord factor, constitute the major lipids of the mycobacterial cell wall. They can detach from the bacteria easily and are known to be moderately surface active. We hypothesize that these surface-active mycobacterial cell wall lipids could interact with the pulmonary surfactant and result in lung surfactant dysfunction. In this study, the major phospholipid of the lung surfactant, dipalmitoylphosphatidylcholine (DPPC) and binary mixtures of DPPC:phosphatidylglycerol (PG) in 9:1 and 7:3 ratios were modelled as lung surfactant monolayers and the inhibitory potential of mycolic acid and cord factor on the surface activity of DPPC and DPPC:PG mixtures was evaluated using Langmuir monolayers. The mycobacterial lipids caused common profile changes in all the isotherms: increase in minimum surface tension, compressibility and percentage area change required for change in surface tension from 30 to 10 mN/m. Higher minimum surface tension values were achieved in the presence of mycolic acid (18.2+/-0.7 mN/m) and cord factor (13.28+/-1.2 mN/m) as compared to 0 mN/m, achieved by pure DPPC film. Similarly higher values of compressibility (0.375+/-0.005 m/mN for mycolic acid:DPPC and 0.197+/-0.003 m/mN for cord factor:DPPC monolayers) were obtained in presence of mycolic acid and cord factor. Thus, mycolic acid and cord factor were said to be inhibitory towards lung surfactant phospholipids. Higher surface tension and compressibility values in presence of tubercular lipids are suggestive of an unstable and fluid surfactant film, which will fail to achieve low surface tensions and can contribute to alveolar collapse in patients suffering from pulmonary tuberculosis. In conclusion a biophysical inhibition of lung surfactant may play a role in the pathogenesis of tuberculosis and may serve as a target for

  10. Co-endemicity of Pulmonary Tuberculosis and Intestinal Helminth Infection in the People’s Republic of China

    Li, Xin-Xu; Ren, Zhou-Peng; Wang, Li-Xia; Zhang, Hui; Jiang, Shi-Wen; Chen, Jia-Xu; Wang, Jin-Feng; Zhou, Xiao-Nong

    2016-01-01

    Both pulmonary tuberculosis (PTB) and intestinal helminth infection (IHI) affect millions of individuals every year in China. However, the national-scale estimation of prevalence predictors and prevalence maps for these diseases, as well as co-endemic relative risk (RR) maps of both diseases’ prevalence are not well developed. There are co-endemic, high prevalence areas of both diseases, whose delimitation is essential for devising effective control strategies. Bayesian geostatistical logistic regression models including socio-economic, climatic, geographical and environmental predictors were fitted separately for active PTB and IHI based on data from the national surveys for PTB and major human parasitic diseases that were completed in 2010 and 2004, respectively. Prevalence maps and co-endemic RR maps were constructed for both diseases by means of Bayesian Kriging model and Bayesian shared component model capable of appraising the fraction of variance of spatial RRs shared by both diseases, and those specific for each one, under an assumption that there are unobserved covariates common to both diseases. Our results indicate that gross domestic product (GDP) per capita had a negative association, while rural regions, the arid and polar zones and elevation had positive association with active PTB prevalence; for the IHI prevalence, GDP per capita and distance to water bodies had a negative association, the equatorial and warm zones and the normalized difference vegetation index had a positive association. Moderate to high prevalence of active PTB and low prevalence of IHI were predicted in western regions, low to moderate prevalence of active PTB and low prevalence of IHI were predicted in north-central regions and the southeast coastal regions, and moderate to high prevalence of active PTB and high prevalence of IHI were predicted in the south-western regions. Thus, co-endemic areas of active PTB and IHI were located in the south-western regions of China, which

  11. Treatment outcome of extra-pulmonary tuberculosis in Finland: a cohort study

    Liippo Kari

    2010-07-01

    Full Text Available Abstract Background We investigated the treatments given, the outcome and the patient- and treatment-system dependent factors affecting treatment outcome in a national two-year cohort of culture-verified extra-pulmonary tuberculosis cases in Finland. Methods Medical records of all cases in 1995 - 1996 were abstracted to assess treatment and outcome, using the European recommendations for outcome monitoring. For risk factor analysis, outcome was divided into three groups: favourable, death and other unfavourable. Predictors of unfavourable outcome were assessed in univariate and multivariate analysis. Results In the study cohort of 276 cases, 116 (42.0% were men and 160 (58.0% women. The mean age was 65.7 years. A favourable outcome was achieved in 157/276 (56.9% cases, consisting of those cured (8.0% and treatment completed (48.9%. Death was the outcome in 17.4% (48/276 cases, including cases not treated. Other unfavourable outcomes took place in 45 (16.3% cases. Significant independent risk factors for death in multinomial logistic regression model were male sex, high age, immunosuppression, any other than a pulmonary specialty being responsible at the end of the treatment and other than standard combination of treatment. For other unfavourable treatment outcomes, significant risk factor was treatment with INH + RIF + EMB/SM. Deep site of TB was inversely associated with the risk of other unfavourable outcome. Conclusions The proportion of favourable outcome was far below the goal set by the WHO. Age and comorbidities, playing an important role in treatment success, are not available in routine outcome data. Therefore, comparisons between countries should be made in cohort analyses incorporating data on comorbidities.

  12. Evaluation of antitubercular drug-loaded surfactants as inhalable drug-delivery systems for pulmonary tuberculosis.

    Chimote, G; Banerjee, R

    2009-05-01

    Pulmonary tuberculosis is associated with a year-long chemotherapy, poor alveolar drug levels, drug-related systemic toxicity, and patient noncompliance. In this study, exogenous pulmonary surfactant is proposed as a drug carrier for antitubercular drugs. Dipalmitoylphosphatidylcholine (DPPC), the major lung-surfactant lipid, has been combined with antitubercular drugs isoniazid (INH), rifampicin (RFM), and ethambutol (ETH) in 1:1 ratio by weight, in which drugs had a ratio of 1:2:3 by weight. At 37 degrees C, the formulation had better surfactant function with quicker reduction of surface tension on adsorption (32.71 +/- 0.65 mN/m) than DPPC liposomes (44.67 +/- 0.57 mN/m) and maintained 100% airway patency in a capillary surfactometer. Drug-loaded surfactant liposomes were about 2 microm and had entrapment efficiency of 30.04% +/- 2.05%, 18.85% +/- 2.92%, and 61.47% +/- 3.32% for INH, RFM, and ETH, respectively. Sustained release of the drugs from surfactants was observed over 24 h. In vitro alveolar deposition efficiency using the twin impinger showed 12.06% +/- 1.87% of INH, 43.30% +/- 0.87% of RFM, and 22.07% +/- 2.02% of ETH deposited in the alveolar chamber upon nebulization for a minute using a jet nebulizer. The formulation was biocompatible and stable with physicochemical properties being retained even after storage for a month at 4 degrees C. Antitubercular drug-loaded surfactants developed could serve dual purposes of alveolar stabilization due to surfactant action and better reach of these drugs to the alveoli due to antiatelectatic effect of the surfactant. PMID:18431766

  13. Serological Testing Versus Other Strategies for Diagnosis of Active Tuberculosis in India: A Cost-Effectiveness Analysis

    Steingart, Karen R; Flores, Laura L.; Dendukuri, Nandini; Schiller, Ian; Laal, Suman; Ramsay, Andrew,; Hopewell, Philip C.; Pai, Madhukar

    2011-01-01

    Editors' Summary Background Every year nearly 10 million people develop tuberculosis—a contagious bacterial infection—and about two million people die from the disease. Mycobacterium tuberculosis, the bacterium that causes tuberculosis, is spread in airborne droplets when people with the disease cough or sneeze. It usually infects the lungs (pulmonary tuberculosis) but can also infect the lymph nodes, bones, and other tissues (extrapulmonary tuberculosis). The characteristic symptoms of tuber...

  14. Nutritional supplements for people being treated for active tuberculosis

    Grobler, Liesl; Nagpal, Sukrti; Sudarsanam, Thambu D; Sinclair, David

    2016-01-01

    Background Tuberculosis and malnutrition are linked in a complex relationship. Tuberculosis may cause undernutrition through increased metabolic demands and decreased intake, and nutritional deficiencies may worsen the disease, or delay recovery by depressing important immune functions. At present, there is no evidence-based nutritional guidance for adults and children being treated for tuberculosis. Objectives To assess the effects of oral nutritional supplements in people being treated with antituberculous drug therapy for active tuberculosis. Search methods We searched the Cochrane Infectious Disease Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2016), MEDLINE (from 1946 to 4 February 2016), EMBASE (from 1980 to 4 February 2016), LILACS (from 1982 to 4 February 2016), the metaRegister of Controlled Trials (mRCT), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and the Indian Journal of Tuberculosis up to 4 February 2016, and checked the reference lists of all included studies. Selection criteria Randomized controlled trials that compared any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis. The primary outcomes of interest were all-cause death, and cure at six and 12 months. Data collection and analysis Two review authors independently selected trials for inclusion, and extracted data and assessed the risk of bias in the included trials. We presented the results as risk ratios (RR) for dichotomous variables, and mean differences (MD) for continuous variables, with 95% confidence intervals (CIs). Where appropriate, we pooled data from trials with similar interventions and outcomes. We assessed the quality of the evidence using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Main results Thirty-five trials

  15. Rapid Mycobacterium tuberculosis DNA Detection on Fine Needle Aspirates from Extra Pulmonary Lymph Nodes

    Objective: To evaluate the diagnostic efficacy of two rapid methods i.e. Mycobacterium tuberculosis (MTB) Polymerase Chain Reaction (PCR) on Fine Needle Aspiration (FNA) samples by comparing with cytology of respective site sample. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan, from July 2010 through November 2013. Methodology: A total of 105 extra pulmonary lymph nodes aspirates obtained through fine needle aspiration were processed. Cytology and PCR were done on each specimen. Cytology was taken as gold standard. Results: Out of the total 105 samples, 71 (67.6 percentage) were positive for the MTB PCR while 34 (32.4 percentage) showed negative status. According to FNA cytology (FNAC) results, 72 (68.6 percentage) cases were positive for the disease while 33 (31.4 percentage) were negative. Sensitivity of PCR was 90.3 percentage, specificity 81.8 percentage, positive predictive value (PPV) 91.5 percentage, negative predictive value (NPV) 79.4 percentage, with diagnostic accuracy of 87.6 percentage. Area under the curve was 0.860 (p < 0.001). Conclusion: PCR is a sensitive tool for detection of MTB on FNA samples from EPTB cases. The results are available within few hours which is helpful for the clinicians to initiate therapy. (author)

  16. Predictive Role of Serum Tumor Markers in Diagnosis of Pulmonary Tuberculosis

    MA, Jingjing; XIA, Dan; HU, Jing; FU, Rui; XU, Lijun; ZHANG, Ying; ZHANG, Mengying; LI, Benhe; YANG, Jianghua; WEN, Yufeng

    2016-01-01

    Background: The diagnosis of pulmonary tuberculosis (PTB) is complicated and time-consuming currently. There was association of PTB with serum tumor markers. In this study we aimed to evaluate the predictive role of serum CA125, CA199 and CEA as diagnostic tools for PTB. Methods: This study was designed as a case-control study with 565 subjects who visited the Yijishan Hospital from Jun to Dec in 2014.This case-control study matched as for age and sex with 113 cases and 452 controls. Serum CA125, CA199 and CEA levels were detected by electrochemiluminescence instrument. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic value on PTB. Results: Serum levels of CA125, CA199 and CEA in PTB patients were significantly higher than those in control group (P<0.001). There was no significantly different of three tumor markers between initial treatment group and retreatment group. The logistic regression analysis showed that CA125 was an impact factor to PTB. The ROC analysis revealed that AUC of CA125 was 0.966 (95%CI: 0.951–0.981), the sensitivity, specificity in serum and cut-off were 95.6%, 85.0% and 10.30 U/ml, respectively. Conclusion: The serum CA125 has potential good diagnostic performance for PTB. PMID:27252912

  17. Adjuvant interferon gamma in patients with drug – resistant pulmonary tuberculosis: a pilot study

    Carbonell Dalia

    2004-10-01

    Full Text Available Abstract Background Tuberculosis (TB is increasing in the world and drug-resistant (DR disease beckons new treatments. Methods To evaluate the action of interferon (IFN gamma as immunoadjuvant to chemotherapy on pulmonary DR-TB patients, a pilot, open label clinical trial was carried out in the Cuban reference ward for the management of this disease. The eight subjects existing in the country at the moment received, as in-patients, 1 × 106 IU of recombinant human IFN gamma intramuscularly, daily for one month and then three times per week up to 6 months as adjuvant to the indicated chemotherapy, according to their antibiograms and WHO guidelines. Sputum samples collection for direct smear observation and culture as well as routine clinical and thorax radiography assessments were done monthly. Results Sputum smears and cultures became negative for acid-fast-bacilli before three months of treatment in all patients. Lesion size was reduced at the end of 6 months treatment; the lesions disappeared in one case. Clinical improvement was also evident; body mass index increased in general. Interferon gamma was well tolerated. Few adverse events were registered, mostly mild; fever and arthralgias prevailed. Conclusions These data suggest that IFN gamma is useful and well tolerated as adjunctive therapy in patients with DR-TB. Further controlled clinical trials are encouraged.

  18. Prevalence of Pulmonary Tuberculosis among Prison Inmates in Ethiopia, a Cross-Sectional Study.

    Solomon Ali

    Full Text Available Tuberculosis (TB is one of the major health problems in prisons.This study was done to assess the prevalence and determinants of active tuberculosis in Ethiopian prisons.A cross-sectional study was conducted from January 2013 to December 2013 in 13 zonal prisons. All incarcerated inmates underwent TB symptom screening according to WHO criteria. From identified TB-suspects two sputum samples were analyzed using smear microscopy and solid culture. A standardized questionnaire assessing TB risk factors was completed for each TB suspect.765 (4.9% TB suspects were identified among 15,495 inmates. 51 suspects were already on anti-TB treatment (6.67% and 20 (2.8% new culture-confirmed TB cases were identified in the study, resulting in an overall TB prevalence of 458.1/100,000 (95%CI: 350-560/100,000. Risk factors for active TB were alcohol consumption, contact with a TB case before incarceration and no window in prison cell. HIV prevalence was not different between TB suspects and active TB cases. Further, the TB burden in prisons increased with advancing distance from the capital Addis Ababa.The overall TB prevalence in Ethiopian prisons was high and extremely variable among different prisons. TB risk factors related to conditions of prison facilities and the impact of implemented TB control measures need to be further studied in order to improve TB control among inmates.

  19. An acidic sphingomyelinase Type C activity from Mycobacterium tuberculosis.

    Castro-Garza, Jorge; González-Salazar, Francisco; Quinn, Frederick D; Karls, Russell K; De La Garza-Salinas, Laura Hermila; Guzmán-de la Garza, Francisco J; Vargas-Villarreal, Javier

    2016-01-01

    Sphingomyelinases (SMases) catalyze the hydrolysis of sphingomyelin to ceramide and phosphorylcholine. Sphingolipids are recognized as diverse and dynamic regulators of a multitude of cellular processes mediating cell cycle control, differentiation, stress response, cell migration, adhesion, and apoptosis. Bacterial SMases are virulence factors for several species of pathogens. Whole cell extracts of Mycobacterium tuberculosis strains H37Rv and CDC1551 were assayed using [N-methyl-(14)C]-sphingomyelin as substrate. Acidic Zn(2+)-dependent SMase activity was identified in both strains. Peak SMase activity was observed at pH 5.5. Interestingly, overall SMase activity levels from CDC1551 extracts are approximately 1/3 of those of H37Rv. The presence of exogenous SMase produced by M. tuberculosis during infection may interfere with the normal host inflammatory response thus allowing the establishment of infection and disease development. This Type C activity is different from previously identified M. tuberculosis SMases. Defining the biochemical characteristics of M. tuberculosis SMases helps to elucidate the roles that these enzymes play during infection and disease. PMID:26948102

  20. Diabetes Mellitus Increases the Risk of Active Tuberculosis: A Systematic Review of 13 Observational Studies

    Jeon, Christie Y.; Murray, Megan B.

    2008-01-01

    Editors' Summary Background. Every year, 8.8 million people develop active tuberculosis and 1.6 million people die from this highly contagious infection that usually affects the lungs. Tuberculosis is caused by Mycobacterium tuberculosis, bacteria that are spread through the air when people with active tuberculosis cough or sneeze. Most infected people never become ill—a third of the world's population is actually infected with M. tuberculosis—because the human immune system usually contains ...

  1. Drug therapy in spinal tuberculosis

    Rajasekaran, S.; Khandelwal, Gaurav

    2012-01-01

    Although the discovery of effective anti-tuberculosis drugs has made uncomplicated spinal tuberculosis a medical disease, the advent of multi-drug-resistant Mycobacterium tuberculosis and the co-infection of HIV with tuberculosis have led to a resurgence of the disease recently. The principles of drug treatment of spinal tuberculosis are derived from our experience in treating pulmonary tuberculosis. Spinal tuberculosis is classified to be a severe form of extrapulmonary tuberculosis and henc...

  2. The difference of the regional pulmonary function after treatment between bronchial tuberculosis and bronchogenic carcinoma using positron emission tomography, N-13 gas and Tc-MAA

    The authors studied regional pulmonary function after treatment with bronchial plastic surgery for bronchial lesion from bronchial tuberculosis and with irradiation for bronchial lesion from carcinoma using positron emission tomography and Tc-MAA. Six patients with bronchial tuberculosis and 6 with bronchogenic carcinoma were examined. Two of the 6 bronchial tuberculosis patients were examined before and after surgery. In all 6 patients with bronchial tuberculosis, ventilation and alveolar volume were recovered with improvement of bronchial lesion. In 2 patients examined before and after surgery, lung function of the normal disease-free side became worse after surgery. This phenomenon was explained by the fact that the compensated pulmonary function of contra lateral lung due to decreased function of the diseased side returned to normal function with improvement of the diseased lung. On the other hand, the regional pulmonary function did not improve in 2 patients with main bronchial lesion from bronchogenic carcinoma, even if atelectasis of the diseased lung was improved by irradiation. However, the regional pulmonary function was improved with the recovery of bronchial obstruction in lobar atelectasis by carcinoma. The difference of the results depended on whether pulmonary blood flow disturbance existed or not. If pulmonary blood flow disturbance was severe, ventilatory function was not recovered due to the mechanism of maintaining the ventilation-perfusion equilibrium. (author)

  3. QuantiFERON® TB Gold IT in the diagnosis of active pulmonary TB

    Clara Fabris

    2010-03-01

    Full Text Available The IGRAs (Interferon-γ Release Assays are commercial assays which measure T-cell-mediated response in vitro after specific stimulation, and represent the alternative to TST (Tuberculin Skin Test in the diagnosis of latent tuberculosis infection (ILTB and of active tuberculosis (TB. Among these we choose the assay QuantiFERON ®-TB Gold IT (Cellestis Ltd, Carnegie,Victoria, Australia (QFT in which interferon-γ (IFN-γ was measured after lymphocyte stimulation with 3 antigens of the RD1 region of M. tuberculosis: ESAT-6, CFP-10 and TB 7.7. We wanted to assess the sensitivity of the method in cases of pulmonary TB, using cultured isolates of M. tuberculosis as gold-standard. From August 2006 to July 2009 there were 54 suspected cases of pulmonary TB, confirmed by culture.The QFT was requested for 32 patients before any microbiological confirmation and therapy. Of these patients 14 aged 20-50 years, 6 aged 50-70 years and 12 were more than 70-year-old. The QFT was positive in 25 patients (INF-γ> 0.35 IU/mL and negative in 7 patients (INF-γ <0.35 IU/mL while 2 patients had an INF-γ value of 0.34 IU/mL. Susceptibility to pulmonary TB is very high in young subjects and decreases with increasing age. In elderly population it is frequent a TB reactivation due to a decline in T-cell-immune response.Therefore, a negative or borderline value of IFN-γ should be interpreted with care.

  4. Nutritional status in multi-drug resistance-pulmonary tuberculosis patients

    Amit Kumar

    2014-12-01

    Full Text Available Introduction: Malnutrition and tuberculosis are the major concerns of underdeveloped regions of the world. Undernutrition increases the risk of tuberculosis (TB and in turn TB can lead to Malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and severe form viz. MDR-TB. Undernutrition is a predictor of increased risk of death and TB relapse. Objectives: To study the effect of nutrition in MDR-TB patients at DR-TB centre, Dehradun. Methodology: The Observational cross sectional study was conducted at Drug Resistant Tuberculosis (DR-TB Centre of HIMS, Dehradun over a   period of 12 months to include all the cases reported from 1st October, 2011 (start of DR-TB Centre at HIMS, Dehradun to 30th April, 2014. 376 Subjects were recruited from 1598 suspected MDR TB subjects who were screened by Drug Susceptibility Testing (DST results. Results: Out of 376 MDR-TB patients, 258 (68.6% subjects were found to be undernourished. The mean body mass index (BMI was 17.33+1.99 kg/m2. Though undernutrition was more common among Males (61.2% but female’s BMI was more affected by MDR in comparison to males. Treatment success was better amongst males between 21- 60 year age group with normal BMI having mono drug resistance with no adverse reaction. The majority 47 (18.2% of adverse effect was found in undernourished patients. Treatment outcome was also poor among undernourished (76.9% MDR-TB patients. Conclusion: Prevalence of undernutrition was high (68.6% among subjects and the mean BMI was lower in female. Adverse drug reaction, poor treatment outcome are attributes of Undernutrition.

  5. Evaluación en salud pública: lecciones aprendidas de la gestión de la tuberculosis pulmonar Measurement in Public Health: what pulmonary tuberculosis management has taught us

    C. Patrick Chaulk

    2008-08-01

    Full Text Available Las tasas de tuberculosis pulmonar están aumentando en todo el mundo, incluida España. Uno de los retos principales al tratar esta enfermedad es conseguir un buen cumplimiento terapéutico, puesto que alrededor de un 30-35% de los pacientes no sigue la pauta de medicación prescrita. Este artículo revisa un conjunto de estrategias de evaluación y medidas de la práctica para valorar la efectividad de los programas comunitarios orientados a reforzar el cumplimiento terapéutico de los pacientes con tuberculosis pulmonar activa. Se revisan 4 estrategias de evaluación tradicionales (estudio de un caso, estudio retrospectivo y de casos controles, predicción/pronóstico y análisis de coste-efectividad y 2 enfoques de evaluación emergentes y prometedores (evaluación de calidad de vida e indicadores de continuidad de la asistencia. Varias de las estrategias de evaluación revisadas indican que los programas de tratamiento mediante la terapia de observación directa (directly observed therapy [DOT], amplios, comunitarios y centrados en el paciente, alcanzan los índices más altos de cumplimiento terapéutico. Se recomienda la utilización conjunta de varias de estas estrategias de evaluación para crear un cuerpo de evidencia que refleje el impacto de los programas de intervención comunitaria en la mejora de los resultados de salud, en este caso concreto para los pacientes con tuberculosis pulmonar.Pulmonary tuberculosis rates are increasing worldwide, including in Spain. One of the main challenges when treating this disease is achieving treatment completion, since studies have shown that approximately 30-35% of all patients do not take their medications as intended. The present article explores a continuum of evaluation strategies and performance measures for assessing the effectiveness of community-based programs designed to enhance treatment completion in patients with active pulmonary tuberculosis. Four traditional evaluation strategies

  6. Tuberculosis in the lung (image)

    Tuberculosis is caused by a group of organisms Mycobacterium tuberculosis, M bovis , M africanum and a few other rarer subtypes. Tuberculosis usually appears as a lung (pulmonary) infection. However, ...

  7. Interferon-gamma assay in combination with tuberculin skin test are insufficient for the diagnosis of culture-negative pulmonary tuberculosis.

    Marcin Wlodarczyk

    Full Text Available OBJECTIVE: Early diagnosis of infectious cases and treatment of tuberculosis (TB are important strategies for reducing the incidence of this disease. Unfortunately, traditional TB diagnostic methods are time-consuming and often unreliable. This study compared the accuracy and reliability of the tuberculin skin test (TST and interferon (IFN-γ-based assay (IGRA for the diagnosis of active pulmonary TB Polish cases that could or could not be confirmed by M. tuberculosis (M.tb culture. METHODS: In total, 126 adult patients with clinically active TB or non-mycobacterial, community-acquired lung diseases (NMLD hospitalised at the Regional Specialised Hospital of Tuberculosis, Lung Diseases and Rehabilitation in Tuszyn, Poland were enrolled in the present study. Sensitivity, specificity, positive predicted value (PPV, negative predicted value (NPV, and analytic accuracy (Acc of TST and IGRA testing for the diagnosis of culture-positive and culture-negative TB patients were calculated. The quantities of IFN-γ produced in the response to M.tb specific antigens (TB Ag - Nil in the cultures of blood from patients with active TB and NMLD patients were also analysed. RESULTS: The IGRA sensitivity in culture-positive and culture-negative TB patients was similar, measuring 65.1% and 55.6%, respectively. The sensitivity of TST did not differ from the parameters designated for IGRA, measuring 55.8% in culture-positive and 64.9% in culture-negative TB. The sensitivity of TST and IGRA was age-dependent and decreased significantly with the age of the patients. No differences in the frequency or intensity of M.tb-stimulated IFN-γ production, as assessed by IGRA testing between culture-positive and culture-negative TB were noticed. Significantly lower concentrations of IFN-γ were observed in patients with advanced TB forms compared with those with mild or moderate TB pathologies. CONCLUSIONS: Our results do not show that a combination of IGRA and TST might be a

  8. Investigation on Pulmonary Tuberculosis Prevalence of Freshmen from 2004 to 2010 in a Wuhan University%武汉某高校2004-2010年新生肺结核患病情况调查分析

    阎驰

    2012-01-01

    目的:了解高校新生肺结核的患病状况及其影响因素,为高校的结核病防治工作提供科学依据。方法:回顾性地对武汉某高校2004-2010年新生肺结核患病状况进行流行病学调查和分析。结果:2004-2010年武汉某高校新生检出活动性肺结核病例63例,年检出率分别为231.27/10万、309.77/10万、366.88/10万、239.38/10万、263.00/10万、106.16/10万、169.41/10万。男生发病40例,女生发病23例,男女生发病性别比为1∶0.58。结论:武汉某高校入学新生的肺结核检出率较高,高校应高度重视新生入学体检中的结核病专项检查。对查出的结核病患者应规范治疗和管理,同时应采取综合措施防止结核病在校内传播流行。%Objective: To investigate the prevalence and effects of pulmonary tuberculosis for freshmen,and provide scientific references for tuberculosis control in universities.Methods: The pervalence situation of pulmonary tuberculosis for freshmen from 2004 to 2010 in a Wuhan university was studied by epidemiologic investigation and analysis retrospectively.Results: 63 cases of active pulmonary tuberculosis were detected in freshmen of a Wuhan university from 2004 to 2010,and the annual rate was 231.27/100000,309.77/100000,366.88/100000,239.38/100000,263.00/100000,106.16/100000,169.41/100000,respectively.There were 40 cases of boys,23 cases of girls,and the sex ratio of pervalence was 1∶0.58.Conclusion: As there are higher pervalence ratio of pulmonary tuberculosis in freshmen,the university should pay attention to tuberculosis special inspection in freshmen examination.The patients should be treated and managed normatively.At the same time,comprehensive measures should be taken to prevent the spread of tuberculosis in the university.

  9. Tc 99m-infecton and Tc99m-HiG in evaluation of patients with pulmonary tuberculosis

    The m of the present study is to clarify the role of Tc99m-HIG and Tc99m-infecton in assessment of patients with pulmonary TB. Thirty-four patients with pulmonary tuberculosis proved by X-ray, bronchial lavage, sputum analysis and culture were included in the study. Tc99m-infecton and Tc99m-HIG were given intravenous in a dose of 740 MBq (20 md) with imaging after 1 and 4 hours. Images were correlated with clinical, radiological and laboratory data. Tc99m-infecton and Tc99m-HIG showed true positive results in 30 and 24 patients and false negative study in 4 and 10 patients, respectively. The sensitivity of Tc99m-infecton was 88% whereas that of Tc99m-HIG was 70%. When eighteen patients were followed up for 8 months after therapy with anti-tuberculous therapy, sixteen of them showed conversion of mycobacterium culture to negative. Tc99m-infecton images were true negative in 12 of them (specificity 75%) while only 8 of them were true negative on Tc99m-HIG study (specificity 50%) and only 6 were true negative on chest X-ray (specificity 37.5%). It can be concluded that Tc99m-infecton is more sensitive than Tc99m-HIG in diagnosis and monitoring response to treatment of pulmonary tuberculosis

  10. Extra pulmonary tuberculosis: Rapid identification of Mycobacterium tuberculosis grown in Mycobacterium growth indicator tube 960 and Lowenstein-Jensen media, employing Standard diagnostics Bioline Mycobacterium tuberculosis protein 64 antigen detection kit

    G Kandhakumari

    2015-01-01

    Full Text Available Background: Investigation of extra pulmonary tuberculosis (EPTB in and around Pondicherry is being carried out since August 2011 in our tertiary care super specialty hospital. Objectives: To compare the rapid Kit SD Bio-Line MPT 64 Ag with conventional and time consuming biochemical tests. Confirmation of Mycobacterium tuberculosis at a reasonable time frame is the main thrust. Materials and Methods: Thirty three Mycobacterium tuberculosis and four Non-Tuberculous Mycobacteria (NTM grown in MGIT960 system/Lowenstein-Jensen media (LJ were examined by the rapid MPT 64 antigen detection as well as a battery of conventional tests like niacin, nitrate reduction, paraminobenzoic acid susceptibility and cord formation. Results and Conclusion: . Both the rapid kit and conventional tests correctly identified 33 M.tuberculosis isolates. Keeping conventional identification as reference, sensitivity and specificity for rapid kit was 100%. Rapid kit which takes only 15 minutes is accurate, cost effective, and facilitates early treatment for these EPTB patients, whose clinical specimens are paucibacillary.

  11. Meta-analysis to compare the accuracy of GeneXpert, MODS and the WHO 2007 algorithm for diagnosis of smear-negative pulmonary tuberculosis

    Walusimbi, Simon; Bwanga, Freddie; Costa, Ayesha; Haile, Melles; Joloba, Moses; Hoffner, Sven

    2013-01-01

    Background Smear-negative pulmonary tuberculosis (SN-PTB), which is common in HIV-infected patients, is difficult to diagnose using smear microscopy alone. In 2007, the WHO developed an algorithm to improve the diagnosis and management of smear-negative tuberculosis in HIV prevalent and resource constrained settings. Implementation of the algorithm required individuals with presumptive TB to be initially evaluated using two sputum microscopy examinations followed by clinical diagnosis that ma...

  12. Change in Health-Related Quality of Life among Pulmonary Tuberculosis Patients at Primary Health Care Settings in South Africa: A Prospective Cohort Study

    Louw, Julia S.; Mabaso, Musawenkosi; PELTZER, Karl

    2016-01-01

    Introduction Pulmonary tuberculosis (TB) remains a major public health challenge in South Africa. However, little attention is paid to the impact of health related quality of life (HRQL) among TB patients at the beginning and at the end of TB treatment. This study assesses factors associated with HRQL among tuberculosis patients in three high risk provinces in South Africa. Methods A prospective cohort study was conducted at primary health care settings. Patients completed the HRQL social fun...

  13. Diagnostic value of serum adenosine deaminase levels in sputum smear negative pulmonary tuberculosis patients in Nepalese population

    Anil Chander; Chandrika Devi Shrestha

    2012-01-01

    Objective: To assess the levels of adenosine deaminase (ADA) in serum in patients with sputum smear negative pulmonary tuberculosis (SNPTB) and to compare it with serum ADA levels in patients with non-tuberculous pulmonary disease - chronic obstructive pulmonary disease (COPD) and with healthy control group and to explore its validity as a diagnostic marker in serum in SNPTB patients.Methods:Three groups of study populations were made. Group I: SNPTB - 142 cases, Group II:non-tubercular pulmonary disease - COPD - 40 cases, Group III: healthy controls - 80 cases. Serum samples were collected and ADA assay was done by the method of Guisti and Galanti. Results: ADA levels (Mean±SD, U/L) in the three groups were as follows: Group I: 42.26±21.22, Group II: 23.31±8.22, Group III: 18.88±6.67. Difference between Group I and Group III was statistically significant (P < 0.0001). The test showed a high specificity 91.25% (95% confidence interval - CI 83.00 - 95.7) and a sensitivity of 83.10% (95% CI 76.08-88.37) in Group I. Positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and accuracy in Group I were 94.00%, 69.52%, 9.49, 0.18 and 82.43% respectively.Conclusions: Overall assessment of the use of serum ADA levels as a diagnostic biochemical marker in smear-negative pulmonary tuberculosis patients showed promising results. Studies with a larger population group are required to validate its use as a routine diagnostic test in these cases.

  14. 肺结核合并糖尿病75例临床分析%Clinical analysis of 75 cases of pulmonary tuberculosis combined with diabetes

    奚志鹰; 倪庆红

    2012-01-01

    目的 分析肺结核合并糖尿病患者的临床特点.方法 肺结核合并糖尿病患者75例和同期肺结核患者650例的临床资料进行比较.结果 前者较后者痰抗酸杆菌涂片阳性率高、空洞形成多、治疗后痰菌阴转速度慢、肺部病灶吸收慢、空洞闭合少、抗痨疗程长.结论 对于肺结核合并糖尿病患者需适当延长疗程,积极控制血糖是肺结核合并糖尿病者康复的关键.%Objective To analyze clinical characteristics of pulmonary tuberculosis combined with diabetes. Methods 75 cases of pulmonary tuberculosis combined with diabetes and 650 cases of pulmonary tuberculosis with no diabetic during January 2005 and December 2009 were reviewed,analyzed and compared. Results Compared with the simple TB, TB combined with diabetes patients have the following characteristics:Acid-fast bacilli sputum smear-positive rate is higher,the tuberculosis cavity formation rate is more, the sputum conversion rate is slower after the treatment, the lung infection absorbs slower, empty closed fewer, the anti-tuberculosis treatment course is longer. Conclusions The treatment course to the pulmonary tuberculosis combined with diabetes should be extended, and blood sugar control is the key to cure the pulmonary tuberculosis combined with diabetes.

  15. Clinical value of urinary neopterin in monitoring of pulmonary tuberculosis drug resistance in 112 children%尿新蝶呤在112例儿童肺结核耐药性监测中的临床价值

    韩风英

    2008-01-01

    目的 探讨尿新蝶呤在儿童肺结核耐药性监测中的临床价值.方法 应用纸片扩散法进行结核耐药性检测.根据耐药检测结果,将肺结核活动期患儿112例分为耐药组(n=48)和非耐药组(n=64),健康儿童50例作为健康对照组.ELISA法检测其尿新蝶呤水平.结果 结核耐药组、非耐药组、健康对照组尿新蝶呤水平差异有统计学意义,结核患儿尿新蝶呤水平显著高于健康对照组,耐药组又显著高于非耐药组.结论 尿新蝶呤水平测定不仅对儿童肺结核有辅助诊断价值,而且在儿童结核耐药性监测中有重要的预警价值.尿新蝶呤测定作为一种无创、快速、简捷、敏感的结核耐药性初筛方法,值得临床推广应用.%Objective To investigate the clinical value of urinary neopterin in monitoring of pulmonary tuberculosis drug resistance in 112 children.Methods Slip diffusion method was applied to performing tuberculosis drug resistance test. According to the detecting results, 112 children with active pulmonary tuberculosis were divided into resistance group(n=48) and non-resistance group(n=64). 50 healthy children were enrolled as healthy control group. ELISA was employed to measure the urinary neopterin level for all subjects.Results There were statistical differences in urinary neopterin levels among resistance group, non-resistance group and healthy control group. The urinary neopterin level was more elevated in patients with pulmonary tuberculosis than that of healthy controls;while, the urinary neopterin level was much higher in resistance group than that of non-resistance group.Conclusion Not only does the measurement of urinary neopterin play a assisted role in diagnosis of pulmonary tuberculosis in children, but also it is of prewarning value in monitoring of children pulmonary tuberculosis drug resistance. As a non-invasive, rapid, simple and sensitive preliminary screening index, urinary neopterin is worthy of spreading

  16. The radiological findings of pulmonary tuberculosis: the analysis of 117 cases in Nagquka, tibet (with the comparison of 109 cases in Zhanjiang, Guangdong)

    Objective: It is an investigation of the characteristic radiological findings of pulmonary tuberculosis in population of Nagquka, northern Tibet. Method: During July, 1996 to September, 1999, the initial chest film (CXR) of 117 cases of pulmonary tuberculosis from Nagquka, were compared with the CXR of 109 cases encountered in sea-side city Zhanjiang, with the same constituent ratio of age. According to the classification system for pulmonary tuberculosis of 1998, double-blinded investigation was made on the two groups and (x2 test was applied for statistical analysis. Results: Higher rate (7.69%) of primary pulmonary tuberculosis with higher ratio of adult patients were revealed in Nagquka group, while high rate (93.6%) of secondary pulmonary tuberculosis was found in the control group. More cases (16.2%) presented segmental consolidation in Nagquka group than that in control group, while in most of cases (74.3%) of control group, small patchy lesions were the predominant pattern. In 31.6% cases of the research group, 4 or more lung fields were involved, while in the control group the ratio was 16.5%. More rare locations of the lesion, like inferior lung field were revealed in the research group, and the ratio of rare location was 12.8% in research group and 0.9% in the control group. The rate of cavity (11.97%) was not high in research group, but 32.1% in control group. Statistical significance was indicated (P 2 test. Conclusion: For the radiological manifestations of pulmonary tuberculosis, there are significant differences between the population of Nagquka and the sea-side city Zhanjiang

  17. Systematic review: Comparison of Xpert MTB/RIF, LAMP and SAT methods for the diagnosis of pulmonary tuberculosis.

    Yan, Liping; Xiao, Heping; Zhang, Qing

    2016-01-01

    Technological advances in nucleic acid amplification have led to breakthroughs in the early detection of PTB compared to traditional sputum smear tests. The sensitivity and specificity of loop-mediated isothermal amplification (LAMP), simultaneous amplification testing (SAT), and Xpert MTB/RIF for the diagnosis of pulmonary tuberculosis were evaluated. A critical review of previous studies of LAMP, SAT, and Xpert MTB/RIF for the diagnosis of pulmonary tuberculosis that used laboratory culturing as the reference method was carried out together with a meta-analysis. In 25 previous studies, the pooled sensitivity and specificity of the diagnosis of tuberculosis were 93% and 94% for LAMP, 96% and 88% for SAT, and 89% and 98% for Xpert MTB/RIF. The I(2) values for the pooled data were >80%, indicating significant heterogeneity. In the smear-positive subgroup analysis of LAMP, the sensitivity increased from 93% to 98% (I(2) = 2.6%), and specificity was 68% (I(2) = 38.4%). In the HIV-infected subgroup analysis of Xpert MTB/RIF, the pooled sensitivity and specificity were 79% (I(2) = 72.9%) and 99% (I(2) = 64.4%). In the HIV-negative subgroup analysis for Xpert MTB/RIF, the pooled sensitivity and specificity were 72% (I(2) = 49.6%) and 99% (I(2) = 64.5%). LAMP, SAT and Xpert MTB/RIF had comparably high levels of sensitivity and specificity for the diagnosis of tuberculosis. The diagnostic sensitivity and specificity of three methods were similar, with LAMP being highly sensitive for the diagnosis of smear-positive PTB. The cost effectiveness of LAMP and SAT make them particularly suitable tests for diagnosing PTB in developing countries. PMID:26786658

  18. Study on drug resistance of mycobacterium tuberculosis in patients with pulmonary tuberculosis by drug resistance gene detecting

    To investigate drug resistance of mycobacterium tuberculosis in different age group, compare detecting effect of two methods and evaluate their the clinical application value, all of the strains of mycobacterium tuberculosis were tested for resistance to RFP, INH SM PZA and EMB by the absolute concentration method on Lowenstein-Jensen medium and the mutation of the rpoB, katG, rpsL, pncA and embB resistance genes in M. tuberculosis was tested by PCR-SSCP. In youth, middle and old age group, the rate of acquired drug resistance was 89.2%, 85.3% and 67.6% respectively, the gene mutation rate was 76.2%, 81.3% and 63.2% respectively. The rate of acquired drug resistance and multiple drug resistance in youth group was much higher than those in other groups. The gene mutation was correlated with drug resistance level of mycobacterium tuberculosis. The gene mutation rate was higher in strains isolated from high concentration resistance than those in strains isolated from low concentration resistance. The more irregular treatment was longer, the rate of drug resistance was higher. Acquired drug resistance varies in different age group. It suggested that surveillance of drug resistence in different age group should be taken seriously, especially in youth group. PCR - SSCP is a sensitive and specific method for rapid detecting rpoB, katG, rpsL, pncA and embB genes mutations of MTB. (authors)

  19. Lesion-Specific Immune Response in Granulomas of Patients with Pulmonary Tuberculosis: A Pilot Study.

    Selvakumar Subbian

    Full Text Available The formation and maintenance of granulomas is central to the host response to Mycobacterium tuberculosis (Mtb infection. It is widely accepted that the lungs of patients with tuberculosis (TB usually contain multiple infection foci, and that the granulomas evolve and differentiate independently, resulting in considerable heterogeneity. Although gene expression profiles of human blood cells have been proposed as biomarkers of Mtb infection and/or active disease, the immune profiles of discrete lesion types has not been studied extensively. Using histology, immunopathology and genome-wide transcriptome analysis, we explored the immunological profile of human lung TB granulomas. We show that although the different granulomas share core similarities in their immunological/inflammatory characteristics, they also exhibit significant divergence. Despite similar numbers of CD68+ macrophages in the different lesions, the extent of immune reactivity, as determined by the density of CD3+ T cells in the macrophage rich areas, and the extent of fibrosis, shows considerable variation. Both quantitative and qualitative differences among significantly differentially expressed genes (SDEG were noted in each of the lesion types studied. Further, network/pathway analysis of SDEG revealed differential regulation of inflammatory response, immune cell trafficking, and cell mediated immune response in the different lesions. Our data highlight the formidable challenges facing ongoing efforts to identify peripheral blood biomarkers due to the diversity of lesion types and complexity of local immune responses in the lung.

  20. Time-kill kinetics of anti-tuberculosis drugs, and emergence of resistance, in relation to metabolic activity of Mycobacterium tuberculosis.

    Steenwinkel, J.E. de; Knegt, G.J. de; Kate, M.T. Ten; Belkum, A. van; Verbrugh, H.A.; Kremer, K.; Soolingen, D. van; Bakker-Woudenberg, I.A.

    2010-01-01

    OBJECTIVES: The pharmacodynamics of tuberculosis (TB) treatment should be further explored, to prevent emergence of resistance, treatment failure and relapse of infection. The diagnostic drug susceptibility tests guiding TB therapy investigate metabolically active Mycobacterium tuberculosis (Mtb) is

  1. Pulmonary tuberculosis mimicking lung cancer on radiological findings: Evaluation of chest CT findings in pathologically proven 76 patients

    To evaluate chest CT features of pulmonary tuberculosis mimicking lung malignancy. We retrospectively reviewed chest CT findings for 76 consecutive patients (21-84 years, average: 63 years; M : F = 30 : 46) who underwent an invasive diagnostic procedure under the suspicion of lung cancer and were pathologically diagnosed as pulmonary tuberculosis by bronchoscopic biopsy (n = 49), transthoracic needle biopsy (n = 17), and surgical resection (n = 10). We categorized the chest CT patterns of those lesions as follows: bronchial narrowing or obstruction without a central mass like lesion (pattern 1), central mass-like lesion with distal atelectasis or obstructive pneumonia (pattern 2), peripheral nodule or mass including mass-like consolidation (pattern 3), and cavitary lesion (pattern 4). CT findings were reviewed with respect to the patterns and the locations of the lesions, parenchymal abnormalities adjacent to the lesions, the size, the border and pattern of enhancement for the peripheral nodule or mass and the thickness of the cavitary wall in the cavitary lesion. We also evaluated the abnormalities regarding the lymph node and pleura. Pattern 1 was the most common finding (n = 34), followed by pattern 3 (n = 23), pattern 2 (n = 11) and finally, pattern 4 (n = 8). The most frequently involving site in pattern 1 and 2 was the right middle lobe (n = 14/45). However, in pattern 3 and 4, the superior segment of right lower lobe (n = 5/31) was most frequently involved. Ill-defined small nodules and/or larger confluent nodules were found in the adjacent lung and at the other segment of the lung in 31 patients (40.8%). Enlarged lymph nodes were most commonly detected in the right paratracheal area (n = 9/18). Pleural effusion was demonstrated in 10 patients. On the CT, pulmonary tuberculosis mimicking lung cancer most commonly presented with bronchial narrowing or obstruction without a central mass-like lesion, which resulted in distal atelectasis and obstructive

  2. Prevalence of tuberculous peritonitis in the North of Iraq and sociodemographic comparison with pulmonary tubercu-losis

    Abdulqadir Maghded Zangana; Tariq SAl-Hadithi MSc; Sherzad Ali Ismail

    2009-01-01

    Objective:Tuberculosis continues to be an important health problem in the world.Despite the widespread im-pression that abdominal tuberculosis is rare today,the disease is still endemic in developing world and is re-emerging in the West.The aim is to review our local experience with tuberculous peritonitis.Methods:Be-tween January 2000 and December 2006,the case records of histologically documented tuberculous peritonitis (TBP)diagnosed and treated at the tuberculosis coordinating center in Erbil city,Iraq were reviewed.Com-parisons were made with pulmonary tuberculosis patients regarding socio-demographic,clinical and laboratory findings.Results:Forty one cases of TBP were diagnosed during the study period.Their age range was 26-72 years (46 ±17),with a male:female ratio of 1.5:1.The median duration of symptoms before diagnosis was 6 weeks (range:10 days to 18 months.).Eleven patients (26.8%)had comorbid conditions and 6 patients (14.6%)had a history of positive contact with Tuberculosis(TB)case.Presenting symptoms were abdominal distension (70%),abdominal pain (65%),fever (68%),anorexia (65%)and weight loss (44%).Four patients had pulmonary symptoms:cough and /dyspnoea (n =2)and cough (n =2).Chest X-ray changes consistent with pulmonary tuberulosis(PTB)were seen in 25%.Tuberculous peritonitis was diagnosed by lap-aroscopy (n =29)and laparotomy (n =12).Adverse effects of TB drugs occurred in nearly 40%,consisting of hepatitis (n =2),nausea /vomiting (n =11),rash (n =2)and encephalopathy (n =1).Hemoglobin and serum albumin levels were significantly lower in tuberculous peritonitis(TBP)TBP patients (P =0.027 and 0. 003,respectively).There was a significantly greater occurrence of adverse effects (P <0.001)in TBP pa-tients.No significant differences between TBP and PTB were demonstrated in regard to age and sex distribu-tion,non-specific symptoms (fever,weight loss,and anorexia)and erythrocyte sedimentation rate.All were treated with standard regimens and responded

  3. Half of Pulmonary Tuberculosis Cases Were Left Undiagnosed in Prisons of the Tigray Region of Ethiopia: Implications for Tuberculosis Control.

    Kelemework Adane

    Full Text Available Prison settings have been often identified as important but neglected reservoirs for TB. This study was designed to determine the prevalence of undiagnosed pulmonary TB and assess the potential risk factors for such TB cases in prisons of the Tigray region.A cross-sectional study was conducted between August 2013 and February 2014 in nine prisons. A standardized symptom-based questionnaire was initially used to identify presumptive TB cases. From each, three consecutive sputum samples were collected for acid-fast bacilli (AFB microscopy and culture. Blood samples were collected from consented participants for HIV testing.Out of 809 presumptive TB cases with culture result, 4.0% (95% CI: 2.65-5.35 were confirmed to have undiagnosed TB. The overall estimated point prevalence of undiagnosed TB was found to be 505/100,000 prisoners (95% CI: 360-640. Together with the 27 patients who were already on treatment, the overall estimated point prevalence of TB would be 793/100,000 prisoners (95% CI: 610-970, about four times higher than in the general population. The ratio of active to passive case detection was 1.18:1. The prevalence of HIV was 4.4% (36/809 among presumptive TB cases and 6.3% (2/32 among undiagnosed TB cases. In a multivariate logistic regression analysis, chewing Khat (adjusted OR = 2.81; 95% CI: 1.02-7.75 and having had a close contact with a TB patient (adjusted OR = 2.18; 95% CI: 1.05-4.51 were found to be predictors of undiagnosed TB among presumptive TB cases.This study revealed that at least half of symptomatic pulmonary TB cases in Northern Ethiopian prisons remain undiagnosed and hence untreated. The prevalence of undiagnosed TB in the study prisons was more than two folds higher than in the general population of Tigray. This may indicate the need for more investment and commitment to improving TB case detection in the study prisons.

  4. Predominant location of pulmonary parenchymal lesions of tuberculosis primary complex in infants aged less than one year

    It is useful to know the distribution of pulmonary lesions in the diagnosis of tuberculosis on radiological examination. The aim of this study was to investigate if there is predominant lung segment or lobe for tuberculous lesions in infants aged less than one year using contrast enhanced CT. We studied 57 infants (40 boys, 17 girls) who were diagnosed as tuberculosis by isolation of Mycobacterium tuberculosis or combination of family contact, radiographic findings suggesting tuberculosis, and positive reaction of 5 mm or more induration to purified protein derivative (PPD) tuberculin. All the infants had lesions in mediastinal and/or hilar lymphonodes, and 54 out of 57 infants had parenchymal lesions as well. In the study of the segmental predominance of tuberculous lesions, each infant had a share of 100 points. If an infant had a single focus, all the points were distributed to the corresponding segment. If he or she had multiple foci, the 100 points were equally divided into affected lung segments. There was no significant difference between right (3385 points/10 segments) and left (2005 points/8 segments) lungs. The points in upper lobes (2224 points/5 segments) were significantly higher than the combined points of middle and lingual (896 points/4 segments) and lower (2270 points/9 segments) lobes (p<0.05). The points in posterior lung segments (2839 points/7 segments) were significantly higher than the combined points of middle (436 points/3 segments) and anterior (2115 points/8 segments) lung segments (p<0.05). These results suggest that upper lobes and posterior segments are predominant parenchymal regions of tuberculosis among infants less than one year, although tuberculous lesions may locate in any lung segment. (author)

  5. Incremental yield of submitting three sputum specimens for the diagnosis of pulmonary tuberculosis

    Objectives: To assess the efficacy and diagnostic yield of third sputum smear among pulmonary TB patients. Study type, settings and duration: This retrospective data analysis was done at PMRC TB Research Centre in collaboration with Institute of Chest Medicine, King Edward Medical University/Mayo Hospital Lahore, from January 2010 to December 2011. Materials and Methods: Patients presenting with respiratory symptoms, having abnormal chest X-rays and having a clinical suspicion of tuberculosis were asked to submit three sputum samples on two consecutive days (1st spot, 2nd early morning, 3rd spot) for acid-fast bacilli smear microscopy. Smears were prepared and stained by Ziehl-Neelsen method. Results: A total of 7785 TB suspects submitted three sputum samples making a total of 23,355 slides for checking acid-fast bacilli using smear microscopy examinations. The smear positivity rate was 11.8%. About 12% suspects fulfilled the case definition of having one positive smear confirmed by a second smear, while, only 2.5% suspects fulfilled the case definition based on third smear in combination with first or second. A total 1164(15%) suspects had at least one positive smear; of these 896(77%) were positive in first smear, 190(16%) were negative in first smear but positive in second and 78(6.7%) were positive in third smear after two negative smears. Conclusion: Recently changed WHO criteria for examination of two sputum smears is based on evidences collected from the globe however, for Pakistan the value of third smear which picked almost 7% cases is quite significant and should still be practiced. Policy message: Checking AFB using 3 sputum smears should still be practiced in Pakistan especially, for those who are initially negative on 2 smears. (author)

  6. Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis

    Bruno Horta Andrade

    2013-08-01

    Full Text Available Introduction This study evaluated the efficacy of retreatment of pulmonary tuberculosis (TB with regard to treatment outcomes and antimicrobial susceptibility testing (ST profiles. Methods This retrospective cohort study analyzed 144 patients treated at a referral hospital in Brazil. All of them had undergone prior treatment, were smear-positive for TB and received a standardized retreatment regimen. Fisher's 2-tailed exact test and the χ2 test were used; RRs and 95% CIs were calculated using univariate and multivariate binary logistic regression. Results The patients were cured in 84 (58.3% cases. Failure was associated with relapsed treatment and abandonment (n=34. Culture tests were obtained for 103 (71.5% cases; 70 (48.6% had positive results. ST results were available for 67 (46.5% cases; the prevalence of acquired resistance was 53.7%. There were no significant differences between those who achieved or not therapeutic success (p=0.988, despite being sensitive or resistant to 1 or more drugs. Rifampicin resistance was independently associated with therapeutic failure (OR: 4.4, 95% CI:1.12-17.37, p=0.034. For those cases in which cultures were unavailable, a 2nd model without this information was built. In this, return after abandonment was significantly associated with retreatment failure (OR: 3.59, 95% CI:1.17-11.06, p=0.026. Conclusions In this cohort, the general resistance profile appeared to have no influence on treatment outcome, except in cases of rifampicin resistance. The form of reentry was another independent predictor of failure. The use of bacterial culture identification and ST in TB management must be re-evaluated. The recommendations for different susceptibility profiles must also be improved.

  7. Adjunct therapy of Ayurvedic medicine with anti tubercular drugs on the therapeutic management of pulmonary tuberculosis

    P K Debnath

    2012-01-01

    Full Text Available Background: Pulmonary tuberculosis (PTB is an age old disease described in Vedic Medicine as ′Yakshma′. Later on, in Ayurveda it earned a prefix and found way into mythology as ′Rajayakshma′. After the discovery of streptomycin, the therapeutic management of PTB received a major breakthrough. The treatment module changed remarkably with the formulation of newer anti-tubercular drugs (ATD with appreciable success. Recent resurgence of PTB in developed countries like United States posed a threat to the medical community due to resistant strains. Consequently, WHO looked toward traditional medicine. Literature reveals that Ayurvedic treatment of PTB was in vogue in India before the introduction of ATD with limited success. Records show that 2766 patients of PTB were treated with Ayurvedic drugs in a tertiary care hospital in Kolkata in the year 1933-1947. Objectives: To evaluate the toxicity reduction and early restoration by adjunct therapy of Ayurvedic drugs by increasing the bio-availability of ATDs. Materials and Methods: In the present study, treatment response of 99 patients treated with ATD as an adjunct with Aswagandha (Withania somnifera and a multi-herbal formulation described in Chikitsa-sthana of Charaka samhita i.e. Chyawanprash were investigated. Hematological profile, sputum bacterial load count, immunoglobulin IgA and IgM, blood sugar, liver function test, serum creatinine were the assessed parameters besides blood isoniazid and pyrazinamide, repeated after 28 days of treatment. Results: The symptoms abated, body weight showed improvement, ESR values were normal, there was appreciable change in IgA and IgM patterns and significantly increased bioavailability of isoniazid and pyrazinamide were recorded. Conclusion: This innovative clinical study coupled with empowered research may turn out to be promising in finding a solution for the treatment of PTB.

  8. Cytokine production and mRNA expression in pulmonary tuberculosis patients and their household contacts of younger age group (15-25years).

    Joshi, Lavanya; Ponnana, Meenakshi; Sivangala, Ramya; Chelluri, Lakshmi Kiran; Nallari, Pratibha; Valluri, Vijaya Lakshmi; Gaddam, Sumanlatha

    2016-05-01

    Household contacts of tuberculosis patients are at high risk of infection and development of active disease. In this study we evaluated the cytokine production and mRNA expression of IFN-γ, TNF-α, IL-10&IL-6 stimulated with r32kDa M. bovis BCGAg in active pulmonary tuberculosis patients (APTB), household contacts (HHC) and healthy controls (HC). The results showed the stimulated levels of IFN-γ and TNF-α were low while IL-10 levels were high in APTB and HHC compared to HC. IL-6 has not shown any significant difference. The mRNA expression of TNF- α was 8 fold high in HCs compared to APTB and HHC. The IL-6 expression was 2.2 fold &1 fold less in APTB and HHC compared to HCs. Multinomial logistic regression analysis indicated that the stimulated levels of IFN-γ & IL-6 and sex significantly predicted the HHC group from HCs at p<0.05.In conclusion further follow up studies with r32kd antigen might help to identify the high risk individuals. PMID:26876300

  9. 仪陇县和嘉陵区肺结核密切接触者结核病知识知晓现状%Awareness Situation of Tuberculosis Related Knowledge Among the Close Contacts of Pulmonary Tuberculosis

    高晓凤; 李健; 许平; 贾显奉

    2012-01-01

    目的 了解贫困地区肺结核密切接触者结核病防治知识的知晓现状,为进一步有针对性开展结核病健康教育奠定基础 方法 采用“全国第五次结核病流行病学抽样调查知晓率调查问卷”对西部2个国家级贫困县的肺结核病密切接触者进行抽样调查.结果 共调查486名肺结核病密切接触者,结核病知识总知晓率为73.6%,单一知识知晓率均>50%,平均得分为3.68分.密切接触者的性别、年龄、文化程度、职业及宣传教育对其结核病知识得分的影响具有统计学意义.结论 2个国家级贫困县肺结核密切接触者的知晓情况较低,与国家有关目标仍有一定差距,应加强结核病健康教育及提高教育水平.%Objective To understand the awareness situation of tuberculosis - related knowledge among the close contacts of pulmonary tuberculosis in poverty - stricken areas. Method The questionnaire of the fifth nationwide sampling survey on tuberculosis prevalence was used to investigate the close contacts of pulmonary tuberculosis in two state - designated impoverished counties. Results Totally 486 close contacts of pulmonary tuberculosis were investigated, the total awareness rate on tuberculosis messages was 73.6% , and the awareness rates on special tuberculosis message were all >50% , with the average score 3. 68. The close contacts' attributes of sex, age, the education level, occupation and health education were respectively correlated with their scores on the tuberculosis messages. Conclusion The awareness rate of tuberculosis related knowledge among close contacts of pulmonary tuberculosis in two state - designated impoverished counties is low, which is still far from the national goal. It is .necessary to enhance the health education and improve the level of education.

  10. Correlation between tuberculin skin test and IGRAs with risk factors for the spread of infection in close contacts with sputum smear positive in pulmonary tuberculosis

    de Souza-Galvão, Maria Luiza; Latorre, Irene; Altet-Gómez, Neus; Jiménez-Fuentes, María Ángeles; Milà, Celia; Solsona, Jordi; Seminario, Maria Asunción; Cantos, Adela; Ruiz-Manzano, Juan; Domínguez, José

    2014-01-01

    Background The aim of the study was to assess the correlation between the tuberculin skin test (TST) and in vitro interferon-gamma released assays (IGRAs) with risk factors for the spread of infection in smear positive pulmonary tuberculosis (TB) contacts. Methods We recruited prospective contacts with smear positive pulmonary TB cases. We looked at human immunodeficiency virus (HIV) infection and other conditions of immunosuppression, presence of BCG vaccination and the degree of exposure to...

  11. An evaluation of Universal Sample Processing method under Revised National Tuberculosis Control Programme set up for the diagnosis of pulmonary tuberculosis

    Savitha Parashuram

    2013-10-01

    Full Text Available Context: The main stay in the management of tuberculosis is its early diagnosis and treatment. Aim: To evaluate the utility of Universal Sample Processing (USP method, claimed to be more sensitive than direct smear microscopy. Materials and Methods: Sputum samples from 1000 patients with history of cough for more than two weeks, visiting the two RNTCP centers between November 2011 and November 2012, were subjected to direct Ziehl-Neelsen staining and staining after USP method. To find out if there was any difference in the time taken to detect Acid Fast Bacilli (AFB between the methods, the smears were screened by two trained RNTCP technicians. Sputum samples positive for AFB in the USP method were put up for culture on Lowenstein-Jensen medium to evaluate the suitability of USP method as a pre-treatment procedure before culture. The growth was identified as Mycobacterium tuberculosis (MTB by the Niacin test. Results: Ninety four samples were positive for AFB by both methods. The USP method did not detect more positives among those which were found negative by direct microscopy. There was no significant difference in the time taken to detect AFB between the methods. Among the 94 smear positive samples subjected to USP method as a pre-treatment procedure, only 40 (42.5% samples yielded growth of MTB. Conclusions: USP technique did not offer additional advantage over direct microscopy for detection of AFB to diagnose pulmonary tuberculosis. As a pre-treatment procedure, USP method yielded low mycobacterial growth even from those samples positive for AFB by microscopy, making it unsuitable for culture of MTB.

  12. Paradoxical tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS in HIV patients with culture confirmed pulmonary tuberculosis in India and the potential role of IL-6 in prediction.

    Gopalan Narendran

    Full Text Available BACKGROUND: The incidence, manifestations, outcome and clinical predictors of paradoxical TB-IRIS in patients with HIV and culture confirmed pulmonary tuberculosis (PTB in India have not been studied prospectively. METHODS: HIV+ patients with culture confirmed PTB started on anti-tuberculosis therapy (ATT were followed prospectively after anti-retroviral therapy (ART initiation. Established criteria for IRIS diagnosis were used including decline in plasma HIV RNA at IRIS event. Pre-ART plasma levels of interleukin (IL-6 and C-reactive protein (CRP were measured. Univariate and multivariate logistic regression models were used to evaluate associations between baseline variables and IRIS. RESULTS: Of 57 patients enrolled, 48 had complete follow up data. Median ATT-ART interval was 28 days (interquartile range, IQR 14-47. IRIS events occurred in 26 patients (54.2% at a median of 11 days (IQR: 7-16 after ART initiation. Corticosteroids were required for treatment of most IRIS events that resolved within a median of 13 days (IQR: 9-23. Two patients died due to CNS TB-IRIS. Lower CD4(+ T-cell counts, higher plasma HIV RNA levels, lower CD4/CD8 ratio, lower hemoglobin, shorter ATT to ART interval, extra-pulmonary or miliary TB and higher plasma IL-6 and CRP levels at baseline were associated with paradoxical TB-IRIS in the univariate analysis. Shorter ATT to ART interval, lower hemoglobin and higher IL-6 and CRP levels remained significant in the multivariate analysis. CONCLUSION: Paradoxical TB-IRIS frequently complicates HIV-TB therapy in India. IL-6 and CRP may assist in predicting IRIS events and serve as potential targets for immune interventions.

  13. Routine examination for tuberculosis is still indicated during bronchoscopy for pulmonary infiltrates

    Laub, Rasmus Rude; Sivapalan, Pradeesh; Wilcke, Torgny;

    2015-01-01

    INTRODUCTION: Tuberculosis (TB) can present in numerous ways and can be radiological indistinguishable from cancer. In several guidelines for bronchoscopy (FOB) in low-incidence areas, a Mycobacterium tuberculosis test is only recommended when TB is clinically suspected. Due to the expenses assoc...

  14. Smears and cultures for diagnosis of pulmonary tuberculosis in an asymptomatic immigrant population

    Assael, Roberto; Cervantes, Joaquin; Barrera, Gerardo

    2013-01-01

    Background The World Health Organization estimated in 2010 that 8.8 million new tuberculosis (TB) cases. About one-third of the world’s population is infected and 10% will develop active TB disease. While cultures remain the international gold standard for diagnosing TB disease, in many other low-income countries, sputum smears remain the only and most accessible tool with which to diagnose active TB disease. As a consequence, in patients with TB who have negative smears, their TB remains undetected. Aim The objective of the study reported here was to demonstrate the proportion of smear-positive/culture-positive cases compared with smear-negative/culture-positive TB cases in Mexican immigrants bound for the USA. Methods A retrospective study was undertaken of the medical records of 122 active TB cases diagnosed at a clinic in Ciudad Juarez, Mexico, from 2009 to 2012. All cases were confirmed by culture, regardless of the sputum smear results. Results Of the cases, 80% (97 active TB cases) had negative sputum smears, while only 25 cases (20%) had at least one positive smear. All of the cultures were confirmed as positive for Mycobacterium tuberculosis complex. Conclusion The fact that 80% of the TB cases were smear negative and 20% smear positive shows that there is a clear gap between the actual state of active TB disease within patients under screening conditions, meaning that eight out of ten actual cases are being missed when sputum smear is the only diagnostic tool in asymptomatic patients with abnormal chest X-rays. Based on these results, it is highly recommended that countries that have not standardized culturing as the gold standard for the diagnosis of active TB do so, so that TB cases – which may endanger global public health – are not missed. It is also recommended that further studies be undertaken to determine the clinical background of the patients diagnosed by smear and culture to identify a direct relationship between clinical signs and

  15. Smears and cultures for diagnosis of pulmonary tuberculosis in an asymptomatic immigrant population

    Assael R

    2013-09-01

    Full Text Available Roberto Assael, Joaquin Cervantes, Gerardo Barrera Clinica Medica Internacional, Ciudad Juarez, Mexico Background: The World Health Organization estimated in 2010 that 8.8 million new tuberculosis (TB cases. About one-third of the world's population is infected and 10% will develop active TB disease. While cultures remain the international gold standard for diagnosing TB disease, in many other low-income countries, sputum smears remain the only and most accessible tool with which to diagnose active TB disease. As a consequence, in patients with TB who have negative smears, their TB remains undetected. Aim: The objective of the study reported here was to demonstrate the proportion of smear-positive/culture-positive cases compared with smear-negative/culture-positive TB cases in Mexican immigrants bound for the USA. Methods: A retrospective study was undertaken of the medical records of 122 active TB cases diagnosed at a clinic in Ciudad Juarez, Mexico, from 2009 to 2012. All cases were confirmed by culture, regardless of the sputum smear results. Results: Of the cases, 80% (97 active TB cases had negative sputum smears, while only 25 cases (20% had at least one positive smear. All of the cultures were confirmed as positive for Mycobacterium tuberculosis complex. Conclusion: The fact that 80% of the TB cases were smear negative and 20% smear positive shows that there is a clear gap between the actual state of active TB disease within patients under screening conditions, meaning that eight out of ten actual cases are being missed when sputum smear is the only diagnostic tool in asymptomatic patients with abnormal chest X-rays. Based on these results, it is highly recommended that countries that have not standardized culturing as the gold standard for the diagnosis of active TB do so, so that TB cases – which may endanger global public health – are not missed. It is also recommended that further studies be undertaken to determine the clinical

  16. TUBERCULIN RESPONSIVENESS AS A PROGNOSTIC INDICATOR IN HIV POSITIVE PULMONARY TUBERCULOSIS, KIMS, AMALAPURUM

    Nagaraja

    2014-11-01

    Full Text Available With the emergence of HIV pandemic there is an alarming increase in both HIV and Tuberculosis cases cause’s major health problems due to poor socio-economic status in developing and resource poor countries. HIV and Tuberculosis infection hand in hand kills more population than all other infections combined. Both HIV and Tuberculosis is a major health problem. So the present study is under taken to know present scenario of HIV and TB in the rural set up, Amalapuram, East Godavari District, Andhra Pradesh. Out of 100 suspected cases with HIV and Tuberculosis with malnutrition, 10 samples were found to be HIV positive by rapid and ELISA. Among 10 positive HIV cases 6 cases were found to be positive for AFB by ZN stain indicating both HIV and Tuberculosis go hand in hand.

  17. Sodium Hypochlorite Sedimentation Technique: A Simple Way to Enhance Sensitivity of Ziehl-Neelsen Stain in Diagnosis of Smear Negative Pulmonary Tuberculosis

    B. V. Peerapur

    2014-07-01

    Full Text Available Background: With the looming global HIV pandemic, the problem of tuberculosis tiptoes as a perpetual companion. Smear negative pulmonary tuberculosis which pose substantially a challenge for diagnosis, hoots this combination into noxious health problem. There is, therefore, an urgent need to establish more sensitive, safe and fairly rapid methodologies that could confirm diagnosis particularly in smear negative pulmonary tuberculosis patients. Aim: This study was carried out to establish whether, 3.5% sodium hypochlorite overnight sedimentation method improves the sensitivity of Ziehl-Neelsen (ZN stain in samples declared as smear negative. Material and Methods: A total of 605 direct ZN smear negative sputum specimens were examined after concentration with 3.5% sodium hypochlorite overnight sedimentation method. Results: Forty one (6.77% samples were found to be positive when smears were repeated after performing sodium hypochlorite sedimentation technique. Sensitivity and specificity of this method was found to be 76.31% and 97.88% respectively. Conclusion: 3.5% Sodium hypochlorite sedimentation technique has the potential to improve the diagnosis in tuberculosis in smear negative pulmonary tuberculosis cases especially in resource poor countries.

  18. Extra pulmonary tuberculosis in a tertiary teaching hospital:A five years review

    Siti Suraiya Md Noor; Zaidah Abdul Rahman; Sarimah Abdullah; Zakuan Zainy Deris; Che Wan Aminuddin

    2009-01-01

    Objective:To investigate the prevalence,clinical and bacteriological features and outcome of extrapulmonary tuberculosis in patients attending a tertiary care hospital at Kota Bharu,Kelantan.Methods:All culture posi-tive tuberculosis cases recorded in Hospital Universiti Sains Malaysia at Kota Bharu during five years period from 2003-2007 were included in the study.Mycobacterium detected in samples originating from sites other than lungs was considered as a case of extrapulmonary tuberculosis.Age,site of infection,bacteriological find-ings and outcomes were analyzed.Results:Out of 437 tuberculosis cases recorded from 2002-2006,59 cases had culture positive extrapulmonary tuberculosis.Their mean age was 37 years and 44% were between the ages of 20-40 years.About 63% were negative for acid-fast bacilli by Z-N stain.Of the 59,97% was Mycobacteri-um tuberculosisc (M.tuberculosis)while two (3%)were atypical Mycobacterium Runyon Group-IV.Only 3 (5%)were isoniazid resistant.Extrapulmonary sites involved were lymph nodes 19 (31%),central nervous system 12 (20%),pleural 11(19%)spine 8 (14%),renal 3 (5.1%)and others 6 (10.2%).In this se-ries,11(18%)were positive for HIV.There was no significant association between extrapulmonary tuberculo-sis and HIV status.The outcome of CNS tuberculosis was the poorest with a mortality rate of 25%.Conclu-sion:M.tuberculosis is the predominant organism in extrapulmonary tuberculosis and culture is the most effec-tive method for its diagnosis.

  19. Comparison of Chest X-Ray Findings of Smear Positive and Smear Negative Patients with Pulmonary Tuberculosis

    Tuberculosis is a chronic pulmonary infectious disease that has affected one-third of the people in the world. It causes nine million new cases and two million deaths per year. Chest radiography associated with Ziehl-Neelsen acid-fast staining procedure significantly helps the diagnosis of pulmonary tuberculosis (PTB). Chest radiography can help the diagnosis of tuberculosis in patients with a negative smear sample result that is mainly diagnosed with delay. In this study, chest X-ray findings of PTB were compared in two groups of smear positive and smear negative patients. In this retrospective descriptive-analytical study, 376 patients who had been confirmed with PTB were referred to Birjand Health Care Center from 2001 to 2006. Out of the 376 patients, 100 patients with a positive smear based on WHO criteria were selected. In addition, among negative smear patients, 100 were selected in whom similar demographic characteristics with positive smear patients were seen. All of them had undergone chest radiographies that were then interpreted by two expert radiologists independently. Moreover, all patients’ sputa were examined by an expert laboratory technician at the reference laboratory of the health center. The obtained data were analyzed by means of frequency distribution table and descriptive statistics using SPSS (version 15) and Chi-square statistical test. Except reticulo-nodular infiltration, the relative frequency of other radiographic findings in positive smear patients were more than negative smear patients; and only differences in calcification variables, mediastinal widening, patchy infiltration and hilar adenopathy were statistically significant (P < 0.05). Based on the results of this study, although radiographic findings are not diagnostic in PTB, they are helpful if the assessment associates with the view of clinical manifestations and sputum smears

  20. Computed tomographic demonstrations of HIV seropositive pulmonary tuberculosis and their relationship with CD4+T-lymphocyte count

    ZHANG Yu-zhong; LI Hong-jun; CHENG Jing-liang; WU Hao; BAO Dong-ying

    2011-01-01

    Background Factors of cell-mediated immunity and allergy together play their roles in the pathogenesis of pulmonary tuberculosis (PTB) and its prognosis. The purpose of this study was to investigate the computed tomographic demonstrations of HIV seropositive PTB and the relationship between its pathogenesis and CD4+ T-lymphocyte count.Methods The documented CT images of a total of 44 patients with HIV seropositive PTB, definitely diagnosed by etiological or pathological examinations, their clinical data and their CD4+ T-lymphocyte count were retrospectively reviewed.Results There were 15 cases of miliary tuberculosis, accounting for 34.1% of the total cases; 15 cases of nodular tuberculosis, 34.1%; 6 cases of ground-glass opacity, 13.6%; 5 cases of cord-liked fiber shadows, 11.4%; 16 cases of flaky and flocculating shadows, 36.4%; 5 cases of cavitation, 11.4%; 5 cases of tumor shadows, 11.4%; 2 cases of pleural thickening, 4.5% and 11 cases of pleural effusion, 25.0%; 1 case of calcification, 2.3%; 16 cases of lymphadenectasis,36.4%. The foci were located around the pulmonary hilum, anterior segment of superior lobe, basal segment of inferior lobe, medial lobe and lingual lobe. CD4+ T-lymphocyte count was closely related to the imaging demonstrations of HIV seropositive PTB.Conclusions CT scanning can demonstrate various signs of PTB. CD4+ T-lymphocyte level determines the variety of imaging demonstrations of HIV seropositive PTB and its prognosis.

  1. 145例肺结核合并糖尿病临床分析%Clinical analysis of 145 patients with diabetes complicated with pulmonary tuberculosis

    陈金涛

    2013-01-01

    目的 分析和探讨肺结核合并糖尿病的临床特点和治疗方法.方法对我科住院的145例肺结核合并糖尿病患者进行分析.结果 血糖控制良好、血糖控制一般、血糖控制不良,肺结核治愈率分别为100%、77.78%、37.93%.结论 肺结核、糖尿病两病并存,相互影响,严格控制血糖、早期规律联合抗痨是关键.%Objective To analyze and explore the rliniral features oi diabetes patients complicated with pulmonary tuberculosis. Methods The clinical data oi 145 diabetes patients complicated with pulmonary tuberculosis were retrospectively analyzed. Results In patients with good control oi blood glucose, the cure rate was 100% . In patients with general control oi blood glucose, the cure rate was 77. 78% . In patients with poor control oi blood glucose, the cure rate was 37. 93% . Conclusion The curative effect oi diabetes patients complicated with pulmonary tuberculosis is related with the control oi blood glucose. Controlling blood glucose and strengthening chemotherapy are helpful to improve the the prognosis oi diabetes patients complicated with pulmonary tuberculosis.

  2. Diagnostic accuracy of the rapid urine lipoarabinomannan test for pulmonary tuberculosis among HIV-infected adults in Ghana-findings from the DETECT HIV-TB study

    Bjerrum, Stephanie; Kenu, Ernest; Lartey, Margaret;

    2015-01-01

    BACKGROUND: Rapid diagnostic tests are urgently needed to mitigate HIV-associated tuberculosis (TB) mortality. We evaluated diagnostic accuracy of the rapid urine lipoarabinomannan (LAM) test for pulmonary TB and assessed the effect of a two-sample strategy. METHODS: HIV-infected adults eligible ...

  3. Risk factors and drug-resistance patterns among pulmonary tuberculosis patients in northern Karnataka region, India

    Gajanan S Gaude

    2014-01-01

    Full Text Available Background: India is one of the high tuberculosis (TB-burden countries in the world. Resistance to anti-tuberculosis (anti-TB drugs has already become an important and alarming threat in most of the regions worldwide. India ranks second in the world in harbouring multi-drug resistant cases (MDRTB. Prevalence of MDR-TB mirrors the functional state and efficacy of TB control programmes and realistic attitude of the community towards implementation of such programmes. The most important risk factor in the development of MDRTB is improper implementation in the guidelines in the management of TB, and high rate of defaults on the part of the patients. The study was carried out to evaluate the drug resistance pattern to first line anti-TB drugs in Northern Karnataka region, India. Materials and Methods: A prospective study was conducted at J. N. Medical College and its associated Hospitals, Belgaum. Between January 2011 and December 2012, 150 sputum samples of suspected pulmonary TB patients based on the history were examined for the AFB culture by Lowenstein-Jensen (LJ culture technique. A total of two early morning samples were collected for the smear [Ziehl-Neelsen (ZN staining] and culture methods. It was observed that ZN staining for AFB was positive in 113 patients (75%, while AFB culture by LJ medium yielded growth in 66 cases (44%. Thus, a total of 66 AFB culture-positive samples by LJ medium were subjected for AFB drug-sensitivity testing (DST. DST was done for Isoniazid (INH, Rifampicin (RIF, Pyrazinamide (PZA, Ethambutol (EMB and Streptomycin (SM after isolation by using the resistance proportion method. Results: A total of 66 AFB culture-positive specimens, 20 (30.3% cases were sensitive to all the five drugs while 46 (69.7% cases showed resistance to one or more drugs. Among these, the resistance to rifampicin was highest (80.4%, while resistance to isoniazid, pyrazinamide, ethambutol and streptomycin were observed to be 60%, 58.7%, 52

  4. Hepatitis C Virus Co-Infection Increases the Risk of Anti-Tuberculosis Drug-Induced Hepatotoxicity among Patients with Pulmonary Tuberculosis

    Nino Lomtadze; Lali Kupreishvili; Archil Salakaia; Sergo Vashakidze; Lali Sharvadze; Kempker, Russell R.; Matthew J Magee; Carlos del Rio; Blumberg, Henry M.

    2013-01-01

    BACKGROUND: The country of Georgia has a high prevalence of tuberculosis (TB) and hepatitis C virus (HCV) infection. PURPOSE: To determine whether HCV co-infection increases the risk of incident drug-induced hepatitis among patients on first-line anti-TB drug therapy. METHODS: Prospective cohort study; HCV serology was obtained on all study subjects at the time of TB diagnosis; hepatic enzyme tests (serum alanine aminotransferase [ALT] activity) were obtained at baseline and monthly during tr...

  5. SOCIO - DEMOGRAPHIC PROFILE AND BASAL METABOLIC INDEX CHARACTERISTICS OF PATIENTS WITH PULMONARY TUBERCULOSIS AND THEIR TREATMENT OUTCOME IN MEDICAL COLLEGE HOSPITAL, AMRITSAR, INDIA

    Kajal

    2015-03-01

    Full Text Available INTRODUCTION: Tuberculosis is an ancient disease associated with high degree of morbidity and mortality worldwide, more so in developing countries having overwhelming problems of poverty, poor living conditions, illiteracy, malnutrition, drug addiction. OBJECTIVES: To evaluate the socio - demographic profile and BMI characteristics of patients with pulmonary tuberculosis and their treatment outcome. MATERIAL & METHOD: This prospective study was conducted on 200 new sputum smear positive patients having ag e >15 years. OBSERVATIONS & RESULT: The present study (n= 200 with 121 males and 79 female revealed that 75.8% of males and 87.5% of females were in the age group of 15 - 45 years, being the most productive years of life. 60.5% cases lived in overcrowded houses with inadequate ventilation (7 3%, poor lighting (68.5%, majority with lower socio - economic status (72.5%. 66% were from medium to large sized families, 65% joint family while 35% with nuclear families. 57.5% were working & thus were included in income generating activity group. illi teracy was observed in 40% & addiction in 47%. 69.5% of the cases were underweight (BMI < 18.5kg/m2 at initiation of treatment and percentage improved to 62.5% at the end of anti - tubercular treatment. CONCLUSION: The study findings emphasise the associati on of the socio - demographic profile including overcrowding, inadequate ventilation of the dwellings, ill - ventilated kitchens, under - nutrition with poor BMI, poor level of education (illiteracy, ignorance, poor knowledge about the disease, low socio - econom ic status with poverty contributing as significant risk factors for tuberculosis & its spread in family & community.

  6. Characterization of the genetic diversity of extensively-drug resistant Mycobacterium tuberculosis clinical isolates from pulmonary tuberculosis patients in Peru.

    Omar Cáceres

    Full Text Available BACKGROUND: Peru holds the fourth highest burden of tuberculosis in the Americas. Despite an apparently well-functioning DOTS control program, the prevalence of multidrug resistant tuberculosis (MDR-TB continues to increase. To worsen this situation, cases of extensively drug resistance tuberculosis (XDR-TB have been detected. Little information exists about the genetic diversity of drug-susceptible vs. MDR-TB and XDR-TB. METHODS: Cryopreserved samples of XDR strains from 2007 to 2009 (second semester, were identified and collected. Starting from 227 frozen samples, a total of 142 XDR-TB strains of Mycobacterium tuberculosis complex (MTBC; 1 isolate per patient were retained for this study. Each strain DNA was analyzed by spoligotyping and the 15-loci Mycobacterial Interspersed Repetitive Unit (MIRU-15. RESULTS: Among the 142 isolates analyzed, only 2 samples (1.41% could not be matched to any lineage. The most prevalent sublineage was Haarlem (43.66%, followed by T (27.46%, LAM (16.2%, Beijing (9.15%, and X clade (1.41%. Spoligotype analysis identified clustering for 128/142 (90.1% isolates vs. 49/142 (34.5% with MIRUs. Of the samples, 90.85% belonged to retreated patients. The drug resistant profile demonstrated that 62.67% showed resistance to injectable drugs capreomycin (CAP and kanamycin (KAN vs. 15.5% to CAP alone and 21.8% to KAN alone. The SIT219/T1 and SIT50/H3 were the most prevalent patterns in our study. The spoligoforest analysis showed that SIT53/T1 was at the origin of many of the T lineage strains as well as a big proportion of Haarlem lineage strains (SIT50/H3, followed by SIT47/H1, SIT49/H3, and SIT2375/H1, as opposed to the SIT1/Beijing strains that did not appear to evolve into minor Beijing sublineages among the XDR-TB strains. CONCLUSION: In contrast with other Latin-American countries where LAM sublineage is the most predominant, we found the Haarlem to be the most common followed by T sublineage among the XDR-TB strains.

  7. Anti-Mycobacterium tuberculosis activity of fungus Phomopsis stipata

    Karina Andrade de Prince

    2012-03-01

    Full Text Available Our purpose was to determine the anti-Mycobacterium tuberculosis activity of the metabolites produced by the endophitic fungus Phomopsis stipata (Lib. B. Sutton, (Diaporthaceae, cultivated in different media. The antimycobacterial activity was assessed through the Resazurin Microtiter Assay (REMA and the cytotoxicity test performed on macrophage cell line. The extracts derived from fungi grown on Corn Medium and Potato Dextrose Broth presented the smallest values of Minimum Inhibitory Concentration (MIC and low cytotoxicity, which implies a high selectivity index. This is the first report on the chemical composition and antitubercular activity of metabolites of P. stipata, as well as the influence of culture medium on these properties.

  8. Evaluation of Giant African Pouched Rats for Detection of Pulmonary Tuberculosis in Patients from a High-Endemic Setting.

    Klaus Reither

    Full Text Available This study established evidence about the diagnostic performance of trained giant African pouched rats for detecting Mycobacterium tuberculosis in sputum of well-characterised patients with presumptive tuberculosis (TB in a high-burden setting.The TB detection rats were evaluated using sputum samples of patients with presumptive TB enrolled in two prospective cohort studies in Bagamoyo, Tanzania. The patients were characterised by sputum smear microscopy and culture, including subsequent antigen or molecular confirmation of Mycobacterium tuberculosis, and by clinical data at enrolment and for at least 5-months of follow-up to determine the reference standard. Seven trained giant African pouched rats were used for the detection of TB in the sputum samples after shipment to the APOPO project in Morogoro, Tanzania.Of 469 eligible patients, 109 (23.2% were culture-positive for Mycobacterium tuberculosis and 128 (27.3% were non-TB controls with sustained recovery after 5 months without anti-TB treatment. The HIV prevalence was 46%. The area under the receiver operating characteristic curve of the seven rats for the detection of culture-positive pulmonary tuberculosis was 0.72 (95% CI 0.66-0.78. An optimal threshold could be defined at ≥ 2 indications by rats in either sample with a corresponding sensitivity of 56.9% (95% CI 47.0-66.3, specificity of 80.5% (95% CI 72.5-86.9, positive and negative predictive value of 71.3% (95% CI 60.6-80.5 and 68.7% (95% CI 60.6-76.0, and an accuracy for TB diagnosis of 69.6%. The diagnostic performance was negatively influenced by low burden of bacilli, and independent of the HIV status.Giant African pouched rats have potential for detection of tuberculosis in sputum samples. However, the diagnostic performance characteristics of TB detection rats do not currently meet the requirements for high-priority, rapid sputum-based TB diagnostics as defined by the World Health Organization.

  9. Evaluation of Giant African Pouched Rats for Detection of Pulmonary Tuberculosis in Patients from a High-Endemic Setting

    Reither, Klaus; Jugheli, Levan; Glass, Tracy R.; Sasamalo, Mohamed; Mhimbira, Francis A.; Weetjens, Bart J.; Cox, Christophe; Edwards, Timothy L.; Mulder, Christiaan; Beyene, Negussie W.; Mahoney, Amanda

    2015-01-01

    Background This study established evidence about the diagnostic performance of trained giant African pouched rats for detecting Mycobacterium tuberculosis in sputum of well-characterised patients with presumptive tuberculosis (TB) in a high-burden setting. Methods The TB detection rats were evaluated using sputum samples of patients with presumptive TB enrolled in two prospective cohort studies in Bagamoyo, Tanzania. The patients were characterised by sputum smear microscopy and culture, including subsequent antigen or molecular confirmation of Mycobacterium tuberculosis, and by clinical data at enrolment and for at least 5-months of follow-up to determine the reference standard. Seven trained giant African pouched rats were used for the detection of TB in the sputum samples after shipment to the APOPO project in Morogoro, Tanzania. Results Of 469 eligible patients, 109 (23.2%) were culture-positive for Mycobacterium tuberculosis and 128 (27.3%) were non-TB controls with sustained recovery after 5 months without anti-TB treatment. The HIV prevalence was 46%. The area under the receiver operating characteristic curve of the seven rats for the detection of culture-positive pulmonary tuberculosis was 0.72 (95% CI 0.66–0.78). An optimal threshold could be defined at ≥2 indications by rats in either sample with a corresponding sensitivity of 56.9% (95% CI 47.0–66.3), specificity of 80.5% (95% CI 72.5–86.9), positive and negative predictive value of 71.3% (95% CI 60.6–80.5) and 68.7% (95% CI 60.6–76.0), and an accuracy for TB diagnosis of 69.6%. The diagnostic performance was negatively influenced by low burden of bacilli, and independent of the HIV status. Conclusion Giant African pouched rats have potential for detection of tuberculosis in sputum samples. However, the diagnostic performance characteristics of TB detection rats do not currently meet the requirements for high-priority, rapid sputum-based TB diagnostics as defined by the World Health

  10. Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course: Systematic Review and Meta-analysis

    Zhuang-Li Si; Ling-Ling Kang; Xu-Bo Shen; Yuan-Zhong Zhou

    2015-01-01

    Background: Malnutrition and tuberculosis (TB) tend to interact with each other.TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions.Nutrition support can promote recovery in the subject being treated for TB.The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy.Methods: English database of the Cochrane Controlled Trials Register, PubMed, EMBASE, and Chinese database ofCBM, CNKI, VIP, and WANFANG were searched.Randomized controlled trials comparing nutrition support (given for more than 2 weeks) with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included.Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer.Data were entered and analyzed by RevMan 5.2 software, and meta-analysis was done using risk ratios (RRs) for dichotomous variables and mean differences (MDs) for continuous variables with 95% confidence intervals (CIs).Results: A total of 19 studies (3681 participants) were included.In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears-or culture-negative conversion rate and chest X-ray (CXR) absorption rate were 1.10 (1.04, 1.17) and 1.22 (1.08, 1.39), respectively, the pooled MD and its 95% CI of body mass index (BMI) and time of sputum smears or culture negativity were 0.59 (0.16, 1.2) and-5.42 (-7.93,-2.92), respectively, compared with the control group.The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant (P =0.76, 0.24, 0.28, and 0.20, respectively) between the intervention group and the control group.No systemic adverse events were recorded.Conclusions: During anti-TB course, nutrition support may be helpful in treatment of TB patients by

  11. Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course: Systematic Review and Meta-analysis

    Si, Zhuang-Li; Kang, Ling-Ling; Shen, Xu-Bo; Zhou, Yuan-Zhong

    2015-01-01

    Background: Malnutrition and tuberculosis (TB) tend to interact with each other. TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions. Nutrition support can promote recovery in the subject being treated for TB. The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy. Methods: English database of the Cochrane Controlled Trials Register, PubMed, EMBASE, and Chinese database of CBM, CNKI, VIP, and WANFANG were searched. Randomized controlled trials comparing nutrition support (given for more than 2 weeks) with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included. Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer. Data were entered and analyzed by RevMan 5.2 software, and meta-analysis was done using risk ratios (RRs) for dichotomous variables and mean differences (MDs) for continuous variables with 95% confidence intervals (CIs). Results: A total of 19 studies (3681 participants) were included. In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears- or culture-negative conversion rate and chest X-ray (CXR) absorption rate were 1.10 (1.04, 1.17) and 1.22 (1.08, 1.39), respectively, the pooled MD and its 95% CI of body mass index (BMI) and time of sputum smears or culture negativity were 0.59 (0.16, 1.2) and − 5.42 (−7.93, −2.92), respectively, compared with the control group. The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant (P = 0.76, 0.24, 0.28, and 0.20, respectively) between the intervention group and the control group. No systemic adverse events were recorded. Conclusions: During anti-TB course, nutrition support may be helpful in treatment

  12. Decreased Expression of T-Cell Costimulatory Molecule CD28 on CD4 and CD8 T Cells of Mexican Patients with Pulmonary Tuberculosis

    German Bernal-Fernandez

    2010-01-01

    Full Text Available Patients with tuberculosis frequently develop anergy, a state of T-cell hyporesponsiveness in which defective T-cell costimulation could be a factor. To know if the expression of T-cell costimulatory molecules was altered in tuberculosis, we analyzed the peripheral blood T-cell phenotype of 23 Mexican patients with pulmonary tuberculosis. There was severe CD4 (P<.001 and CD8 (P<.01 lymphopenia and upregulation of costimulatory molecule CD30 on CD4 and CD8 T cells (P<.05; this increase was higher in relapsing tuberculosis. The main finding was severe downregulation of the major costimulatory molecule CD28 on both CD8 and CD4 T cells (P<.001. Depletion of the CD4/CD28 subset, a hitherto undescribed finding, is relevant because CD4 T cells constitute the main arm of the cell-mediated antimycobacterial immune response.

  13. The imaging manifestations of caseous pulmonary tuberculosis with type-II diabetes mellitus

    Mingyue Wang

    2015-11-01

    Conclusion: Type-II diabetic patients with caseous tuberculosis mainly showed consolidation and atypical lung field lesions on chest radiographs. Becoming familiar with these features will be helpful to imaging diagnosis of DMTB.

  14. Co-Existence of Tuberculous Meningitis and Pulmonary Tuberculosis in a Denim Sandblaster

    Ozden, Kemalettin; Araz, Omer; Ucar, Elif Yilmazel; Alper, Fatih; Akgun, Metin

    2012-01-01

    Silicosis is a well-known occupational lung disease that was discovered by the ancient Greeks and Romans. In 2001, it has emerged again in an unexpected occupation: denim sandblasting. Exposure to crystalline silica, with or without clinical disease, is one of the most important predisposing factors for the development of tuberculosis; however, there has been no previous report of tuberculosis among cases of silicosis due to denim sandblasting. Herein, we report the first case of a denim sand...

  15. Serum adenosine deaminase activity and its isoenzyme in patients treated for tuberculosis

    Objective: Increased serum adenosine deaminase (ADA) activity, mainly associated with tuberculosis can also occur in a number of other diseases thus negatively affecting the diagnostic utility of ADA measurements in tuberculosis. The aim of the study was to determine whether or not the combined use of the activity of ADA, its isoenzymes and differential cell counts would provide a more efficient means of diagnosing tuberculosis than the use of ADA levels alone. Results: Data suggested significant (p0.75) of ADA/sub 2/ADA was found to be better indicator of tuberculosis. Lymphocyte neutrophil ratio (L/N)> 0.69 gave additional benefit to increase the sensitivity and specificity for the use of ADA as marker in diagnosing tuberculosis. Conclusion: The combined use of activity of ADA, its isoenzymes and total and differential cell counts is a better indicator and gives better understanding to diagnose and evaluate tuberculosis and response to therapy. (author)

  16. High resolution computed tomography(HRCT) findings of a solitary pulmonary nodule : differential diagnosis of cancer and tuberculosis

    To evaluate the role of HRCT in the differentiation of Pulmonary tuberculosis and lung cancer, where the manifestation of disease is a solitary pulmonary nodule(SPN). Forty eight SPNs including 29 cancers proven by surgery(n=10), by bronchoscopic biopsy(n=7) and by fine needle aspiration biopsy(n=12), and 19 tuberculous nodules proven by surgery(n=4), by bronchoscopic biopsy(n=4), by fine needle aspiration biopsy(n=5), by a positive result in AFB culture without evidence of malignant cells(n=3), and by a decrease in size on serial plain chests despite negative AFB culture(n=3) were included. Scanning parameters for HRCT were 140 KVp, 170 mA, 1.5 mm collimation, 3 sec scanning time, and a high spatial frequency algorithm was used. With regard to the marginal features of nodules, the findings more commonly observed in malignant nodules were greater average length of the longest spicule(5.35 ± 3.19 mm versus 2.75 ± 1.56 mm), and more commonspiculated nodules greater than 3 cm in diameter, 16(55%) versus 2(10.5%)(p<0.05). Regarding the internal characteristics of nodules and perinodular parenchymal changes, the findings more commonly observed in cases of cancer were air-bronchograms within nodules(14 ; 48.3%) and interlobar fissure puckering (6 ; 20.7%), whereas in tuberculosis cases the most common findings were low density of nodule(16 ; 84.2%), cavitation(12 ; 63.1%), and perinodular focal lung hypodensity(5 ; 26.3%), (p<0.05). no statstically significant difference was observed between the incidence of satellite lesion of tuberculous(73.7%) and of malignant nodules(34.5%). However, perilobular nodules or bronchovascular bundle thickening s were more commonly observed in the satellite lesions of malignant nodules(9 ; 90%), whereas centrilobular nodules or lobular consolidation were more commonly observed in those of tuberculous nodules(12 ; 85.7%), (p<0.05). HRCT provides detailed information concerning perinodular parenchymal changes and characteristics of

  17. Avaliação audiométrica de pacientes em tratamento para tuberculose pulmonar Audiometric evaluation of patients treated for pulmonary tuberculosis

    Karla Anacleto de Vasconcelos

    2012-02-01

    Full Text Available OBJETIVO: Analisar a condição auditiva de uma população em tratamento para tuberculose pulmonar em dois hospitais de referência no Brasil. MÉTODOS: Estudo descritivo envolvendo 97 pacientes de ambos os sexos, com idade entre 18 anos e 60 anos, que estivessem em tratamento para tuberculose pulmonar ativa, internados ou em acompanhamento ambulatorial em dois hospitais de referência no estado do Rio de Janeiro. Os participantes foram entrevistados e realizaram audiometria tonal liminar. RESULTADOS: Na população estudada, 65 pacientes (67% eram homens, 52 (54% estavam em tratamento de primeira linha e 45 (46% estavam em tratamento de segunda linha, o qual incluía aminoglicosídeos. Tabagismo, uso de bebidas alcoólicas, exposição a ruído e uso de medicamentos ototóxicos foram identificados respectivamente em 65 (67%, 51 (53%, 53 (55% e 45 (46,4% pacientes. As queixas auditivas e vestibulares mais frequentemente mencionadas foram tontura, em 28 (28,8%; zumbido, em 27 (27,8%; e hipoacusia, em 23 (23,7%. CONCLUSÕES: Devido ao elevado número de casos de perda auditiva encontrado neste estudo, recomenda-se que todos os pacientes em tratamento para tuberculose sejam submetidos a monitoramento auditivo.OBJECTIVE: To evaluate the hearing status of patients being treated for pulmonary tuberculosis at referral hospitals in Brazil. Methods: This was a descriptive study involving 97 male and female inpatients/outpatients between 18 and 60 years of age who were undergoing treatment for active pulmonary tuberculosis at one of two referral hospitals in the state of Rio de Janeiro. After being interviewed, all of the patients underwent pure tone audiometry. Results: Of the 97 patients studied, 65 (67% were male, 52 (54% were receiving first-line treatment, and 45 (46% were receiving second-line treatment, which included aminoglycosides. Smoking, alcohol consumption, exposure to noise, and ototoxic medication use were identified in 65 (67%, 51 (53

  18. Effect of Pulmonary Surfactant on Antimicrobial Activity In Vitro

    Schwameis, R; Erdogan-Yildirim, Z.; Manafi, M.; Zeitlinger, M. A.; Strommer, S.; Sauermann, R.

    2013-01-01

    Time-kill curve experiments were performed with linezolid, doripenem, tigecycline, moxifloxacin, and daptomycin against Staphylococcus aureus and with colistin, moxifloxacin, and doripenem against Pseudomonas aeruginosa to evaluate the effect of porcine pulmonary surfactant on antimicrobial activity. Pulmonary surfactant significantly impaired the activities of moxifloxacin and colistin. When antibiotics are being developed for respiratory tract infections, the method described here might be ...

  19. Is diagnostic protocol a cause of overestimation of extra-pulmonary tuberculosis in Himachal Pradesh? A report from a high-prevalence tuberculosis unit

    Vishav Chander

    2013-01-01

    Full Text Available Aims and Objectives: To study the diagnostic practices for diagnosis of extra-pulmonary tuberculosis (EPTB in a high-prevalence tuberculosis unit (TU. Material and Methods: It was a cross-sectional study using a pre-designed and pre-tested structured questionnaire. The information was collected from new EPTB cases registered in Rampur TU between 1 July 2007 and 31 March 2008. Diagnostic practices of the medical practitioners for establishing the diagnosis of different types of EPTB were studied. Results: For the diagnosis of pleural TB the main tools used were X-ray chest (37 cases; 100.0% and aspiration of pleural fluid (pleural tap for color of pleural fluid (35 cases; 94.6%. For establishing the diagnosis of lymph node TB, eight (66.6% cases were subjected to fine needle aspiration cytology (FNAC examination of involved lymph nodes. Excision biopsy of lymph nodes was undertaken in the remaining four (33.3% cases. The diagnosis of abdominal TB was primarily established on the basis of X-ray (six cases; 85.7% and ultrasonography (USG of abdomen for the presence of ascites in five (71.4% cases. The patients of tubercular meningitis were diagnosed predominantly on clinical grounds whereas in bone and genitourinary TB, all appropriate investigations were performed for confirmation of EPTB of these organs. Conclusions: Except for lymph node TB and the patients in whom the diagnosis had been established in tertiary care institutions of the state, patients were being diagnosed on clinical grounds.

  20. Clinical Study of Drug-resistant Pulmonary Tuberculosis Treated by Combination of Anti-Tuberculosis Chemicals and Compound Astragalus Capsule(复方黄芪胶囊)

    姜艳; 李新; 于志勇; 尹红义; 韩玉庆

    2004-01-01

    Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared. Results: In the treated group, the sputum bacterial negative conversion rate was 84. 8%, focal absorption effective rate 91.3 %, cavity closing rate 58. 7 % and 10-day symptom improving rate 54.4%, while in the control group, the corresponding rates were 65.2%,73.9 %, 37. 0% and 26.1%, respectively. Comparison between the groups showed significant difference in all the parameters ( P<0.05, P<0.05, P<0.05 and P<0.01 ). The incidence of adverse reaction and 2year bacteriological recurrence rate in the treated group were 23.9 % and 2.6 % respectively, while those in the control group 50.0% and 16.7%, which were higher than the former group with significant difference ( P<0.01 and P<0.05, respectively). Conclusion: The therapeutic effect of combined treatment with antiTB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice.

  1. Comparison of Sputum Smear Microscopy and Rapid Tuberculosisantibody Detection Test Kits for Diagnosis of Pulmonary Tuberculosis in Abia State, Nigeria

    Emmanuel Olufemi Ekundayo[1; Sam D. Abbey[2; Onuka Okorie[3

    2014-01-01

    The SSM (sputum smear microscopy) and five immunochromatographic tuberculosis antibody detection tests (DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB) were compared for diagnosis of active TB at the Leprosy and Tuberculosis Referral Hospital, Uzuakoli, Abia State, Nigeria. Sputum specimens from 150 study participants (male/female ratio, 0.81) were cultured on Lowenstein-Jensen slopes and direct smears were stained by Ziehl-Neelsen technique and examined by light microscopy. Sera were tested for anti-TB antibodies using the rapid TB tests. A total of 91 participants were culture positive, 79 (86.8%) for M. tuberculosis and 12 (13.2%) for nontuberculous mycobacteria. The sensitivity of SSM was 50% (95% CI: 39.0-61.0) and specificity was 92.3% (95% CI: 86.4-98.2) in those culture positive for M. tuberculosis. The sensitivity and specificity of the Rapid TB tests ranged from 24.1-39.2% and 78.4-87.8%, respectively. None of the five rapid TB tests had acceptable level of accuracy for diagnosis of active TB. The sensitivity of SSM though moderate is inadequate for long term TB control in this setting.

  2. Low plasma selenium concentrations, high plasma human immunodeficiency virus load and high interleukin-6 concentrations are risk factors associated with anemia in adults presenting with pulmonary tuberculosis in Zomba district, Malawi.

    Lettow, M.H.E. van; West, C.E.; Meer, J.W.M. van der; Wieringa, F.; Semba, R.D.

    2005-01-01

    BACKGROUND: Although anemia is common among adults with pulmonary tuberculosis and human immunodeficiency virus (HIV) infection in sub-Saharan Africa, the factors contributing to its pathogenesis have not been well characterized. OBJECTIVE: To characterize the antioxidant micronutrient status, inter

  3. Interferon Gamma Release Assays in active Tuberculosis: new medical insights

    Sandro Pierdomenico

    2011-09-01

    Full Text Available Since first presentation, Interferon γ Release Assays (IGRAs have had basic and wide application to LTBI, in accordance with international consensus and CDC recommendations, leaving their use in active TB to the field of study and research.We reviewed the results of 633 patients investigated from 2004 to 2008 targeting active TB, with the objective to highlight immunological data supporting test performances.We evaluated Quantiferon TB Gold (1st generation IGRA kit in association to Culture (MGIT 960 and Lowenstein Jensen and PCR (Probetec-ET having the positivity of culture plus clinical diagnosis as the standard true value to compare. QTB Gold was studied in 69 TB positive patients (42 pulmonary and 27 extra-pulmonary, with Sensitivity, Specificity, PPV and NPV average to 61.8%, 94.5%, 54.3% and 95.9% respectively, after indeterminate results discharging. Significant statistical differences didn’t emerge between pulmonary and extra-pulmonary infections (CI 95%.The overall indeterminate ratio arose up to 20.3% in patients with active TB vs 2.7% of global population (p<0.001. In 22% of patients with active pulmonary disease, IGRA conversed to positivity after 15 days in replicated tests, in spite of current treatment. 4 patients, with pulmonary TB and Quantiferon persistent negativities, underwent 18 months follow-up as not respondent although SIRE phenotypic susceptibilities and enough DOT compliance. Molecular DST documented hetero resistance for rpoB (MUT 1, MUT 3 plus wild lines and katG (MUT 1 plus wild in association to lack of inhA wild lines (Genotype MTBDR plus, Hain Lifescience. These reports suggest a mutational relationship between Rv3874 – 3875 cassette, encoding ESAT-6 / CFP-10, and rpoB, katG, inhA genes plausibly implying weak or absent selective clonal Th 1 activation to IGRA antigens. Our data seem to point out: 1 positive results are able to match true active TB in less than 50% of patients; 2 negative results could leave

  4. Social Determinants of Pulmonary Tuberculosis in Families of Migrants participating in Mexico-Canada Seasonal Agricultural Workers Program: A Study in Guadalupe Zaragoza

    Rodolfo Gines Martínez Fernández

    2010-04-01

    Full Text Available Objective: To analyze the social determinants of pulmonary tuberculosis in the families of migrant laborers registered in the Seasonal Agricultural Workers Program (SAWP and residing in Guadalupe Zaragoza Tlahuapan, Puebla, México. Methods: An exploratory cross-sectional study of the interaction between migration, social determinants, and pulmonary tuberculosis. Results: In this poor and patriarchal community, the SAWP offers financial opportunities for the men of Guadalupe Zaragoza. The remittances of these migrant workers have enabled their families to live in adequate housing, but their health situation is still vulnerable. Only half of the families have access to public health services or the special health programs for migrant worker families. 13% of migrant family members were infected with pulmonary tuberculosis as measured by the Quantiferon-TB test. The female partners of migrants typically do not study past elementary school, become housewives with no pay, are forced to take on added work in the household, and experience subjective symptoms of stress and fatigue. The children of Guadalupe Zaragoza are also vulnerable; the number of children in this community who can regularly attend school is below the national average because many children have to work. These families end up paying more for education, housing, and health services than the average Mexican family. Conclusions: In the families of SAWP migrant workers, the prevalence of latent pulmonary tuberculosis was found to be lower than the national average based on studies using the tuberculin test; this may be due to the greater specificity of the Quantiferon-TB Gold test. There is a significant risk of reactivation tuberculosis in these families due to the inequity in the social determinants of health.

  5. A prospective survey on the incidence of chest malignancies after repeated fluoroscopy during artificial pneumothorax therapy for pulmonary tuberculosis

    Patients with pulmonary tuberculosis treated in 4 sanatoria in Niigata Prefecture between 1941 and 1961 were followed up by a mail questionnaire. Of 2756 patients, 1193 responded and sent back effective information, letters to 1224 were returned because of uncertain or unknown new address, 326 did not respond, and 13 were excluded because of incomplete answers. Out of the 1193 effective responders, 568 had been treated by artificial pneumothorax (the pneumothorax group), and 552 had not been treated by pneumothorax (the control group). There were 65 deaths in the pneumothorax group, but none of them were from chest malignancies; and 40 deaths in the control group with 4 from chest malignancies. In this survey, there was no evidence of an increased number of chest malignancies (including leukemia) after pneumothorax fluoroscopy. (auth.)

  6. Estimation of discovery rate in a justified screening of pulmonary tuberculosis with chest fluoroscopy in Shenzhen city

    The level of justified of the discovery rate in a screening of pulmonary tuberculosis(TB) with chest fluoroscopy in Shenzhen city was estimated based on the principles recommended by IBBS. The results show that the justified discovery rate for TB should not be less than 0.43%. When the possible increase in mortality caused by radiation-induced cancers and the possible decrease in mortality for TB caused by extinguishing the sources of infection were considered, the discovery rate for TB should not be less than 0.033%. It is obvious that use of chest fluoroscopy for screening of TB is unsuitable since the morbidity for TB in Shenzhen city was about 0.053% in 1996

  7. Enhanced effect of BCG vaccine against pulmonary Mycobacterium tuberculosis infection in mice with lung Th17 response to mycobacterial heparin-binding hemagglutinin adhesin antigen.

    Fukui, Masayuki; Shinjo, Kikuko; Umemura, Masayuki; Shigeno, Satoko; Harakuni, Tetsuya; Arakawa, Takeshi; Matsuzaki, Goro

    2015-12-01

    Although the BCG vaccine can prevent tuberculosis (TB) in infants, its ability to prevent adult pulmonary TB is reportedly limited. Therefore, development of a novel effective vaccine against pulmonary TB has become an international research priority. We have previously reported that intranasal vaccination of mice with a mycobacterial heparin-binding hemagglutinin adhesin (HBHA) plus mucosal adjuvant cholera toxin (CT) enhances production of IFN-γ and anti-HBHA antibody and suppresses extrapulmonary bacterial dissemination after intranasal infection with BCG. In the present study, the effects of intranasal HBHA + CT vaccine on murine pulmonary Mycobacterium tuberculosis (Mtb) infection were examined. Intranasal HBHA + CT vaccination alone failed to reduce the bacterial burden in the infected lung. However, a combination vaccine consisting of s.c. BCG priming and an intranasal HBHA + CT booster significantly enhanced protective immunity against pulmonary Mtb infection on day 14 compared with BCG vaccine alone. Further, it was found that intranasal HBHA + CT vaccine enhanced not only IFN-γ but also IL-17A production by HBHA-specific T cells in the lung after pulmonary Mtb infection. Therefore, this combination vaccine may be a good candidate for a new vaccine strategy against pulmonary TB. PMID:26577130

  8. Rapid, Semiquantitative Assay To Discriminate among Compounds with Activity against Replicating or Nonreplicating Mycobacterium tuberculosis

    Gold, Ben; Roberts, Julia; Ling, Yan; Quezada, Landys Lopez; Glasheen, Jou; Ballinger, Elaine; Somersan-Karakaya, Selin; Warrier, Thulasi; Warren, J. David; Nathan, Carl

    2015-01-01

    The search for drugs that can kill replicating and nonreplicating Mycobacterium tuberculosis faces practical bottlenecks. Measurement of CFU and discrimination of bacteriostatic from bactericidal activity are costly in compounds, supplies, labor, and time. Testing compounds against M. tuberculosis under conditions that prevent the replication of M. tuberculosis often involves a second phase of the test in which conditions are altered to permit the replication of bacteria that survived the fir...

  9. National guidelines not always followed when diagnosing smear-negative pulmonary tuberculosis in patients with HIV in Botswana.

    Taurayi A Tafuma

    Full Text Available BACKGROUND: Diagnosis of smear negative pulmonary tuberculosis (SNPTB is challenging, especially in patients with HIV. The Botswana National Tuberculosis Program (BNTP guidelines give guidance in diagnosing and treating SNPTB. Patients with chronic cough should be screened for TB by 3 sputum smear investigations. If negative, a chest x-ray (CXR should be performed. If negative for TB, antimicrobial treatment for other infections should be started. We investigated the clinicians' use of the guidelines in clinical practice. METHODS: Data regarding the medical history (coughing period, requested and conducted investigations concerning tuberculosis diagnosis (sputum smear or culture or CXR or alternative diagnoses (sputum microscopy or blood or sputum culture for diagnosis of other organisms, in SNPTB HIV-positive patients (outpatients and admitted patients from 2006-2009 in a district hospital in Botswana were extracted from all available hospital medical records. Additionally, a survey was done in all doctors diagnosing SNPTB in this hospital using a self-administered questionnaire with questions regarding the application of the BNTP guidelines in practice. Descriptive analyses of collected data were performed to test the compliance to the guidelines. RESULTS: Data from medical records showed that in 47.0% (132/281 of patients, TB treatment was started without microbiological results from sputum smears. Other methods to rule out or confirm PTB were used in 2.1% (6/281; and 99.6% (280/281 of SNPTB patients had received a CXR. The survey in 7 clinicians found that all always used CXR, and all clinicians requested three sputum results only sometimes. Six out of 7 clinicians started antibiotics before starting TB treatment. Reasons clinicians gave for difficulties in following the guidelines included inability of patients to produce sputum; and laboratory delays in releasing sputum results. CONCLUSION: Between 2006 and 2009 a high proportion of SNPTB

  10. Comparison of the safety and efficacy of a fixed-dose combination regimen and separate formulations for pulmonary tuberculosis treatment

    Jiun-Ting Wu

    2015-06-01

    Full Text Available OBJECTIVES: Fixed-dose combination formulations, which simplify the administration of drugs and prevent the development of drug resistance, have been recommended as a standard anti-tuberculosis treatment regimen. However, the composition and dosage recommendations for fixed-dose combination formulations differ from those for separate formulations. Thus, questions about the effectiveness and side effects of combination formulations remain. The aim of this study was to compare the safety and efficacy of these two types of anti-tuberculosis regimens for pulmonary tuberculosis treatment. METHOD: A prospective, randomized controlled study was conducted using the directly observed treatment short-course strategy. Patients were randomly allocated to one of two short-course regimens. One year after completing the treatment, these patients’ outcomes were analyzed. ClinicalTrials.gov: NCT00979290. RESULTS: A total of 161 patients were enrolled, 142 of whom were evaluable for safety assessment. The two regimens had a similar incidence of adverse effects. In the per-protocol population, serum bilirubin concentrations at the peak level, at week 4, and at week 8 were significantly higher for the fixed-dose combination formulation than for the separate formulations. All patients had negative sputum cultures at the end of the treatment, and no relapse occurred after one year of follow-up. CONCLUSIONS: In this randomized study, transient higher serum bilirubin levels were noted for the fixed-dose combination regimen compared with the separate formulations during treatment. However, no significant difference in safety or efficacy was found between the groups when the directly observed treatment short-course strategy was used.

  11. Regulatory role of Cdx-2 and Taq I polymorphism of vitamin D receptor gene on chemokine expression in pulmonary tuberculosis.

    Harishankar, M; Selvaraj, P

    2016-06-01

    Vitamin D receptor (VDR) gene variants have been shown to be regulating the immune response in tuberculosis. We studied the regulatory role of VDR promoter Cdx-2 and 3'UTR TaqI gene variants on chemokine levels from culture filtrate antigen (CFA) stimulated with or without 1,25(OH)2D3 treated peripheral blood mononuclear cells of 50 pulmonary tuberculosis patients (PTB) and 51 normal healthy controls (HCs). In CFA with 1,25(OH)2D3 treated cultures, the MIP-1α, MIP-1β, RANTES levels were significantly decreased in Cdx-2 AA genotype compared to GG genotype, while a significantly increased MIG level was observed in Cdx-2 AA genotype (p<0.05). In TaqI polymorphism, tt genotype significantly decreased MIP-1β and RANTES levels compared to TT genotype. Moreover, a significantly increased level of IP-10 and MIG was observed in TaqI tt genotype compared with TT genotype (p<0.05). The results suggests that the 1,25(OH)2D3 may alter the chemokine response through the VDR polymorphic variants during infection. PMID:27067904

  12. The Assessment of Socio-Economic inequalities in Extra-Pulmonary Tuberculosis Patients undergoing DOTS Therapy in Chitradurga Region

    SHASHANK S HOSUR

    2014-12-01

    Full Text Available India is highest tuberculosis (TB burden country globally, accounting for more than one-fifth of the global incidence. The impact of TB on individuals is often all encompassing, affecting not only physical health, but also social, economic, and psychological well-being. The aim of our study was to assess the socio-economic inequalities of the patients having Extra-pulmonary Tuberculosis (EPTB in Chitradurga region. The ambispective analysis was carried out, by collecting the data of one year. Later they were contacted for getting them enrolled for the study. Among 179 patients, 149 patients agreed to get enrolled in the study. Among them, male patients were 79 (53.0% with mean age of 34.91, Female patients were 70 (47.0%, with mean age of 35.7. It was notified that 68 (45.63% patients have completed their school education. Also 59.0% patients are having their family monthly income of Rs.5001-Rs.10000, 80 patients are from rural age and 114 patients belong to family of 04-07 members under a single roof. Thus our study concluded that EPTB was found more in the average age people; also majorly in the rural area people. Hence their education, occupation, their surroundings etc. plays a major role in the illness behavior who are undergoing the treatment.

  13. Trend of Smear-positive Pulmonary Tuberculosis in Iran during 1995–2012: A Segmented Regression Model

    Khazaei, Salman; Soheilyzad, Mokhtar; Molaeipoor, Leila; Khazaei, Zaher; Rezaeian, Shahab; Khazaei, Somayeh

    2016-01-01

    Background: Describing trend in tuberculosis (TB) over time can play an important role to assess the disease control strategies and predict the future morbidity and mortality. This study aimed to determine the incidence trend of smear-positive pulmonary tuberculosis (SPPT) in sub-age and sex groups during the years of 1995–2012. Methods: This retrospective cohort study was performed in 2015 by using the dataset regarding National Statistics of SPPT reported by World Health Organization during 1995–2012. Annual percent changes (APCs) and average annual percent changes (AAPCs) were estimated to determine the summery statistics of trend using segmented regression model. Results: During 1995–2012, there were 96,579 SPPT case notifications in Iran (male to female ratio: 0.99). There was only one change point in 1997 for SPPT incidence in subgroups of age and sex during 1995–2012. The AAPCs for both genders and also all three age groups had a significant descending trend during the time period (P < 0.05). Conclusions: Our results showed a downward trend in the SPPT incidence. It seems that to achieve the set goals and high successful in TB control program especially reduction in SPPT, pay more attention to old age and males should be considered. In addition, improvement of clinical and medical care services and notification processes would be imperative. PMID:27413517

  14. Pulmonary Tuberculosis in a Young Pregnant Female: Challenges in Diagnosis and Management

    Manogna Maddineni

    2008-01-01

    Full Text Available Background. With the world becoming a global village, tuberculosis is no longer limited to endemic areas. Our case emphasizes the impact of immigration on infectious disease epidemiology and challenges associated with diagnosis and treatment in pregnancy. Case. A 21-year-old Hispanic female presented in preterm labor and was found to be hypoxic. Chest X-ray revealed a paratracheal mass which a CT scan confirmed. PPD test was positive. Bronchoalveolar lavage did not reveal acid-fast bacilli and biopsy revealed caseating granulomas. Diagnosis and treatment were challenging due to constraints in radiological investigations, lack of initial evidence of acid-fast bacilli, and toxic profile of medications. Due to her high risk, she was started on antituberculosis regimen. The diagnosis was confirmed on Day 26 when Mycobacterium tuberculosis was isolated by DNA probe. Conclusion. A high index of suspicion is required to recognize the changing face and disease spectrum of tuberculosis and initiate treatment for better outcomes.

  15. Mycobacterium tuberculosis lipolytic enzymes as potential biomarkers for the diagnosis of active tuberculosis.

    Belinda Brust

    Full Text Available BACKGROUND: New diagnosis tests are urgently needed to address the global tuberculosis (TB burden and to improve control programs especially in resource-limited settings. An effective in vitro diagnostic of TB based on serological methods would be regarded as an attractive progress because immunoassays are simple, rapid, inexpensive, and may offer the possibility to detect cases missed by standard sputum smear microscopy. However, currently available serology tests for TB are highly variable in sensitivity and specificity. Lipolytic enzymes have recently emerged as key factors in lipid metabolization during dormancy and/or exit of the non-replicating growth phase, a prerequisite step of TB reactivation. The focus of this study was to analyze and compare the potential of four Mycobacterium tuberculosis lipolytic enzymes (LipY, Rv0183, Rv1984c and Rv3452 as new markers in the serodiagnosis of active TB. METHODS: Recombinant proteins were produced and used in optimized ELISA aimed to detect IgG and IgM serum antibodies against the four lipolytic enzymes. The capacity of the assays to identify infection was evaluated in patients with either active TB or latent TB and compared with two distinct control groups consisting of BCG-vaccinated blood donors and hospitalized non-TB individuals. RESULTS: A robust humoral response was detected in patients with active TB whereas antibodies against lipolytic enzymes were infrequently detected in either uninfected groups or in subjects with latent infection. High specifity levels, ranging from 93.9% to 97.5%, were obtained for all four antigens with sensitivity values ranging from 73.4% to 90.5%, with Rv3452 displaying the highest performances. Patients with active TB usually exhibited strong IgG responses but poor IgM responses. CONCLUSION: These results clearly indicate that the lipolytic enzymes tested are strongly immunogenic allowing to distinguish active from latent TB infections. They appear as potent

  16. Imaging manifestations of chronic obstructive pulmonary disease complicated with pulmonary tuberculosis%慢性阻塞性肺疾病合并肺结核的影像表现

    冯光; 李宁; 王文秀; 王力; 郑浩; 高江峰

    2014-01-01

    Objective To explore the imaging manifestations of chronic obstructive pulmonary disease com-plicated with pulmonary tuberculosis. Methods 143 cases of chronic obstructive pulmonary disease complicated with pulmonary tuberculosis were divided into the group A, and another 120 cases of chronic obstructive pulmonary disease complicated with pulmonary infection were taken as the group B. The lesions′location and range and the nature of le-sions were analyzed. Results There was no significant difference in lesions nodules, patchy fibrosis, and flaky exu-dative lesions (P>0. 05). But there were obvious differences in upper lobe segment and dorsal segment of lower lobe basal segment involvement, leaves, lesions of calcification, diaphragmatic surface adhesion, multi form lesions mixed, with effusion change (P0.05;累及上叶尖后段和下叶背段,累及下叶基底段,病变性质的钙化灶、膈面粘连、多形态病灶混合、伴积液改变,差异具有统计学意义(P<0.05)。结论 COPD合并肺结核影像表现为病变范围广泛,呈多肺叶散开模式,不典型部位经常被累及,多性状病灶混合存在,病变影像改变缓慢。

  17. Pulmonary tuberculosis in five young infants with nursery exposure: clinical, radiographic and CT findings

    Clinical, radiographic (n = 5) and CT findings (n = 4) of five Korean infants ranging in age from 2 to 3 months with confirmed tuberculosis were retrospectively analysed. All of the patients were symptomatic, anergic to tuberculin, and had a positive culture of Myobacterium tuberculosis in gastric aspirates. The probable source of infection was the hospital in which they were born. CT scans demonstrated hilar and mediastinal lymph node enlargement with central low attenuation and peripheral enhancement in all cases. CT may be useful in diagnosis by demonstrating characteristic adenopathy and disseminated disease in young infants. (orig.)

  18. Cloning and expression of pab gene of M. tuberculosis isolated from pulmonary TB patient in E.coli DH5α

    Tri Y. M. Raras

    2011-11-01

    Full Text Available Background: Mycobacterium tuberculosis antigen38 is a potent serodiagnostic agent containing two M. tuberculosisspecific B-cell epitopes. The high price of imported diagnostic agents hinders realization of fast clinical TB diagnosis in developing countries. Therefore, we produced recombinant antigen38 (recAg38M from M. tuberculosis local strain, which might be used to produce economical tuberculosis serodiagnostic kit.Methods: Pab gene that was isolated from pulmonary TB patient in Malang was cloned into a plasmid vector (pGEMTeasy to construct pMB38. The E.coli DH5α clone carrying pMb38 was selected on X-gal medium. The expression of pab was mediated using pPRoExHTc under the control of Trc promoter and E.coli DH5α as host.Results: Alignment of the pab sequence from the white E.coli DH5α clones with that of M. tuberculosis H37Rv showed 98% homology. The recombinant protein in which the signal peptide has been deleted to prevent the protein being secreted into medium was found in the cytoplasm.Conclusion: pab gene of M. tuberculosis isolated from a TB patient could be expressed in heterologous system in E.coliDH5α. (Med J Indones 2011; 20:247-54Keywords: Mycobacterium tuberculosis, Pab gene expression, recombinant antigen38

  19. Nitroprusside modulates pulmonary vein arrhythmogenic activity

    Chen Yao-Chang

    2010-03-01

    Full Text Available Abstract Background Pulmonary veins (PVs are the most important sources of ectopic beats with the initiation of paroxysmal atrial fibrillation, or the foci of ectopic atrial tachycardia and focal atrial fibrillation. Elimination of nitric oxide (NO enhances cardiac triggered activity, and NO can decrease PV arrhythmogensis through mechano-electrical feedback. However, it is not clear whether NO may have direct electrophysiological effects on PV cardiomyocytes. This study is aimed to study the effects of nitroprusside (NO donor, on the ionic currents and arrhythmogenic activity of single cardiomyocytes from the PVs. Methods Single PV cardiomyocytes were isolated from the canine PVs. The action potential and ionic currents were investigated in isolated single canine PV cardiomyocytes before and after sodium nitroprusside (80 μM, using the whole-cell patch clamp technique. Results Nitroprusside decreased PV cardiomyocytes spontaneous beating rates from 1.7 ± 0.3 Hz to 0.5 ± 0.4 Hz in 9 cells (P Conclusion Nitroprusside regulates the electrical activity of PV cardiomyocytes, which suggests that NO may play a role in PV arrhythmogenesis.

  20. The Mycobacterium tuberculosis PPE protein Rv1168c induces stronger B cell response than Rv0256c in active TB patients.

    Abraham, Philip Raj; Udgata, Atul; Latha, Gaddam Suman; Mukhopadhyay, Sangita

    2016-06-01

    Tuberculosis (TB) caused by Mycobacterium tuberculosis is a serious global health problem and is responsible for millions of deaths every year. For effective control of this dreadful disease, it is necessary to diagnose TB cases at the initial stages of infection. The serodiagnosis of disease represents simple, rapid and inexpensive method that can be used at the primary health care levels. In this study we have compared sensitivity of two PPE proteins of M. tuberculosis, i.e., Rv0256c and Rv1168c for their use as serodiagnostic markers in active tuberculosis patients. Employing a standardized enzyme immunoassay with these PPE proteins as candidate antigens we were able to successfully discriminate the TB patients' sera from the BCG-vaccinated healthy controls. Further, we observed that Rv1168c displayed higher sensitivity in detecting extrapulmonary and smear negative pulmonary TB cases which are difficult to diagnose by available diagnostic methods. Overall the study highlights that Rv1168c can be used as a potential serodiagnostic marker for the diagnosis of active tuberculosis disease. PMID:26364913