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Sample records for miliaris disseminatus faciei

  1. Recurrent lupus miliaris disseminatus faciei: a case report

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    Zonunsanga

    2015-01-01

    Full Text Available Lupus miliaris disseminatus faciei (LMDF is a granulomatous eruption characterized by monomorphic, reddishbrown papules and nodules predominantly localized on the face. A 43 years old lady presented with multiple, painful, papulo-pustules over face 6 years back. Biopsy showed showed large foci of suppurative granulomatous dermatitis with a large central area of suppuration surrounded by histiocytes and occasional giant cells. Epidermis is not disrupted. Perifollicular and perivascular lymphocytic infiltrates were also seen. The lesions were healed with atrophic scars. She is now presented with multiple asymptomatic papules over bilateral periorbital regions of the face.

  2. Atypical manifestations of tinea faciei

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    Mittal R

    1996-01-01

    Full Text Available A study of 58 paitents of tinea faciei was conducted. Twenty five (43.1% patients had history of photosensitivity. Twenty eight (48.2% patients were applying topical steroids, 2 (3.4% patients were on 10 mg of prednisolone daily. Associated tinea of other sites were observed in 14 (24.13%. 23 (39.6% patients had typical circinate, arcuate, annular plaques with raised margin showing vesiculo-pustules. Atypical manifestations were in the form of arcuate plaques on the pinna in 4 patients, erythematous plaques full of vesiculo-pustules without central clearing in 3. Thirty two (55.17% patients had plaques with broad edges and indistinct central clearing. In 2 patients lesions resembled discoid lupus erythematosus. Skin scrapings for fungus was positive in 36 (62.06% cases. All patients responded to systemic griseofulvin 10mg/kg with 1% clotrimazole topicaly in 4-8 weeks.

  3. Tinea faciei caused by Trichophyton rubrum var. raubitschekii in Germany

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    Jochen Brasch

    2008-06-01

    Full Text Available We report the case of a 35-year-old female patient presenting facial erythematous circinate and scaling lesions that had slowly developed over the last nine years. The patient was born in Angola but has lived in Germany for the last ten years. A clinical diagnosis of tinea faciei was made and proven by fungal elements in lesional skin. A darkly pigmented dermatophyte with multiple trichophyton macroconidia was grown in the culture medium, which was subsequently identified as Trichophyton rubrum var. raubitschekii. Combined topical and systemic antimycotic treatment resulted in the complete resolution of the lesions. The variant raubitschekii of Trichophyton rubrum is mostly found in Africa, Asia and South America; in Germany only isolated infections have been seen in immigrants from Africa. In comparison to previous observations our case is noteworthy for two reasons: it is the first communication of tinea faciei caused by Trichophyton rubrum var. raubitschekii in Germany and the patient history suggests that the infection was acquired in Germany. Therefore, Trichophyton rubrum var. raubitschekii should be monitored as an upcoming pathogen in Europe.

  4. 67Gallium Scan Findings in Miliary Tuberculosis

    International Nuclear Information System (INIS)

    Miliary Tuberculosis is an illness produced by acute dissemination of tubercle bacilli via the blood stream. In chest roentgenogram, a diffuse 'miliary' infiltrates are usually seen, but normal or suspicious ground glass pattern also can be seen in early manifestation. Ten patients of miliary tuberculosis who underwent whole-body 67Ga-citrate scintigraphy were evaluated retrospectively to study usefulness of Ga-scan for early diagnosis of miliary Tbc and evaluation of disease activity. All of ten patients demonstrated significantly diffuse bilateral pulmonary uptakes on 48 hours image. All of three patients of ground-glass pattern in chest roentgemogram also demonstrated increased uptakes. In the statistical analysis, the severity of chest roentgenographic findings showed positive correlation with the activity on Ga-scan. These results suggest that Gallium scan is useful for diagnosis of early miliary tuberculosis and for evaluation of disease activity on follow-up examination of miliary tuberculosis of lung.

  5. Miliary pattern in neonatal pneumonia

    International Nuclear Information System (INIS)

    We have seen 10 newborn babies who developed respiratory distress and whose chest radiographs showed a miliary nodular pattern of disease. Of these infants only 3 had blood cultures that were positive for staphylococcus aureus. Of the remaining 7, 2 had conjunctivitis from which staphylococcus aureus was cultured, 4 had negative cultures and 1 did not have a blood culture done. All patients were diagnosed as having bacterial pneumonia and appeared to respond favourably to antibiotic therapy. The pulmonary abnormalities resolved. The children were clinically well in less than 3 weeks. The author suggests that the miliary pattern is one of the radiological patterns of neonatal pneumonia possibly produced by hematogenous bacterial dissemination. (orig.)

  6. Frequency and predictors of miliary tuberculosis in patients with miliary pulmonary nodules in South Korea: A retrospective cohort study

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    Shim Young-Soo

    2008-11-01

    Full Text Available Abstract Background Miliary pulmonary nodules are commonly caused by various infections and cancers. We sought to identify the relative frequencies of various aetiologies and the clinical and radiographic predictors of miliary tuberculosis (TB in patients with miliary pulmonary nodules. Methods We performed a retrospective cohort study of patients who presented with micronodules occupying more than two-thirds of the lung volume, based on computed tomography (CT of the chest, between November 2001 and April 2007, in a tertiary referral hospital in South Korea. Results We analyzed 76 patients with miliary pulmonary nodules. Their median age was 52 years and 38 (50% were males; 18 patients (24% had a previous or current malignancy and five (7% had a history of TB. The most common diagnoses of miliary nodules were miliary TB (41 patients, 54% and miliary metastasis of malignancies (20 patients, 26%. Multivariate analysis revealed that age ?30 years, HIV infection, corticosteroid use, bronchogenic spread of lesions, and ground-glass opacities occupying >25% of total lung volume increased the probability of miliary TB. However, a history of malignancy decreased the probability of miliary TB. Conclusion Miliary TB accounted for approximately half of all causes of miliary pulmonary nodules. Young age, an immune-compromised state, and several clinical and radiographic characteristics increased the probability of miliary TB.

  7. Miliary tuberculosis: HRCT findings in 14 patients

    International Nuclear Information System (INIS)

    To evaluate high-resolution CT(HRCT) findings of the miliary tuberculosis and their significance. We retrospectively studied clinical records, HRCT and chest radiographs of 14 patients with miliary tuberculosis. On HRCT, nodules were seen in all 14 cases, 10 of them evenly, and 4 were irregularly distributed. The size of each nodule was less than 1 mm in 7 cases, 1 - 2 mm in 6 cases, and 3 mm or more in 1 case. The ground - glass opacity was accompanied in 8 cases, and fine reticular opacity was also noted in 8 cases. Other associated findings were pleural effusion (n=4), hilar and mediastinal lymphadenopathy (n=3), consolidation of the exudative tuberculosis (n=4). HRCT findings of miliary tuberculosis are diffusely distributed micro nodules of variable size, less than 5 mm in diameter. The ground-glass opacity can be combined

  8. Miliary tuberculosis with empyema, a case report

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    Abbas Ali Imani Fooladi; Mohammad Javad Hosseini

    2010-01-01

    We report a 39 year-old patient who presented with chest pain, malaise, lassitude, anorexia, weight loss, fever, chills, productive coughs, pleural pain in the left thorax area and septic empyema without hemoptysis. Laboratory investigations’ including tuberculosis (TB) skin test by PPD, HIV, HBV and HCV serologic tests were negative. The CBC showed anemia and leucocytosis. The ESR was elevated and he had hypoalbuminaemia. Both chest radiograph and high-resolution CT scan showed miliary inf...

  9. Diffuse radioiodine lung uptake in miliary thyroid carcinoma metastases

    International Nuclear Information System (INIS)

    A diffuse pattern of homogeneous tracer uptake is seen by I-131 scintigraphy in a patient with widespread miliary lung metastases due to papillary thyroid carcinoma. This case report emphasizes the need to include metastatic thyroid carcinoma in the differential diagnosis of miliary lung nodules

  10. Miliary tuberculosis following homograft valve replacement.

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    Anyanwu, C H; Nassau, E; Yacoub, M

    1976-02-01

    Postoperative septicaemia with infective endocarditis is a recognized complication of open-heart surgery, in particular homograft or prosthetic replacement of cardiac valves. Several infective organisms, both bacterial and fungal, have been incriminated but infection due to tubercle bacilli has not, to our knowledge, been reported. The clinicopathological features of this condition are discussed. During a five-year period, over 800 homograft replacements in the aortic and/or mitral positions have been performed at Harefield Hospital. Seven cases of miliary tuberculosis following homograft valve replacement are descrbied here. In three, there was a past history suggestive of tuberculosis infections but necropsy failed to reveal any caseous or other tuberculous lesion apart from recent miliary tuberculosis. Vegetations on the homograft valves contained microcolonies of acid-fast bacilli in most cases. Tubercle bacilli of the human type were recovered by culture or guinea-pig inoculation in six of the seven cases, and in three the diagnosis was established during life; two of these survived on antituberculosis chemotherapy. The onset of symptoms varied from a few weeks to 12 months after operation. The main presenting symptom was intermittent pyrexia. In two patients the diagnosis was made on radiological and clinical grounds and in both, tubercle bacilli were grown from drill biopsy specimens of lung tissue. The source of infection was presumed to be the homograft valves contaminated in the postmorten room. The antibiotic mixture used in the sterilization of the homografts was not effective against tubercle bacilli. PMID:816028

  11. Miliary tuberculosis with left brachial monoplegia: A case report.

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    Iqbal, Nayyar; Natarajan, Nagarajan; Periyasamy, Sivakumar; George, Sanjoy; Basheer, Aneesh; Mookkappan, Sudhagar

    2014-01-01

    Tuberculoma of the brain is a major neurological problem in developing countries accounting for 12 to 30 per cent of all intracranial masses. It often presents with focal neurological symptoms or seizures. Simultaneous occurrence of brain tuberculoma with miliary mottling in the lungs is uncommon in the immunocompetent patient. We report only the second case of monoplegia and miliary tuberculosis, wherein the patient presented with acute onset left brachial monoplegia, upper motor neuron facial palsy, and fever with an MRI of the brain showing multiple granulomas and chest x-ray showing miliary mottling. The patient's neurological deficit started to resolve with corticosteroids and anti-tubercular treatment. PMID:25379061

  12. Cutaneous miliary tuberculosis in a chronic kidney disease patient.

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    Suraprasit, Pudit; Silpa-Archa, Narumol; Triwongwaranat, Daranporn

    2014-09-01

    A 79-year-old Thai woman with advanced renal failure, dyslipidemia and anemia of chronic disease was admitted to hospital with prolonged fever, productive cough and multiple discrete small pustules on her face, trunk and extremities. A chest X-ray revealed diffuse miliary infiltration. Mycobacterium tuberculosis complex DNA was detected by polymerase chain reaction in sputum and scrapings of pustules from her skin. Blood culture identified M. tuberculosis complex. Pulmonary and cutaneous miliary tuberculosis was diagnosed. The patient's symptoms improved after 3 weeks of treatment with isoniazid, rifampicin, ethambutol and pyrazinamide. This report details a case of cutaneous miliary tuberculosis in a non-dialysis chronic kidney disease patient. PMID:25493081

  13. Disseminated histoplasmosis simulating miliary tuberculosis: a case report

    International Nuclear Information System (INIS)

    Histoplasmosis is a disease caused by inhalation of the fungus Histoplasma capsulatum. In rare cases the disease affects immunocompetent individuals. Disseminated and severe disease is seen in immunocompromised patients. We report a case of a 45 year old immunocompromised patient presenting with weight loss and abdominal pain. Chest x-ray and computerized tomography examinations showed interstitial infiltrate and diffuse micro nodules. The initial diagnosis was miliary tuberculosis. However, the definitive diagnosis of miliary histoplasmosis was made later on. (author)

  14. Miliary tuberculosis with left brachial monoplegia: A case report

    OpenAIRE

    Iqbal, Nayyar; Natarajan, Nagarajan; Periyasamy, Sivakumar; George, Sanjoy; Basheer, Aneesh; Mookkappan, Sudhagar

    2014-01-01

    Tuberculoma of the brain is a major neurological problem in developing countries accounting for 12 to 30 per cent of all intracranial masses. It often presents with focal neurological symptoms or seizures. Simultaneous occurrence of brain tuberculoma with miliary mottling in the lungs is uncommon in the immunocompetent patient. We report only the second case of monoplegia and miliary tuberculosis, wherein the patient presented with acute onset left brachial monoplegia, upper motor neuron faci...

  15. Asymptomatic pons tuberculoma in an infant with miliary tuberculosis

    International Nuclear Information System (INIS)

    Miliary tuberculosis is caused by the hematogenous spread of Mycobacterium tuberculosis and consists of 1.5% of all tuberculosis cases. It is seen mostly in infants because of the immature immune system, and central nervous system CNS involvement is not rare. Tuberculomas are rarely seen in the localized form of CNS tuberculosis, and only 4% are localized in the brain stem. We report a 4.5-month-old infant who deteriorated during follow-up with the diagnosis of cytomegalovirus pneumonia, and afterwards received the diagnosis of miliary tuberculosis. Although the baby had no neurologic abnormality and cerebrospinal fluid findings were normal, cranial MRI revealed contrast enhanced nodular lesions in pons, cerebellum, and right parietal region. The case is presented to intensify the importance of CNS investigation even if the patient with miliary tuberculosis has no neurologic finding. (author)

  16. A case of miliary pulmonary cryptococcosis and review of literature.

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    Severo, Cecília Bittencourt; Bruno, Rosana Mussoin; de Mattos Oliveira, Flávio; Teixeira, Paulo Zimmermann; Hochhegger, Bruno; Severo, Luiz Carlos

    2015-04-01

    We describe a case of cryptococcal fungemia in a 62-year-old male renal transplant patient. The diagnosis was established by isolation of Cryptococcus neoformans using the Isolator(®) blood culture lysis-centrifugation system. Testing for cryptococcal antigens was negative in the serum and cerebrospinal fluid. Transbronchial lung biopsies and bronchoalveolar lavage were negative. Antifungal therapy with fluconazole was started, resulting in fever remission, and a sustained clinical response was achieved. The literature on miliary pulmonary cryptococcosis is reviewed, and three similar cases were previously reported with disseminated cryptococcosis that resembled miliary tuberculosis on imaging. These emphasize the importance of eliminating causes other than tuberculosis in patients presenting with miliary pulmonary disease, even in countries with a high prevalence of tuberculosis. PMID:25563716

  17. A case of anxiety associated with miliary tuberculosis

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    Alosaimi FD

    2014-06-01

    Full Text Available Fahad D Alosaimi,1 Feras A Alkharboush,2 Maram H Altuwariqi11Department of Psychiatry, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2College of Medicine, King Saud University, Riyadh, Kingdom of Saudi ArabiaAbstract: Miliary tuberculosis (TB is a serious infection with various presentations that can perplex even the most experienced clinicians. To our knowledge, there is a lack of published reports that link psychiatric symptoms directly with miliary TB (either alone or co-occurring with other medical symptoms. Mental health workers may, therefore, not consider, and consequently miss, this important diagnosis. Here we are reporting a case of cyclical anxiety occurring in a 67-year-old patient. For 3 years prior to admission, the patient failed to respond to multiple courses of different antianxiety medications. The patient required hospital admission as he deteriorated and had a reduced level of consciousness. A chest X-ray revealed bilateral nodules and a magnetic resonance imaging scan showed multiple enhancing tuberculous lesions in the cerebral white matter, brain stem, and cerebellum. A diagnosis of miliary TB was finally made. Several characteristics of this case suggest that the diagnosed anxiety disorder was due to miliary TB. However, we cannot exclude the possibility that generalized anxiety disorder preceded the onset of miliary TB or that both diseases were coincidental. The report serves as a reminder that organic causes for psychiatric symptoms always need to be considered, particularly if they follow an atypical pattern or fail to improve with usual psychiatric medications.Keywords: anxiety disorder, elderly, psychosomatic, case report, Saudi Arabia

  18. Retrospective survey of the management of miliary tuberculosis in South and West Wales, 1976-8.

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    Monie, R. D.; Hunter, A. M.; Rocchiccioli, K. M.; White, J. P.; Campbell, I. A.; Kilpatrick, G. S.

    1983-01-01

    In a survey of 1000 patients with tuberculosis 28 were found to have miliary disease. Half of these patients were over 60 years old. Anorexia and weight loss were present in 19 (70%) and pyrexia in 17 (63%). A factor predisposing to tuberculosis or a history of recent contact was found in 12 (43%), and 21 (75%) had positive cultures. Seventeen (61%) had classical miliary shadowing while four (14%) had cryptic miliary tuberculosis with no radiological evidence of tuberculosis. The remaining se...

  19. Tuberculous meningitis with pulmonary miliary tuberculosis: A clinicoradiological study

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    Kalita J

    2004-04-01

    Full Text Available BACKGROUND AND AIMS: This study aims at evaluating the clinical and radiological outcome of tuberculous meningitis (TBM patients with pulmonary miliary tuberculosis. MATERIAL AND METHODS: Diagnosis of TBM was based on clinical, CT scan or MRI and CSF criteria, and that of miliary tuberculosis on chest radiograph. Detailed clinical evaluation was done in all. Severity of meningitis was graded into Grades I, II and III. Complete hemogram, serum chemistry and Montaux tests were performed. The recovery was defined on the basis of 6 months Barthel index score as poor, partial or complete. RESULTS: 20 out of 165 patients with TBM had pulmonary miliary tuberculosis. Their mean age was 30 years; there was one child and 13 patients were females. The mean duration of symptoms was 6.3 months. Montoux test was negative in 9 patients. Six patients were in stage I, 3 in stage II, and 11 in stage III meningitis. Hemoglobin was below 12 gm% in 13 and liver dysfunction and hypocalcaemia was present in 8 and 18 patients respectively. CT scan was abnormal in 16 patients and revealed hydrocephalus (10, granuloma (7, exudates (3 and infarction (1. MRI was abnormal in 7 out of 8 patients and 3 of these patients had normal CT scan. MRI revealed multiple granuloma in 7 patients and exudates in 2. At 6 months, 2 patients died, 10 had complete, 2 had partial and 4 had poor recovery. CONCLUSION: TBM with pulmonary miliary tuberculosis was commoner amongst females who were anemic and hypocalcaemic. MRI revealed multiple granuloma and the majority of the patients improved.

  20. Sequential radiographic changes of nodules in patients with miliary pulmonary tuberculosis

    International Nuclear Information System (INIS)

    The purpose of this study is to evaluate sequential changes in miliary nodules, as seen on chest radiographs in patients with miliary tuberculosis. We retrospectively analyzed sequential changes in miliary nodules, as seen on the chest radiographs of 13 patients with miliary tuberculosis who recovered completely after antituberculous medication. Two were children and 11 were adults, and their ages ranged from 2 months to 73 years (mean, 38 years). In cases in which miliary tuberculosis had been diagnosed from initial chest radiographs, follow-up chest radiographs were obtained 5 to 15 (mean, 10) months later. After complete resolution of miliary nodules, as seen on chest radiographs, high-resolution CT scanning was performed in three patients. As seen on follow-up chest radiographs obtained at one week, the number and size of miliary nodules had decreased in eight to nine patients (89%), and on those obtained at one month, these decreases were seen in all 13 patients. The mean duration of complete resolution of miliary nodules was 6.3 months; in children, this was 3.5 (range, 2-5) months, and in adults, 6.8 (range, 3-10) months. In all three patients involved, high-resolution CT scans obtained after complete radiographic resolution of miliary nodules showed no recurrence. In patients with miliary tuberculosis, the size and number of nodules had decreased within one month of adequate chemotherapy and on chest radiographs, complete resolution was seen at 6.3 months, on ete resolution was seen at 6.3 months, on average. (author). 17 refs., 1 tab., 3 figs

  1. High-resolution CT findings of miliary pulmonary tuberculosis

    International Nuclear Information System (INIS)

    This study was performed to identify the characteristic findings of miliary pulmonary tuberculosis on HRCT and to evaluated the usefulness of HRCT by comparison with chest radiographs. High resolution CT, chest radiographs and medical records were retrospectively reviewed in 10 patients with miliary pulmonary tuberculosis. We analysed the size, distribution and margin of nodules, reticular or ground-glass density, parenchymal lesion, mediastinal lymphadenopathy and pleural effusion on HRCT which were compared with chest radiographic findings. On HRCT, characteristic 1-2 mm sized sharp or ill-defined nodular densities were randomly distributed throughout both lungs in all cases. In seven cases, the nodules were evenly scattered, but slightly more in upper lung zone in two cases, and in lower in one case. Only three cases revealed somewhat large and abundant nodules in posterior lung zone. There were findings of ill-defined margin of nodules in three cases, reticular densities in three cases and ground-glass opacity in two cases, all of which were observed within 4 weeks after onset of symptom. In one case, HRCT scan revealed a micronodular pattern in the lung parenchyma, even though chest radiographs of 2 days before were not obviously abnormal. HRCT was better to evaluate the margin of nodule and distribution than chest radiographs in four cases. Focal parenchymal lesion (n = 5), pleural effusion (n = 4), mediastinal lymphadenopathy (n = 6) and ARDS (n = 1) were also opathy (n = 6) and ARDS (n = 1) were also associated. HRCT could suggest a more specific diagnosis of miliary pulmonary tuberculosis with the above characteristic findings in appropriate clinical setting and normal or interstitial pattern of chest radiographs

  2. Asymptomatic pons tuberculoma in an infant with miliary tuberculosis.

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    Gulnar Uysal; Tugba Gursoy; Umut Altunc; Akif Guven

    2005-01-01

    ABSTRACT Miliary tuberculosis is caused by the hematogenous spread of Mycobacterium tuberculosis and consists of 1.5% of all tuberculosis cases. It is seen mostly in infants because of the immature immune system, and central nervous system CNS involvement is not rare. Tuberculomas are rarely seen in the localized form of CNS tuberculosis, and only 4% are localized in the brain stem. We report a 4.5-month-old infant who deteriorated during follow-up with the diagnosis of cytomegalovirus pne...

  3. Drug susceptibility pattern of Mycobacterium tuberculosis in adult patients with miliary tuberculosis.

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    Irfan, Muhammad; Hussain, Syed Fayyaz; Jabeen, Kausar; Islam, Muhammad

    2007-07-01

    Miliary tuberculosis (TB) is a fatal form of TB. Although drug resistance in TB patients has increased worldwide, there is limited information on drug resistance in miliary TB. This study from Pakistan evaluated drug susceptibility pattern among miliary TB patients of a high TB-burden country. All adult patients with miliary TB, admitted between 1994 and 2001, were identified using a computerized database. Culture-positive isolates were evaluated for drug susceptibility using middle brook 7H10 agar according to National Committee for Clinical Laboratories Standard criteria. Of 110 patients diagnosed with miliary TB, 32 (30%) were culture positive (yielding 35 culture isolates). The sources of positive cultures were sputum (37%), cerebrospinal fluid (18%), lymph nodes (12%), bone marrow (9%), bronchial wash (9%), urine (6%), lungs (6%) and liver (3%). Isoniazid resistance was found in three (9%) isolates. All the isolates were sensitive to rifampicin, ethambutol, pyrazinamide and streptomycin. Despite a worldwide increase in TB drug resistance, patients with miliary TB have infection with drug-sensitive mycobacterium. First-line anti-TB drugs should be used as initial therapy in miliary TB patients. PMID:17716515

  4. A Rare Case of Non-Small Cell Carcinoma of Lung Presenting as Miliary Mottling

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    Jayaram Subhashchandra, Ballaekere; Ismailkhan, Mohammed; Chikkaveeraiah Shashidhar, Kuppegala; Gopalakrishna Narahari, Moda

    2013-01-01

    Miliary mottling on chest radiography is seen in miliary tuberculosis, certain fungal infections, sarcoidosis, coal miner’s pneumoconiosis, silicosis, hemosiderosis, fibrosing alveolitis, acute extrinsic allergic alveolitis, pulmonary eosinophilic syndrome, pulmonary alveolar proteinosis, and rarely in hematogenous metastases from the primary cancers of the thyroid, kidney, trophoblasts, and some sarcomas. Although very infrequent, miliary mottling can be seen in primary lung cancers. Herein, we report the case of a 28-year-old female with chest X-ray showing miliary mottling. Thoracic computed tomography (CT) features were suggestive of tuberculoma with miliary tuberculosis. CT-guided fine needle aspiration cytology confirmed the diagnosis as lower-lobe, left lung non-small cell carcinoma (adenocarcinoma). It is rare for the non-small cell carcinoma of the lung to present as miliary mottling. The rarity of our case lies in the fact that a young, non-smoking female with miliary mottling was diagnosed with non-small cell carcinoma of the lung. PMID:23645961

  5. A Rare Case of Non-Small Cell Carcinoma of Lung Presenting as Miliary Mottling

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    Ballaekere Jayaram Subhashchandra

    2013-03-01

    Full Text Available Miliary mottling on chest radiography is seen in miliary tuberculosis, certain fungal infections, sarcoidosis, coal miner’s pneumoconiosis, silicosis, hemosiderosis, fibrosing alveolitis, acute extrinsic allergic alveolitis, pulmonary eosinophilic syndrome, pulmonary alveolar proteinosis, and rarely in hematogenous metastases from the primary cancers of the thyroid, kidney, trophoblasts, and some sarcomas. Although very infrequent, miliary mottling can be seen in primary lung cancers. Herein, we report the case of a 28-year-old female with chest X-ray showing miliary mottling. Thoracic computed tomography (CT features were suggestive of tuberculoma with miliary tuberculosis. CT-guided fine needle aspiration cytology confirmed the diagnosis as lower-lobe, left lung non-small cell carcinoma (adenocarcinoma. It is rare for the non-small cell carcinoma of the lung to present as miliary mottling. The rarity of our case lies in the fact that a young, non-smoking female with miliary mottling was diagnosed with non-small cell carcinoma of the lung.

  6. Magnetic resonance imaging of miliary tuberculosis of the central nervous system in children with tuberculous meningitis

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    Janse van Rensburg, Pieter; Andronikou, Savvas; Pienaar, Manana [University of Stellenbosch, Department of Radiology, Faculty of Health Sciences, Tygerberg (South Africa); Toorn, Ronald van [University of Stellenbosch, Department of Paediatrics and Child Health, Faculty of Health Sciences, Tygerberg (South Africa)

    2008-12-15

    Tuberculous meningitis (TBM) is closely associated with miliary tuberculosis and a pathogenetic relationship is suspected, although it has been proposed that the two processes are unrelated. To describe miliary tuberculosis of the central nervous system (CNS) on MRI in children with TBM. A retrospective descriptive study of 32 paediatric TBM patients referred for MRI. The presence of miliary nodules in the CNS was recorded. Lesions were categorized according to their distribution, enhancement pattern, size and signal characteristics. A miliary distribution of nodules was present in 88% of patients. All patients with a miliary distribution had leptomeningeal nodules and 18% of these patients had deep parenchymal nodules in addition. At least one tuberculoma with central T2 hypointensity was identified in 39% of patients. The high prevalence of miliary leptomeningeal nodules in the CNS of children with TBM is significant because it points to a pathogenetic relationship that has long been suspected on epidemiological grounds. Our findings challenge the concept that miliary tuberculosis is only an incidental finding in TBM patients and suggest that it plays an integral part in the pathogenesis. (orig.)

  7. Magnetic resonance imaging of miliary tuberculosis of the central nervous system in children with tuberculous meningitis

    International Nuclear Information System (INIS)

    Tuberculous meningitis (TBM) is closely associated with miliary tuberculosis and a pathogenetic relationship is suspected, although it has been proposed that the two processes are unrelated. To describe miliary tuberculosis of the central nervous system (CNS) on MRI in children with TBM. A retrospective descriptive study of 32 paediatric TBM patients referred for MRI. The presence of miliary nodules in the CNS was recorded. Lesions were categorized according to their distribution, enhancement pattern, size and signal characteristics. A miliary distribution of nodules was present in 88% of patients. All patients with a miliary distribution had leptomeningeal nodules and 18% of these patients had deep parenchymal nodules in addition. At least one tuberculoma with central T2 hypointensity was identified in 39% of patients. The high prevalence of miliary leptomeningeal nodules in the CNS of children with TBM is significant because it points to a pathogenetic relationship that has long been suspected on epidemiological grounds. Our findings challenge the concept that miliary tuberculosis is only an incidental finding in TBM patients and suggest that it plays an integral part in the pathogenesis. (orig.)

  8. [Lymphoid form of intestinal tuberculosis with miliary dissemination: case report].

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    Goi?-Barisi?, Ivana; Ledina, Dragan; Tonki?, Marija; Luksi?, Boris; Barisi?, Igor

    2006-12-01

    Tuberculosis with the incidence 28-29/100000 residents still presents a major public health problem in Croatia. Miliary tuberculosis is uncommon cause of fever of unknown origin. Intestinal tuberculosis pose as diagnostic problem that can be identified by colonoscopy and/or explorative laparatomy involving histopathology and microbiology. A case is reported of a 40-year-old HIV negative patient admitted to the Department of Infectious Diseases after two weeks of fever, diarrhea, abdominal pain and weight loss. Biochemistry testing showed mild elevation of the erythrocyte sedimentation rate and increased serum aminotransferases. On admission, chest x-ray was normal and tuberculin skin test was negative. Crohn's disease was suspected. Computed tomography of the abdomen revealed solid infiltrative mass located retroperitoneally, along with enlarged lymph nodes. Explorative laparoscopy was necessary to confirm the diagnosis. Intraoperative specimens were referred for histopathologic and microbiologic examination, which proved the existence of granulomatous inflammation of the areas with caseous necrosis. Direct microscopy of the periappendicular abscess and Ziehl-Neelsen staining of a lymph node specimen confirmed the presence of an acidoresistant bacillus. The specimen culture on solid egg based agar (Löwenstein Jensen) and liquid broth (MGIT) showed the growth of Mycobacterium tuberculosis. Then the causative agent was cultured from all specimens: sputum, stool and urine. Repeat cheast x-ray, performed on day 30 of hospitalization, showed miliary dissemination to the lungs. The patient was treated with four antituberculotics (streptomycin, isoniazide, rifampin, ethambutol) and methylprednisolone for one month, then with isoniazide, rifampin and for 11 months ethambutol. Therapy led to a decrease of abdominal lymph nodes and absence of miliary lesions on chest radiography after two months of treatment. Intestinal tuberculosis has been almost forgotten in Croatia. The latest published cases referred to HIV infected patients. In less than 50% of patients with intestinal tuberculosis the lungs are also affected, which poses a diagnostic problem. Crohn's disease is the most common diagnostic problem. Histopathology of a specimen obtained on colonoscopy and/or explorative laparoscopy can often solve the dilemma, as also confirmed in our patient. Of diagnostic studies, computed tomography has the advantage of evaluating intestinal wall involvement, which is important for the early diagnosis of intestinal tuberculosis. Enteroclysis and irrigography provide diagnostic information in the advanced stage of intestinal tuberculosis. In a patient with fever, abdominal disorders and parameters which implicate granulomatosis hepatitis or Crohn's disease, the existence of abdominal tuberculosis is also possible. Computed tomography and biopsy obtained on colonoscopy for microbiology can help in making the diagnosis and initiating appropriate treatment. PMID:17217110

  9. Isolated Pulmonary Langerhans-Cell Histiocytosis Mimicking Miliary Tuberculosis

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    Metehan Özen

    2009-09-01

    Full Text Available Isolated involvement of lungs in the course of Langerhans'-cell histiocytosis (LCH is very rare in childhood. Spontaneous pneumothorax (PTX may occur during the course which necessitates rapid intervention. We present a 17 months-old girl who was sent with the pre-diagnosis of miliary tuberculosis. Despite antituberculosis therapy, her pulmonary function deteriorated. The chest tomography showed a different lung pattern which is suggestive of LCH. The biopsy findings and immunohistochemistry staining supported the diagnosis. She experienced recurrent pneumothorax incidences which were managed by drainage. She responded well to chemotherapy. Although rare, isolated pulmonary LCH should be remembered in differential diagnosis of cystic lung disease in childhood. On time diagnosis, appropriate therapy and rapid intervention for pneumothorax have important impacts on patient prognosis.

  10. Miliary Osteoma Cutis of the Face: A Case

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    Selma Emre

    2014-03-01

    Full Text Available Osteoma cutis (cutaneous ossification (OC is a rare disorder with true bone formation within the skin. Multiple miliary osteoma cutis of the face (MMOCF is a cause of acquired OC, is characterized by multiple, small, and primary osteomas in the skin tissue of the face and is a benign extraskeletal and rare bone formation. To date, 52 cases with MMOCF have been reported in the literature. Herein, we report a 56-year-old female patient presented with multiple small, firm, skin-colored papules on the forehead and face lasting for 4 years. She had no history of preexisting acne or any local inflammatory disease at the lesional sites. The skin biopsy revealed osteoid formation with central degeneration and calcification in the dermis. Depending on these clinical and histopathological findings, the patient was diagnosed as MMOCF.

  11. A case of miliary tuberculosis with nodular dissemination to brain demonstrated by computed tomography

    International Nuclear Information System (INIS)

    A case of miliary tuberculosis with tuberculous meningitis was reported. The computed tomography of the brain demonstrated spread of small nodular shadows in the brain. At the beginning the small nodular shadows increased both in number and size, which disappeared after six months combination treatment of anti-tuberculous drugs and corticosteroid hormone. These results suggest that the tuberculous miliary spread to brain was demonstrated by the computed tomography with advanced resolving power. (author)

  12. Multiple jejunoileal perforations because of intestinal involvement of miliary tuberculosis in an infant.

    Science.gov (United States)

    Acer, Tu?ba; Karnak, Ibrahim; Ekinci, Saniye; Talim, Beril; Kiper, Nural; Senocak, Mehmet Emin

    2008-09-01

    Infants are more susceptible to tuberculous bacilli and may develop severe extrapulmonary and miliary forms of the disease. However, miliary tuberculosis (MT) presenting with multiple intestinal perforations as an initial manifestation of the disease is extremely rare in children. The authors describe an infant who underwent emergency laparotomy because of jejunoileal perforations secondary to intestinal involvement of MT to emphasize the characteristics of the abdominal disease and the importance of controlling systemic disease to achieve a favorable outcome. PMID:18778982

  13. Disseminated histoplasmosis simulating miliary tuberculosis: a case report; Histoplasmose disseminada simulando tuberculose miliar: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Tavares Junior, Wilson Campos; Madureira, Marcus Magalhaes; Andrade, Diego Correa de; Guimaraes, Silvana Mangeon Meireles; Queiroz, Leonardo Campos [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Hospital das Clinicas. Dept. de Radiologia e Diagnostico por Imagem]. E-mail: wilsontavaresjrmd@yahoo.fr; Avila, Renata Eliane de [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Hospital das Clinicas. Servico de Doencas Infecciosas e Parasitarias; Lambertucci, Jose Roberto [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Faculdade de Medicina. Clinica Medica

    2005-04-15

    Histoplasmosis is a disease caused by inhalation of the fungus Histoplasma capsulatum. In rare cases the disease affects immunocompetent individuals. Disseminated and severe disease is seen in immunocompromised patients. We report a case of a 45 year old immunocompromised patient presenting with weight loss and abdominal pain. Chest x-ray and computerized tomography examinations showed interstitial infiltrate and diffuse micro nodules. The initial diagnosis was miliary tuberculosis. However, the definitive diagnosis of miliary histoplasmosis was made later on. (author)

  14. Miliary tuberculosis in Qatar: A review of 32 adult cases

    International Nuclear Information System (INIS)

    This study was conducted to define the demographic, clinical andlaboratory features, methods of diagnosis and outcome, in patients withmilitary tuberculosis (TB) in Qatar, and compare the findings with otherreported studies. A retrospective review of 32 cases of military TB treatedat the Hamad Medical Corporation during a seven year period (1992 to 1998)was undertaken. The 32 patients comprised 24 males and 8 females, and theirmean age was 33.3 years. The majority (90%) were expatriates. The clinicalfeatures of the patients were similar to those of previously reported series.The most common presenting symptoms were fever, cough, night sweats, weightloss and sputum production. Fever, rales, lymphadenopathy, alerted mentalstatus and hepatomegaly were the most common signs. Chest radiograph wasabnormal in 94% of patients, and showed a military pattern in 69%. Sputum,cerebrospinal fluid, bronchial washings and urine smears for acid-fastbacilli were rarely positive, however, cultures for Mycobacteriumtuberculosis were positive in 54.8%, 37.5%, 33% and 25% respectively. Thediagnoses in the majority of patients were made on the basis of the clinicalpresentation and supported by a military pattern on chest radiograph. Inthose whom chest radiograph did show the classic military pattern,transbranchial biopsy was diagnostic in 1 of 2 patients (50%), bone marrowbiopsy in 5 of 11 (45%), liver biopsy in 1 of 2 (50%) and lymph node biopsyin all 7 patients (100%). Thirty patients werall 7 patients (100%). Thirty patients were treated with a four-drugregimen consisting of isoniazid, rifampin, pyrazinamide and streptomycin orethambutol. Mortality due to miliary TB was 3%. Miliary TB is common inQatar, especially among expatriates. Because the clinical features of thedisease are nonspecific, a high index of suspicion is essential for earlydiagnosis in order to avoid delays in therapy and poor outcome. (author)

  15. Miliary Tuberculosis with Concurrent Brain and Spinal Cord Involvement: A Case Report

    International Nuclear Information System (INIS)

    Central nervous system involvement by tuberculosis is rare, and intramedullary involvement is even more rare. A patient that developed intermittent amnesia during anti-tuberculous therapy underwent brain CT and MRI and spine MRI. The latter showed multiple small enhancing nodules in the brain and spinal cord. The patient was treated with anti-tuberculous medication and steroids under the suspected diagnosis of miliary tuberculosis. Follow-up CT showed decreased nodule size and number. We report a case of miliary tuberculosis in the brain and spinal cord and present a review of the literature related to similar cases

  16. Miliary Tuberculosis with Concurrent Brain and Spinal Cord Involvement: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Chang Keun; Na, Hyoung Il; Yu, Hyeon; Byun, Jun Soo; Youn, Young Chul; Seo, Jae Seung; Kim, Gi Hyeon [Chung-Ang University, Seoul (Korea, Republic of)

    2008-11-15

    Central nervous system involvement by tuberculosis is rare, and intramedullary involvement is even more rare. A patient that developed intermittent amnesia during anti-tuberculous therapy underwent brain CT and MRI and spine MRI. The latter showed multiple small enhancing nodules in the brain and spinal cord. The patient was treated with anti-tuberculous medication and steroids under the suspected diagnosis of miliary tuberculosis. Follow-up CT showed decreased nodule size and number. We report a case of miliary tuberculosis in the brain and spinal cord and present a review of the literature related to similar cases.

  17. CT and pathologic correlation acute miliary pulmonary tuberculosis

    International Nuclear Information System (INIS)

    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 ?m) and histologic section (5 ?m) 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 (?2=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)

  18. Muerte por tuberculosis milliar / Death from miliary tuberculosis

    Scientific Electronic Library Online (English)

    Haidee, Marrero Rodríguez.

    2013-05-01

    Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se describe el caso clínico de un anciano, en estado senil y desnutrido, quien presentaba síndrome febril prolongado, por lo que fue ingresado en el Hospital Clinicoquirúrgico Docente "Dr. Ambrosio Grillo Portuondo" de Santiago de Cuba, pero al efectuar los exámenes complementarios no se obtuvo un d [...] iagnóstico definitivo. Posteriormente tuvo descompensación cardiovascular y fue trasladado a la Unidad de Terapia Intensiva, donde se le realizó urgentemente una radiografía de tórax, la cual mostró lesiones características de tuberculosis milliar. En consecuencia, se interconsultó con especialistas de neumología y se decidió iniciar el tratamiento con drogas antituberculosas; sin embargo, el paciente falleció un día después de comenzada la terapia. La necropsia mostró una granulomatosis crónica inespecífica, cuyo resultado solo se confirmó 2 meses más tarde, cuando el cultivo de las secreciones bronquiales fue positivo (codificación 7) de Mycobacterium tuberculosis. Abstract in english A case report of an elderly man in senile and malnourished state was described, who had prolonged febrile syndrome and was admitted to «Dr "Ambrosio Grillo Portuondo" Clinical and Surgical Teaching Hospital of Santiago de Cuba, but a definitive diagnosis could not be obtained with complementary test [...] s. Later he had cardiovascular decompensation and was transferred to the Intensive Care Unit, where he underwent an emergent chest radiograph, which showed characteristic lesions of miliary tuberculosis. Consequently, pulmonary specialists were consulted and it was decided to start treatment with antitubercular drugs; however, the patient died a day after the beginning of therapy. The autopsy showed a nonspecific chronic granulomatosis, which results were only confirmed 2 months later, when the culture of bronchial secretions was positive (coding 7) for Mycobacterium tuberculosis.

  19. X-ray findings in patients with miliary appearance of metallic mercury after suicide attempt

    International Nuclear Information System (INIS)

    This case report evaluates X-ray findings in patients with miliary accumulation of mercury observed after parenteral application of metallic mercury in a suizide attempt. There are certain discrepancies between clinical symptoms and the X-ray findings. A clear demonstration of mercury in coronary blood vessels is possible by fluoroscopy. (orig.)

  20. Multiple Tuberculoma Involving the Brain and Spinal Cord in a Patient with Miliary Pulmonary Tuberculosis

    OpenAIRE

    Park, Hyun-seok; Song, Young-jin

    2008-01-01

    Although tuberculosis of the central nervous system is well known, the incidence of intramedullary tuberculomas is low and a combination of intramedullary with intracranial tuberculomas is extremely rare. We report a case of disseminated tuberculoma involving brain and spine with miliary pulmonary tuberculosis in a 66-year-old woman initially presenting with fever, general weakness, back pain and motor weakness of both lower extremities. Despite medical therapy, she developed progressive moto...

  1. Pulmonary miliary tuberculosis complicated with tuberculous spondylitis; an extraordinary rare association: a case report

    OpenAIRE

    Palama, Eleni; Golias, Christos; Illiadis, Iosif; Charalabopoulos, Konstantinos

    2009-01-01

    In the last decade a significant rise in the prevalence of tuberculosis as well as in its extrapulmonary manifestations is detected worldwide. The central nervous system, the genitourinary tract, the organs of the abdomen and the skeletal system, are common sites of infection. Misdiagnosis and delay in treatment are common events. Herein, we present a case of a 78-year-old man non-smoker, with miliary tuberculosis complicated with tuberculous spondylitis. The patient presented with anemia and...

  2. Varicella Vaccination During Early Pregnancy: A Cause of in utero Miliary Fetal Tissue Calcifications and Hydrops?

    OpenAIRE

    Anthony Al-Khan; Leslie Iffy; Vijaya Ganesh; Joseph Apuzzio

    2002-01-01

    BACKGROUND: It is the purpose of this article to describe a suspected association of inadvertent vaccination with varicella vaccine during early pregnancy with the subsequent development of in utero miliary fetal tissue calcifications and fetal hydrops detected by sonogram at 15 weeks of gestation. CASE: This is a case presentation of a pregnant patient who received varicella vaccination during the same menstrual cycle that she became pregnant, and is supplemented by a literary review. The fe...

  3. Predictors and outcome of patients with acute respiratory distress syndrome caused by miliary tuberculosis: a retrospective study in Chongqing, China

    Directory of Open Access Journals (Sweden)

    Deng Wang

    2012-05-01

    Full Text Available Abstract Background Miliary tuberculosis (TB is an uncommon cause of acute respiratory distress syndrome (ARDS with a high mortality. The aim of the present study was to evaluate the clinical characteristics, predictors and outcome of patients with ARDS caused by miliary TB. Methods A retrospective study was conducted among patients with a diagnosis of ARDS with miliary TB in four hospitals from 2006 to 2010. Medical records and laboratory examinations of these patients were taken during the first 24 h of admission. Results Eighty-five patients with miliary TB developed ARDS, 45 of whom survived (52.9%. The median age was 36.6?±?12.5 years with 38 males (44.7%. Diabetes mellitus (DM was the most common underlying disease (18.8%.ICU mortality was 47.1%. The time from admission to anti-tuberculosis therapy was 4.5?±?2.0 days. Mean duration of mechanical ventilation was 8.5?±?3.0 days in all patients. Duration of time to diagnosis, time from diagnosis to mechanical ventilation, and time to anti-tuberculosis therapy were significantly shorter in survivors than those in non-survivors. Diabetes mellitus (OR 5.431, 95%CI 1.471-20.049; P?=?0.005, ALT (70-100U/L, OR 10.029, 95%CI 2.764-36.389; P?=?0.001, AST (>94U/L,OR 8.034, 95%CI 2.200-29.341; P?=?0.002, D-dimer (>1.6mg/L, OR 3.167, 95%CI 0.896-11.187; P?=?0.042, hemoglobin ( Conclusions Accurate diagnosis, early initiation of anti-tuberculosis therapy and mechanical ventilation are important for the outcome of patients with ARDS caused by miliary TB. DM, ALT, AST, D-dimer, hemoglobin, and albumin are independent predictors of ARDS development in patients with miliary TB.

  4. Abdominal miliary tuberculosis in a patient with AIDS: a case report.

    Science.gov (United States)

    Pop, Monica; Pop, Cezar; Homorodean, Daniela; Itu, Corina; Man, Milena; Goron, Monica; Gherasim, Ruxandra; Coroiu, Georgiana

    2003-09-01

    We present a 34 year old patient, intravenous drug user, hospitalized with fever, distortion of general status, dry irritating cough, abdominal colicative pains, and we established the diagnosis of HIV infection advanced stage/AIDS; his antecedents revealed (August 2000) abdominal tuberculosis not treated during the last 3 months. He presented a pneumonia with Pneumocystis carinii during hospitalization. Death was due to a colon perforation with secundary peritonitis. Miliary tuberculous lesions in liver, spleen and colon were revealed at necropsy and cytomegalovirus was identified in necrotic samples also. PMID:14502324

  5. Case for diagnosis / Caso para diagnostico

    Scientific Electronic Library Online (English)

    Adriana, Tiengo; Hugo Rocha, Barros; Daniele Bueno, Carvalho; Gabriela Mantovanelli de, Oliveira; Ney, Romiti.

    2013-08-01

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese A Dermatite Periorificial Granulomatosa da Infância é erupção facial acneiforme que afeta área periorificial do segmento cefálico de pré-puberes. Consiste em pápulas assintomáticas de 1 a 3 mm, monomorfas, eritematosas ou hipopigmentadas em áreas periorificiais - boca, nariz e olhos. A doença é beni [...] gna e auto-limitada, curando sem deixar cicatriz e por regra sem terapia específica. Diagnósticos diferenciais incluem a dermatite perioral, rosácea granulomatosa, sarcoidose e lúpus miliar da face. Relata-se paciente de 4 anos, masculino, com erupção papulosa há 2 anos em áreas periorificais. Devido à sua baixa incidência e o reduzido número de publicações relata-se o presente caso. Abstract in english Childhood Granulomatous Periorificial Dermatitis is an acneiform facial rash that affects the periorificial area in children. The clinical aspectare asymptomatic 1-3 mm papules of, monomorphic, erythematous or hypopigmented in periorificial areas - mouth, nose and eyes. It's a benign and self-limite [...] d disease that heals spontaneously without scarring and specific therapy. Differential diagnoses include perioral dermatitis, granulomatous-rosacea, sarcoidosis, and lupus miliaris disseminatus faciei. We present the case of a 4-year-old boy, presenting papules in periorificials areas. Due to its low incidence and low number of publications we report the present case.

  6. Reproductive ecology and behavior of Thoropa miliaris (Spix, 1824) (Anura, Leptodactylidae, Telmatobiinae) / Ecologia e Comportamento Reprodutivo de Thoropa miliaris (Spix, 1824) (Anura, Leptodactylidae, Telmatobiinae)

    Scientific Electronic Library Online (English)

    Ariovaldo Antonio, Giaretta; Kátia Gomes, Facure.

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese Ecologia e Comportamento Reprodutivo de Thoropa miliaris (Spix, 1824) (Anura, Leptodactylidae, Telmatobiinae). As espécies de Thoropa estão distribuídas no sul e sudeste do Brasil e têm girinos semiterrestres em ambientes rochosos. Aqui apresentamos dados complementares sobre reprodução, cuidado pat [...] ernal e canibalismo por girinos em T. miliaris. Machos guardiões foram testados quanto a perturbações às suas desovas. As desovas foram postas em faixas de umidade na rocha; os ovos foram postos em camada única e estavam aderidos à superfície da rocha, raízes e uns aos outros. Os girinos eclodiram entre quatro e seis dias após a oviposição. O número de ovos em duas desovas foi 750 e 1190; os ovos eram cinza e a porção vitelínica mediu cerca de 1,7 mm em diâmetro; 2,3 mm com a cápsula gelatinosa. Foram observadas interações agressivas entre os machos. Os machos permaneceram com suas desovas durante a noite e reagiram agressivamente às perturbações experimentais. Girinos em estágios tardios foram vistos canibalizando ovos. Uma desova em uma faixa de umidade recém formada morreu por desidratação. As faixas de umidade na rocha são os únicos locais onde os ovos e os girinos podem se desenvolver e representam um fator limitante para a reprodução porque são raras. Para as fêmeas, a seleção de faixas úmidas recém formadas deve representar um balanço entre as vantagens em ocupar lugares livres de girinos canibais e/ou competidores e os riscos de perda de prole por desidratação. Nossos resultados não apóiam Cycloramphinae como um táxon válido, indicando que as similaridades morfológicas e comportamentais entre as espécies de Thoropa e Cycloramphus devem ser interpretadas como convergência. Abstract in english Thoropa species are distributed in southern and southeastern Brazil and have semiterrestrial tadpoles on rocky environments. Herein, we provide further data on reproduction, paternal care and tadpole cannibalism in T. miliaris. Guarding males were tested for disturbances in their egg masses. Egg mas [...] ses were laid in stripes of wet rock; eggs were in a single layer and were adhered to the rock surface, roots, and to one another. The tadpoles hatched between four and six days. The egg number in two egg masses was 750 and 1190; eggs were gray and the yolk were about 1.7 mm in diameter; 2.3 mm with the jelly capsule. Aggressive interactions were observed between males. Males remained with their egg masses during the night and reacted aggressively to the experimental disturbances. Late stage tadpoles were found cannibalizing eggs. An egg mass in a recently formed wet stripe died from drought. The strips of wet rock are the only places where eggs and tadpoles can develop and represent a limiting factor for reproduction because they occur in short supply. For the females, the selection of newly formed wet strips may represent a trade-off between the advantages of using places free of cannibalistic and/or competitive tadpoles and the risks of losing offspring by drought. Our results do not support Cycloramphinae as a valid taxon, indicating that the morphological and behavioral similarities between Thoropa and Cycloramphus species should be interpreted as convergence.

  7. Diagnostic performance of the QuantiFERON-TB Gold In-Tube assay and factors associated with nonpositive results in patients with miliary tuberculosis.

    Science.gov (United States)

    Kim, Chang Ho; Lim, Jae Kwang; Yoo, Seung Soo; Lee, Shin Yup; Cha, Seung Ick; Park, Jae Yong; Lee, Jaehee

    2014-04-01

    The QuantiFERON-TB Gold In-Tube (QFT-GIT) assay provides suboptimal diagnostic performance in patients with miliary tuberculosis. QFT-GIT results should be carefully interpreted, particularly in patients suspected of having miliary tuberculosis with severe lymphocytopenia or an extent of ground glass opacity (GGO) >50% on chest computed tomography (CT). Diagnostic performance of the QFT-GIT assay was evaluated in 44 patients with miliary tuberculosis. Among these individuals, 30 (68%) had true-positive QFT-GIT results. Severe lymphocytopenia and an extent of GGO >50% on chest CT were independent risk factors for nonpositive QFT-GIT results. PMID:24457341

  8. Miliary tuberculosis with positive acid-fast bacilli in a pediatric patient

    Scientific Electronic Library Online (English)

    Sara Regina Castanheira, Fernandes; Marcia Noriko de Oliveira, Homa; Aghata, Igarashi; Andréa Luiza Mendes, Salles; Ana Paula, Jaloretto; Maria Silvia, Freitas; Paulo Cesar Koch, Nogueira.

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO: A tuberculose representa importante problema de Saúde Pública no Mundo. O governo brasileiro relatou 78.460 mil novos casos no ano de 1999. A tuberculose miliar é uma forma grave desta doença. OBJETIVO: Reportar uma forma atípica de manifestação da tuberculose miliar em paciente pediátrico [...] . RELATO DO CASO: Paciente masculino, cinco anos, compareceu ao serviço de emergência com fadiga e emagrecimento importantes. A radiografia torácica tinha como resultado condensação lobar com padrão miliar associado a cavitações em lobos superiores. O paciente havia apresentado, sete meses antes, um episódio de pneumonia estafilocócia complicada com derrame pleural. A antibióticoterapia foi iniciada. O escarro da criança veio positivo para pesquisa do bacilo álcool-ácido-resistente e, portanto, o tratamento recomendado para tuberculose foi iniciado. O paciente foi tratado por nove meses e, ao fim do seguimento, apresentou recuperação clínica completa. CONCLUSÃO: Limitações do exame de escarro forçam os pediatras a investigar a tuberculose através de dados epidemiológicos, achados clínicos e do padrão miliar ao raio-x, embora, em alguns raros casos, o escarro possa ser positivo em crianças. Neste paciente, a hipótese mais provável para explicar este achado é de que os bacilos usaram as cicatrizes da pneumonia estafilocócica prévia (pneumatoceles) para alcançar concentrações expressivas no escarro e, com isso, tornar positivo o resultado do exame. Abstract in english CONTEXT: Tuberculosis is an important public health issue. The Brazilian government reported 78,460 new cases in 1999. Miliary tuberculosis is a severe form of this disease. OBJECTIVE: To report on an uncommon clinical presentation of miliary tuberculosis in a child. CASE REPORT: A 5-year old boy pr [...] esented in the emergency room with fatigue and weight loss. He had had Staphylococcus aureus pneumonia 7 months before. Chest radiography revealed lobar consolidation and miliary pattern associated with small cavities in both upper lobes. Antibiotic therapy was started. The sputum was positive for acid-fast bacilli and hence the treatment recommended for tuberculosis (rifampicin, isoniazid [INH], pyrazinamide) was started. The patient was treated for 9 months and at the end of the follow-up period he had made a complete clinical recovery. CONCLUSION: Although in some particular cases sputum can be positive for acid-fast bacilli in children, limitations to the sputum test have forced pediatricians to base tuberculosis diagnosis on epidemiological data, clinical findings and radiographic pattern. In this particular case, we hypothesize that the sputum bacillus test was positive because bacilli grew inside residual pneumatoceles that were produced during previous pneumonia.

  9. Pulmonary miliary tuberculosis complicated with tuberculous spondylitis; an extraordinary rare association: a case report

    Science.gov (United States)

    Palama, Eleni; Golias, Christos; Illiadis, Iosif

    2009-01-01

    In the last decade a significant rise in the prevalence of tuberculosis as well as in its extrapulmonary manifestations is detected worldwide. The central nervous system, the genitourinary tract, the organs of the abdomen and the skeletal system, are common sites of infection. Misdiagnosis and delay in treatment are common events. Herein, we present a case of a 78-year-old man non-smoker, with miliary tuberculosis complicated with tuberculous spondylitis. The patient presented with anemia and a left shoulder pain, accompanied by rigor and fever 37.5°C-38°C of one month duration. This entity is extremely rare, since only two similar cases have been reported in the English literature according to PubMed search. PMID:19918444

  10. ECF and TCF bleaching of Saccharum officinerum-CO89003 bagasse soda-AQ pulp with alkali-thermo-tolerant crude xylanase from Coprinellus disseminatus SW-1 NTCC1165

    Directory of Open Access Journals (Sweden)

    Swarnima Agnihotri

    2012-11-01

    Full Text Available An alkali-thermo-tolerant crude xylanase from Coprinellus disseminatus SW-1 NTCC1165 produced under solid-state fermentation conditions improves the brightness of sugarcane bagasse soda-AQ pulp by 7.3, 4.7, 6.1, and 8.2% in XODED, XOD(EOPDP, OX(EOPP, and XO(EOPP bleaching sequences, respectively, at an enzyme dose of 8IU/g, a reaction time of 120 min, a consistency of 10%, and a pH of 6.4 at 55 oC. An improvement in brightness by 2.1% for pulp bleached by XO(EOPP compared to OX(EOPP sequence validates that xylanase treatment is more effective for hydrolysing lignin-carbohydrates complexes before oxygen treatment. AOX after XODED and XOD(EOPDP sequences is reduced by 41.43 and 40%, respectively, compared to controls, but an increase in COD and color in studied bleaching sequences is attributable to the hydrolysis of hemicelluloses and the release of lignin-carbohydrates complexes after xylanase treatment. Xylanase treatment modifies fibre surface by introducing cracks, peelings, swelling, and external fibrillation, which facilitates faster penetration of bleach chemicals by disrupting physical barriers, as revealed by scanning electron microscopy.

  11. Miliary tuberculosis in human immunodeficiency virus infected patients not on antiretroviral therapy: Clinical profile and response to shortcourse chemotherapy

    Directory of Open Access Journals (Sweden)

    Swaminathan S

    2007-01-01

    Full Text Available Background: An increase in tuberculosis (TB incidence has been associated with human immunodeficiency virus (HIV. Aims: To describe the clinical characteristics and treatment outcome of patients with HIV and miliary TB treated with short-course intermittent chemotherapy in the absence of access to highly active antiretroviral therapy (HAART. Settings and Design: Prospective study of HIV infected adults referred to a TB clinic between July 1999 and July 2004. Materials and Methods: On diagnosis of miliary TB, patients were treated with a standard regimen of two months of isoniazid, rifampicin, ethambutol and pyrazinamide followed by four months of isoniazid and rifampicin (2EHRZ 3 /4RH 3 thrice weekly and followed up for 24 months. Patients were reviewed clinically every month and two sputa were collected. Chest radiographs and blood investigations were done at two months, end of treatment and every six months thereafter. Results: Of 498 patients with HIV and tuberculosis, 31 (6% were diagnosed as miliary tuberculosis. At diagnosis, sputum smear was positive for acid-fast bacilli (AFB in 14 patients (45% and Mycobacterium tuberculosis was isolated in 21 (68%. The mean CD4 cell count was 129 ± 125 cells/mm 3 . Twenty-five patients were declared cured at the end of treatment (81% while one (3% died and five (16% failed. The recurrence rate was 19.4/100 person-years and the median survival was 17 months (95% CI 14 to 20. None of the patients received antiretroviral therapy. Conclusions: Miliary TB tends to occur among HIV infected patients with severe immunosuppression. Though the initial response to short-course chemotherapy was encouraging, a high recurrence rate and mortality was observed indicating poor prognosis in HIV.

  12. Miliary pulmonary metastases of well-differentiated thyroid carcinoma (medullary excluded) about 10 cases

    International Nuclear Information System (INIS)

    Thyroid cancer is relatively a rare cancer; about 1% from all cancers: between 10 and 1591 of patients with differentiated thyroid cancer develop micro or macro-nodular pulmonary metastases. In this study we examined the characteristics and evolution after treatment of 10 patients with micro-nodular or miliary metastases of well-differentiated thyroid carcinoma. Total body scintigraphy with 131 iodine, chest X-ray or CT scan, and thyroglobulin assay were performed for all patients. The treatment was iodine 131 (3. 7 GBq). therapeutic 131 iodine scan was done for all patients seven days after the 131 administration. The effect of 131 iodine treatment was evaluated by means of changes in the number and size of lung metastases on the total body scintigraphy with 131 iodine and by serum thyroglobulin levels six months after 131 iodine ablation, they all received L-thyroxine (2,4 ?g/kg/j). The minimum duration of follow-up was 12 months. There were six females and four males within a range of 13-70 years old. Eight had papillary and two follicular thyroid cancer. These 10 patients benefited 131 iodine therapy. The effect of 131 iodine treatment and the prognostic values of the following variables mere examined: age at the time of 131 iodine. treatment and histological findings. The miliary was rarely diagnosed on the initial investigation. only in to o cases by 131 iodine scar. alter surgery. two cases by chest X-ray, and two cases by CT scan, the initial thyroglobulin le by CT scan, the initial thyroglobulin levels was very high in seven cases, between 10 and 40 ng/ml in one case and less than 10 ng/ml in two cases. These results indicate that age, 131 iodine uptake. histological findings and the presence of other metastases are important factors in predicting the effects of 131 treatment for pulmonary metastases of well-differentiated thyroid carcinoma. Among all the variables studied. the best prognosis for survival was demonstrated by increased 131 uptake in pulmonary metastases and by early diagnosis during post surgery 131 iodine scanning of radiologically non-apparent metastases. (authors)

  13. Facial miliary osteoma in HIV patient / Osteoma miliar da face em paciente portadora do HIV

    Scientific Electronic Library Online (English)

    Camila, Camozzato; Franciani de Oliveira, Basso; Rodrigo Pereira, Duquia; Ana Letícia, Boff; Hiram Larangeira de, Almeida Jr.

    2011-08-01

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os osteomas miliares da face são caracterizados por múltiplas pápulas normocrômicas na face, afetando, geralmente, mulheres de meia idade, com história pregressa de acne. Uma paciente de 39 anos, portadora do HIV, apresentou pápulas endurecidas, com 3 anos de evolução, localizadas na região malar, g [...] labela e mento. A microscopia óptica demonstrou formações ósseas esféricas na derme. A tomografia computadorizada da face observou pequenas calcificações na superfície, compatíveis com formação óssea. Os osteomas múltiplos da face são raros assim como sua associação com a infecção pelo HIV Abstract in english Facial miliary osteoma is characterized by the presence of multiple normochromic papules, affecting mainly middle-aged women, with a previous history of acne. A 39-year-old HIV positive female patient presented hardened papules which had appeared 3 years before, located on the malar region, glabella [...] and mentum. Optical microscopy showed spherical bone formations in the dermis. Computerized tomography of the face revealed small calcifications on the surface consistent with bone formation. Multiple facial osteomas are rare as well as its association with HIV virus infection

  14. Tuberculosis congénita asociada con tuberculosis materna miliar diseminada Congenital tuberculosis associated with maternal disseminated miliary tuberculosis

    Directory of Open Access Journals (Sweden)

    Julio César Mantilla

    2007-12-01

    Full Text Available La tuberculosis sin tratamiento en mujeres gestantes es un riesgo definido para la transmisión de la enfermedad al recién nacido y para resultados adversos, obstétricos y perinatales. La tuberculosis en mujeres gestantes y la tuberculosis congénita son afecciones infrecuentes y de difícil diagnóstico por la falta de especificidad de las manifestaciones clínicas.
    Se presenta el caso de una mujer primigestante con tuberculosis miliar diseminada, con inicio de las manifestaciones en el puerperio inmediato, diagnóstico en el segundo mes del puerperio y desenlace fatal. Además, se presenta el caso de su hijo prematuro con manifestaciones desde el nacimiento, evidencia de complejo pulmonar primario, atelectasia persistente por obstrucción bronquial por las adenopatías e infección por citomegalovirus; recibió tratamiento estándar con mejoría.Untreated tuberculosis during pregnancy presents a serious risk for transmission of disease to the newborn and can result in adverse perinatal and obstetrical outcomes. Tuberculosis during pregnancy and congenital tuberculosis are infrequent conditions and are difficult to diagnose due the non-specificity of the symptoms. A case report is presented of a woman who had no children previously with disseminated miliary tuberculosis. Tuberculosis symptoms appeared immediately after birth of the first child, with a clinical diagnosis on the second month after childbirth, whereupon the patient died. The son, a premature infant, showed disease symptoms from the first day, with primary pulmonary complex and persistent atelectasis due to bronchial obstruction. The obstruction was due to thoracic lymphadenitis and coinfection with cytomegalovirus. The infant received standard treatment and his condition improved.

  15. Tuberculosis miliar secundaria a instilación endovesical de BCG / Miliary tuberculosis in a patient treated with BCG intravesical instillation

    Scientific Electronic Library Online (English)

    H., Fernández Jiménez-Ortiz; J.J., Gómez Marco; I., Rojo Zamanillo; E., Fernández Fernández.

    2007-08-01

    Full Text Available La instilación endovesical con bacilo de Calmette-Guerin es el tratamiento de elección para el carcinoma superficial e in situ de vejiga. En raras ocasiones presenta complicaciones graves que deben ser tenidas en cuenta. A continuación presentamos un caso de reactivación endógena de tuberculosis mil [...] iar secundaria a dicho tratamiento. Abstract in english Intravesical instillation of bacillus Calmette-Guérin is the elective treatment for trnasitional cell and in situ bladder carcinoma. Severe complications occur very seldom but must be known and promptly recognized. We present a case of miliary tuberculosis reactivation secondary to the mentioned tre [...] atment.

  16. Tuberculose miliar e febre Q em doente imunocompetente / Miliary tuberculosis and Q fever in an immunocompetent Patient

    Scientific Electronic Library Online (English)

    Sandra, Simões; Arsénio, Santos; Teresa, Vaio; Sara, Leitão; Rui M, Santos; Nascimento, Costa.

    2009-03-01

    Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese A tuberculose miliar é a forma de doença progressiva resultante da disseminação hematogénea maciça do Mycobacterium tuberculosis (MT). Afecta imunodeprimidos e idosos e tem manifestações clínicas insidiosas e inespecíficas. O caso clínico descrito refere-se a um homem adulto, sem imunodeficiência, c [...] om infecção simultânea por Coxiella burnetti e MT. A raridade desta associação e a sua forma de apresentação sublinham a necessidade de alto grau de suspeição clínica para a formulação dos diagnósticos, sendo este o segundo caso descrito na literatura. Abstract in english Miliary tuberculosis is a progressive disease resulting from the massive hematogeneous dissemination of Mycobacterium tuberculosis. Immunocompromised and elderly patients are the most affected. A case of an immunocompetent 45 year old man, with miliary tuberculosis and a simultaneous infection by Co [...] xiella burnetti is presented. The clinical presentation demands a high awareness for the presence of tuberculosis. The rarity of this association, only one case reported in literature, appears to be a fortuity coincidence.

  17. Retreived bacteria from Noctiluca miliaris (green) bloom of the northeastern Arabian Sea

    Science.gov (United States)

    Basu, Subhajit; Matondkar, S. G. Prabhu; Furtado, Irene

    2013-01-01

    In recent years, seasonal blooms of the dinoflagellate Noctiluca miliaris have appeared in the open-waters of the northern Arabian Sea (NAS). This study provides the first characterization of bacteria from a seasonal bloom of green Noctiluca of NAS (20°N-17°N and 64°E-70°E), during the spring-inter-monsoon cruise of Sagar Sampada 253, in March 2007. Bacterial growth as assessed by most-probable number (MPN) and plate counts, revealed `variable-physiotypes' over a wide range of salinities (0%-25% w/v NaCl), pH levels (5-8.5), and organic nutrient strengths, in comparison to non-bloom waters. MPN indices of bacteria in surface waters of bloom stations *DWK and *PRB, corresponded to (3.08-4.41)×103 cells/mL at 3.5% NaCl (w/v), and (2.82-9.49)×102 cells/mL at 25% (w/v) NaCl in tryptone-yeast extract broth (TYE). Plate counts were (1.12-4)×106 CFU/mL at 0% (w/v) NaCl, (1.28-3.9)×106 CFU/mL at 3.5% (w/v) NaCl, and (0.4-7)×104 CFU/mL at 25% NaCl (w/v) on TYE. One-tenth-strength Zobell's gave (0.6-3.74)×105 CFU/mL at pH 5 to (3.58-7.5)×105 CFU/mL at pH 8.5. These bacteria were identified to the genera Bacillus, Cellulomonas, Staphylococcus, Planococcus, Dietzia, Virgibacillus, Micrococcus, Sporosarcinae, Leucobacter, and Halomonas. The identity of three strains (GUFBSS253N2, GUFBSS253N30, and GUFBSS253N84) was confirmed through 16S rDNA sequence homology as Bacillus cohnii, Bacillus flexus, and Bacillus cereus. The ˜2-3-fold higher plate counts of culturable bacteria from the open-waters of the NAS indicate that these bacteria could critically determine the biogeochemical dynamics of the bloom and its milieu. The role of these bacteria in sustaining/terminating the bloom is under evaluation.

  18. A case of isoniazid-resistant miliary tuberculosis in which tuberculous meningitis paradoxically developed despite systemic improvement.

    Science.gov (United States)

    Ikegame, Satoshi; Wakamatsu, Kentaro; Fujita, Masaki; Nakanishi, Yoichi; Harada, Mine; Kajiki, Akira

    2011-10-01

    A 63-year-old man with chronic myelomonocytic leukemia was admitted to our hospital with miliary tuberculosis. He received anti-tuberculosis drugs: isoniazid (INH), rifampicin (RFP), ethambutol (EB), and pyrazinamide (PZA). His condition clearly and immediately improved after the therapy, but he experienced a high fever of about 38°C every day from 1 month after the initiation of the therapy. Drug-induced fever and tumor fever were suspected as causes, but the etiology could not be determined. The tuberculosis was identified as an INH-resistant strain, so INH was stopped and levofloxacin (LVFX) was introduced, with streptomycin (SM), in addition to RFP, EB, and PZA. At 2 months after the initiation of the therapy (about one week after the change in the anti-tuberculosis drug regimen), his spinal fluid was examined, given his complaints of headache and vomiting. The spinal fluid analysis revealed invasion of lymphocytic inflammatory cells and high adenosine deaminase activity; the patient was thus diagnosed with tuberculous meningitis. His condition gradually improved after the changing of the anti-tuberculosis drugs. Thus, to summarize, the tuberculous meningitis had worsened paradoxically despite his systemic improvement, although it was successfully treated by the addition of LVFX and SM. We must keep in mind that a potential cause of fever during anti-tuberculosis therapy may be INH-resistant tuberculous meningitis. PMID:21327690

  19. Macrofaunal involvement in the sublittoral decay of kelp debris: The sea urchin Psammechinus miliaris (Gmelin) (Echinodermata: Echinoidea)

    Science.gov (United States)

    Bedford, A. P.; Moore, P. G.

    1985-01-01

    Psammechinus miliaris occurs in the Clyde Sea area in large numbers (choice, growth rate, absorption efficiencies of both carbon and protein, gut retention times and rate of faecal output) to fresh and rotting weed. Younger urchins grew faster than older individuals on a diet of rotting weed but not on fresh weed. Large seasonal variation existed, however, with fast growth occurring in June-August and little, or no, growth in December-February, irrespective of diet. Starved controls did not grow. Correcting for seasonality, rotting kelp still promoted faster growth of young urchins than did fresh weed. Larger (older) individuals showed no difference. Urchins fed fresh weed had significantly longer gut retention times. Protein absorption efficiency was higher on fresh than rotting weed, varying with weed protein content and size of urchin. Very young individuals can only digest high protein weed efficiently, eg. material derived from near the frond meristem. Organic carbon content of rotting weed was significantly lower than fresh weed. Carbon absorption efficiencies were significantly higher on fresh weed which related to organic carbon content. Standard-sized urchins fed rotting weed produced larger dry weights of faeces per day, reflecting increased ingestion rate. In closed-system choice experiments urchins preferred rotting weed kinetically. Size-frequency analysis of field populations suggested that weed beds are principally colonized by larval settlement from the plankton. Mature Psammechinus have evolved different 'strategies' for exploiting fresh and rotting weed. Fresh weed is relatively difficult to digest and long gut retention times allow high protein absorption efficiencies to be attained. Rotting weed has microbial protein in quantities and a lower organic carbon fraction. Some bacterial protein is seemingly unavailable though and lower protein absorption efficiencies result. Thus gut retention time is shortened and more food passed through the gut. Growth remains equivalent. Substratum digestion is of paramount importance for Psammechinus feeding on either fresh or rotting weed, cf. the 'classical' microbe-stripping detritivore of Fenchel.

  20. Differential adaptations between cold-stenothermal environments in the bivalve Lissarca cf. miliaris (Philobryidae) from the Scotia Sea islands and Antarctic Peninsula

    Science.gov (United States)

    Reed, Adam J.; Linse, Katrin; Thatje, Sven

    2014-04-01

    The cold stenothermal nature of the Southern Ocean, and highly adapted fauna living within, raises the question of how much intra-specific variation there is among invertebrate populations, and how variation may have a role in speciation processes through ecological divergence, natural selection, and reproductive isolation. Despite decades of collecting biological material, this question remains largely unanswered, and many studies compare ‘populations' of pooled material from wide geographic ranges to compensate for sampling constraints. In this study, variations in ecophysiological traits are explored by measuring growth, reproduction, and shell morphology among six populations of the small bivalve Lissarca cf. miliaris (Philippi, 1845) from the Southern Ocean, which experience subtle differences in temperature, disturbance, and food availability. There are significant differences in shell morphology and growth among different populations and slower growth rates at higher latitude populations. Prodissoconch sizes show an inverse ‘U' shaped relationship with latitude, and are correlated with egg size at South Georgia and King George Island's Potter Cove. Higher brood sizes at the South Georgia population represent a trade-off with lower egg size, and correlate with shell morphology by offering lower internal capacity to brood young. Lower investment into offspring and morphological variations in L. cf. miliaris highlight the importance of local scale environmental variations on species' ecology. These variations in physical traits appear to be underestimated in the Southern Ocean, but may be important drivers of ecological divergence and speciation, which should be considered in future genetic investigations on different invertebrate populations.

  1. Miliary tuberculosis with no pulmonary involvement in myelodysplastic syndromes: a curable, yet rarely diagnosed, disease: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Krambovitis Elias

    2008-03-01

    Full Text Available Abstract Background Although tuberculosis is not uncommon among patients with myelodysplastic syndrome (MDS, only a few reports of such patients suffering from miliary tuberculosis (MT exist. MT often presents as a fever of unknown origin and it is a curable disease, yet fatal if left untreated. Case presentation We report a case of MT with no clinical or laboratory indications of pulmonary involvement in a patient with MDS, and review the relevant literature. Mycobacterium tuberculosis was isolated from the liquid culture of a bone marrow aspirate. Conclusion Even if the initial diagnostic investigation for a fever of obscure etiology is negative, MT should not be excluded from the differential diagnosis list. Since it is a curable disease, persistent and vigorous diagnostic efforts are warranted. In suspected cases, mycobacterial blood cultures should be collected as soon as possible after hospital admission and early bone marrow aspirate with mycobacterial cultures is advocated.

  2. Tuberculosis miliar, ganglionar, pancreática y costal: Presentación clínica y revisión bibliográfica / Miliary, ganglionar, pancreatic and costal tuberculosis: Clinical presentation and bibliography review

    Scientific Electronic Library Online (English)

    I., Inchaurraga Álvarez; A., Herrejón Silvestre; P., Plaza Valía; R., Blanquer Olivas.

    2001-09-01

    Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Se presenta un paciente de 42 años que ingresa en nuestro hospital con fiebre, dolor abdominal y patrón radiológico miliar. Tenía un aumento de amilasemia y amilasuria y de la lipasa sérica. El mantoux era negativo. En el estudio de TAC había engrosamiento costal, lesiones hepáticas focales múltiple [...] s y adenopatías necrosadas en zona peripancreática. Las biopsias transbronquiales y la punción pancreática mostraron lesiones granulomatosas necrotizantes, cultivándose M. tuberculosis complex en el broncoaspirado. El tratamiento específico normalizó todas las alteraciones pulmonares, costales y pancreáticas. Abstract in english A 42-year-old man was admitted to the hospital with fever, abdominal pain and miliary radiological pattern.The amylase and lipase in serum, and the amylase in urine were increased. The tuberculin skin test was negative. The thoracic and abdominal CT scan showed costal afectation, multiple focal hepa [...] tic lesions and large necrosing peripancreatic lymphadenopathies. The transbronchial biopsy and the pancreatic punction demostrated granulomatous necrotic lesions, and M. tuberculosis growed in the bronchial washing culture. The specific treatment normalized the pulmonary, costal and pancreatic lesions.

  3. Hepatitis granulomatosa en paciente con tuberculosis miliar: presentación de un caso / Granulomatous hepatitis in a patient with Miliary Tuberculosis: presentation of a case

    Scientific Electronic Library Online (English)

    Dalia, García Cuervo; Yanet, Acosta Piedra; Omara, Bandera Rodríguez; Janet, Testar de Armas; Adianez, Jiménez Álvarez.

    2014-02-01

    Full Text Available La hepatitis granulomatosa como elemento inicial de una enfermedad tuberculosa es muy poco frecuente. El rendimiento de las pruebas para el diagnóstico de tuberculosis hepática resulta baja, siendo las principales causas de granulomatosis hepática las infecciones (tuberculosis, brucelosis, hongos, p [...] arásitos, etc.). En la tuberculosis miliar, durante la diseminación hemática, que ocurre en el desarrollo de la primoinfección, el hígado es capaz de recibir y albergar una carga considerable de bacilos por sus características anatomofuncionales que se agrupan en forma de granuloma, que es un patrón de reacción inflamatoria crónica en el que predomina un tipo especial de célula denominada macrófago. Esto es causa frecuente de síndrome febril prolongado de causa sistémica, puede debutar con manifestaciones clínicas poco precisas. Se presentó un caso del sexo masculino que ingresa en el servicio de Medicina del Hospital Militar Docente Dr. Mario Muñoz Monroy, de Matanzas, que ingresa por cuadro de fiebre de origen desconocido, que resultó ser por esta causa. Abstract in english Granulomatous hepatitis as initial element of a tubercular disease is few frequent; the efficacy of the tests for diagnosing hepatic tuberculosis is low, being infections (tuberculosis, brucellosis, fungi, parasites, etc.). The main cause of hepatic granulomatosis. during the hematic dissemination i [...] n the miliary tuberculosis, occurring in the development of primo-infection, liver is able of receiving and dwelling a considerable charge of bacilli due to its anatomic functional characteristics; they group in the form of granulomas, a pattern of chronic inflammatory reaction, in which there is a predomination of an special kind of cells called macrophages; it frequently causes a prolonged febrile syndrome and may start with little precise clinical manifestations. We present the case of a male patient entering the Medicine Service of the Military Hospital Dr. Mario Muñoz Monroy of Matanzas, with a picture of unknown origin fever, resulting being originated by this cause.

  4. Associação de osteomielite tibial e pneumonite por tuberculose miliar em paciente com lúpus eritematoso sistêmico / Association of tibial osteomyelitis and pneumonitis due to miliary tuberculosis in a patient with systemic lupus erythematosus

    Scientific Electronic Library Online (English)

    Vitor Emer Egypto, Rosa; Daniel, Martin; André Marun, Lyrio; Maria Aparecida Barone, Teixeira; José Roberto, Provenza.

    2011-12-01

    Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese O lúpus eritematoso sistêmico (LES) é uma doença autoimune multissistêmica na qual há grande prevalência e manifestações incomuns de doenças infecciosas oportunistas, principalmente pelas múltiplas anormalidades no sistema imunológico e pelo efeito imunossupressor das medicações utilizadas em seu tr [...] atamento. Pacientes com LES têm incidência aumentada de tuberculose, e o acometimento osteoarticular ocorre em 1%-3% desses casos. Manifesta-se com dor, diminuição da mobilidade e aumento do volume osteoarticular, e os achados radiográficos costumam ser inespecíficos. A ressonância magnética nuclear (RMN) é exame útil para definir o grau de acometimento ósseo; entretanto, o diagnóstico etiológico é dado apenas pela cultura de líquido sinovial, pela cultura óssea ou pela histologia dessas regiões. Devido à inespecificidade dos achados, geralmente há atraso diagnóstico, em média de 11 meses. Relata-se o caso de uma paciente do gênero feminino com LES apresentando fatores predisponentes para a infecção/reativação da tuberculose. A RMN foi importante para definir o acometimento ósseo, e o diagnóstico etiológico foi dado pela biópsia óssea. A paciente também apresentava acometimento pulmonar devido à tuberculose, em sua forma miliar, demonstrado pela radiografia simples de tórax e pela tomografia computadorizada e confirmado pela cultura do bacilo de Koch no escarro. Houve demora de 1,5 mês para o início da terapêutica, tempo considerado curto em relação à literatura. Conclui-se dessa maneira que a tuberculose óssea, apesar de rara, deve sempre ser lembrada como diagnóstico diferencial nos pacientes lúpicos com osteomielite, principalmente naqueles com antecedente de tuberculose pulmonar. Abstract in english Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease, which has great prevalence and uncommon manifestations of opportunistic infectious diseases, mainly due to the multiple abnormalities of the immune system and the immunosuppressive effect of the medications used in its treatment [...] . Patients whit SLE have an increased incidence of tuberculosis, and osteoarticular involvement occurs in 1%-3% of the cases, manifesting as pain, reduction in mobility, and increased osteoarticular volume. The radiographic findings are often nonspecific. Magnetic resonance imaging (MRI) is an useful test to define the severity of bone involvement; however, the etiological diagnosis can only be established by use of synovial fluid or bone cultures or the histological study of the affected areas. Due to the lack of specificity of the findings, there is usually a mean diagnosis delay of 11 months. We report the case of a female patient with SLE and predisposing factors for tuberculosis infection/reactivation. The MRI was important to define bone involvement, and the etiological diagnosis was established by use of bone biopsy. The patient also had lung involvement due to miliary tuberculosis, shown on plain chest radiography and CT scan and confirmed on culture of Mycobacterium tuberculosis in the sputum. There was a 1.5-month delay in beginning therapy, which is considered a short time when compared to the reports in the literature. In conclusion, bone tuberculosis, although rare, should always be remembered as a differential diagnosis of patients with SLE and osteomyelitis, mainly those with history of pulmonary tuberculosis.

  5. Pulmonary Tuberculoma and Miliary Tuberculosis in Silicosis

    OpenAIRE

    Verma, Sanjeev Kumar; Karmakar, Saurabh

    2013-01-01

    Tuberculosis is a disease with protean manifestations. We present a case which was initially suspected as bronchogenic carcinoma with lymphangitic carcinomatosis, based on radiological appearance but later diagnosed as pulmonary tuberculoma with military tuberculosis and silicosis after thoracotomy and open lung biopsy. The patient was treated successfully with Antituberculosis Therapy (ATT). Rarity of presentation in form of pulmonary tuberculoma co-existing with histological features of mil...

  6. CLINICO-PATHOLOGY AND ULTRASTRUCTURAL ETUDY OF NEPHROPATHY CHANGES DUE TO LUPUS ERYTHEMATOSIS DISSEMINATUS

    Directory of Open Access Journals (Sweden)

    A. Modjtabai

    1969-01-01

    Full Text Available Nephrotic syndrome _ Nephrotic syndrome is found in 30% of all of the cases of systematic LE. Nephropathy Changes Due to Lupus Erythematosus 21 (15,16 in peripheral blood may confirm definitively lupus cryhcrornatosus. Additional serological evidence such as hyper g-gJobu":nemia, and 19_s-g_ globulin may then positively confirm the (17. Supporting evidence of 11 specific type of glomerular substantiates prior clinical and paracIinical evidence: The foregoing ultrasnucturat chnracteristtcs are then seen to represent an additional check of routine diagnostic procedures In addition observed permits an opportunity to• correlate• min~te changes with known biochemical changes previosly A. Modjtabai et at Diagnostically the presence of kidney disease and the presence of L.E. Urine albumin _ The appearance of urine albumin to the extent of 8-10 mgm.mil is a sign of kidney damage. This may be accompanied by acute kidney inadequacy, cyrtitis with fever and pain. There may be a varying globulin excretion which is taken by some as a precursor of ensuing damage. This point, of course, has been debated. When clinical and paraclinical signs indicate LE. definitive conclu, sions may be. reached utilizing electron microscopy. The disease occurs more frequently in women than in men and especially among young people. More than one person in a family may bevaffectcd leading to the assumption that the trait is inherited. The hereditary nature of the disease, however, has not been definitely estab., lishcd. Basically the disease appears to original as an abnormal imrnu., nological reaction to external or internal causes or perhaps even auto.; immunological. Causative or aggravating factors may be long exposure to sunlight, and ultraviolet rays which may free lysozyrnes or other proteolytic enzymes which attack the ground substance of the cell membranes of the endothelium. Drugs such as penicillin, sulfonamide and hydralyzin have caused allergic reactions resulting in lupus although differences of opinions exist as to the roles these drugs may play, as a causative agent since in some patients a withdrawal at medication results in accessation of the symptoms but in other patients there is no apparent change. It has been proposed that the above mentioned drugs react with body proteins to form the antibodies causative .of the disease. Infections also have been mentioned as a causative factor as well as rheumatic factors and rheumatic arthritis. 20 Differences exist as to the physical manifestation of the L. E. syndrome however certain basic symptoms appear in all cases of the disease. These basic cyrnptorns may not be accompied by other peripheral manifestations,

  7. Evolution of the Bipolar Mating System of the Mushroom Coprinellus disseminatus From Its Tetrapolar Ancestors Involves Loss of Mating-Type-Specific Pheromone Receptor Function

    OpenAIRE

    James, Timothy Y.; Srivilai, Prayook; Ku?es, Ursula; Vilgalys, Rytas

    2006-01-01

    Mating incompatibility in mushroom fungi is controlled by the mating-type loci. In tetrapolar species, two unlinked mating-type loci exist (A and B), whereas in bipolar species there is only one locus. The A and B mating-type loci encode homeodomain transcription factors and pheromones and pheromone receptors, respectively. Most mushroom species have a tetrapolar mating system, but numerous transitions to bipolar mating systems have occurred. Here we determined the genes controlling mating ty...

  8. Impetigo-like tinea faciei around the nostrils caused by Arthroderma vanbreuseghemii identified using polymerase chain reaction-based sequencing of crusts.

    Science.gov (United States)

    Kang, Daoxian; Ran, Yuping; Li, Conghui; Dai, Yaling; Lama, Jebina

    2013-01-01

    We report a case of Arthroderma vanbreuseghemii (a teleomorph of Trichophyton interdigitale) infection around the nostrils in a 3-year-old girl. The culture was negative, so the pathogenic agent was identified using polymerase chain reaction-based sequencing of the crusts taken from the lesion on the nostril. Treatment with oral itraconazole and topical 1% naftifine/0.25% ketoconazole cream after a topical wash with ketoconazole shampoo was effective. PMID:23278484

  9. Delay in diagnosis of generalized miliary tuberculosis with osseo-articular involvement: a case report

    Directory of Open Access Journals (Sweden)

    Atukorala Inoshi

    2011-10-01

    Full Text Available Abstract Introduction Diagnosis of atypical tuberculosis is difficult. Therefore, it is important that physicians are aware of rare presentations of tuberculosis to avoid diagnostic delays. Case presentation We present the case of a 17-year-old Sri Lankan man who presented to our facility with an ill-defined large induration over the skin of his left buttock and thigh. A cause could not be found despite extensive investigations. He also complained of chronic knee pain, but this was not investigated further at the time due to spontaneous resolution. Three years later his knee disease flared up again, with pain, swelling and restriction of movement. A synovial biopsy was suggestive of tuberculosis. He was started on antituberculosis therapy, to which he responded well. Our patient was asymptomatic two months after completion of therapy without any subsequent flare-ups. A chest roentgenogram taken on his second presentation showed evidence of tuberculosis sequelae in his lungs. The most likely diagnosis for the buttock and thigh swelling, when considering the entire clinical picture, is a tuberculous abscess. The constellation of skin and skeletal symptoms and pulmonary tuberculosis is a rare occurrence in an immunocompetent individual, but cases have been reported. Conclusions This case demonstrates the different presentations and the diagnostic difficulties posed by atypical manifestations of tuberculosis. It also demonstrates the value of maintaining a high degree of suspicion in endemic areas, even in the absence of microbiological evidence.

  10. Delay in diagnosis of generalized miliary tuberculosis with osseo-articular involvement: a case report

    OpenAIRE

    Atukorala Inoshi; Rodrigo Chaturaka

    2011-01-01

    Abstract Introduction Diagnosis of atypical tuberculosis is difficult. Therefore, it is important that physicians are aware of rare presentations of tuberculosis to avoid diagnostic delays. Case presentation We present the case of a 17-year-old Sri Lankan man who presented to our facility with an ill-defined large induration over the skin of his left buttock and thigh. A cause could not be found despite extensive investigations. He also complained of chronic knee pain, but this was not invest...

  11. Cerebral miliary micro aneurysms in polyarteritis nodosa : Report of two cases

    Directory of Open Access Journals (Sweden)

    Sharma Sandeep

    2010-01-01

    Full Text Available Cerebral involvement is rare in polyarteritis nodosa (PAN and is mostly characterized by ischemic events and intracranial hemorrhages secondary to cerebral aneurysms is extremely rare. We report two patients of PAN with multiple intracranial aneurysms. One patient presented with intracerebral hemorrhage and in the other patient multiple intracranial aneurysms were incidental findings and were asymptomatic. Both our cases suggest that multiple intracranial aneurysms are not very uncommon in PAN and cerebral angiography should be considered while doing abdominal angiogram in these patients.

  12. Cerebral miliary micro aneurysms in polyarteritis nodosa: report of two cases.

    Science.gov (United States)

    Sharma, Sandeep; Kumar, Subhash; Mishra, N K; Gaikwad, S B

    2010-01-01

    Cerebral involvement is rare in polyarteritis nodosa (PAN) and is mostly characterized by ischemic events and intracranial hemorrhages secondary to cerebral aneurysms is extremely rare. We report two patients of PAN with multiple intracranial aneurysms. One patient presented with intracerebral hemorrhage and in the other patient multiple intracranial aneurysms were incidental findings and were asymptomatic. Both our cases suggest that multiple intracranial aneurysms are not very uncommon in PAN and cerebral angiography should be considered while doing abdominal angiogram in these patients. PMID:20644280

  13. Cerebral miliary micro aneurysms in polyarteritis nodosa : Report of two cases

    OpenAIRE

    Sharma Sandeep; Kumar Subhash; Mishra N; Gaikwad S

    2010-01-01

    Cerebral involvement is rare in polyarteritis nodosa (PAN) and is mostly characterized by ischemic events and intracranial hemorrhages secondary to cerebral aneurysms is extremely rare. We report two patients of PAN with multiple intracranial aneurysms. One patient presented with intracerebral hemorrhage and in the other patient multiple intracranial aneurysms were incidental findings and were asymptomatic. Both our cases suggest that multiple intracranial aneurysms are not very uncommon in P...

  14. Choroidal tuberculoma showing paradoxical worsening in a patient with miliary TB.

    Science.gov (United States)

    Yilmaz, Turgut; Selcuk, Engin; Polat, Nihat; Mutlu, Kayhan

    2015-02-01

    Tuberculosis (TB) remains an important public health problem worldwide. Ocular involvement in patients with systemic TB has traditionally been considered uncommon. Diagnosing ocular TB is challenging and often delayed, especially in the absence of pulmonary signs or symptoms typical of TB. Here we describe a case of paradoxical reaction after antituberculosis therapy in an immunocompetent patient with ocular TB. PMID:25140405

  15. Miliary tuberculosis occurred after immunosuppressive drug in PNH patient with completely cured tuberculosis; a case report

    OpenAIRE

    Lee Jihyun; Gong Soojung; Lee Byounghoon; Lee Soyoung; Lee Jungae; Kim Naeyu

    2012-01-01

    Abstract Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal disorder that presents with hemolytic anemia, marrow failure and thrombophilia. During acute attacks, corticosteroid can alleviate the hemolytic paroxysm, but the prolonged administration induces serious toxicity including immunosuppression. So American thoracic society (ATS) for tuberculosis (TB) recommends prophylactic anti-TB medication in patients with a long-term steroid therapy. However, in the patient who was treated for ac...

  16. MRI in carcinomatous encephalitis

    International Nuclear Information System (INIS)

    We report a rare case of miliary brain metastases presenting with symptoms similar to encephalitis (''carcinomatous encephalitis''). Contrast-enhanced MRI demonstrated miliary metastases more distinctly than other imaging methods and reproduced the pathological features. (orig.). With 4 figs

  17. Rigors in tuberculosis.

    OpenAIRE

    Harvey, C.; Eykyn, S.; Davidson, C.

    1993-01-01

    Rigors are not a recognized characteristic of miliary tuberculosis. We report two patients presenting with persistent rigors, thought to be suggestive of acute pyogenic infection, who were subsequently found to have miliary tuberculosis. In both cases, there was significant diagnostic delay. Miliary tuberculosis should therefore be included in the differential diagnosis of any patient presenting with unexplained rigors.

  18. A Case of Dermatophytic Blepharitis

    Directory of Open Access Journals (Sweden)

    Mustafa Kulaç

    2008-07-01

    Full Text Available Dermatophytoses are the most common fungal infections of the skin. In the clinical practise, tinea pedis is most common clinical form of dermatophytosis. Other clinical forms are tinea cruris, tinea capitis, tinea corporis and tinea faciei. Tinea faciei is a rare form of dermatophytosis of glabrous skin, characterized by a well- circumscribed erythematous patch, and is more commonly misdiagnosed with some dermatologic diseases as seborrheic dermatitis, contact dermatitis, polymorphic light eruption and lymphocytic infiltrations. In addition, it is reported its clinical forms resembling folliculitis, perioral dermatitis, impetigo and sycosis. To date, a few cases of dermatophytosis involving eyelid were presented in the literature. Here, we present a patient who has an erythematous and fine scaly patch on her eyelid and who is diagnosed as dermatophytic blepharitis by helping typical tinea corporis on her wrist.

  19. Caso para diagnóstico / Case for diagnosis

    Scientific Electronic Library Online (English)

    Roberto Souto da, Silva; João Carlos Macedo, Fonseca; Daniel, Obadia.

    2010-12-01

    Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese Eritromelanose folicular faciei et colli é uma doença rara, de origem desconhecida, caracterizada por hiperpigmentação eritêmato-acastanhada e simétrica nas regiões frontal, temporal e malar, associada com envolvimento do folículo piloso. É comum apresentar ceratose pilar no pescoço e nos ombros. Su [...] a característica clínica primária é composta pela tríade: eritema (com ou sem telangiectasias), pápulas foliculares discretas e hiperpigmentação acastanhada. Abstract in english Erythromelanosis follicularis faciei et colli is a rare disease of unknown etiology characterized by symmetric erythematous brownish hyperpigmentation on the frontal, malar and temporal areas associated with involvement of the pilary follicle. It is common to present pilar keratosis on the shoulders [...] and neck. The three main clinical characteristics are: erythema (with or without telangiectasias), discrete follicular papules and brownish hyperpigmentation.

  20. Caso para diagnóstico Case for diagnosis

    Directory of Open Access Journals (Sweden)

    Roberto Souto da Silva

    2010-12-01

    Full Text Available Eritromelanose folicular faciei et colli é uma doença rara, de origem desconhecida, caracterizada por hiperpigmentação eritêmato-acastanhada e simétrica nas regiões frontal, temporal e malar, associada com envolvimento do folículo piloso. É comum apresentar ceratose pilar no pescoço e nos ombros. Sua característica clínica primária é composta pela tríade: eritema (com ou sem telangiectasias, pápulas foliculares discretas e hiperpigmentação acastanhada.Erythromelanosis follicularis faciei et colli is a rare disease of unknown etiology characterized by symmetric erythematous brownish hyperpigmentation on the frontal, malar and temporal areas associated with involvement of the pilary follicle. It is common to present pilar keratosis on the shoulders and neck. The three main clinical characteristics are: erythema (with or without telangiectasias, discrete follicular papules and brownish hyperpigmentation.

  1. The nodular form of hepatic tuberculosis: a review with five additional new cases

    OpenAIRE

    Huang, W-t; Wang, C-c; Chen, W-j; Cheng, Y-f; Eng, H-l

    2003-01-01

    Background: Tuberculosis presenting as an isolated liver tumour, without active pulmonary or miliary tuberculosis, or other clinical evidence of tuberculosis, is distinctly rare. A greater awareness of this rare clinical entity may prevent needless surgical intervention.

  2. Imaging Features of Pediatric Pentastomiasis Infection: a Case Report

    OpenAIRE

    Lai, Can; Wang, Xi Qun; Lin, Long; Gao, Chun; Zhang, Hong Xi; Zhang, Yi Ying; Zhou, Yin Bao

    2010-01-01

    We report here a case of pentastomiasis infection in a 3-year-old girl who had high fever, abdominal pain, abdominal tension and anemia. Ultrasound scanning of the abdomen revealed disseminated hyperechoic nodules in the liver and a small amount of ascites. Abdominal MRI showed marked hepatomegaly with disseminated miliary nodules of high signal intensity throughout the hepatic parenchyma on T2-weighted images; retroperitoneal lymphadenopathy and disseminated miliary nodules on the peritoneum...

  3. Transcription of sea urchin histone genes in Escherichia coli.

    OpenAIRE

    Mellado, R. P.; Delius, H.; Klein, B.; Murray, K.

    1981-01-01

    DNA fragments comprising units of the repeated histone genes form the sea urchins Psammechinus miliaris and Echinus esculentus were placed under the control of bacteriophage Lambda promoters by cloning into lambda replacement vectors. Although promoter-like regions exist within the cloned fragments, transcription of the histone genes is controlled mainly, but not exclusively, by lambda PL promoter. A transcription map of the cloned P. miliaris histone DNA fragment was obtained. The order of h...

  4. Fulminant hepatic failure caused by tuberculosis.

    OpenAIRE

    Hussain, W.; Mutimer, D.; Harrison, R.; Hubscher, S.; Neuberger, J.

    1995-01-01

    A 54 year old Asian woman developed fulminant hepatic failure followed by renal failure. Because of a past history of possible tuberculosis, she was given antituberculous drugs. The chest x ray was normal. A transjugular liver biopsy showed caseating necrosis, granulomas, and acid fast bacilli indicative of miliary tuberculosis. Despite full supportive therapy, her condition deteriorated and she died. Postmortem examination showed widespread miliary tuberculosis; culture confirmed the presenc...

  5. An Interesting Case of Dysphagia in a HIV Patient

    OpenAIRE

    Madi, Deepak; Achappa, Basavaprabhu; Ramapuram, John T.; Chowta, Nithyananda; Mahalingaman, Soundarya

    2013-01-01

    Oesophageal tuberculosis is a rare disease. Tuberculosis (TB) can cause dysphagia due to oesophageal ulcers, Tracheo-Oesophageal Fistulas (TOFs) and an extrinsic compression which is caused by the mediastinal lymph nodes. A 33-year-old gentleman was admitted to our hospital for the evaluation of fever, dysphagia and cough. His chest X-ray was suggestive of miliary tuberculosis. A CT scan of his chest revealed miliary tuberculosis, mediastinal lymphadenopathy and pneumomediastinum. His sputum ...

  6. Dermatophytoses in a desert district of Western Rajasthan

    OpenAIRE

    Karmakar Sanchita; Kalla G; Joshi K; Karmakar Somnath

    1995-01-01

    Clinico-mycological study of 250 cases of dermatophytoses was undertaken in a desert district of Western Rajasthan. Incidence of dermatophytoses in this area was 8.60% with tinea cruris (34.4%) as the major clinical type followed by tinea corporis (24.0%) Incidence of tinea capitis was 16.8% and 90% of those affected were in the age group of 0-10 years. Male preponderance was observed (M:F=2:1). There were 15 cases of tinea faciei (6%), majority belon...

  7. Pulmonary alveolar microlithiasis with the absence of technetium-99m MDP uptake of lungs

    International Nuclear Information System (INIS)

    The authors report a patient with alveolar microlithiasis who was treated for miliary tuberculosis eight years earlier and whose Tc-99m MDP scan revealed absent lung uptake. Diagnosis was established by bronchoalveolar lavage. Both the roentgenogram and computed tomography of the chest confirmed alveolar microlithiasis

  8. Taxonomy Icon Data: dog [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available dog Canis lupus ... familiaris Chordata/Vertebrata/Mammalia/Theria/Eutheria/Carnivora Canis_lupus _fa ... miliaris_L.png Canis_lupus _familiaris_NL.png Canis_lupus _familiaris_S.png Can ... is_lupus _familiaris_NS.png http://biosciencedbc.jp/taxonomy ...

  9. Isolated tuberculous liver abscess in immunocompetent children – Report of two cases

    OpenAIRE

    Bhatt, Girish Chandra; Nandan, Devki; Singh, Sarman

    2013-01-01

    Isolated tuberculous liver abscess (TLA) without active pulmonary or miliary tuberculosis, or other clinical evidence of tuberculosis, is distinctly rare and only few cases have been reported in the literature. We report two cases of isolated TLA in immunocompetent children, treated successfully by percutaneous aspiration followed by systemic antituberculous drugs.

  10. Immune Thrombocytopenia in Tuberculosis: Causal or Coincidental?

    OpenAIRE

    Srividya, Gopalakrishnan; Nikhila, Gopalakrishna Pillai Syamala; Kaushik, Adusumilli Venkatakrishna; Jayachandran, Kuppusamy

    2014-01-01

    Immune thrombocytopenia is a relatively rare hematological manifestation in tuberculosis. We report two cases of immune thrombocytopemia, one in sputum positive pulmonary tuberculosis and the other in miliary tuberculosis. Antituberculous drugs and immunosuppressive therapy corrected the thrombocytopenia in both patients. Our case reports stress that tuberculosis should be considered during the evaluation of immune thrombocytopenia, and also highlights the safety of immunosuppressive therapy ...

  11. Mature ovarian teratoma with gliomatosis peritonei - A case report

    Directory of Open Access Journals (Sweden)

    Das C

    2005-01-01

    Full Text Available Gliomatosis peritonei (GP, a rare condition related to ovarian teratomas, is characterized by miliary implants of mature glial tissues on the peritoneum or omentum. We report herein a case of mature teratoma of the ovary with GP with imaging features and pathological correlation

  12. Hepatotoxicity caused by the combined action of isoniazid and rifampicin.

    OpenAIRE

    Askgaard, D. S.; Wilcke, T.; Døssing, M.

    1995-01-01

    A 35 year old black Somalian woman with miliary tuberculosis developed hepatotoxicity after a few days of treatment with isoniazid, rifampicin, pyrazinamide, and ethambutol. After withdrawal of all drugs the liver profile returned to normal and remained so after challenge with isoniazid. Hepatotoxicity recurred when rifampicin was added, but it was well tolerated when reintroduced without isoniazid.

  13. Gene : CBRC-CFAM-17-0013 [SEVENS

    Lifescience Database Archive (English)

    Full Text Available CBRC-CFAM-17-0013 17 C UNKNOWN MOT1_BOVIN 1e-148 89% ref|XP_533065.2| PREDICTED: similar to Mono ... carboxylate transporter 1 (MCT ... 1) isoform 1 [Canis familiaris] 1e-165 100% gnl|UG ... miliaris similar to Monocarboxylate transporter 1 (MCT ... 1), transcript variant 1 (LOC475856), mRNA /cds=p( ...

  14. [Tinea capitis in adults and adolescents. A note on 8 cases].

    Science.gov (United States)

    García Pérez, A; Moreno Giménez, J C

    1981-01-01

    We have studied five cases of "Tinea capitis" in adults and two in young people (13 years old). All the adults cases and one of the young people were female. The causative fungi have been: "T. violaceum" in four patients; "T. mentagrophytes", var. granulosum, "T. mentagrophytes", var. vellosa and "T. tonsurans", in each of the others three, respectively. The clinical features in one case was similar to a seborrheic dermatites with a resaciform "Tinea faciei"; three other cases were suggestive of cronic imptigo contagiosa and even of favus impetigoid; still other one was mimicking a pseudopelada; other one started as a alopecia areata. developing later on, deep abscesiform lesions of torpid evolution; the last one had a typical kerion Celsii. All the patients have showed a good response to specific treatment, with satisfactory regrowing of hair. There are comments on the casuistic and comparation with the reviewed cases in the medical literature. PMID:7038346

  15. Dermatophytoses in a desert district of Western Rajasthan

    Directory of Open Access Journals (Sweden)

    Karmakar Sanchita

    1995-01-01

    Full Text Available Clinico-mycological study of 250 cases of dermatophytoses was undertaken in a desert district of Western Rajasthan. Incidence of dermatophytoses in this area was 8.60% with tinea cruris (34.4% as the major clinical type followed by tinea corporis (24.0% Incidence of tinea capitis was 16.8% and 90% of those affected were in the age group of 0-10 years. Male preponderance was observed (M:F=2:1. There were 15 cases of tinea faciei (6%, majority belonging to 0-10 years age group. Trichophyton violaceumwas isolated In majority (55.76% from all clinical types followed by Trichophyton rubrum(42.3%

  16. Imaging Features of Pediatric Pentastomiasis Infection: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Can; Wang, Xi Qun; Lin, Long; Gao, De Chun; Zhang, Hong Xi; Zhang, Yi Ying; Zhou, Yin Bao [Zhejiang University School of Medicine, Zhejiang (China)

    2010-08-15

    We report here a case of pentastomiasis infection in a 3-year-old girl who had high fever, abdominal pain, abdominal tension and anemia. Ultrasound scanning of the abdomen revealed disseminated hyperechoic nodules in the liver and a small amount of ascites. Abdominal MRI showed marked hepatomegaly with disseminated miliary nodules of high signal intensity throughout the hepatic parenchyma on T2-weighted images; retroperitoneal lymphadenopathy and disseminated miliary nodules on the peritoneum were also noted. Chest CT showed scattered small hyperdense nodules on both sides of the lungs. The laparoscopy demonstrated diffuse white nodules on the liver surface and the peritoneum. After the small intestinal wall and peritoneal biopsy, histological examination revealed parenchymal tubercles containing several larvae of pentastomids and a large amount of inflammatory cell infiltration around them. The pathological diagnosis was parasitic granuloma from pentastomiasis infection

  17. Pulmonary Strongyloides stercoralis infection

    Science.gov (United States)

    Dogan, Canan; Gayaf, Mine; Ozsoz, Ayse; Sahin, Birsen; Aksel, Nimet; Karasu, Isil; Aydogdu, Zekiye; Turgay, Nevin

    2014-01-01

    The 17-year-old male patient presented with fever, weakness, dyspnea and weight loss. His chest radiography demonstrated diffuse reticulonodular density, and high-resolution lung tomography indicated diffuse micronodules and prevalent ground-glass pattern. The findings were consistent with miliary involvement. The patient underwent examinations for rheumatology, immunology, cytology and infectious conditions. His immune system was normal and had no comorbidities or any history of immunosuppressive treatment. Strongyloides stercoralis larvae were noted upon direct inspection of the feces. Clinical and radiological improvement was achieved with albendazole 400 mg/day. This case is being presented since miliary involvement in the lungs caused by S. stercoralis infection in an individual with intact immune system is rare and difficult to diagnosis.

  18. Tuberculosis and TNF-inhibitors: history of exposure should outweigh investigations.

    Science.gov (United States)

    Reichmann, Michaela T; Marshall, Ben G; Cummings, Fraser; Elkington, Paul T

    2014-01-01

    A 39-year-old Indian man was diagnosed with ulcerative colitis on colonic biopsy and started on mesalazine, prednisolone and azathioprine. However, the colitis remained active and required antitumour necrosis factor (TNF) treatment with infliximab. Prior to starting infliximab, his chest X-ray was normal and QuantiFERON interferon ? release assay for tuberculosis (TB) was negative. However, his wife had been treated for pulmonary TB 11 years previously when they were cohabiting. On attending for his third dose of infliximab, he was feverish and tachycardic, and was admitted for investigation. Chest X-ray on admission showed changes consistent with miliary TB, and thoracic CT confirmed extensive miliary nodules with supraclavicular and mediastinal lymphadenopathy. Abdominal CT showed multiple mesenteric lymph nodes. Subsequent bronchoalveolar lavage, neck lymph node aspirate and colonic biopsies all cultured Mycobacterium tuberculosis. In retrospect, a clear history of close household TB exposure should have precipitated consideration of TB chemoprophylaxis prior to anti-TNF treatment. PMID:24798354

  19. Imaging features of pediatric pentastomiasis infection: a case report.

    Science.gov (United States)

    Lai, Can; Wang, Xi Qun; Lin, Long; Gao, De Chun; Zhang, Hong Xi; Zhang, Yi Ying; Zhou, Yin Bao

    2010-01-01

    We report here a case of pentastomiasis infection in a 3-year-old girl who had high fever, abdominal pain, abdominal tension and anemia. Ultrasound scanning of the abdomen revealed disseminated hyperechoic nodules in the liver and a small amount of ascites. Abdominal MRI showed marked hepatomegaly with disseminated miliary nodules of high signal intensity throughout the hepatic parenchyma on T2-weighted images; retroperitoneal lymphadenopathy and disseminated miliary nodules on the peritoneum were also noted. Chest CT showed scattered small hyperdense nodules on both sides of the lungs. The laparoscopy demonstrated diffuse white nodules on the liver surface and the peritoneum. After the small intestinal wall and peritoneal biopsy, histological examination revealed parenchymal tubercles containing several larvae of pentastomids and a large amount of inflammatory cell infiltration around them. The pathological diagnosis was parasitic granuloma from pentastomiasis infection. PMID:20592934

  20. Imaging Features of Pediatric Pentastomiasis Infection: a Case Report

    International Nuclear Information System (INIS)

    We report here a case of pentastomiasis infection in a 3-year-old girl who had high fever, abdominal pain, abdominal tension and anemia. Ultrasound scanning of the abdomen revealed disseminated hyperechoic nodules in the liver and a small amount of ascites. Abdominal MRI showed marked hepatomegaly with disseminated miliary nodules of high signal intensity throughout the hepatic parenchyma on T2-weighted images; retroperitoneal lymphadenopathy and disseminated miliary nodules on the peritoneum were also noted. Chest CT showed scattered small hyperdense nodules on both sides of the lungs. The laparoscopy demonstrated diffuse white nodules on the liver surface and the peritoneum. After the small intestinal wall and peritoneal biopsy, histological examination revealed parenchymal tubercles containing several larvae of pentastomids and a large amount of inflammatory cell infiltration around them. The pathological diagnosis was parasitic granuloma from pentastomiasis infection

  1. Disseminated Mycobacterium avium complex infection in an immunocompetent pregnant woman

    Directory of Open Access Journals (Sweden)

    Kim Woo

    2006-10-01

    Full Text Available Abstract Background Disseminated mycobacterium avium complex (MAC occurs mainly in immunocompromised hosts, which is associated with abnormal cellular immunity. Case presentation A 26-year-old pregnant woman presented with fever and general weakness. Miliary lung nodules were noted on chest X-ray. Under the impression of miliary tuberculosis, anti-tuberculosis medication was administered. However, the patient was not improved. Further work-up demonstrated MAC in the sputum and placenta. The patient was treated successfully with clarithromycin-based combination regimen. Conclusion This appears to be the first case of disseminated MAC in an otherwise healthy pregnant woman. Clinicians should be alert for the diagnosis of MAC infection in diverse clinical conditions.

  2. Disseminated tuberculosis in an immunocompetent patient.

    Science.gov (United States)

    Mearelli, Filippo; Burekovic, Ismet; Zanetti, Michela; Altamura, Nicola; Carlo, Giansante; Biolo, Gianni; Cernic, Stefano; Casarsa, Chiara

    2013-09-01

    Miliary tuberculosis refers to the clinical disease resulting from the hematogenous dissemination of Mycobacterium tuberculosis. A tuberculous aneurysm of the aorta is exceedingly rare. Contiguous tuberculosis in the form of lymphadenitis is generally responsible for the aortic involvement. We report a case of tuberculous mycotic aneurysm in patient with miliary disease, not affected by a cellular immunodeficiency and with no other common risk factor for infection. He received anti-tubercular therapy and endovascular stenting before the identification of Mycobacterium tuberculosis in lung, lymph nodes, and gastric lavage. The clinician should be aware that a mycotic abdominal aortic aneurysm could be caused by M. tuberculosis, even if microbiological confirmation is lacking or is negative, especially if a contiguous focus of tubercular infection is detected. PMID:23931745

  3. January 2012 case of the month

    Directory of Open Access Journals (Sweden)

    Gotway MB

    2012-01-01

    Full Text Available No abstract available. Article truncated at 61 words. Clinical History A 69-year-old woman with no significant past medical history presented with progressive shortness of breath. A chest radiograph (Figure 1 was obtained.Figure 1. Frontal chest radiograph.How would you describe the findings on the chest radiograph (Figure 1?1.Multifocal consolidation2.Blunting of the costophrenic angles suggesting pleural effusion3.Multifocal reticulonodular opacities4.Bilateral cavitary lung consolidation5.Miliary nodular opacities …

  4. UNSUSPECTED FATAL DRUG-RESISTANT TUBERCULOSIS IN A CLOSELY MONITORED CHILD: A PLEA FOR IMPROVED SOURCE-CASE TRACING AND DRUG SUSCEPTIBILITY TESTING

    OpenAIRE

    Innes, Steve; Schaaf, H. Simon; Hoek, Kim Gp; Rabie, Helena; Cotton, Mf

    2010-01-01

    We report a case of rapidly progressive miliary tuberculosis in a 21-month old HIV-infected girl exposed to tuberculosis, despite early access to highly active antiretroviral therapy and proven adherence to isoniazid chemoprophylaxis. Post mortem revealed multidrug-resistant tuberculosis. This case report illustrates the consequences of inadequate programmatic management of children exposed to an adult case of sputum smear-positive multidrug-resistant tuberculosis. Drug susceptibility testing...

  5. Combination therapy of disseminated coccidioidomycosis with caspofungin and fluconazole

    OpenAIRE

    Ja Kim Min; Kim Woo; Cheong Hee; Sohn Jang; Park Dae; Kim Je Hyeong; Shin Chol

    2006-01-01

    Abstract Background The current recommended therapy for diffuse coccidioidal pneumonia involves initial treatment with amphotericin B deoxycholate or high-dose fluconazole, followed by an azole after clinical improvement. Amphotericin B is more frequently used as initial therapy if the patient's deterioration is rapid. Case presentation A 31-year-old Korean male with coccidioidomycosis presented to the hospital with miliary infiltrates on chest X-ray (CXR) and skin rash on the face and trunk....

  6. Adrenal function in patients with active tuberculosis

    OpenAIRE

    Mustchin, Peter

    1989-01-01

    Although tuberculosis is a recognised cause of adrenal insufficiency, little is known about adrenal function in patients with active tuberculosis. Ninety Melanesian adults with active tuberculosis (30 pulmonary, 30 miliary, 30 extrapulmonary) had adrenal function assessed prospectively before and three to four weeks after starting antituberculous chemotherapy. Basal serum cortisol concentrations were normal in 55 (61%) and raised in 35 (39%) of the subjects. No patient had a low basal cortiso...

  7. FOLLICULITIS ET PERIFOLLICULITIS CAPITIS ABSCEDENS ET SUFFODIENS CONTROLLED WITH A COMBINATION THERAPY: SYSTEMIC ANTIBIOSIS (METRONIDAZOLE PLUS CLINDAMYCIN), DERMATOSURGICAL APPROACH, AND HIGH-DOSE ISOTRETINOIN

    OpenAIRE

    Tchernev, Georgi

    2011-01-01

    Folliculitis et perifolliculitis capitis abscedens et suffodiens is a rare disease of unknown etiology. It is a suppurative process that involves the scalp, eventually resulting in extensive scarring and irreversible alopecia. The condition is also known as ‘acne necrotica miliaris’ or ‘Proprionibacterium’ folliculitis. Most often the disease affects men of African-American or African-Caribbean descent between 20 and 40 years of age. The clinical picture is determined by fluctuating p...

  8. Intracardiac left atrial tuberculoma in an eleven-month-old infant: case report

    OpenAIRE

    Cantinotti, M.; Gaudio, M.; Martino, M.; Assanta, N.; Moschetti, R.; Veneruso, G.; Crocetti, M.; Murzi, B.; Chiappini, E.; Galli, L.

    2011-01-01

    Abstract Background Cardiac tuberculosis is rare and usually manifests as tuberculous pericarditis. Involvement of other part of the heart is unusual and descriptions in the pediatric literature are confined to few case reports regarding mainly myocardial tuberculosis. Case presentation We describe a case of pulmonary miliary tuberculosis associated with intracardiac left atrial tuberculoma in an immunocompetent eleven-month-old infant successfully treated with surgery and antituberculous the...

  9. Para-aminosalicylic acid-induced hypoglycaemia in a patient with diabetic nephropathy.

    OpenAIRE

    Dandona, P.; Greenbury, E.; Beckett, A. G.

    1980-01-01

    A 62-year-old Indian with diabetic nephropathy controlled with metformin, developed miliary tuberculosis for which he was treated with rifampicin, isoniazid and ethambutol. Soon afterwards he developed cholestatic hepatitis and visual disturbance. Rifampicin and ethambutol were stopped. Streptomycin caused vertigo and had to be stopped. The introduction of para-aminosalicylic acid (PAS) led to hypoglycaemic coma. Metformin was stopped. Hypoglycaemic coma recurred. PAS was stopped and the pati...

  10. The adult respiratory distress syndrome bronchogenic pulmonary tuberculosis.

    OpenAIRE

    Dyer, R. A.; 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...

  11. Tuberculous pancreatic abscess: an unusual manifestation of HIV infection.

    OpenAIRE

    Desmond, N. M.; Kingdon, E.; Beale, T. J.; Coker, R. J.; Tanner, A. G.; Harris, J. W.

    1995-01-01

    Pancreatic tuberculosis is unusual occurring in only 2.7% of autopsy studies of persons with miliary disease. Reports of focal pancreatic tuberculosis are rare, even in patients with the acquired immunodeficiency syndrome (AIDS) in whom abdominal tuberculosis is a frequent feature. We describe two patients infected with the human immunodeficiency virus (HIV) who developed tuberculous pancreatic abscesses. In both this was their AIDS-defining illness.

  12. Tuberculosis and renal transplantation--observations from an endemic area of tuberculosis.

    OpenAIRE

    Malhotra, K. K.; Dash, S. C.; Dhawan, I. K.; Bhuyan, U. N.; Gupta, A.

    1986-01-01

    Ninety-five renal transplant recipients from an endemic area of tuberculosis were investigated to find out the prevalence and course of tuberculosis in pre- and post-transplant periods. Eleven patients had tuberculosis in the pre-transplant period - pulmonary (2), pleural (2), miliary (1), abdominal (2), lymph node (5) and pericardial (1). They were transplanted after antituberculous therapy of 3 to 6 months with satisfactory results. The anti-tuberculous treatment was usually continued for 2...

  13. Ruptured Tuberculous False Aneurysm of the Abdominal Aorta: A Case Report

    OpenAIRE

    Mechchat, Alae; Lekehal, Brahim; Mesnaoui, Abbes; Ammar, Fannid; Bensaid, Younes

    2011-01-01

    Tuberculous false aneurysm of the aorta is rare and has an unpredictable complication of aneurysm rupture. We report a case of a 32-year old woman who was referred to the Department of Vascular Surgery, Avicenne Hospital for severe abdominal pain. Chest x-ray revealed miliary tuberculosis. Contrast enhanced computed tomography (CT) scan showed a false aortic aneurysm involving the juxtarenal aorta. Antituberculous treatment was started because of high presumption of tuberculosi...

  14. Making wider use of the world's most widely used vaccine: Bacille Calmette–Guérin revaccination reconsidered

    OpenAIRE

    Dye, Christopher

    2013-01-01

    Approximately 100 million newborn children receive Bacille Calmette–Guérin (BCG) annually, because vaccination is consistently protective against childhood tuberculous meningitis and miliary TB. By contrast, BCG efficacy against pulmonary TB in children and adults is highly variable, ranging from 0% to 80%, though it tends to be higher in individuals who have no detectable prior exposure to mycobacterial infections, as judged by the absence of delayed-type hypersensitivity response (a nega...

  15. Multiple intestinal perforations as a primary manifestation of abdominal tuberculosis in a HIV-infected patient

    Directory of Open Access Journals (Sweden)

    Amir Hossein Sarrami

    2010-12-01

    Full Text Available Abdominal tuberculosis (TB is the sixth commonest extra-pulmonary TB form after lymphatic, genitourinary, bone and joint, miliary and meningeal tuberculosis. Perforation is a serious and uncommon complication of abdominal tuberculosis which can occur even during the treatment. A 30-year-old man was admitted with a three-day history of abdominal pain who had emergency surgery for multiple perforations of the distal ileum.

  16. Multiple intestinal perforations as a primary manifestation of abdominal tuberculosis in a HIV-infected patient

    OpenAIRE

    Amir Hossein Sarrami; Mohsen Sharifi; Majid Ahsan; Noushin Afsharmoghaddam

    2010-01-01

    Abdominal tuberculosis (TB) is the sixth commonest extra-pulmonary TB form after lymphatic, genitourinary, bone and joint, miliary and meningeal tuberculosis. Perforation is a serious and uncommon complication of abdominal tuberculosis which can occur even during the treatment. A 30-year-old man was admitted with a three-day history of abdominal pain who had emergency surgery for multiple perforations of the distal ileum.

  17. Bubo masquerading as an incarcerated inguinal hernia.

    Science.gov (United States)

    Hodge, K R; Orgler, R J; Monson, T; Read, R C

    2001-06-01

    A 44-year old, male, tattooed, leather jacket clad, Harley-Davidson motorcyclist arrived at the emergency room with a tender, irreducible mass, presenting at the external inguinal ring. In 1998, lung biopsy was read as miliary granuloma. No herniation was found on urgent preperitoneal exploration. Incision of the mass showed acid-fast bacilli. Culture later revealed Mycobacterium avium-intracellulare (MAI). A blood count showed CD4 lymphopenia; HIV was negative and remains so 2 years later. PMID:11505657

  18. Gene : CBRC-CFAM-17-0014 [SEVENS

    Lifescience Database Archive (English)

    Full Text Available CBRC-CFAM-17-0014 Novel 17 C UNKNOWN MOT1_HUMAN 1e-133 83% ref|XP_544668.2| PREDICTED: similar t ... o Monocarboxylate transporter 1 (MCT ... 1) [Canis familiaris] 1e-144 92% gnl|UG|Cfa#S22752 ... miliaris similar to Monocarboxylate transporter 1 (MCT ... 1), transcript variant 1 (LOC475856), mRNA /cds=p( ...

  19. Gene : CBRC-CFAM-09-0000 [SEVENS

    Lifescience Database Archive (English)

    Full Text Available CBRC-CFAM-09-0000 9 B UNKNOWN MOT4_RAT 1e-127 93% ref|XP_540498.2| PREDICTED: similar to Monocar ... boxylate transporter 4 (MCT ... 4) (MCT ... 3) [Canis familiaris] 1e-134 99% gnl|UG|Cf ... miliaris similar to Monocarboxylate transporter 4 (MCT ... 4) (MCT ... 3) (LOC483379), mRNA /cds=p(1,1413) /gb=XM ...

  20. Gene : CBRC-CFAM-30-0031 [SEVENS

    Lifescience Database Archive (English)

    Full Text Available CBRC-CFAM-30-0031 30 C UNKNOWN MOT1_BOVIN 1e-142 74% ref|XP_544668.2| PREDICTED: similar to Mono ... carboxylate transporter 1 (MCT ... 1) [Canis familiaris] 0.0 100% gnl|UG|Cfa#S2275221 ... miliaris similar to Monocarboxylate transporter 1 (MCT ... 1), transcript variant 1 (LOC475856), mRNA /cds=p( ...

  1. [A young girl with abdominal pain].

    Science.gov (United States)

    Gilje, Ann Marit; Knudsen, Per Kristian; Øymar, Knut

    2011-06-17

    Abdominal pain combined with fever is common during childhood. We present a 12-year-old girl who was admitted to hospital with abdominal pain, fever and nausea, but she also complained of cough, weight loss and night sweat. Investigations revealed multiple and randomly distributed lung nodules, impaired lung function, meningitis and multiple small brain lesions, consistent with tuberculomas. The polymerase chain reaction was positive for Mycobacterium tuberculosis in sputum. Cultures of sputum and cerebrospinal fluid were also positive and confirmed miliary tuberculosis with concomitant meningitis. The result of the Mantoux test was 13 mm and that of the Quantiferon-TB Gold was 5.17 IU/ml. She was given four antituberculous drugs (isoniazide, rifampicin, pyrazinamide and ethambutol) for two months and two drugs (isoniazide and rifampicin) for an additional ten months. The intracranial tuberculomas increased in size during the first two months of treatment, but demonstrated regression after seven months. The girl was HIV-negative and had no sign of immunodeficiency, but had recently been ill with mononucleosis and varicella infections. She recovered completely. The combination of miliary tuberculosis and meningitis is uncommon, particularly among previously healthy children of this age. Temporary immune suppression, caused by viral infections, could possibly explain the unusual clinical course. Pediatricians should be aware of miliary tuberculosis as a possible diagnosis in children presenting with common symptoms. PMID:21694748

  2. Concomitant pulmonary tuberculosis and tuberculous appendicitis in a recipient of a renal transplant: a case report

    Directory of Open Access Journals (Sweden)

    Ghabili Kamyar

    2011-05-01

    Full Text Available Abstract Introduction Tuberculosis is still a serious infection among recipients of renal transplants. Although the ileocecal region is the most affected part in intestinal tuberculosis, acute tuberculous appendicitis is quite a rare entity. We report a case of concomitant pulmonary tuberculosis and tuberculous appendicitis in a recipient of a renal transplant. Case presentation A 27-year-old Iranian woman, who had been the recipient of a renal transplant five years earlier, presented with a two-week history of coughing, fever and weight loss. The cause of her end-stage renal disease was chronic pyelonephritis. There were fine crackles noted during a chest examination, and a plain chest radiography showed fine miliary nodules throughout her entire lung fields. Sputum and bronchial aspirate examination was positive for acid-fast bacilli, suggestive of Mycobacterium tuberculosis infection. A chest computed tomography scan revealed widespread miliary nodules, compatible with miliary tuberculosis. She developed severe abdominal pain and abdominal surgery disclosed a perforated appendicitis. Histopathological examination of the resected appendix revealed widespread caseating epithelioid granulomas, suggestive of tuberculosis. Conclusion Our case report highlights a rare presentation of tuberculosis in a patient who has undergone renal transplant. Such unusual presentation of tuberculosis, particularly among patients receiving potent immunosuppressive protocols, should be considered by clinicians.

  3. Escape and aggregation responses of three echinoderms to conspecific stimuli.

    Science.gov (United States)

    Campbell, A C; Coppard, S; D'Abreo, C; Tudor-Thomas, R

    2001-10-01

    In marine invertebrates, waterborne chemical stimuli mediate responses including prey detection and predator avoidance. Alarm and flight, in response to damaged conspecifics, have been reported in echinoderms, but the nature of the stimuli involved is not known. The responses of Asterias rubens Linnaeus, Psammechinus miliaris (Gmelin), and Echinus esculentus Linnaeus to conspecifics were tested in a choice chamber against a control of clean seawater (no stimulus). All three species showed statistically significant movement toward water conditioned by whole animals or homogenate of test epithelium. P. miliaris and E. esculentus displayed a statistically significant avoidance reaction, moving away from conspecific coelomic fluid, gut homogenate, and gonad homogenate. A. rubens was indifferent to conspecific coelomic fluid, pyloric cecum homogenate, and gonad homogenate but moved away from cardiac gut homogenate. P. miliaris was indifferent to gametes, but the other two species were significantly attracted to them. No species showed preference for one particular side of the chamber during trials to balance water flow. These echinoderms can distinguish between homogenates of conspecific tissues that might be exposed when a predator damages the test, and those that may emanate from the exterior surface during normal activities. PMID:11687389

  4. Diagnostic value of CT on hepatic tuberculosis

    International Nuclear Information System (INIS)

    Objective: To assess CT manifestations and diagnostic value in patients with hepatic tuberculosis. Methods: Ten cases of hepatic tuberculosis proved by hepatic biopsy or surgical specimens were analyzed retrospectively. Results: This group of hepatic tuberculosis included three types. (1) Five cases of miliary hepatic tuberculosis demonstrated that the liver swelled diffusely associated with multiple miliary low attenuations, and showed no enhancement after contrast agents administration. (2) Three cases of tubercle hepatic tuberculosis depicted multiple hypodensity areas or mixed density regions in the liver. The extension of lesions reduced in arterial phase, and a ring-like enhancement was displayed in the portal phase. (3) One case of hepatic tuberculoma illustrated solitary space occupying lesion accompanied with central necrosis. The envelope was thin and smooth which enhanced slightly after injecting Gd-DTPA. Another one was hepatic abscess and depicted fluid-fluid level inside the lesion. Conclusions: The CT manifestations of miliary hepatic tuberculosis lack of characteristics, it is hard to make the diagnosis clear-cut unless integrating the medical history and lab test. The 'powder calcification' findings of tubercle hepatic tuberculosis is propitious to draw a qualitative diagnosis. And the feature of hepatic tuberculomas with fluid- fluid level is in favor of making a differential diagnosis against parallel tumors. (authors). (authors)

  5. Clinical variations in dermatophytosis in HIV infected patients.

    Science.gov (United States)

    Kaviarasan, P K; Jaisankar, T J; Thappa, Devinder Mohan; Sujatha, S

    2002-01-01

    Dermatophyte infections are common in HIV infected patients and can occur at some point during their illness. They may show clinical variations. The present study was to note the prevalence and clinical variations in dermatophytosis in HIV infected patients. Out of 185 HIV infected patients screened at our hospital, the diagnosis of dermatophytosis was made in 41 cases. The prevalence of dermatophytosis was 22.2% Male to female ratio was 3:1 The mean age of our patients was 30.7 years. The occupations of our patients in decreasing order of frequency were labourers (43.9%), drivers (29.3%) and rest were housewives, commercial sex workers etc. Heterosexual route was the most common mode of acquisition of HIV infection. Tinea corporis was the commonest dermatophyte infection and was seen in 22 (53.7%) cases, followed by tinea cruris in 18 (49.9%), tinea pedis in 7 (17.1), tinea faciei in 6 (14.7%) and one patient had tinea manum infection. Tinea unguium was recorded in 11 cases. Out of the 22 patients with tinea corporis, 19 were in the HIV Group IV. Ten of them presented with multiple, large sharply marginated areas of hyperkeratosis resembling dry scaly skin (anergic form of tinea corporis). Proximal white subungual onychomycosis (PWSO), thought to be pathognomonic of HIV was seen in 3 cases only. This study has brought into focus variations in presentations of dermatophytosis. PMID:17656940

  6. Clinical variations in dermatophytosis in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Kaviarasan P

    2002-01-01

    Full Text Available Dermatophyte infections are common in HIV infected patients and can occur at some point during their illness. They may show clinical variations. The present study was to note the prevalence and clinical variations in dermatophytosis in HIV infected patients. Out of 185 HIV infected patients screened at our hospital, the diagnosis of dermatophytosis was made in 41 cases. The prevalence of dermatophytosis was 22.2% Male to female ratio was 3:1 The mean age of our patients was 30.7 years. The occupations of our patients in decreasing order of frequency were labourers (43.9%, drivers (29.3% and rest were housewives, commercial sex workers etc. Heterosexual route was the most common mode of acquisition of HIV infection. Tinea corporis was the commonest dermatophyte infection and was seen in 22 (53.7% cases, followed by tinea cruris in 18 (49.9%, tinea pedis in 7 (17.1, tinea faciei in 6 (14.7% and one patient had tinea manum infection. Tinea unguium was recorded in 11 cases. Out of the 22 patients with tinea corporis, 19 were in the HIV Group IV. Ten of them presented with multiple, large sharply marginated areas of hyperkeratosis resembling dry scaly skin (anergic form of tinea corporis. Proximal white subungual onychomycosis (PWSO, thought to be pathognomonic of HIV was seen in 3 cases only. This study has brought into focus variations in presentations of dermatophytosis.

  7. Epidemiological studies on Dermatophytosis in human patients in Himachal Pradesh, India.

    Science.gov (United States)

    Bhatia, Vikesh Kumar; Sharma, Prakash Chand

    2014-01-01

    Dermatophytes are among the common fungal agents implicated in superficial skin infections worldwide. They include species of Trichophyton, Microsporum and Epidermophyton. In hot and humid climates of tropical and subtropical regions, the incidence of these pathogens is higher. We present in this article, the epidemiological data regarding the prevalence of different dermatophyte species involved in superficial mycoses in human patients in the state of Himachal Pradesh (India) and different clinical conditions, age and sex of the patients. A total of 202 samples in the form of skin and nail scrapings, hair follicles were collected from different ringworm/tinea conditions which included: Tinea corporis, T. capitis, T. cruris, T. pedis, T. unguium, T. faciei, T. manuum and T. gladiatorum. On culturing, 74 samples (36.6%) were found positive for dermatophyte spp. Trichophyton spp. was the predominant one (98.65% cases) followed by Microsporum gypseum (1.35% cases). However, we did not recover any Epidermophyton spp. Among the Trichophyton spp., T. mentegrophyte was the predominant spp. (63.5%) followed by T. rubrum (35.1%). The male to female ratio of the positive cases was recorded as 63:11. The most effected age group was 21-50 years (64.9%) followed by 1-20 years (28.4%) and above 50 years (6.8%). PMID:25674437

  8. Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ebina, Yasuhiko; Yamada, Hideto [Kobe University Graduate School of Medicine, Department of Obstetrics and Gynecology, Kobe (Japan); Watari, Hidemichi; Kaneuchi, Masanori; Takeda, Mahito; Hosaka, Masayoshi; Kudo, Masataka; Sakuragi, Noriaki [Hokkaido University Graduate School of Medicine, Department of Gynecology, Sapporo (Japan)

    2014-03-15

    To investigate the impact of PET and PET/CT scanning on decision-making in management planning and to identify the optimal setting for selecting candidates for surgery in suspicious recurrent ovarian cancer. A retrospective chart review was performed in patients with possible recurrent ovarian cancer after primary optimal cytoreduction and taxane/carboplatin chemotherapy who had undergone FDG PET or FDG PET/CT scans from July 2002 to August 2008 to help make treatment decisions. The analysis included 44 patients who had undergone a total of 89 PET scans. The positive PET scans were classified as follows. (1) localized (one or two localized sites of FDG uptake), (2) multiple (three or more sites of FDG uptake), (3) diffuse (extensive low-grade activity outlining serosal and peritoneal surfaces). Of the 89 PET scans, 52 (58.4 %) led to a change in management plan. The total number of patients in whom cytoreductive surgery was selected as the treatment of choice increased from 12 to 35. Miliary disseminated disease, which was not detected by PET scan, was found in 22.2 % of those receiving surgery. Miliary disseminated disease was detected in 6 of the 12 patients with recurrent disease whose treatment-free interval (TFI) was <12 months, whereas none of those with a TFI of ?12 months had such disease (P = 0.0031). PET or PET/CT is useful for selecting candidates for cytoreductive surgery among patients with recurrent ovarian cancer. To avoid surgical attempts in those with miliary dissemination, patients with a TFI of ?12 months are the best candidates for cytoreductive surgery. (orig.)

  9. Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

    International Nuclear Information System (INIS)

    To investigate the impact of PET and PET/CT scanning on decision-making in management planning and to identify the optimal setting for selecting candidates for surgery in suspicious recurrent ovarian cancer. A retrospective chart review was performed in patients with possible recurrent ovarian cancer after primary optimal cytoreduction and taxane/carboplatin chemotherapy who had undergone FDG PET or FDG PET/CT scans from July 2002 to August 2008 to help make treatment decisions. The analysis included 44 patients who had undergone a total of 89 PET scans. The positive PET scans were classified as follows. (1) localized (one or two localized sites of FDG uptake), (2) multiple (three or more sites of FDG uptake), (3) diffuse (extensive low-grade activity outlining serosal and peritoneal surfaces). Of the 89 PET scans, 52 (58.4 %) led to a change in management plan. The total number of patients in whom cytoreductive surgery was selected as the treatment of choice increased from 12 to 35. Miliary disseminated disease, which was not detected by PET scan, was found in 22.2 % of those receiving surgery. Miliary disseminated disease was detected in 6 of the 12 patients with recurrent disease whose treatment-free interval (TFI) was <12 months, whereas none of those with a TFI of ?12 months had such disease (P = 0.0031). PET or PET/CT is useful for selecting candidates for cytoreductive surgery among patients with recurrent ovarian cancer. To avoid surgical attempts in those with miliary dissemination, patients with a TFI of ?12 months are the best candidates for cytoreductive surgery. (orig.)

  10. Sensitivity of Ocean Reflectance Inversion Models for Identifying and Discriminating Between Phytoplankton Functional Groups

    Science.gov (United States)

    Werdell, P. Jeremy; Ooesler, Collin S.

    2012-01-01

    The daily, synoptic images provided by satellite ocean color instruments provide viable data streams for observing changes in the biogeochemistrY of marine ecosystems. Ocean reflectance inversion models (ORMs) provide a common mechanism for inverting the "color" of the water observed a satellite into marine inherent optical properties (lOPs) through a combination of empiricism and radiative transfer theory. lOPs, namely the spectral absorption and scattering characteristics of ocean water and its dissolved and particulate constituents, describe the contents of the upper ocean, information critical for furthering scientific understanding of biogeochemical oceanic processes. Many recent studies inferred marine particle sizes and discriminated between phytoplankton functional groups using remotely-sensed lOPs. While all demonstrated the viability of their approaches, few described the vertical distributions of the water column constituents under consideration and, thus, failed to report the biophysical conditions under which their model performed (e.g., the depth and thickness of the phytoplankton bloom(s)). We developed an ORM to remotely identifY Noctiluca miliaris and other phytoplankton functional types using satellite ocean color data records collected in the northern Arabian Sea. Here, we present results from analyses designed to evaluate the applicability and sensitivity of the ORM to varied biophysical conditions. Specifically, we: (1) synthesized a series of vertical profiles of spectral inherent optical properties that represent a wide variety of bio-optical conditions for the northern Arabian Sea under aN Miliaris bloom; (2) generated spectral remote-sensing reflectances from these profiles using Hydrolight; and, (3) applied the ORM to the synthesized reflectances to estimate the relative concentrations of diatoms and N Miliaris for each example. By comparing the estimates from the inversion model to those from synthesized vertical profiles, we were able to identifY those bio-optical conditions under which the inversion model performs both well and poorly.

  11. Central pontine myelinolysis in advanced HIV infection with tuberculosis and multicentric Castleman's disease.

    Science.gov (United States)

    Katchanov, J; Branding, G; Stocker, H

    2013-07-01

    We present a case of central pontine myelinolysis (CPM) in a patient with advanced HIV infection and miliary tuberculosis. While hospitalized the patient developed an unusual ataxic variant of CPM with full clinical recovery. Follow-up imaging revealed resolution of pontine lesions. To our knowledge, this is the first report of a clinical and radiological recovery from CPM in advanced HIV disease. Our report extends our knowledge of neurological presentations in patients with advanced HIV infection. It highlights the importance of considering CPM in patients with advanced HIV disease presenting with an ataxic syndrome, even in the absence of an electrolyte derangement. PMID:23970776

  12. Delimitation of far upstream sequences required for maximal in vitro transcription of an H2A histone gene.

    OpenAIRE

    Grosschedl, R.; Birnstiel, M. L.

    1982-01-01

    Sea urchin (psammechinus miliaris) H2A histone genes shown to be promoter mutants from oocyte injection experiments were tested for their ability to initiate transcription in vitro. Circular templates were transcribed with HeLa cell extracts, and the transcripts were assayed by mung bean or S1 nuclease mapping of the 5' ends. The transcripts of the H2A mutants produced in vitro were qualitatively similar and, in most cases, identical to those seen in oocyte injection experiments, but quite la...

  13. Tuberculous Pseudoaneurysm of the Descending Thoracic Aorta from Tuberculous Aortitis: CT Findings and Treatment with an Endovascular Stent Graft

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ji Younbg; Lee, In Jae; Jeon, Eui Yong; Kim, Min Jeong; Lee, Kwan Seop; Lee, Yul [Dept. of Radiology, Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2011-12-15

    Tuberculous pseudoaneurysms of the aorta are rare entities that have been reported as fatal complications requiring early diagnosis and treatment. Here, we describe a case of a tuberculous pseudoaneurysm of the descending thoracic aorta in a patient with miliary tuberculosis. The computed tomography findings of a tuberculous pseudoaneurysm and outcomes of treatment with endovascular stent graft are described. Tuberculous pseudoaneurysms of the descending thoracic aorta were treated with endovascular stent graft. However, perigraft recurrence of tuberculosis after cessation of antituberculous drugs led to surgical treatment.

  14. CT appearances of abdominal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, W.-K., E-mail: leewk33@hotmail.com [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)

    2012-06-15

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  15. Disseminated tuberculomas in spinal cord and brain demonstrated by MRI with gadolinium-DTPA

    Energy Technology Data Exchange (ETDEWEB)

    Shen, W.C. (Dept. of Radiology, Taichung Veterans General Hospital (Taiwan, Province of China)); Cheng, T.Y. (Section of Neurology, Dept. of Internal Medicine, Taichung Veterans General Hospital (Taiwan, Province of China)); Lee, S.K. (Dept. of Radiology, Taichung Veterans General Hospital (Taiwan, Province of China)); Ho, Y.J. (Dept. of Radiology, Taichung Veterans General Hospital (Taiwan, Province of China)); Lee, K.R. (Inst. of Life Science, National Tsing-Hua Univ. (Taiwan, Province of China))

    1993-03-01

    Intramedullary tuberculoma is rare, and there has been no report of concurrent intramedullary and intracerebral tuberculomas. We report a 30-year-old man with miliary tuberculosis of the lung. He suffered sudden paraplegia due to tuberculomas in the thoracic spinal cord and MRI showed more tuberculomas in the cervical spinal cord, brain stem, and cerebral and cerebellar hemispheres. The tuberculomas were isointense on the T1-weighted images, and hyperintense on the T2-weighted images; there was marked enhancement with intravenous gadolinium-DTPA. All the tuberculomas were very small 1 year after antituberculous chemotherapy. (orig.)

  16. Central nervous system tuberculosis: an imaging-focused review of a reemerging disease.

    Science.gov (United States)

    Sanei Taheri, Morteza; Karimi, Mohammad Ali; Haghighatkhah, Hamidreza; Pourghorban, Ramin; Samadian, Mohammad; Delavar Kasmaei, Hosein

    2015-01-01

    Central nervous system (CNS) tuberculosis is a potentially life threatening condition which is curable if the correct diagnosis is made in the early stages. Its clinical and radiologic manifestations may mimic other infectious and noninfectious neurological conditions. Hence, familiarity with the imaging presentations of various forms of CNS tuberculosis is essential in timely diagnosis, and thereby reducing the morbidity and mortality of this disease. In this review, we describe the imaging characteristics of the different forms of CNS tuberculosis, including meningitis, tuberculoma, miliary tuberculosis, abscess, cerebritis, and encephalopathy. PMID:25653877

  17. CT appearances of abdominal tuberculosis

    International Nuclear Information System (INIS)

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  18. CT and high resolution CT in diagnosis of pulmonary complications of bone marrow transplants

    International Nuclear Information System (INIS)

    The aim of this prospective study was to compare conventional and high resolution CT for demonstrating pulmonary complications. 23 patients treated by bone marrow transplantation were included in the study between December 1990 and August 1991. These patients were examined radiologically at regular intervals following the transplants. In 9 patients lung changes were detected by CT: There were pneumonic infiltrates, including one CMV pneumonia, two cases of mild parenchymal fibrosis, two cases of extensive lung fibrosis and one of miliary tuberculosis. The advantages and disadvantages of conventional and high resolution techniques are discussed in relation to our findings. (orig.)

  19. Ventriculoatrial shunt in tuberculous meningitis with hydrocephalus.

    Science.gov (United States)

    Bhagwati, S N

    1971-09-01

    Raised intracranial tension affects the course of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a ventriculoatrial shunt significantly alters the course of the disease. The results in seven cases have been detailed and discussed. The levels of consciousness improved, hemiplegia and aphasia practically cleared up, and vision returned even in children who were blind for 4 to 6 weeks. Operation could be performed even in an active stage of the disease without much fear of miliary dissemination. PMID:22046643

  20. Tuberculosis Can Mimic Lung Cancer: A Case Series

    Directory of Open Access Journals (Sweden)

    Levent Dalar

    2013-03-01

    Full Text Available Tuberculosis can mimic all pathological considerations of the lung and can present in many various forms and appearances. Most common radiographic appearances are cavitary, fibroproductive, exudative, acinary, micro and macronodular and miliary types. Six patients (5 men; ages ranging from 38 to 74 years who presented at our clinic during previous years were evaluated. In this case series report we discussed the consideration that, very rarely, post- primary lung tuberculosis presenting with large nodular and mass-like forms in a chest X-ray or tomography scan, can be considered as having a neoplastic pattern.

  1. Tuberculous Pseudoaneurysm of the Descending Thoracic Aorta from Tuberculous Aortitis: CT Findings and Treatment with an Endovascular Stent Graft

    International Nuclear Information System (INIS)

    Tuberculous pseudoaneurysms of the aorta are rare entities that have been reported as fatal complications requiring early diagnosis and treatment. Here, we describe a case of a tuberculous pseudoaneurysm of the descending thoracic aorta in a patient with miliary tuberculosis. The computed tomography findings of a tuberculous pseudoaneurysm and outcomes of treatment with endovascular stent graft are described. Tuberculous pseudoaneurysms of the descending thoracic aorta were treated with endovascular stent graft. However, perigraft recurrence of tuberculosis after cessation of antituberculous drugs led to surgical treatment.

  2. BIODIVERSIDAD DE MACROHONGOS DE LA RESERVA NACIONAL MAGALLANES BIODIVERSITY OF MACROFUNGI OF THE MAGALLANES NATIONAL RESERVE

    Directory of Open Access Journals (Sweden)

    Verónica Mancilla

    2008-01-01

    Full Text Available El presente estudio entrega antecedentes cuantitativos sobre la riqueza y abundancia de macrohongos existentes en comunidades vegetales de la Reserva Nacional Magallanes. Se realizó entre los meses de enero a mayo de 2005 sobre cuatro comunidades vegetales (bosque de lenga, bosque de coigüe, murtillar y pastizal húmedo. En cada una se delimitaron parcelas permanentes, en las cuales mediante cuadrantes aleatorios se evaluó la riqueza y abundancia de macrohongos periódicamente cada 14 días. Paralelamente se realizaron muéstreos intensivos, lo que permitió complementar la lista de especies. En total se identificó un total de 40 especies considerando ambos muéstreos. El estudio de diversidad demostró que la mayor riqueza y abundancia de macrohongos se presenta en comunidades boscosas, siendo superior en las parcelas relevadas en coigüe. En el matorral no se registraron individuos. La especie más abundante fue Russula nothofaginea. Por otro lado, Coprinus disseminatus fue la especie presente en mayor cantidad de ambientes. Un análisis de la variación estacional de las fructificaciones permite concluir que la mayor diversidad de macromicetes se presenta en el mes de mayo. Los resultados validan la hipótesis que los bosques de coigüe presentan la mayor abundancia de macrohongos comparados con otras comunidades vegetales. Sin embargo, en los muéstreos intensivos, considerando bosques mixtos y diversos ambientes, aumenta la riqueza de especies en las cuencas de árboles caducifolios. Por otro lado, se estima que las condiciones climáticas extremas presentadas en este estudio (nevazones tempranas y temperaturas congelantes pudieron afectar la diversidad de macrohongos en las distintas comunidades.The present study delivers qualitative precedents on the richness and abundance of macro- fungi existing in plant communities of the National Reserve Magallanes. It was realized between January to May 2005 on four plant communities (forest of lenga, forest of coigüe, murtillar and humid grassland. In every community there were delimited permanent plots, in which by means of random quadrants the richness and abundance of macrofungi were evaluated from time to time every 14 days. Parallel intensive sampling realized what allowed to complement the list of species. In whole there was identified a whole of 40 species considering both samplings. The study demonstrated that la major richness and abundance of macrofungi appears in forest communities, being superior in the plots relieved in coigüe. In the bushes did not register individuáis. The most abundant species was Russula nothofaginea. On the other hand, Coprinus disseminatus was the present species in major quantity of environments. An analysis of the seasonal variation of the fructifications allows to conclude that the major diversity of macromicetes appears in May. The results valídate the hypothesis that the forests the forests of coigüe present the major abundance of macro fungicompared with other plant communities. Nevertheless, the intensive samplings, considering mixed forests and diverse environments, the richness of species increases in the trees caducifolios basins. On the other hand, it estimates that the climatic extreme conditions presented in this study (snow early and temperatures cool could affect the diversity of macro fungi in the different communities.

  3. BIODIVERSIDAD DE MACROHONGOS DE LA RESERVA NACIONAL MAGALLANES / BIODIVERSITY OF MACROFUNGI OF THE MAGALLANES NATIONAL RESERVE

    Scientific Electronic Library Online (English)

    Verónica, Mancilla; Juan Marcos, Henríquez; Jorge, Vera.

    Full Text Available SciELO Chile | Language: Spanish Abstract in spanish El presente estudio entrega antecedentes cuantitativos sobre la riqueza y abundancia de macrohongos existentes en comunidades vegetales de la Reserva Nacional Magallanes. Se realizó entre los meses de enero a mayo de 2005 sobre cuatro comunidades vegetales (bosque de lenga, bosque de coigüe, murtill [...] ar y pastizal húmedo). En cada una se delimitaron parcelas permanentes, en las cuales mediante cuadrantes aleatorios se evaluó la riqueza y abundancia de macrohongos periódicamente cada 14 días. Paralelamente se realizaron muéstreos intensivos, lo que permitió complementar la lista de especies. En total se identificó un total de 40 especies considerando ambos muéstreos. El estudio de diversidad demostró que la mayor riqueza y abundancia de macrohongos se presenta en comunidades boscosas, siendo superior en las parcelas relevadas en coigüe. En el matorral no se registraron individuos. La especie más abundante fue Russula nothofaginea. Por otro lado, Coprinus disseminatus fue la especie presente en mayor cantidad de ambientes. Un análisis de la variación estacional de las fructificaciones permite concluir que la mayor diversidad de macromicetes se presenta en el mes de mayo. Los resultados validan la hipótesis que los bosques de coigüe presentan la mayor abundancia de macrohongos comparados con otras comunidades vegetales. Sin embargo, en los muéstreos intensivos, considerando bosques mixtos y diversos ambientes, aumenta la riqueza de especies en las cuencas de árboles caducifolios. Por otro lado, se estima que las condiciones climáticas extremas presentadas en este estudio (nevazones tempranas y temperaturas congelantes) pudieron afectar la diversidad de macrohongos en las distintas comunidades. Abstract in english The present study delivers qualitative precedents on the richness and abundance of macro- fungi existing in plant communities of the National Reserve Magallanes. It was realized between January to May 2005 on four plant communities (forest of lenga, forest of coigüe, murtillar and humid grassland. I [...] n every community there were delimited permanent plots, in which by means of random quadrants the richness and abundance of macrofungi were evaluated from time to time every 14 days. Parallel intensive sampling realized what allowed to complement the list of species. In whole there was identified a whole of 40 species considering both samplings. The study demonstrated that la major richness and abundance of macrofungi appears in forest communities, being superior in the plots relieved in coigüe. In the bushes did not register individuáis. The most abundant species was Russula nothofaginea. On the other hand, Coprinus disseminatus was the present species in major quantity of environments. An analysis of the seasonal variation of the fructifications allows to conclude that the major diversity of macromicetes appears in May. The results valídate the hypothesis that the forests the forests of coigüe present the major abundance of macro fungicompared with other plant communities. Nevertheless, the intensive samplings, considering mixed forests and diverse environments, the richness of species increases in the trees caducifolios basins. On the other hand, it estimates that the climatic extreme conditions presented in this study (snow early and temperatures cool) could affect the diversity of macro fungi in the different communities.

  4. Pulmonary tuberculosis

    International Nuclear Information System (INIS)

    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

  5. Echinoderms as bioindicators, bioassays, and impact assessment tools of sediment-associated metals and PCBs in the North Sea.

    Science.gov (United States)

    Coteur, G; Gosselin, P; Wantier, P; Chambost-Manciet, Y; Danis, B; Pernet, Ph; Warnau, M; Dubois, Ph

    2003-08-01

    The study assessed the occurrence, possible toxicity, and impact of sediment-associated metals and PCBs in the coastal zone of the southern North Sea using echinoderms as representatives of the macrobenthos. Metals and PCBs were analyzed in the sediments and in the body compartments of the starfish Asterias rubens from 11 stations. The general toxicity of sediment-associated contaminants was assessed by bioassays using embryonic and larval developments of both A. rubens and the sea urchin Psammechinus miliaris. The impact of contamination was assessed by measuring cellular immune responses of A. rubens collected in the same stations. Contamination of the starfish by metals and PCBs closely reflected that of the sediments. However, bioaccumulation was element-specific for metals and depended on the chlorination pattern for PCBs. The sediment-associated contaminants appeared to be toxic in both the A. rubens and P. miliaris developmental assays. Moreover, metals were shown to affect the immune responses of starfishes living in contaminated stations. The most significant effects on biological responses were recorded in the plumes of the Scheldt/Rhine/North Sea Canal and the Elbe/Weser Rivers. PMID:14565576

  6. Ultrasonic diagnosis of hepatic metastases in patients with stomach cancer and colon cancer

    International Nuclear Information System (INIS)

    To assess the value of hepatic ultrasound in cancer patients, a prospective evaluation was performed by comparing the preoperative ultrasound report and surgeon's diagnosis at the time of operation in 86 patients with stomach cancer and 26 patients with colon cancer. In a total of 112 patients considered to have a metastasis free liver on ultrasound scanning 10 patients were turned out to have had hepatic metastasis at the time of laparotomy. Among these, 4 patients had miliary metastasis, 4 patients had nodular metastasis at the dome of the right hepatic lobe, and 2 patients had surface metastasis or direct invasion from the primary tumor. These observations suggest that false negative preoperative hepatic ultrasound scanning is 9% had this is considered due to small size of the metastatic lesions, and lesions roundabout the dome of the right hepatic lobe or surface metastasis. Thus one should keep in mind the possibility of miliary metastasis in cancer patient was has coarse hepatic echotexture. In addition, the hepatic dome as well as hepatic surfaces should be searched carefully as the lesions in these areas tend to be easily neglected by ultrasound

  7. Tuberculosis among atomic bomb survivors

    International Nuclear Information System (INIS)

    Effects of atomic bomb on tuberculosis among atomic bomb survivors necropsied after 1956 when Atomic Bomb Hospital was opened were observed statistically and the following results were obtained. The morbidity of tuberculosis in the group exposed within 2 km from the hypocenter was higher than that of the control group, but there was not a significant difference between the both groups. The morbidity of all types of tuberculosis was significantly higher in the group exposed within 2 km from the hypocenter than in the control group. The morbidity of tuberculosis tended to decrease in both exposed and non-exposed groups with time. However, the morbidity of miliary or active tuberculosis has tended to rise in the exposed since 1975. The morbidity in young a-bomb survivors exposed within 2 km was higher than that in those of other groups, but there was not a difference in the morbidity among the aged. The higher the rate of complication of active tuberculosis with stomach cancer or acute myelocytic leukemia or liver cirrhosis, the nearer the places of exposure were to the hypocenter. Out of 26 patients with miliary tuberculosis, 6 were suspected to have leukemia while they were alive and were suggested to have leukemoid reaction by autopsy. They all were a-bomb survivors, and 4 of them were exposed within 2 km from the hypocenter. (Tsunoda, M.)

  8. Radiographic study of soft tissue calcification in the oral and maxillofacial area

    International Nuclear Information System (INIS)

    The radiographic findings of soft tissue calcification in the oral and maxillofacial area was analysed using panoramic, skull P-A and intraoral radiographs in 250 patients. The following results were obtained; 1. Salivary stone had the highest rate of occurrence at 46% (116 cases), followed by lymph node calcification (97 cases), phlebolith (21 cases), multiple miliary osteoma (15 cases), antrolith (1 case), vessel calcification (1 case) and cysticercosis (1 case). 2. The prevalence of salivary stone was slightly higher in females, on the right side and in the middle-aged group and was especially higher in the submandibular gland (83%). The majority of them were round-shaped, homogeneously radiopaque and associated with sialodochitis. 3. The prevalence of lymph node calcification was higher in the female and old-aged group. Irregular shape and radiopaque bodies were seen in the cervical area, bilaterally. 4. The prevalence of phlebolith was slightly higher in the male, and the third decade group. The radiopaque bodies were 4-8 mm in diameter and had laminated appearance. 5. The prevalence of multiple miliary osteoma was higher in old-aged females. The numerous doughnut-shaped radiopaque bodies, sized 2-4 mm in diameter, were seen bilaterally in the cheek and were usually associated with the edentulous ridge.

  9. An Interesting Case of Dysphagia in a HIV Patient.

    Science.gov (United States)

    Madi, Deepak; Achappa, Basavaprabhu; Ramapuram, John T; Chowta, Nithyananda; Mahalingaman, Soundarya

    2013-03-01

    Oesophageal tuberculosis is a rare disease. Tuberculosis (TB) can cause dysphagia due to oesophageal ulcers, Tracheo-Oesophageal Fistulas (TOFs) and an extrinsic compression which is caused by the mediastinal lymph nodes. A 33-year-old gentleman was admitted to our hospital for the evaluation of fever, dysphagia and cough. His chest X-ray was suggestive of miliary tuberculosis. A CT scan of his chest revealed miliary tuberculosis, mediastinal lymphadenopathy and pneumomediastinum. His sputum AFB (acid-fast bacilli) test was positive. An upper gastrointestinal endoscopy revealed a large ulcer in the oesophagus with a fistulous opening which was suggestive of a tracheo-oesophageal fistula. A biopsy from the ulcer was positive for AFB. The test for HIV-1 was positive. A nasogastric feeding tube was placed and the Anti Tubercular Therapy ( ATT) was started. The main aim of this case report is to sensitize the clinicians about the fact that Tuberculosis can present with dysphagia, especially in HIV patients. PMID:23634414

  10. Imaging diagnosis of pulmonary tuberculosis in immunocompromised patients

    International Nuclear Information System (INIS)

    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

  11. Snakes from coastal islands of State of São Paulo, Southeastern Brazil / Serpentes das ilhas costeiras do Estado de São Paulo, Sudeste do Brasil

    Scientific Electronic Library Online (English)

    Paulo José Pyles, Cicchi; Marco Aurélio de, Sena; Denise Maria, Peccinini-Seale; Marcelo Ribeiro, Duarte.

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese Há poucos estudos sobre a fauna de serpentes em ilhas costeiras do Estado de São Paulo, Sudeste do Brasil e um baixo número de espécies depositadas em coleções zoológicas. No Brasil, pela primeira vez, foi realizado um inventário em 18 ilhas do litoral paulista a partir de pesquisa de registros nas [...] coleções herpetológicas do Sudeste do Brasil. Também foram realizadas coletas de campo em onze ilhas. Trinta e seis espécies de quatro famílias foram registradas: uma espécie de Boidae, trinta de Colubridae, uma de Elapidae e quatro de Viperidae. Os dados de campo apresentaram treze ocorrências novas de espécies sem registro nas coleções. Para estimar a raridade das espécies utilizaram-se categorias de abundância relativa: comum, não-freqüente e rara. Das espécies amostradas, 44,4% foram consideradas raras. As espécies mais comuns foram Micrurus corallinus, presente em doze ilhas; Bothrops jararaca e Liophis miliaris, presentes em onze ilhas, B. jararacussu e Chironius bicarinatus, presentes em 10 ilhas. Foram efetuados sete novos registros para a Ilha do Cardoso (25° 05’ S e 47° 59’ W): C. bicarinatus, C. multiventris, Dipsas petersi, Echinanthera bilineata, E. cephalostriata, Helicops carinicaudus e Xenodon neuwiedii; três para Ilha Comprida (24° 54’ S e 47° 48’ W): B. jararacussu, C. bicarinatus e H. carinicaudus; um para Ilha Anchieta (23° 32’ S e 45° 03’ W): Spilotes pullatus; um para a Ilha das Couves (23° 25’ S e 44° 52’ W): L. miliaris; um para a Ilha dos Porcos (23° 23’ S e 44° 54’ W): B. jararaca. B. alcatraz e B. insularis, endêmicos à Ilha de Alcatrazes e à Ilha da Queimada Grande, respectivamente, são considerados criticamente em perigo segundo IUCN. Foi registrada a extinção da fauna de serpentes na Ilha Monte de Trigo. Os ecossistemas insulares, mais vulneráveis que os continentais, carecem de uma proteção mais efetiva. A maioria destas espécies (cerca de 52%) preda anfíbios, reforçando a necessidade de conservação das florestas. Abstract in english There are relatively few studies on snake fauna from coastal islands of the State of São Paulo (SSP), Southeastern Brazil and the number of species housed in Brazilian institutional zoological collections is relatively limited. In Brazil, for the first time, a snake inventory for eighteen islands of [...] coastal SSP is presented. Here we record data from sampling on eleven islands as well information on vouchered species in the main herpetological collections. Thirty-six species from four families: one Boidae, thirty Colubridae, one Elapidae and four Viperidae from eighteen islands are listed as well as the thirteen new island records for snakes. Relative abundance categories were used for species rarity: common, infrequent and rare; 44.4% of the snakes with voucher specimens were considered rare. The most common species in twelve of the eighteen islands was Micrurus corallinus; in eleven of the eighteen islands were Bothrops jararaca and Liophis miliaris; in ten of the eighteen islands were B. jararacussu and Chironius bicarinatus. The most common snake species on coastal islands were Micrurus corallinus which was found in twelve of the eighteen islands, followed by Bothrops jararaca and Liophis miliaris found on eleven of the eighteen islands and B. jararacussu and Chironius bicarinatus which were found in ten of the eighteen islands studied. There are seven new records of snake species for Cardoso Island (25° 05’ S and 047° 59’ W): C. bicarinatus, C. multiventris, Dipsas petersi, Echinanthera bilineata, E. cephalostriata, Helicops carinicaudus and Xenodon neuwiedii; three new records for Comprida Island (24° 54’ S and 47° 48’ W): B. jararacussu, C. bicarinatus and H. carinicaudus; one for Anchieta Island (23° 32’ S and 045° 03’ W): Spilotes pullatus; one for Couves Island (23° 25’ S and 44° 52’ W): L. miliaris; one for Porcos Island (23° 23’ S and 44° 54’ W), B. jararaca. The endemi

  12. Mycology - an update part 2: dermatomycoses: clinical picture and diagnostics.

    Science.gov (United States)

    Nenoff, Pietro; Krüger, Constanze; Schaller, Jörg; Ginter-Hanselmayer, Gabriele; Schulte-Beerbühl, Rudolf; Tietz, Hans-Jürgen

    2014-09-01

    Most fungal infections of the skin are caused by dermatophytes, both in Germany and globally. Tinea pedis is the most frequent fungal infection in Western industrial countries. Tinea pedis frequently leads to tinea unguium, while in the elderly, both may then spread causing tinea corporis. A variety of body sites may be affected, including tinea glutealis, tinea faciei and tinea capitis. The latter rarely occurs in adults, but is the most frequent fungal infection in childhood. Following antifungal treatment of tinea unguium and also tinea capitis a dermatophytid or hyperergic reaction to dermatophyte antigens may occur. Yeast infections affect the mucous membranes both of the gastro-intestinal system and the genital tract as candidiasis mostly due to Candida albicans. Cutaneous candidiasis affects predominantely the intertriginous regions such as groins and the inframammary area, but also the intertriginous space of fingers and toes. In contrast, pityriasis versicolor is a superficial epidermal fungal infection primarily on the the trunk. Mold infections are rare in dermatology; they play a role nearly exclusively in nondermatophyte-mold (NDM) onychomycosis. The diagnosis of dermatomycoses comprises the microscopic detection of fungi using the potassium hydroxide preparation or alternatively the fluorescence optical Blankophor preparation together with culture. The histological fungal detection with PAS staining possesses a high sensitivity, and it should play a more important role in particular for diagnosis of onychomycosis. Molecular biological methods, based on the amplification of fungal DNA with use of specific primers for the distinct causative agents are on the rise. With PCR, such as dermatophyte-PCR-ELISA, fungi can be detected directly in clinical material in a highly specific and sensitive manner without prior culture. Today, molecular methods, such as Matrix Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry (MALDI TOF MS) as culture confirmation assay, complete the conventional mycological diagnostics. PMID:25176455

  13. Indications, diagnostic yields and complications of transbronchial biopsy over 5 years in the State of Qatar

    International Nuclear Information System (INIS)

    To review the indications, diagnostic yields and complications of transbronchial biopsy (TBB) in a tertiary hospital in the State of Qatar. A retrospective review of our records revealed 1006 adult flexible fibre optic bronchoscopies (FFB) at Hamad General Hospital, State of Qatar between January 1999 and December 2003. A total of 85 (8.4%) TBB were performed, but complete data were available for 71/85 (83.5%), which were reviewed for indications, diagnostic yields and complications. Adequate samples were obtained in 58/71 TBBs (81.7%), while 13/71 TBBs (18.3%) yielded mucosa. The main indications in 16/71 (22.5%) TBBs for radiographic localized pulmonary diseases were to rule out (TB) in 13 cases, and malignancy in 3 cases. Tuberculosis was verified in 3 (23%) of 13 cases with localized disease. 45 out of 71 (77.5%) TBBs were performed for radiographic diffuse pulmonary disease: 16/55 (29%) for miliary shadows, while 39/55 (70.9%) were carried out for reticular /reticulonodular infiltrates. Histopathology showed granulomatous lesions consistent with TB in 10/16 (62.5%) cases of miliary shadow. In other pattern of diffuse disease, the histopathological diagnosis were obtained in 25/39 (64%) cases. It showed non-specific pulmonary fibrosis in 13 cases, sarcoidosis in 4 cases, connective tissue disease associated interstitial fibrosis in 4 cases, bronchiolitis obliterans organizing pneumonia (BOOP) in one case, eosinophilic pneumonia in one case, amiodarone toxicity in monia in one case, amiodarone toxicity in one case and lymphangitis carcinomatosis in one case. The main complications were minor bleeding <50 cc in 17 cases (23.9%) pneumothorax in 7 cases (9.8%) and one case has sepsis. Our experience substantiates previous reports of the value and safety of transbronchial biopsy in rapid diagnosis smear-negative miliary TB. In diffuse lung diseases of a non-infectious nature, other than sarcoidosis, lymphangitis carcinomatosis and few other conditions, a pathological diagnosis are much less likely to be reliably made on small pieces of tissue such as those provided by TBB . (author)

  14. Chest X-Ray Findings of Sputum Positive Tuberculosis Patients in Rafsanjan City

    Directory of Open Access Journals (Sweden)

    H. Farahmand

    2004-01-01

    Full Text Available Plain chest x- ray is the first imaging modality for suspected tuberculosis patients because it is available, sensitive and inexpensive . The aim of this study was to identify the plain x- ray findings in sputum positive tuberculosis patients . One hundred and fourteen plain chest films of sputum positive tuberculosis patients that referred to health center of Rafsanjan were evaluated between 1988 and 1996 . This investigation was a retrospective cross sectional study that showed 92% of the cases had positive radiographic findings and 8% had normal chest x- ray. The most commom radiographic findings was exudative (pneumonic tubercolosis of lungs and other radiographic findings with decreasing frequency include: cavitation , fibro productive tuberculosis , pleural effusion, calcification, bronchopneumonia , atelectasis , lymphadenopathy bronchectasis and miliary tuberculosis.

  15. CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Lucas, Susan; Andronikou, Savvas [Faculty of Health Sciences, University of the Witwatersrand, Department of Radiology, Johannesburg (South Africa); Goussard, Pierre; Gie, Robert [Stellenbosch University, Department Paediatrics, Stellenbosch (South Africa)

    2012-08-15

    Lymphobronchial tuberculosis (TB) is tuberculous lymphadenopathy involving the airways, which is particularly common in children. To describe CT findings of lymphobronchial TB in children, the parenchymal complications and associated abnormalities. CT scans of children with lymphobronchial TB were reviewed retrospectively. Lymphadenopathy, bronchial narrowing, parenchymal complications and associations were documented. Infants comprised 51% of patients. The commonest site of lymphadenopathy was the subcarinal mediastinum (97% of patients). Bronchial compression was seen in all children (259 bronchi, of these 28% the bronchus intermedius) with severe or complete stenosis in 23% of affected bronchi. Parenchymal complications were present in 94% of patients, including consolidation (88%), breakdown (42%), air trapping (38%), expansile pneumonia (28%), collapse (17%) and bronchiectasis (9%), all predominantly on the right side (63%). Associated abnormalities included ovoid lesions, miliary nodules, pleural disease and intracavitary bodies. Airway compression was more severe in infants and most commonly involved the bronchus intermedius. Numerous parenchymal complications were documented, all showing right-side predominance. (orig.)

  16. Coexistence of granulomatous enteric inflammation and neoplasia in an adult sheep.

    Science.gov (United States)

    Benavides, J; Garcia-Pariente, C; Garrido, J M; Sevilla, I A; García-Marín, J F; Pérez, V; Ferreras, M C

    2013-11-01

    A 7-year-old dairy sheep suffering from chronic loss of weight without diarrhea or anorexia was euthanized after failing to respond to any treatment (antibiotic and antiparasitic). The main findings at the necropsy of this animal were multifocal miliary nodules in several organs, mainly in the Peyer's patches of the small intestine, and a segmental thickening of the jejunal wall. Histologic examination of the samples taken at the necropsy showed a multifocal chronic granulomatous inflammation, with mineralization and caseous necrosis at the core of the larger granulomas and scarce intrahistiocytic acid-fast bacilli consistent with a disseminated digestive tuberculosis. Polymerase chain reaction and bacteriological culture from these samples confirmed Mycobacterium avium subsp avium to be the etiologic agent of this infection. Histologically, the cause of the segmental thickening of the jejunal wall was found to be a small intestine adenocarcinoma, which in some areas coexisted with the granulomatous lesion. PMID:23456963

  17. Aerospace Technologies and Applications for Dual Use : A New World of Defense and Commercial in 21st Century Security

    DEFF Research Database (Denmark)

    2008-01-01

    Events which occurred over the past years have shown how the threat related to both intentional and natural disasters could bring the civil and the miliary worlds closer in the conception and deployment of countermeasures, as well as in the identification of effective strategies for enhancing the Planet safety and security. In this frame, the concept of dual use - the set of technologies and applications that can be exploied for both civil and military purposes - becomes a key-topic. In addition, the aerospace is a strategic building block in the deployment of a network centric environment that aims at the global protection of the mankind. Aeropsace is also a natural environment for dual use: many of the related enabling technologies have been first developed for the military world and then applied to civil - including commercial - purposes.

  18. Bromeliad treefrogs as phoretic hosts of ostracods

    Science.gov (United States)

    Sabagh, Leandro T.; Rocha, Carlos F. D.

    2014-06-01

    Aquatic organisms can use many methods of dispersal among discrete freshwater habitats, and phoresy is an important but poorly understood mechanism. Tank bromeliads are small and unconnected habitats used by many animals, and some of them use phoresy for dispersal. Ostracods living in bromeliads used treefrogs as phoretic hosts for dispersal. We investigated the distribution of phoretic ostracods among body parts of treefrogs ( Scinax littoreus and Scinax perpusillus), the prevalence and intensity of ostracods ( Elpidium sp.) between Scinax species, and the prevalence and mean intensity of ostracods among the frogs in wet vs. dry seasons in two inselbergs areas at Rio de Janeiro State (Brazil). There were significant differences among the body parts occupied by ostracods and between the Scinax species. Seasonal differences were found only for S. littoreus showing greater abundance during the wet season. Additionally, we record Scinax cuspidatus and Thoropa miliaris as new phoretic hosts for Elpidium sp. to use phoresy.

  19. Lung deposits of Lipiodol in normal and cirrhotic rats

    Energy Technology Data Exchange (ETDEWEB)

    Chiang, J.H.; Cheng, H.C.; Yang, M.C.M.; Lo, J.G.; Chi, C.W.; Lui, W.Y.; Liu, R.S.; Chang, T. (Veterans General Hospital, Taipei (Taiwan). Dept. of Radiology Veterans General Hospital, Taipei (Taiwan). Dept. of Medical Research Veterans General Hospital, Taipei (Taiwan). Dept. of Surgery Veterans General Hospital, Taipei (Taiwan). Dept. of Nuclear Medicine National Tsing Hua Univ., Hsinchu (Taiwan). Inst. of Nuclear Science)

    1991-11-01

    The distribution of Lipiodol in the liver and lungs following arterial or portal injection was studied in normal (n=55) and cirrhotic rats (n=20). Using magnified xeroradiography and radioisotope labeled tracers, it was found that Lipiodol was deposited mainly in the liver and lung after either arterial or portal administration. In control rats after arterial injection, deposits in the lung peaked after 2 hours and gradually declined over 48 hours; whereas after portal injection, the deposit steadily increased for 48 hours. Twenty-five percent of cirrhotic rats demonstrated a Lipiodol-induced miliary pattern in the lung. An increased number of portosystemic shunts in cirrhotic rats was also noted. These results suggest that cirrhosis of the liver may be a potential risk factor for developing pulmonary complications after Lipiodol administration. (orig.).

  20. A case of calcified intracranial tuberculoma presenting unique MRI findings

    International Nuclear Information System (INIS)

    A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25 mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T1 weighted inversion recovery sequence and heterogenously low intensity using the T2 weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptmycin, isoniazid and rifapicin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed. (author)

  1. CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities

    International Nuclear Information System (INIS)

    Lymphobronchial tuberculosis (TB) is tuberculous lymphadenopathy involving the airways, which is particularly common in children. To describe CT findings of lymphobronchial TB in children, the parenchymal complications and associated abnormalities. CT scans of children with lymphobronchial TB were reviewed retrospectively. Lymphadenopathy, bronchial narrowing, parenchymal complications and associations were documented. Infants comprised 51% of patients. The commonest site of lymphadenopathy was the subcarinal mediastinum (97% of patients). Bronchial compression was seen in all children (259 bronchi, of these 28% the bronchus intermedius) with severe or complete stenosis in 23% of affected bronchi. Parenchymal complications were present in 94% of patients, including consolidation (88%), breakdown (42%), air trapping (38%), expansile pneumonia (28%), collapse (17%) and bronchiectasis (9%), all predominantly on the right side (63%). Associated abnormalities included ovoid lesions, miliary nodules, pleural disease and intracavitary bodies. Airway compression was more severe in infants and most commonly involved the bronchus intermedius. Numerous parenchymal complications were documented, all showing right-side predominance. (orig.)

  2. Paradoxical reaction to antituberculosis therapy in a patient with lupus vulgaris.

    Science.gov (United States)

    Santesteban, R; Bonaut, B; Córdoba, A; Yanguas, I

    2015-03-01

    Patients receiving treatment for tuberculosis may experience an unexpected deterioration of their disease; this is known as a paradoxical reaction. We present the case of a 59-year-old man with lupus vulgaris who experienced a paradoxical deterioration of cutaneous lesions after starting antituberculosis therapy. The reaction was self-limiting; the lesions gradually improved, and the final outcome was very good. Paradoxical reactions are well-known in patients with human immunodeficiency virus (HIV) infection who start antiretroviral therapy, but they can also occur in non-HIV-infected patients with tuberculosis who start antituberculosis therapy. In the literature reviewed, paradoxical reactions involving skin lesions were described in patients with miliary tuberculosis. The case we report is the first of a paradoxical reaction in lupus vulgaris. The increasing frequency of tuberculosis in Spain could lead to a rise in the number of paradoxical reactions. PMID:25089032

  3. Disseminated tuberculosis manifesting as cholestasis in a patient with AIDS: a presentation to remember.

    Science.gov (United States)

    Lee, Theresa May; Shenoi, Sheela V; Ogbuagu, Onyema

    2014-01-01

    A 48-year-old man of Indian descent and chronic untreated HIV infection presented with a 3-week history of persistent fever, jaundice and a subacute 10-pound weight loss. His presentation was notable for a painless cholestatic jaundice. An extensive evaluation was pursued around cholestasis and liver disease, with a resulting unremarkable workup for viral, bacterial and tick borne infectious aetiologies. A CT scan of the abdomen fortuitously revealed incidental pleural effusions and a subsequent CT scan of the chest demonstrated miliary infiltrates, suspicious for disseminated tuberculosis (TB). The diagnosis was confirmed by GeneXpert PCR and culture of induced sputa, which were positive for Mycobacterium tuberculosis. We have highlighted this unusual presentation of disseminated TB, manifesting initially as cholestasis in a patient with AIDS. PMID:24567181

  4. June 2013 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Gotway MB

    2013-06-01

    Full Text Available No abstract available. Article truncated after first page. Clinical History A 42-year-old woman complained of cough and intermittent wheezing with shortness of breath. Her previous medical history was unremarkable. Frontal and lateral (Figures 1A and B chest radiography was performed. Figure 1. Frontal (Panel A and lateral (Panel B chest x-ray. Which of the following statements regarding the chest radiograph is most accurate? 1.The chest radiograph shows no abnormalities 2.The chest radiograph shows bilateral, basal reticulation suggesting fibrotic lung disease 3.The chest radiograph shows medial left lower lobe opacities 4.The chest radiograph shows large lung volumes associated with faint cystic change 5.The chest radiograph shows numerous small nodules suggesting a miliary pattern

  5. The snake community of Serra do Mendanha, in Rio de Janeiro State, southeastern Brazil: composition, abundance, richness and diversity in areas with different conservation degrees / A comunidade de serpentes da Serra do Mendanha, Estado do Rio de Janeiro, Sudeste do Brasil: composição, abundância, riqueza e diversidade em áreas com diferentes graus de conservação

    Scientific Electronic Library Online (English)

    JAL., Pontes; RC., Pontes; CFD., Rocha.

    2009-08-01

    Full Text Available Estudamos e comparamos parâmetros da comunidade de serpentes da Serra do Mendanha, Estado do Rio de Janeiro, Brasil (22º 48'-22º 51' S e 43º 28'-43º 31' W), tais como: distribuição de abundância, riqueza e diversidade de espécies e biomassa total, entre áreas florestadas, áreas em regeneração e área [...] s agrícolas (bananais); para obter informações sobre a história natural e facilitar o desenvolvimento de futuros estudos. Para a captura dos animais foram usadas armadilhas de queda (pitfalls) com cercas-guia e procura visual (diurna e noturna) ao longo de quatro transectos por ambiente. As serpentes capturadas foram identificadas, medidas com trena e paquímetro, pesadas com dinamômetro e sexadas com uso de cateter. Um exemplar por espécie foi fixado e depositado como material testemunho no Museu Nacional, Rio de Janeiro. Os demais indivíduos coletados foram marcados (com corte de escamas ventrais) e soltos. Empreendemos um esforço de cerca de 840 h/homem, resultando na captura de 207 serpentes pertencentes a 25 espécies (Colubridae 80,2%, Elapidae 12,6%, Viperidae 6,3% e Boidae 0,9%). As três espécies mais abundantes foram Liophis miliaris (n = 33), Micrurus corallinus e Chironius fuscus (ambas com n = 26), sendo as três menos abundantes Elapomorphus quinquelineatus, Siphlophis compressus e Tropidodryas serra (todas com n = 1). Contribuíram com a maior biomassa Spilotes pullatus (7.925 g), Chironius laevicollis (4.694 g), Liophis miliaris (3.675 g) e Pseustes sulphureus (3.050 g). As que menos contribuíram foram Siphlophis compressus, Tropidodryas serra (ambas com 4 g) e Elapomorphus quinquelineatus (3 g). Encontramos diferenças significativas nos parâmetros estudados entre os três tipos de ambientes amostrados na Serra do Mendanha (mata pouco perturbada, mata secundária e monocultura de bananeiras). Os resultados indicaram uma acentuada redução na abundância, riqueza, diversidade e biomassa de serpentes quando a floresta nativa é substituída pela monocultura de bananeiras. Abstract in english We studied and compared parameters of the snake community of the Serra do Mendanha, Rio de Janeiro State, southeastern Brazil (22º 48'-22º 51' S and 43º 31'-43º 28' W), such as: abundance distribution, richness, species diversity and biomass, between forested areas, areas under regeneration and agri [...] culture areas (banana plantations); to obtain information about the natural history and facilitate the development of future research. For capturing the snakes we used: pitfall traps, drift-fences and visual search (diurnal and nocturnal) along four transects for each habitat. The captured snakes were measured with a tape and caliper, weighed with dynamometers and sexed with the use of a catheter. The animals marked (with ventral scales cut) were released for posterior recapture. One individual per species was fixed and deposited at the Museu Nacional, Rio de Janeiro. We undertook an effort of 840 man/hour, and captured a total of 207 snakes belonging to 25 species (Colubridae 80.2%, Elapidae 12.6%, Viperidae 6.3% and Boidae 0.9%). The most abundant were: Liophis miliaris (n = 33), Micrurus corallinus and Chironius fuscus (both with n = 26); the least abundant: Elapomorphus quinquelineatus, Siphlophis compressus and Tropidodryas serra (all with n = 1). The species that contributed the greatest biomass were Spilotes pullatus (7,925 g), Chironius laevicollis (4,694 g), Liophis miliaris (3,675 g) and Pseustes sulphureus (3,050 g); those that contributed the lowest biomass were: Siphlophis compressus, Tropidodryas serra (both with 4 g) and Elapomorphus quinquelineatus (3 g). We found significant differences between the sampled habitats at the Serra do Mendanha (undisturbed forest, secondary forest and banana plantations). The results showed that a great reduction in the abundance, richness, diversity and biomass of the snakes occurs when the native forest is replaced by banana plantations.

  6. Hepatic capillariasis in a Cape ground squirrel (Xerus inaurus)

    Scientific Electronic Library Online (English)

    K H, Erlwanger; B A, De Witt; L G, Fick; R S, Hetem; L C R, Meyer; D, Mitchell; W A, Wilson; B, Mitchell.

    Full Text Available SciELO South Africa | Language: English Abstract in english We report, for the first time, an incidental finding of Calodium hepaticum infestation in a sub-adult female Cape ground squirrel (Xerus inaurus). Post mortem examination of the squirrel revealed severe haemoperitoneum, splenomegaly and hepatomegaly with miliary white spots distributed diffusely thr [...] oughout the hepatic parenchyma. Histologically the portal tracts in the liver showed granulomatous inflammation with fibrosis and numerous giant cells. Occasional adult worms were identified and there were multiple C. hepaticum eggs distributed diffusely throughout the portal tracts and the parenchyma. The spleen also contained C. hepaticum eggs. The genus Rattus is the primary host and reservoir of C. hepaticum, but C. hepaticum infections have been reported previously in other Sciuridae. Based on our findings, people should be cautious of the zoonotic potential of C. hepaticum, when they come into contact with the Cape ground squirrel.

  7. Hepatic capillariasis in a Cape ground squirrel (Xerus inaurus : short communication

    Directory of Open Access Journals (Sweden)

    B. Mitchell

    2012-05-01

    Full Text Available We report, for the first time, an incidental finding of Calodium hepaticum infestation in a sub-adult female Cape ground squirrel (Xerus inaurus. Post mortem examination of the squirrel revealed severe haemoperitoneum, splenomegaly and hepatomegaly with miliary white spots distributed diffusely throughout the hepatic parenchyma. Histologically the portal tracts in the liver showed granulomatous inflammation with fibrosis and numerous giant cells. Occasional adult worms were identified and there were multiple C. hepaticum eggs distributed diffusely throughout the portal tracts and the parenchyma. The spleen also contained C. hepaticum eggs. The genus Rattus is the primary host and reservoir of C. hepaticum, but C. hepaticum infections have been reported previously in other Sciuridae. Based on our findings, people should be cautious of the zoonotic potential of C. hepaticum, when they come into contact with the Cape ground squirrel.

  8. Combination therapy of disseminated coccidioidomycosis with caspofungin and fluconazole

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    Ja Kim Min

    2006-02-01

    Full Text Available Abstract Background The current recommended therapy for diffuse coccidioidal pneumonia involves initial treatment with amphotericin B deoxycholate or high-dose fluconazole, followed by an azole after clinical improvement. Amphotericin B is more frequently used as initial therapy if the patient's deterioration is rapid. Case presentation A 31-year-old Korean male with coccidioidomycosis presented to the hospital with miliary infiltrates on chest X-ray (CXR and skin rash on the face and trunk. Initially, the patient did not respond to amphotericin B deoxycholate therapy. However, following caspofungin and fluconazole combination therapy, the patient showed favourable radiological, serological, and clinical response. Conclusion This appears to be the first case of diffuse coccidioidal pneumonia with skin involvement in an immunocompetent patient who was treated successfully with caspofungin and fluconazole. Combination therapy with caspofungin and fluconazole may, therefore, be an alternative treatment for diffuse coccidioidal pneumonia that does not respond to amphotericin B deoxycholate therapy.

  9. Radiological aspects of intrathoracir paracoccidio mycosis (PS). A review of 170 cases

    International Nuclear Information System (INIS)

    Radiological aspects of intrathoracic paracoccidioidomycosis (PS). A review of 170 cases. A review of chest X-rays of 170 patients with PS showed predominance in males and a greater incidence in the 25-65 age-group. The authors suggest two forms of pulmonary involvement, pure and mixed respectively, each one with different pattern such as: fine reticular, coarse reticular, lymphonodular, nodular, miliary, pseudo-pneumonic and excavated. The late one was found just in association with any of the patterns described. The pure form of PS was predominantly fine reticular. Among the mixed types the reticulum-nodular pattern was most frequently found. Hyperinsulflation was frequently found and the inverted ''Y'' sign was considered important in the differential diagnosis with other fibrotic type of pulmonary infiltrates. (author)

  10. Choroidal Tuberculoma in Two Cases With Multiple Intracranial Tuberculomas

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    Baki ARPACI

    2011-12-01

    Full Text Available We report two cases of concurrent choroidal and multiple intracranial tuberculomas which is rare. A 45-year-old man presented to the hospital with a history of miliary tuberculosis, headache, and blurred vision on his left eye. The other case, a 25-year-old woman complained of coughing, back pain, night sweats, headache, nausea and vomiting. Their neurological examination were unremarkable except the presence of a choroidal lesion in one of their eyes, and brain MRIs revealed peripheral ring enhancing nodules. They were diagnosed as concurrent intracranial and choroidal tuberculomas and four-drug antituberculous regimen was started. After these treatments, the choroidal and brain tuberculomas revealed significant regression. Early diagnosis, adequate treatment and follow-up for the response to the treatment of choroidal tuberculoma can prevent serious complications. Detailed ocular examinations should be performed in all cases with tuberculosis, for possible presence of early asymptomatic choroidal tuberculoma.

  11. Liver tuberculosis in an HIV patient: diagnosis and management.

    Science.gov (United States)

    Bendayan, D; Litman, K; Hendler, A; Polansky, V

    2010-07-01

    Hepatic involvement is common in miliary and extra-pulmonary tuberculosis but is usually clinically silent. Therefore, it is rarely diagnosed. We report the case of a patient that presented with prolonged fever and hepatomegaly. Liver biopsy revealed non-necrotizing granulomas that led in turn to the diagnosis of generalized tuberculosis and HIV infection. The patient reported an old untreated tuberculosis and depression of the immune system provoked the reactivation of this old tuberculosis focus. We describe the clinical course of the disease and the challenges associated with the complexity of the treatment. Diagnosis of hepatic tuberculosis requires a high degree of suspicion especially in AIDS patients who show atypical presentations. However, it is a potential curable disease and good results have been obtained with the four drug regimen. PMID:21043314

  12. Tuberculous peritonitis during pegylated interferon plus ribavirin combination therapy in a patient with chronic hepatitis C.

    Science.gov (United States)

    Fukuba, Ryohei; Kawaratani, Hideto; Kubo, Takuya; Kaya, Daisuke; Aihara, Yosuke; Morioka, Chie; Noguchi, Ryuichi; Mitoro, Akira; Yoshiji, Hitoshi; Fukui, Hiroshi

    2014-12-01

    A woman in her 70s with fever and abdominal distension was referred to our hospital for investigation. She had just finished a course of pegylated interferon and ribavirin combination therapy for chronic hepatitis C. Abdominal computed tomography revealed peritoneal thickening and ascites. QuantiFERON(®)-TB Gold was positive, ascitic adenosine deaminase was high, and fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) showed diffuse accumulation in the peritoneum. Although these findings suggested tuberculous peritonitis, we did not detect Mycobacterium tuberculosis in any bacterial cultures, ascites, or other specimens. However, laparoscopic peritoneal biopsy demonstrated a large number of miliary white nodules in the parietal and visceral peritonea. Pathological examination of these nodules revealed epidermoid granuloma with giant Langhans' cells and caseous necrosis. Finally, the diagnosed of tuberculous peritonitis was established. It is important to consider tuberculosis in patients presenting with new symptoms while receiving interferon therapy. PMID:25482910

  13. Isolation and Identification of Cellulolytic Bacteria from the Gut of Three Phytophagus Insect Species

    Scientific Electronic Library Online (English)

    Rajib Kumar, Shil; Suman, Mojumder; Faozia Faleha, Sadida; Myn, Uddin; Dwaipayan, Sikdar.

    2014-12-01

    Full Text Available The cellulolytic bacteria from the gut of three different phytophagous insects were studied to isolate novel cellulolytic organism for biofuel industry. Among the threse, gut of P. quatuordecimpunctata larvae contained both highest no of total bacterial count (6.8x107 CFU/gut) and cellulolytic bacte [...] ria (5.42x103 CFU/gut). Fifteen different isolates were obtained from the gut of O. velox, A. miliaris and P. quatuordecimpunctata. All the isolates produced clear zone in CMC medium staining with Congo red. The isolates included Gram positive Enterococcus, Microbacterium and Gram negative Aeromonas, Erwinia, Serretia, Flavobacterium, Acenitobacter, Klebsiella, Yersinia, Xenorhabdus, Psedomonas and Photorhabdus. Out of the fifteen isolated and identified bacterial species, twelve bacterial species were novel being reported for first time as having cellulase activity.

  14. Recognition of Pneumocystis carinii in foals with respiratory distress

    International Nuclear Information System (INIS)

    Five 3-month-old foals presenting with fever and respiratory disease were found to have pulmonary abscesses with patchy to diffuse alveolar and interstitial pneumonia on post-mortem examination. All affected foals had evidence of Rhodococcus equi infection and had few to abundant Pneumocystis carinii cysts in the sections of affected lung. Of the 5 foals examined radiographically, 3 had a distinct reticulonodular (miliary) pattern which may aid in the ante-mortem diagnosis of P. carinii pneumonia (PCP). Leukocyte counts of foals with PCP were significantly greater than in the control group of foals with uncomplicated bacterial pneumonia. Foals with PCP tended to be more tachypnoeic than the control foals and 4 of the 5 PCP+ foals appeared dyspnoeic before death. The ante-mortem recognition of PCP may be expedited by bronchoalveolar lavage and successful treatment of foals with PCP may require the administration of adequate levels of potentiated sulphonamides

  15. Radiologic observation of renal tuberculosis

    International Nuclear Information System (INIS)

    Radiographic findings of thirty eight cases of renal tuberculosis treated at this hospital during last 4 years were analysed with following results. The cases examined were 24 male and 14 female patients. Age distribution was broad and evenly distributed ranging from 2nd decades to 5th decades. Main symptoms complained were urinary frequency, hematuria, dysuria and flank pain. Findings of physical examination revealed tenderness of costovertebral angle, palpable mass on flank area and epididymal indutration. The simple chest films showed pulmonary tuberculosis in 22 cases including 6 cases of active military type. Thirty one cases showed increased ESR, 8 cases showed AFB positive in urine and 12 cases showed bilateral renal tuberculosis. Through urographic findings nonvisualization, cyceopelviectasis, motheaten appearance of minor calyx, contracted bladder, delayed visualization, ureteral stricture and beading were observed in order of frequency. Five cases with miliary tuberculosis showed advanced renal lesion on urogram

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

    International Nuclear Information System (INIS)

    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.

  17. Cáncer tiroideo: una causa infrecuente de obstrucción de vía aérea superior en niños: Caso clínico / Thyroid carcinoma as a cause of upper airway obstruction in children: Case report

    Scientific Electronic Library Online (English)

    Lisbeth, Platzer M; Luis E, Vega-Briceño; Hernán, González D; Fernando, Iñiguez O; Cyntia, Escobar F; Francisco, Prado A.

    2006-06-01

    Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Upper airway obstruction (UAO) can be a severe medical condition with a high mortality in children. We report a 10 year-old girl with UAO due to papillary thyroid carcinoma. The study confirmed a thyroid cancer. The patient was referred to our centre for the evaluation of dyspnea and hoarseness. She [...] was admitted in severe respiratory distress. Her chest X-ray revealed a critical narrowing of the cervical trachea and extensive infiltration of the lung with a miliary pattern; CT scan revealed a thyroid mass with bilateral pulmonary dissemination. An early surgical approach with total thyroidectomy and tracheotomy was performed. The study revealed a thyroid carcinoma. The patient was then referred to a specialized centre to receive chemotherapy. Recognition of thyroid carcinoma in children requires a high suspicion index. An early CT scan and fiberoptic assessment could show UAO in many unsuspected lesions

  18. [Clinical symptomps, diagnosis and therapy of feline allergic dermatitis].

    Science.gov (United States)

    Favrot, C; Rostaher, A; Fischer, N

    2014-07-01

    Allergies are often suspected in cats and they are mainly hypersensitivity reactions against insect bites, food- or environmental allergens. Cats, with non flea induced atopic dermatitis, normally present with one oft he following reaction patterns: miliary dermatitis, eosinophilic dermatitis, selfinduced alopecia or head and neck excoriations. None of these reaction patterns is nevertheless pathognomonic for allergic dermatitis, therefore the diagnosis is based on the one hand on the exclusion of similar diseases on the other hand on the successful response on a certain therapy. Recently a study on the clinical presentation of cats with non flea induced atopic dermatitis was published. In this study certain criteria for diagnosing atopy in cats were proposed. For therapy of allergic cats cyclosporin, glucocorticoids, antihistamines, hypoallergenic diets and allergen specific immunotherapy are used. This article should provide a recent overview on the clinical symptoms, diagnosis and therapy of feline allergic dermatitis. PMID:24973320

  19. October 2012 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Gotway MB

    2012-10-01

    Full Text Available No abstract available. Article truncated after first page. Clinical History: A 65-year-old non-smoking woman presented with a history of cough, exertional dyspnea, and occasional wheezing. Frontal chest radiography (Figure 1 was performed.Figure 1. Admission chest x-ray.Which of the following statements regarding the chest radiograph is most accurate?1.The frontal chest radiograph is normal 2.The frontal chest radiograph is non-specifically abnormal3.The frontal chest radiograph shows numerous small nodules, consistent with a “miliary” pattern4. The frontal chest radiograph shows significant right lung volume loss, suggesting endobronchial obstruction5.The frontal chest radiograph shows diffuse fibrotic lung disease

  20. Middle ear tuberculosis: Diagnostic criteria

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    Ješi? Snežana

    2009-01-01

    Full Text Available Introduction. Tuberculous otitis is a diagnostic problem due to the difficulty to obtain microbiological, histomorphological and cytological confirmation of the disease. Objective. Our objective was to compare clinical and radiological characteristic and development of otogenic complications in patients with tuberculous otitis and otitis with cholesteatoma as the most destructive form of chronic nonspecific otitis in the purpose of establishing the diagnostic criteria for tuberculous otitis. Methods. Medical records of 12 patients with tuberculous otitis and 163 patients with cholesteatoma treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery in Belgrade during the eight-year period were analyzed. All of the patients underwent otomicroscopic, audiological and radiological examination of the thorax and temporal bone, microbiological examination of the secretion and histomorphological examination of the tissue taken during middle ear surgery. Statistical analysis was done using ?2 test with Yates correction. Results. Otogenic complication as facial palsy and sensorineural hearing loss were more frequent in tuberculous otitis patients, than in cholesteatoma. Also, fistulas of the labyrinth and facial canal bone destruction were also more frequent in tuberculous otitis than in cholesteatoma. A larger extent of temporal bone destruction was noticed on CT scans of the temporal bone in half of the patents with tuberculous otitis. Coexistence with miliary pulmonary tuberculosis was detected in one third of the patients. There were no microbiological or histomorphological confirmations of the disease, except in one case with positive Ziehl-Neelsen staining. Conclusion. Tuberculous otitis media should be considered in patients with serious otogenic complications and with shorter duration of ear discharge, and in association with diagnosed miliary pulmonary tuberculosis and extensive temporal bone destruction. Polymerase chain reaction still is not reliable for diagnosis.

  1. Ultrasonographic and CT findings of hepatosplenic tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Un Hyeon; Lee, Jeong Seok; Ko, Kang Seok; Park, Byung Ran; Yang, Dong Cheol; Im, Ju Hyeon [Kwangju Christian Hospital, Kwangju (Korea, Republic of); Kang, In Young [Kwangju Green Cross Hospital, Kwangju (Korea, Republic of)

    1998-08-01

    To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis Materials and Methods: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12 patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions of the liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement of tuberculosis were analyzed. Results : There were three cases of hepatic tuberculosis, seven of splenic tuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CT findings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low density mass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonary tuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis such as lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervical lymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. Conclusion : Ultrasonography and CT were valuable in the detection and diagnosis of hepatosplenic tuberculosis.

  2. Comparative radiological features of disseminated disease due to Mycobacterium tuberculosis vs non-tuberculosis mycobacteria among AIDS patients in Brazil

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    Willers Denise MC

    2008-02-01

    Full Text Available Abstract Background Disseminated mycobacterial disease is an important cause of morbidity and mortality in patients with HIV-infection. Nonspecific clinical presentation makes the diagnosis difficult and sometimes neglected. Methods We conducted a retrospective cohort study to compare the presentation of disseminated Mycobacterial tuberculosis (MTB and non-tuberculous Mycobacterial (NTM disease in HIV-positive patients from 1996 to 2006 in Brazil. Results Tuberculosis (TB was diagnosed in 65 patients (67.7% and NTM in 31 (32.3% patients. Patients with NTM had lower CD4 T cells counts (median 13.0 cells/mm3 versus 42.0 cells/mm3, P = 0.002. Patients with tuberculosis had significantly more positive acid-fast smears (48.0% vs 13.6%, P = 0.01. On chest X-ray, miliary infiltrate was only seen in patients with MTB (28.1% vs. 0.0%, P = 0.01. Pleural effusion was more common in patients with MTB (45.6% vs. 13.0%, P = 0.01. Abdominal adenopathy (73.1% vs. 33.3%, P = 0.003 and splenic hypoechoic nodules (38.5% vs. 0.0%, P = 0.002 were more common in patients with TB. Conclusion Miliary pulmonary pattern on X-ray, pleural effusion, abdominal adenopathy, and splenic hypoechoic nodules were imaging findings associated with the diagnosis of tuberculosis in HIV-infected patients. Recognition of these imaging features will help to distinguish TB from NTM in AIDS patients with fever of unknown origin due to disseminated mycobacterial disease.

  3. Exposure to 2,4-decadienal negatively impacts upon marine invertebrate larval fitness.

    Science.gov (United States)

    Caldwell, Gary S; Lewis, Ceri; Olive, Peter J W; Bentley, Matthew G

    2005-06-01

    Diatoms liberate volatile, biologically active unsaturated aldehydes following cell damage, which negatively impact upon invertebrate reproductive processes such as fertilization, embryogenesis and larval survival. 2,4-Decadienal is frequently identified among the aldehydes produced and is one of the more biologically active. The majority of studies which have examined the toxic effects of diatom aldehydes to invertebrate reproduction have scored egg production and/or hatching success as indicators of biological impacts. There are very few studies which have dealt specifically with the impacts of diatom-derived aldehydes on larval fitness. Larval stages of the polychaetes Arenicola marina and Nereis virens and the echinoderms Asterias rubens and Psammechinus miliaris exposed to 2,4-decadienal at sub 1 microg ml(-1) concentrations suffered reduced survival over the incubation period (day 1-8 post fertilization) with detectable differences for the polychates at a concentration of 0.005 and 0.01-0.1 microg ml(-1) for the echinoderms. Susceptibility of larval N. virens was investigated using stage specific 24 h exposures at 2,4-decadienal concentrations up to 1.5 microg ml(-1). A clear stage specific effect was found, with earlier larval stages most vulnerable. Nectochaete larvae (9-10 d) showed no reduction in survival at the concentrations assayed. Fluctuating asymmetry (FA), defined as random deviations from perfect bilateral symmetry, was used to analyse fitness of larval P. miliaris exposed to 2,4-decadienal at concentrations of 0.1, 0.5 and 1 microg ml(-1). The degree and frequency of asymmetrical development increased with increasing 2,4-decadienal concentration. Equally, as FA increased larval survival decreased. These results provide further support for the teratogenic nature of 2,4-decadienal and its negative impact on invertebrate larval fitness. PMID:15603766

  4. Unusual radiological findings of adult-onset pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Usual chest radiographic findings in pulmonary tuberculosis are well described in radiologic literatures for both primary and postprimary phases of disease. During the last decade, many authors have enumerated the unusual manifestations of pulmonary tuberculosis in adult population. These unusual findings usually have been involved in the frequent failure of both radiologist and clinician to recognize that tuberculosis could be the cause of a abnormal chest radiograph in patients who are finally and surprisingly proven to have tuberculosis. Authors have evaluated 249 patients who were admitted and newly proven to have adult-onset pulmonary tuberculosis at Chung-Ang University Hospital from January, 1985 to December, 1986. Unusual findings were noted in 76 (30.5%) of the 249 patients with adult-onset pulmonary tuberculosis. These unusual findings most frequently could be seen in 3rd decades and showed no sex difference in incidence. A broad spectrum of abnormal findings including usual and unusual abnormalities were procedure by adult-onset pulmonary tuberculosis. The unusual radiographic findings were arbitrarily classified. Pleural effusion without parenchymal disease (10.0%), unusual location of infiltrate (5.6%) and atelectasis (3.2%) were relatively common. Hilar and / or mediastinal lymphnode enlargement (1.6%), cavity without parenchymal infiltrates (1.6%), septic lung-like infiltrates (1.6%), completely clear lungs (1.2%), miliary infiltrates (1.2%), fibrocalci%), miliary infiltrates (1.2%), fibrocalcific scar-like infiltrates (1.2%), masslike density (1.2%) and rheumatoid lung-like infiltrates (1.2%) were occasionally noted. Pneumothorax without parenchymal disease (0.4%) and bron chocutaneous fistula (0.4%) are. The recognition of these unusual findings could further improve the detection and diagnosis of adult-onset pulmonary tuberculosis

  5. Technetium-99m tetrofosmin single photon emission computed tomography to detect metastatic papillary thyroid carcinoma in patients with elevated human serum thyroglobulin levels but negative I-131 whole body scan

    Energy Technology Data Exchange (ETDEWEB)

    Wu, H.-S.; Liu, F.-Y.; Huang, W.-S.; Liu, Y.-C.; Chang, C.-T.; Kao, C.-H. E-mail: d10040@www.cmch.org.tw

    2003-10-01

    AIM: The aim of this study was to evaluate the effectiveness of technetium-99m tetrofosmin (Tc-99m TF) single photon emission computed tomography (SPECT) of the neck and chest to detect metastatic lesions in papillary thyroid carcinoma (PTC) after near total thyroidectomy and radioiodine (I-131) treatment in patients who present with elevated serum human thyroglobulin (hTg) levels but negative I-131 whole body scan (WBS). MATERIALS AND METHODS: Twenty patients with PTC treated by near total thyroidectomy and I-131 treatments were included in this study. All 20 patients had negative I-131 WBS results and elevated hTg levels (hTg 2.0 {mu}IU/ml) under thyroid-stimulating hormone (TSH) stimulation (TSH 30 {mu}IU/ml). Nineteen of the 20 cases were confirmed to have metastases by operation/biopsy histopathological findings or clinical follow-up longer than 1 year by additional morphological imaging techniques. The remaining patient has been followed up closely and has been disease free for 10 months. Tc-99m TF SPECT was performed to detect metastatic lesions. RESULTS: Tc-99m TF SPECT demonstrated lesions in 11/19 patients; a sensitivity of 57.9%. Tc-99m TF SPECT failed to demonstrate lesions in eight patients including smaller lymph nodes and miliary lung metastases. CONCLUSIONS: We conclude that Tc-99m TF SPECT is a useful additional tool to detect metastatic lesions in PTC with elevated hTg but negative I-131 WBS. However, smaller lymph nodes and miliary lung metastases may be missed.

  6. Habitat selection by anurofauna community at rocky seashore in coastal Atlantic Forest, Southeastern Brazil / Selecao de habitat por uma comunidade de anuros em um costao rochoso na Mata Atlantica costeira, sudeste do Brasil

    Scientific Electronic Library Online (English)

    RC., Pontes; RT., Santori; FC. Goncalves e, Cunha; JAL., Pontes.

    2013-08-01

    Full Text Available Costões rochosos são morros graníticos distribuídos ao longo da costa do sudeste brasileiro, com vegetação xeromórfica devido ao seu solo raso. O conhecimento sobre comunidades de anfíbios e seus padrões reprodutivos é especialmente reduzido neste tipo de ambiente. Neste estudo, nós apresentamos os [...] resultados de dois anos de monitoramento de uma comunidade de anfíbios em um costão rochoso localizado na área protegida do Parque Estadual da Serra da Tiririca, município de Niterói, estado do Rio de Janeiro, Brasil. Nós fizemos buscas diurnas e noturnas para encontrar anuros em bromélias-tanque, superfície rochosa e vegetação arbustiva. O padrão anual de atividade reprodutiva também foi estimado. Indivíduos da bromélia-tanque mais abundante no local, Alcantarea glaziouana, foram coletados e tiveram diversas variáveis mensuradas a fim de se entender a seleção de bromélias por anuros. Verificamos a influência das condições ambientais sobre a abundância dos anfíbios, e a associação entre as medidas das bromélias e a capacidade de estocar água no seu tanque. Diferenças na utilização de microhábitats e na ocupação de bromélias pelos anuros também foram investigadas, assim como também foi testada a influência das variáveis das bromélias sobre a ocorrência dos anuros nestas plantas. Foram registradas as seguintes espécies: Scinax aff. x-signatus; S. cuspidatus; S. littoreus; Thoropa miliaris e Gastrotheca sp. As bromélias foram o habitat preferido pelos anuros. O hábito noturno foi predominante para todas as espécies. Durante buscas diurnas, os espécimes foram encontrados abrigados nas axilas das folhas das bromélias. O número de machos vocalizando, assim como a abundância de anfíbios, foi associado com o período mais quente e chuvoso. Machos adultos de T. miliaris foram observados vocalizando especialmente na estação chuvosa. A precipitação e a temperatura combinadas foram positivamente correlacionadas com o número total de anfíbios capturados. Entretanto, individualmente, a precipitação não foi significativamente correlacionada, enquanto que a temperatura foi positivamente correlacionada com a abundância de anfíbios. A capacidade de armazenamento de água pelas bromélias está correlacionada com as características e tamanho da planta. Na estação chuvosa, a altura da planta e o seu diâmetro foram correlacionados com a ocorrência de anfíbios, enquanto que durante o período seco não existiu correlação entre variáveis e o uso da bromélia pelos anfíbios. As espécies registradas estão fortemente associadas ao domínio da Floresta Atlântica. Entretanto, a ocupação dos costões rochosos por anuros pode estar mais associado com modos reprodutivos especializados apresentados pelas espécies, já que não existem riachos ou poças d'água permanentes disponíveis no local. Abstract in english Rocky seashores are low granitic hills distributed along the southeastern Brazilian coast with xeric-like vegetation due to the shallow soil. Knowledge on amphibian communities and their reproductive patterns is especially reduced on this kind of environment. Herein, we present a framework of two ye [...] ars monitoring an amphibian community at a rocky seashore environment located at the protected area of Parque Estadual da Serra da Tiririca, municipality of Niterói, state of Rio de Janeiro, Brazil. We conducted diurnal and nocturnal searches for frogs in tank bromeliads, rocky surface and shrubby vegetation. Annual pattern of breeding activity of anurans was also estimated. Individuals of the most abundant tank-bromeliad, Alcantarea glaziouana were collected and measured according to several variables to understanding the selection of bromeliads by frogs. We checked the influence of the environmental conditions on amphibian abundance, association between the bromeliads measures, and the water storage in the tank. We recorded the species: Scinax aff. x-signatus; S. cuspidatus; S. littoreus; Thoropa miliaris and Gastrotheca sp. Bromelia

  7. Cavitary Lesions and Nodular Infiltration Patterns in Multi-Drug Resistant TB and Non-Tuberculosis Mycobacterium: Comparison of Chest CT

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    Shahram Kahkouee

    2010-05-01

    Full Text Available Background/Objective: By increasing of HIV frequency, MDRTB has also increased. Clinical and laboratory findings of multi-drug resistant TB (MDRTB and non-tuberculosis mycobacterium (NTM are very similar. Maybe imaging findings help early differentiation before culture result. This study has compared cavitary lesions and nodular infiltration patterns in the chest CT of MDRTB and NTM."nPatients and Methods: A retrospective study was performed on 66 hospitalized patients (43 MDRTB and 23 NTM in Masih Daneshvari Hospital (from 2006-2009. Lung CT scans were evaluated by a radiologist and two radiology residents without any information about the culture result. Nodular infiltrations were classified into 6 patterns (tree in bud, scattered nodule, lobar nodular infiltration, cavitary nodule, macronodule, miliary pattern and cavitary lesions to thick and thin, single and multiple with lobar distribution and satellite nodule adjacent to cavity. Chi-square statistics analysis was performed."nResult: Respectively in NTM and MDRTB: Mean age (51.5%-44.8%, sex (34.8% M and 65.2 F, 58.1% M and 41.9% F, treatment history (56.5%,83.7%, scattered nodular infiltration (47.8%, 60.5%, lobar nodular infiltration (13%, 9.3%, TIB (47.8%, 46.5%, miliary pattern (0%, 0%, cavitary nodule (21.7%, 27.9%, macro nodule (nodule?10mm (43.5%, 25.6%, cavity (69.6%, 76.7%, thin wall cavity (65.2%, 46.5%, thick wall cavity (26.1%, 58.1%, satellite nodule adjacent to cavity (39.1%, 9.3%, single cavity (13%, 14%, lobar distribution of single cavity: RUL (8.7%, 4.7%, RML (0%, 0%, RLL (0%, 0%, LUL (4.3%, 4.7%, lingual (0%, 0%, LLL (0%, 4.7%, multiple cavity (56.5%, 60.5%, lobar distribution of multiple cavity: RUL (26.1%, 51.2%, RML (21.7%, 9.3%, RLL (26.1%, 23.3%, LUL (47.8%, 44.2%, lingual (26.1%, 18.6%, LLL (30.4%, 16.3%."nConclusion: Treatment history (p=0.016, satellite nodule adjacent to cavity (p=0.004, thick wall cavity (p=0.013 and multiple cavity in RUL (p=0.05 are more common in NTM with significant difference. Frequency difference in other variables was not significant (p>0.05.

  8. Clinical analysis of foreign-born patients with tuberculosis found in Malaysia.

    Science.gov (United States)

    Nissapatorn, V; Kuppusamy, I; Wan-Yusoff, W S; Anuar, A Khairul

    2005-05-01

    In this retrospective study, we investigated 263 foreign patients who were diagnosed as having tuberculosis at the National Tuberculosis Center (NTBC) from January 2001 to December 2002. The age range was 14-72 years, with a mean of 33.3 +/- 9.95 years. The study subjects were predominantly males (60%) and females comprised 40%, where the greater impact of tuberculosis was observed in the young and active ones (up to 34 years of age), than middle-age (up to 54). A significantly higher percentage of these patients were from the Southeast Asian countries (87%) and particularly occurred in single male (47.5%) and married female (71.4%) patients (ptuberculosis was significantly higher in female (50.5%) and male (64%) with smoking laborers (pdisease (94.3%) occurred more commonly in males and the pleura (3.2%) was the most common site of disseminated tuberculosis. By contrast, the lymph node (11.4%) and miliary (4.8%) forms were the more common extrapulmonary tuberculosis in females. More males had higher percentage of treatment completed at > or = 6 (38%) and > or = 9 (13.3%) months in pulmonary tuberculosis, whilst, more females showed higher percentage of treatment completed (8.7%) in extrapulmonary tuberculosis. Surprisingly, more women showed non-compliance to the anti-tubercular therapy than their counterpart in this study. PMID:16124444

  9. Infectious diseases in atomic bomb survivors

    International Nuclear Information System (INIS)

    Incidences of various infectious diseases in 986 autopsy cases at Hiroshima Atomic Bomb Hospital and Hiroshima Red Cross Hospital from 1965 to 1975 were compared according to the distance from the explosion place, and the following results were obtained. There was not a significant difference at incidences of most infectious diseases between each exposured group and not-exposured group. Incidence of old tuberculosis focus was a little higher in exposured groups, but incidences of main lesions such as tuberculosis, active tuberculosis, and miliary tuberculosis were lower in exposured groups and effect of exposure was negative. Out of urinary tract infections, the nearer the distance to the explosion place was, the higher incidence of cistitis in female was. Incidence of cystitis of female was higher than that of male in the group exposured near to the explosion place. With respect to stomach cancer, leukemia, malignant lymphoma, and cerebrovascular disorder, the nearer the distance to the explosion place was, the higher incidences of various infectious diseases were. (Tsunoda, M.)

  10. A preliminary investigation of tuberculosis and other diseases in African buffalo (Syncerus caffer in Queen Elizabeth National Park, Uganda

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    A.L. Michel

    2010-09-01

    Full Text Available A survey to determine the prevalence of bovine tuberculosis caused by Mycobacterium bovis and certain other infectious diseases was conducted on 42 free-ranging African buffaloes, (Syncerus caffer from May to June 1997 in the Queen Elizabeth National Park, Uganda. Using the gamma interferon test, exposure to M. bovis was detected in 21.6 % of the buffaloes. One dead buffalo and an emaciated warthog (Phacochoerus aethiopicus that was euthanased, were necropsied; both had miliary granulomas from which M. bovis was isolated. None of the buffaloes sampled in Sector A of the park, which has no cattle interface, tested positive for bovine tuberculosis (BTB exposure. The prevalence and distribution of BTB does not appear to have changed significantly since the 1960s, but this may be due to fluxes in the buffalo population. Serological testing for foot-and-mouth disease (FMD demonstrated positive exposure of 57.1% of the buffaloes sampled, with types A, O and SAT 1-3, which is the first known report of FMD antibodies to A and O types in free ranging African buffaloes. Foot-and-mouth disease virus types SAT 1 and SAT 3 were isolated from buffalo probang samples. Two percent of the buffaloes had been exposed to brucellosis. None of the buffaloes tested had antibodies to rinderpest, leptospirosis or Q fever.

  11. Abnormal chest shadow on CT in immunosuppressed patients

    International Nuclear Information System (INIS)

    An abnormal chest shadow was observed on CT scans in 25 cases of 23 immunosuppressed patients. Pulmonary disease was pathologically confirmed to be pneumocystis carinii pneumonia (PC pneumonia) in four patients, cytomegalovirus pneumonia (CMV pneumonia) in one, bacterial pneumonia in seven, fungal infection in three, miliary tuberculosis in one, leukemic infiltration in two, lymphangitis carcinomatosa in three, drug-induced pneumonitis in three, and ARDS in one. In almost all patients, especially those with infectious diseases such as PC pneumonia, CMV pneumonia, and bacterial pneumonia, the abnormal shadow was wide and visible in the bilateral lung fields. We presumed that such findings as lobular shadow, centrilobular shadow, and mosaic pattern reflected the extension of disease via the respiratory tract, and that those findings are typical of infectious diseases. Because such findings as abnormal linear shadow and swelling of a broncho-vascular bundle were very frequently recognized in patients with lymphangitis carcinomatosa and frequently recognized in those with drug-induced pneumonitis, these diseases may be distinguished from other diseases. An area of slightly increased density was frequently recognized in patients with PC pneumonia, bacterial pneumonia, and drug-induced pneumonitis. Such lesions were pathologically confirmed to be located in the interstitium and/or alveolus. CT was extremely useful in comprehending the character and extension of particular dhe character and extension of particular diseases among various diseases. As the number of patients studied was small, the utility of CT in immunosuppressed patients requires further investigation in a larger number of patients. (author)

  12. Effectiveness of BCG Vaccination in Prevention of Childhood Tuberculosis: A Prospective Study from Kishanganj, Bihar

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    Kashif Shahnawaz, Goutam Sarkar, Palash Das, Mausumi Basu, Biman Roy

    2013-01-01

    Full Text Available Introduction: BCG vaccine has shown consistently high efficacy against childhood tubercular meningitis and miliary tuberculosis and other mycobacterial diseases. It is considered to be a safe vaccine with a low incidence of adverse effects. Efficacy of BCG vaccine found in different clinical trials is variable in different geography. Objectives: Study was done to assess the efficacy of BCG vac-cine. Materials and Methods: All the children who were less than three years of age and were previously BCG vaccinated and not-vaccinated, were included in this study. A total of sixty (60 vaccinated children and sixty non-vaccinated children were selected. These children were followed up prospectively for 24 months, at the end of which, it was seen whether they developed tuberculosis or not. Results: Out of these 60 children in both the cases and control groups, total number of BCG vaccinated children who developed TB were 4 (i.e. 6.6% and total number of Non-BCG vaccinated children who developed TB were 12 (i.e. 20%. Thus, the efficacy of BCG vaccine calculated in our study was 67%. Conclusion: Most studies in different parts of the world have shown that the efficacy of BCG vaccine varies from zero to eigh-ty percent. This study favors the efficacy of BCG vaccine. This vaccination strategy will be favorable for our children. Creation of awareness among the parents and family members for an early administration of BCG vaccine after child birth can be recom-mended.

  13. Tuberkulosis Perinatal Bermanifestasi sebagai Tuberkulosis Milier dan Meningitis

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    Heda Melinda D. Nataprawira

    2014-10-01

    Full Text Available Perinatal tuberculosis (TB is rarely reported, because the clinical manifestations are not specific and there is a problem in its laboratory and radiology examination which caused undiagnosed. Perinatal TB is the preferred description that encompasses TB acquired either intra uterine, during or post delivery in early newborn period. A-3- month old baby was transferred to Pediatric Emergency Hasan Sadikin Hospital because of prolong fever and unable to breastfeed. There was no problem with delivery. Lethargic, fever, tachypnea, and hepatosphlenomegali were found on physical examination. Ziehl Neelsen smear of gastric lavage yielded positive acid fast bacilli. Tuberculine test was non reactive, chest x-ray showed a miliary pattern, and cerebral spinal fluid analysis gave tuberculous meningitis interpretation. By active finding, his father and grandfather were detected as a source of TB transmission. In additon to oral antituberculosis regimen, antibiotics and prednison were also given. Septic shock and disseminated intravascular coagulation were occurred during his illness and the baby died. Staphylococcus haemolyticus was identified from blood culture. In conclusion, although there were no problems during labor, active investigation of perinatal TB possibility is required on the family with a source of TB. Caution on TB in pregnant women is necessary at developing country with high rates of TB.

  14. Neonatal BCG vaccination is associated with enhanced T-helper 1 immune responses to heterologous infant vaccines

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    Daniel H. Libraty

    2014-01-01

    Full Text Available Neonatal Bacille Calmette Guérin (BCG vaccination has been reported to have beneficial effects beyond preventing infantile tuberculous meningitis and miliary disease. We hypothesized that BCG vaccine given at birth would enhance T-helper 1 (Th1 immune responses to the first vaccines given later in infancy. We conducted a nested case-control study of neonatal BCG vaccination and its heterologous Th1 immune effects in 2–3 months old infants. BCG vaccination at birth was associated with an increased frequency of interferon-? (IFN-? producing spot-forming cells (SFC to tetanus toxoid 2–3 months later. The frequency of IFN-? producing SFC to polioviruses 1–3 also trended higher among infants who received BCG vaccination at birth. The frequency of IFN-?+/tumor necrosis factor-? (TNF-?+CD45RO+CD4+ T-cells upon stimulation with phorbol myristate acetate (PMA/Ionomycin was higher in 2–3 months old infants who received BCG vaccination at birth compared to those who did not. The circulating frequency of forkhead box P3 (FoxP3+ CD45RO+ regulatory CD4+ T-cells also trended lower in these infants. Neonatal BCG vaccination is associated with heterologous Th1 immune effects 2–3 months later.

  15. Case of calcified intracranial tuberculoma presenting unique MRI findings

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    Kinjo, Toshihiko; Mukawa, Jiro; Miyagi, Kouichi; Takara, Eiichi; Mekaru, Susumu; Ishikawa, Yasunari

    1988-05-01

    A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25 mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T/sub 1/ weighted inversion recovery sequence and heterogenously low intensity using the T/sub 2/ weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptmycin, isoniazid and rifapicin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed.

  16. Nontuberculous Mycobacterial (NTM) Disease in Immunocompetent Patients: Expanding Image Findings on Chest CT

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    Shin, Hyo Hyun; Seon, Hyun Ju; Kim, Mok Hee; Choi, Song; Song, Sang Gook; Shin, Sang Soo; Kim, Yun Hyeon; Park, Jin Gyoon [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2010-04-15

    The aim of this study was to evaluate the chest CT features of nontuberculous mycobacterial (NTM) disease regardless of the specific organisms. This study included 74 consecutive patients (35 men, 39 women; mean age, 63 years; age range, 25-89 years) who were diagnosed with NTM disease according to the American Thoracic Society Guidelines (1997 and 2007) between January 2005 and July 2007. Chest CT images were randomly reviewed by two radiologists with consensus. The most common organism associated with NTM disease is M. avium-intracellulare complex (87.8%), followed by M. abscesses, M. kansasii, and M. chelonae. The most common chest CT finding was a nodular bronchiectatic lesion (n = 35, 46.7%), followed by a cavitary lesion of the upper lobe (n = 21, 28.0%), combined lesions of two prior subtypes (n = 6, 8.0%), consolidative lesion (s) (n = 5, 6.7%), a bronchogenic spreading pulmonary tuberculosis-like lesion (n = 5, 6.7%), a cavitary mass lesion with small satellite nodules (n = 2, 2.7%), and a miliary nodular lesion (n = 1, 1.3%). More than 5 segments were involved in 60 cases (81.1%). The nodular bronchiectatic lesion or cavitary lesion of upper lobe presents with multi-segmental involvement and the occurrence of combined consolidation is indicative of NTM disease

  17. The chest radiological manifestation in psittacosis

    International Nuclear Information System (INIS)

    Objective: To summarize the clinical characteristics and imaging features of psittacosis. Methods: The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed. Results: The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dissociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of neutrophils might be increased. The chest X-ray and CT scan showed air-space consolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were also present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittaci. Erythromycin was effective in all 3 patients. Conclusion: Although the appearance of psittacosis on clinical findings and chest X-ray and CT scan is not characteristic, psittacosis can be diagnosed with the combination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging features of psittacosis is helpful in differential diagnosis. (authors)rs)

  18. Demographic And Risk Factors Related To Military Tuberculosis

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    M. Rasolinejad

    2006-05-01

    Full Text Available Background and Aim: Tuberculosis is one the major health care problems in developing countries. Miliary tuberculosis is induced by blood dissemination of multiple tubercle bacilli, the paramount importance of accurate diagnosis of military tuberculosis is because of its dismal outcome if untreated and the chance of cure if diagnosis happens early in the course of the disorder. In this study we describe the demographic and risk factors related to military tuberculosis, which enables us to control and reduce the incidence of military tuberculosis. This ultimately reduces the mortality and morbidity consistent with this disorder. Materials and Methods: we conducted a retrospective case control study, which compares 28 patients with military tuberculosis and 56 patients with pulmonary tuberculosis as control. We reviewed all the patients' documents registered between years 1994-2004, after extracting raw data we analyzed them with chi-square and Fisher exact tests. Results and Conclusion: We found that HIV (P< 0.05 infection and lack of BCG vaccination (P< 0.05 increases the number of military tuberculosis among our patients. In addition we did not find any other significant risk factor.

  19. Study of tuberculous meningitis by CT

    International Nuclear Information System (INIS)

    Computed tomography is a very valuable method by which the pathogenic evolution of tuberculous meningitis may be followed, thereby facilitating its differential diagnosis and controlling the efficiency of therapy. The initial miliary tuberculosis in the brain, very often unaccompanied by neurological symptoms, may offer very evident CT images. CT may also demonstrate the fibrogelatinous exudate which fills the basal cisterns and surrounds the arterial vessels which cross this region. Because of this, secondary arteritis is frequent and may be indirectly detected by CT in the form of foci of ischemic infarcts. Tuberculomas may be multiple, and are found equally in the cerebral and the cerebellar parenchyma. These tuberculomas present different images on CT, depending on the evolution of the disease at that moment. Hydrocephalus is a common complication of TM and is caused by a lack of reabsorption of the cerebrospinal fluid, or by an obstructive lesion in the ventricular drainage pathways due to a tuberculoma. This complication is usually easily identified by CT, which, moreover, permits the control of its evolution. (orig.)

  20. Epstein-Barr virus (EBV) genome carrying monoclonal B-cell lymphoma in a patient with adult T-cell leukemia-lymphoma.

    Science.gov (United States)

    Tobinai, K; Ohtsu, T; Hayashi, M; Kinoshita, T; Matsuno, Y; Mukai, K; Shimoyama, M

    1991-01-01

    A Japanese patient with adult T-cell leukemia-lymphoma (ATL) showed a disease progression from the smoldering type to the chronic type and finally to the acute type. The patient was variously treated, including 2'-deoxycoformycin, with some beneficial effects. During the chronic type he developed a composite lymphoma consisting of T-cell lymphoma (ATL) of medium-sized cells and B-cell lymphoma of diffuse large cell type. At that time, he also suffered from miliary tuberculosis and adenovirus type 11-induced hemorrhagic cystitis, indicating that he was in a marked immunodeficient state. Southern-blot analysis revealed that the two malignancies have distinct clonal origin on the basis of the following results: (1) clonally rearranged T-cell receptor beta-chain gene (TcR-beta gene) and germline configuration of immunoglobulin heavy chain gene (IgH gene) in ATL leukemic cells, (2) clonal rearrangement of IgH gene in lymphoma cells, indicating a monoclonal B-cell lymphoma, (3) monoclonal integration of HTLV-I provirus in ATL leukemic cells, (4) definite presence and monoclonal origin of EBV genome in lymphoma cells. This is the first report of secondary EBV genome carrying monoclonal B-cell lymphoma in an ATL patient. It is suggested that the immunodeficient state in the patient with ATL allows the emergence of EBV-related B-cell lymphoma. PMID:1656151

  1. Total hip arthroplasty for surgical management of advanced tuberculous hip arthritis: Case report.

    Science.gov (United States)

    Tan, Shi Ming; Chin, Pak Lin

    2015-03-18

    Tuberculosis (TB) arthritis of the hip is a debilitating disease that often results in severe cartilage destruction and degeneration of the hip. In advanced cases, arthrodesis of the hip confers benefits to the young, high-demand and active patient. However, many of these patients go on to develop degenerative arthritis of the spine, ipsilateral knee and contralateral hip, necessitating the need for a conversion to total hip arthroplasty. Conversion of a previously fused hip to a total hip arthroplasty presents as a surgical challenge due to altered anatomy, muscle atrophy, previous surgery and implants, neighbouring joint arthritis and limb length discrepancy. We report a case of advanced TB arthritis of the hip joint in a middle-aged Singaporean Chinese gentleman with a significant past medical history of miliary tuberculosis and previous hip arthrodesis. Considerations in pre-operative planning, surgical approaches and potential pitfalls are discussed and the operative technique utilized and post-operative rehabilitative regime of this patient is described. This case highlights the necessity of pre-operative planning and the operative technique used in the conversion of a previous hip arthrodesis to a total hip arthroplasty in a case of TB hip arthritis. PMID:25793173

  2. Increased incidence of tuberculosis in patients of systemic sclerosis on dexamethasone pulse therapy: A short communication from Kashmir

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    Ahmad Qazi

    2008-01-01

    Full Text Available Background: Systemic sclerosis is a multi-systemic autoimmune disorder affecting predominantly the skin, lungs, gut and kidneys. Purpose: To report the increased incidence of tuberculosis in patients of systemic sclerosis on dexamethasone pulse (DP therapy. Methods: Forty-seven patients of systemic sclerosis were included in the study. After taking a complete history and doing a detailed physical examination, the patients were submitted to a battery of investigations including complete hemogram(CBC with erythrocyte sedimentation rate (ESR(F, Chest X-ray CXR (PA view Mantoux test and urine analysis. CBC, ESR and urine examination was done monthly and CXR were repeated six-monthly. Findings: Seven patients on DP therapy developed genitourinary tuberculosis. Four had pulmonary tuberculosis. One patient developed tubercular lymphadenitis, one patient succumbed to miliary tuberculosis. Conclusion: There is an increased incidence of tuberculosis amongst patients of systemic sclerosis on DP therapy. Limitation of the Study: There was no control group of systemic sclerosis patients not on DP therapy to rule out the confounding effect of the disease per se predisposing to tuberculosis as all our patients as a matter of routine were put on steroid pulse. Also, the increased incidence of tuberculosis was detected incidentally while on monthly follow-up.

  3. Study of tuberculous meningitis by CT

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    Rovira, M.; Romero, F.; Torrent, O.; Ibarra, B.

    1980-04-01

    Computed tomography is a very valuable method by which the pathogenic evolution of tuberculous meningitis may be followed, thereby facilitating its differential diagnosis and controlling the efficiency of therapy. The initial miliary tuberculosis in the brain, very often unaccompanied by neurological symptoms, may offer very evident CT images. CT may also demonstrate the fibrogelatinous exudate which fills the basal cisterns and surrounds the arterial vessels which cross this region. Because of this, secondary arteritis is frequent and may be indirectly detected by CT in the form of foci of ischemic infarcts. Tuberculomas may be multiple, and are found equally in the cerebral and the cerebellar parenchyma. These tuberculomas present different images on CT, depending on the evolution of the disease at that moment. Hydrocephalus is a common complication of TM and is caused by a lack of reabsorption of the cerebrospinal fluid, or by an obstructive lesion in the ventricular drainage pathways due to a tuberculoma. This complication is usually easily identified by CT, which, moreover, permits the control of its evolution.

  4. Disseminated tuberculosis in a pregnant woman presenting with numerous brain tuberculomas: case report

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    Gasparetto Emerson L.

    2003-01-01

    Full Text Available Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which has the pulmonary form as the most common presentation. Dissemination of the disease is common in immunocompromised patients, but immunodeficiency related to pregnancy severe enough to cause dissemination of the Mycobacteria is exceedingly rare. When dissemination occurs, any organ may be affected and in central nervous system, the infection presents as meningitis and single brain parenchyma tuberculomas. We report the case of a 17 year-old woman at the 34th week of pregnancy with respiratory and high intracranial pressure symptoms. On the day before admission she had a sudden onset of paraparesis and urinary retention and ten hours after the delivery she presented with paraplegia . The chest X-ray and CT scan were compatible with miliary tuberculosis. The cranial CT scan revealed numerous rounded hypodense lesions located at cerebral and cerebellar hemispheres, which presented ring-like enhancement after contrast injection. The patient underwent a craniotomy with biopsy of the lesions confirming the diagnosis of brain tuberculomas. The three-drug regimen was started and the cranial CT scan performed a year after diagnosis showed no brain lesions. We emphasize the aggressive dissemination of the disease in this case associated with pregnancy and the importance of early diagnosis and institution of therapy resulting in regression of the lesions.

  5. Computed tomography of intracranial tuberculosis

    International Nuclear Information System (INIS)

    CT is a valuable method in determining number, location and extent of lesions, although a definite diagnosis is often not possible on CT. In intracranial tuberculosis, CT was helpful in the diagnosis, assessing the degree of hydrocephalus and evaluating the effectiveness of antituberculous therapy. Twenty-one cases of clinically proven intracranial tuberculosis were studied by CT in our hospital during last 3 years. Of them, eighteen cases were tuberculous meningitis and the rests were tuberculoma. The results were as follows: 1. Tuberculous meningitis presented the following three patterns of CT findings according to its disease process. a. In early stage of the disease, suspicious multiple isodense small nodules in the cerebral and cerebellar hemispheres showed dense enhancement in postcontrast scan representing miliary tubercles. b. In later stage of the disease, precontrast scan showed partial or total obliteration of the basal and sylvian cisterns with mild dilatation of ventricular system. Postcontrast scan showed dense enhancement of basal and sylvian cisterns. This type of finding was the most common in our series. c. Moderate to marked dilatation of ventricle with or without a cluster of calcifications in suprsella area on precontrast scan was seen in far later stage of as a sequellae of the disease. No enhancement was noted in postcontrast study. 2. Tuberculoma showed an isodense or slightly hyperdense area in the cerebral or cerebellar hemisphere with assocrebral or cerebellar hemisphere with associated minimal edema in precontrast study. Postcontrast scan showed a small ring enhancement with central lucent area

  6. Radiological manifestations of pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Andreu, J. E-mail: andreuj@hg.vhebron.es; Caceres, J.; Pallisa, E.; Martinez-Rodriguez, M

    2004-08-01

    Pulmonary tuberculosis (TB) is a common worldwide lung infection. The radiological features show considerable variation, but in most cases they are characteristic enough to suggest the diagnosis. Classically, tuberculosis is divided into primary, common in childhood, and postprimary, usually presenting in adults. The most characteristic radiological feature in primary tuberculosis is lymphadenopathy. On enhanced CT, hilar and mediastinal nodes with a central hypodense area suggest the diagnosis. Cavitation is the hallmark of postprimary tuberculosis and appears in around half of patients. Patchy, poorly defined consolidation in the apical and posterior segments of the upper lobes, and in the superior segment of the lower lobe is also commonly observed. Several complications are associated with tuberculous infection, such as hematogenous dissemination (miliary tuberculosis) or extension to the pleura, resulting in pleural effusion. Late complications of tuberculosis comprise a heterogeneous group of processes including tuberculoma, bronchial stenosis bronchiectasis, broncholithiasis, aspergilloma, bronchoesophageal fistula and fibrosing mediastinitis. Radiology provides essential information for the management and follow up of these patients and is extremely valuable for monitoring complications.

  7. Role of endoscopy in recalcitrant intraventricular tuberculoma-innovative novel treatment adjunct.

    Science.gov (United States)

    Udayakumaran, Suhas; Nair, Prakash; Kumar, Anil; Panikar, Dilip

    2014-09-15

    Introduction. Intraventricular tuberculomas are rare entities. To the best of our knowledge, only 14 cases have been reported in English literature. Medical management of cerebral tuberculomas is well accepted. Intraventricular tuberculomas may be recalcitrant for unclear reasons. An effective management protocol for this entity is unclear. To the best of our knowledge, the definitive indication, timing, and possible role of surgery in these lesions have not been discussed in literature. Materials and methods. A 27-year-old nursing professional who was undergoing treatment for miliary tuberculosis at another center presented to us in 2008 with right hemiparesis, deteriorating vision, and progressive decline in consciousness. In addition to antituberculous therapy (ATT), she underwent multiple CSF diversion procedures for the obstructive hydrocephalus secondary to a recalcitrant third ventricular tuberculoma. Finally, she underwent endoscopic decompression of the lesion with a very good clinical response at 1-year follow-up. Discussion. We discuss a patient with recalcitrant intraventricular tuberculoma managed using neuroendoscopy along with the standard antituberculous therapy. We also discuss in detail the technique we utilized for endoscopic management of this lesion. Conclusion. Being a rare entity, a consensus for management of these lesions is not possible, but we have demonstrated that neuroendoscopic management of these rare entities is an option giving the advantage of definitive diagnosis when required, hastening the resolution, and clearing the CSF pathway. PMID:25222506

  8. Computed tomography of intracranial tuberculosis

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    Park, Yong Lan; Lee, Jung Suk; Eun, Chung Kie; Kim, Soon Yong [School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    1981-09-15

    CT is a valuable method in determining number, location and extent of lesions, although a definite diagnosis is often not possible on CT. In intracranial tuberculosis, CT was helpful in the diagnosis, assessing the degree of hydrocephalus and evaluating the effectiveness of antituberculous therapy. Twenty-one cases of clinically proven intracranial tuberculosis were studied by CT in our hospital during last 3 years. Of them, eighteen cases were tuberculous meningitis and the rests were tuberculoma. The results were as follows: 1. Tuberculous meningitis presented the following three patterns of CT findings according to its disease process. a. In early stage of the disease, suspicious multiple isodense small nodules in the cerebral and cerebellar hemispheres showed dense enhancement in postcontrast scan representing miliary tubercles. b. In later stage of the disease, precontrast scan showed partial or total obliteration of the basal and sylvian cisterns with mild dilatation of ventricular system. Postcontrast scan showed dense enhancement of basal and sylvian cisterns. This type of finding was the most common in our series. c. Moderate to marked dilatation of ventricle with or without a cluster of calcifications in suprsella area on precontrast scan was seen in far later stage of as a sequellae of the disease. No enhancement was noted in postcontrast study. 2. Tuberculoma showed an isodense or slightly hyperdense area in the cerebral or cerebellar hemisphere with associated minimal edema in precontrast study. Postcontrast scan showed a small ring enhancement with central lucent area.

  9. Total hip arthroplasty for surgical management of advanced tuberculous hip arthritis: Case report

    Science.gov (United States)

    Tan, Shi Ming; Chin, Pak Lin

    2015-01-01

    Tuberculosis (TB) arthritis of the hip is a debilitating disease that often results in severe cartilage destruction and degeneration of the hip. In advanced cases, arthrodesis of the hip confers benefits to the young, high-demand and active patient. However, many of these patients go on to develop degenerative arthritis of the spine, ipsilateral knee and contralateral hip, necessitating the need for a conversion to total hip arthroplasty. Conversion of a previously fused hip to a total hip arthroplasty presents as a surgical challenge due to altered anatomy, muscle atrophy, previous surgery and implants, neighbouring joint arthritis and limb length discrepancy. We report a case of advanced TB arthritis of the hip joint in a middle-aged Singaporean Chinese gentleman with a significant past medical history of miliary tuberculosis and previous hip arthrodesis. Considerations in pre-operative planning, surgical approaches and potential pitfalls are discussed and the operative technique utilized and post-operative rehabilitative regime of this patient is described. This case highlights the necessity of pre-operative planning and the operative technique used in the conversion of a previous hip arthrodesis to a total hip arthroplasty in a case of TB hip arthritis. PMID:25793173

  10. Tuberculose hepática pseudotumoral Pseudotumoral hepatic tuberculosis

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    Antonio Nocchi Kalil

    1999-06-01

    Full Text Available Tuberculous involvement of the liver is usually a diffuse process, associated with miliary tuberculosis. However localized tuberculosis of the liver producing a macronodular tuberculoma or an abscess is rare. The authors present a case of pseudotumoral hepatic tuberculosis in a 34-year old woman. This patient presented a 2 month history of fever weight loss of 4Kg and right upper quadrant abdominal pain. She denied jaundice, choluria, or acholia. Laboratory investigation, including renal and liver function tests. revealed normal levels. Chest X-ray was normal. Abdominal ultrasonography demonstrated a hypoechoic nodule in the right hepatic lobe. CT scan showed hypodense areas in the same place and no retroperitoneal lymphadenopathy. Due to the inespecificity of the signs, symptoms and image findings, a diagnostic laparoscopy was performed, it was however inconclusive. Then, the patient was submitted to a laparotomy with ressection of the lesion. Histological examination revealed a tuberculoid granulomatous lesion with caseous necrosis. Postoperatively, the patient was placed on antituberculous chemotherapy with rifampin, isoniazid and pyrazinamide. Eight months later the patient is asymptomatic.

  11. Tuberculose hepática pseudotumoral / Pseudotumoral hepatic tuberculosis

    Scientific Electronic Library Online (English)

    Antonio Nocchi, Kalil; Fernanda Alvarez, Coelho; Gislaine Silveira, Olm.

    1999-06-01

    Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese [...] Abstract in english Tuberculous involvement of the liver is usually a diffuse process, associated with miliary tuberculosis. However localized tuberculosis of the liver producing a macronodular tuberculoma or an abscess is rare. The authors present a case of pseudotumoral hepatic tuberculosis in a 34-year old woman. Th [...] is patient presented a 2 month history of fever weight loss of 4Kg and right upper quadrant abdominal pain. She denied jaundice, choluria, or acholia. Laboratory investigation, including renal and liver function tests. revealed normal levels. Chest X-ray was normal. Abdominal ultrasonography demonstrated a hypoechoic nodule in the right hepatic lobe. CT scan showed hypodense areas in the same place and no retroperitoneal lymphadenopathy. Due to the inespecificity of the signs, symptoms and image findings, a diagnostic laparoscopy was performed, it was however inconclusive. Then, the patient was submitted to a laparotomy with ressection of the lesion. Histological examination revealed a tuberculoid granulomatous lesion with caseous necrosis. Postoperatively, the patient was placed on antituberculous chemotherapy with rifampin, isoniazid and pyrazinamide. Eight months later the patient is asymptomatic.

  12. Computed tomography ub abdominal tuberculosis

    International Nuclear Information System (INIS)

    Computed tomography (CT) examination of abdomen and pelvis was undertaken omongst suspected abdominal tuberculosis (TB) subjects and the findings were correlated with barium meal follow through (BMFT), surgical and pathological findings wherever possible. CT features highly suggestive of abdominal tuberculosis in 50 cases studied so far, include: mesenteric and omental masses or lymph nodes usually with hypodense centres (25 cases), bowel wall thickening (20 cases), inflammatory reaction of mesentery and omentum (28 cases), psoas abscesses (two cases), contracted caecum (six cases), tubo-ovarian masses (five cases) miliary tubercles (one case), fistula and sinus tract (two cases). To the best of our knowledge, the latter four findings have not previously been reported in the CT literature. CT proved supreior to BMFT in demonstrating mural, serosal and mesenteric abnormalities. It was especially useful in defining the nature of mass effects, separation or displacement of small bowel segments seen on barium meal follow through. CT features of intra-abdominal tuberculosis need to be recognized so that laparotomy may be avoided wherever possible. Less invasive procedures, such as ultrasound or CT-guided needle aspiration biopsy or a trial of antituberculous therapy (ATT) should be instituted early in the disease. (author). 19 refs.; 5 figs.; 1 tab

  13. Paradoxical response during antituberculous therapy in a patient discontinuing infliximab: a case report

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    Yoon Young Kyung

    2009-04-01

    Full Text Available Abstract Introduction The use of the drug infliximab for the treatment of patients with Crohn's disease can be complicated by tuberculosis. A paradoxical reaction during antituberculosis chemotherapy and immunologic reconstitution after discontinuation of infliximab can result in severe disseminated tuberculosis. Case presentation A 38-year-old Korean man with severe Crohn's disease presented with fever and diffuse abdominal pain. Infliximab had been started 2 months before admission. A chest X-ray and abdominal computed tomography scan revealed numerous miliary nodules in both lung fields and microabscesses in the spleen. Given the diagnosis of disseminated tuberculosis, the infliximab therapy was discontinued and antituberculosis therapy was promptly started. Over the next 3 months, the patient was diagnosed with tuberculosis lymphadenitis on a right supraclavicular lymph node and surgical excision of the lesion was performed. With the diagnosis of a paradoxical response, anti-tuberculous therapy was continued for 12 months. Conclusion Our case suggests that patients who develop tuberculosis after infliximab exposure are at an increased risk of developing a paradoxical reaction. The current recommendation of discontinuing infliximab during tuberculosis treatment should be re-evaluated.

  14. Inhibition of embryonic development and fertilization in broadcast spawning marine invertebrates by water soluble diatom extracts and the diatom toxin 2-trans,4-trans decadienal.

    Science.gov (United States)

    Caldwell, Gary S; Olive, Peter J W; Bentley, Matthew G

    2002-10-01

    Water soluble diatom extracts and the diatom aldehyde 2-trans,4-trans decadienal were assayed on the gametes and embryos of the broadcast spawning polychaetes Arenicola marina and Nereis virens and the echinoderms Asterias rubens and Psammechinus miliaris. Both crude cellular extracts and purified aldehyde were found to inhibit fertilization, embryogenesis and hatching success in a dose dependent manner. Intact diatom cells had no discernable effect on fertilization or development. Extracts of Skeletonema costatum were generally more effective than Nitzschia commutata in inhibiting development and fertilization. There was considerable interspecific variation in terms of toxin sensitivity. The polychaetes were more sensitive to the effects than the echinoderms. Within the polychaetes A. marina was the more tolerant in terms of developmental competence but N. virens had a higher fertilization rate. Echinoid embryos were more tolerant than asteroid embryos. This is the first study to present data on the inhibition of fertilization success by diatom extracts and aldehydes. Our observations are discussed in relation to temporal patterns in spawning and possible adaptive mechanisms to avoid diatom toxicity. PMID:12204592

  15. Development of a clinical scoring system for the diagnosis of smear-negative pulmonary tuberculosis

    Scientific Electronic Library Online (English)

    Alonso, Soto; Lely, Solari; Juan, Agapito; Carlos, Acuna-Villaorduna; Marie-Laurence, Lambert; Eduardo, Gotuzzo; Patrick Van der, Stuyft.

    2008-04-01

    Full Text Available SciELO Brazil | Language: English Abstract in english This study developed a clinical score based on clinical and radiographic data for the diagnosis of smear-negative pulmonary tuberculosis (SNPT). SNPT was defined as a positive culture in Ogawa in a patient with two negative sputum smears. Data from patients admitted to the emergency ward with respir [...] atory symptoms and negative acid-fast bacilli (AFB) smears was analyzed by means of logistic regression to develop the predictive score.Two hundred and sixty two patients were included. Twenty patients had SNPT. The variables included in the final model were hemoptysis, weight loss, age > 45 years old, productive cough, upper-lobe infiltrate, and miliary infiltrate. With those, a score was constructed. The score values ranged from -2 to 6. The area under the curve for the ROC curve was 0.83 (95% CI 0.74-0.90). A score of value 0 or less was associated with a sensitivity of 93% and a score of more than 4 points was associated with a specificity of 92% for SNPT. Fifty-two point twenty-nine percent of patients had scores of less than one or more than four, what provided strong evidence against and in favor, respectively, for the diagnosis of SNPT. The score developed is a cheap and useful clinical tool for the diagnosis of SNPT and can be used to help therapeutic decisions in patients with suspicion of having SNPT.

  16. Tc-99m erythromycin lactobionate inhalation scintigraphy in parenchymal lung diseases

    International Nuclear Information System (INIS)

    We have investigated Technetium 99m erythromycin lactobionate (Tc 99m EL) clearance from the lungs after inhalation, in the presence of an alveolitis. Eighteen patients (6 sarcoidosis, 7 idiopathic fibrosis, and 5 miliary tuberculosis) were imaged after the patients inhaled 1,110 MBq of Tc 99m EL. Clearance half time for the first 45 min, for 24 h, and retention at 24 h correlated with percentage of lymphocytes in bronchoalveolar lavage fluid (BAL) (r=.729, r=.883, and r=.826, respectively). There was a positive correlation between peripheral penetration (PP) and forced expiratory volume in 1 s (FEV1) (r=.806) and forced vital capacity (FVC) (r=.781). Retention was more marked in sarcoidosis compared with tuberculosis (0.025< p?0.05). Radioaerosol lung imaging may reflect the pulmonary function impairment in parenchymal lung diseases. Retention of Tc 99m EL may be related to number of BAL cells or presence of a lymphocytic alveolitis. Long residency time of Tc 99m EL in the lungs implies that erythromycin can also be administered by inhalation for therapeutic purposes

  17. Utility of bone marrow aspiration in extrapulmonary tuberculosis

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    H. Singh

    2002-08-01

    Full Text Available This study was undertaken to look for evidence of acid fast bacilli (AFB in bone marrow (BM in patients of extrapulmonary tuberculosis. Fifty cases suspected of extrapulmonary tuberculosis underwent bone marrow aspiration from sternum/illiac crest and were put on a therapeutic trial of antituberculosis therapy. All cases taken in the study responded to the therapy. The pattern of involvement were – abdominal (20, CNS (19, pericardial involvement (5, cervical lymphadenopathy (2, PUO (2, spinal (1 and miliary (1. 52% cases showed evidence of AFB in BM (on Ziehl Neelsen’s (ZN staining whereas only 4% of cases showed evidence of AFB in any other body fluid (CSF/pericardium/peritonium. Besides this, cytomorphological changes of BM showed evidence of lymphocytosis (22%, increased plasma cells (80% and prominence of macrophages (88%, thus signifying infective pathology with macrophage overactivity. So we conclude that bone marrow aspiration has a definite diagnostic value and may prove useful when other investigations are unrewarding. (Med J Indones 2002; 11: 148-52 Keywords: bone marrow aspiration, acid fast bacilli, extrapulmonary tuberculosis

  18. [Cowpox virus infection in an alpaca (Vicugna pacos) - clinical symptoms, laboratory diagnostic findings and pathological changes].

    Science.gov (United States)

    Goerigk, D; Theuß, T; Pfeffer, M; Konrath, A; Kalthoff, D; Woll, D; Vahlenkamp, T W; Beer, M; Starke, A

    2014-01-01

    Orthopoxvirus infections appear to be rare in South American Camelids, because only a few cases have been reported in the literature. Based on a generalized infection with cowpox virus in an alpaca, the clinical symptoms, laboratory diagnostic findings and the pathological changes are described. The case history showed a long treatment because of chronic skin lesions. The main clinical symptom was miliary papules over the entire skin. Furthermore, a bilateral mucopurulent conjunctivitis occurred as well as excessive salivation due to a severe erosive-ulcerative stomatitis. Although the animal received intensive treatment, it died 8 days after admission to the clinic. During necropsy, an erosive-ulcerative laryngitis as well as a necrotising pneumonia and lymphadenitis were observed. Histopathological examination of representative organ samples led to the diagnosis of a suspected orthopoxvirus infection. Electron microscopy and quantitative polymerase chain reaction (qPCR) of tissue samples confirmed this diagnosis. The virus could be isolated in tissue culture and a PCR with subsequent nucleotide sequencing identified cowpox virus as the causative agent for this generalised infection. PMID:24920091

  19. Radiological manifestations of pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Pulmonary tuberculosis (TB) is a common worldwide lung infection. The radiological features show considerable variation, but in most cases they are characteristic enough to suggest the diagnosis. Classically, tuberculosis is divided into primary, common in childhood, and postprimary, usually presenting in adults. The most characteristic radiological feature in primary tuberculosis is lymphadenopathy. On enhanced CT, hilar and mediastinal nodes with a central hypodense area suggest the diagnosis. Cavitation is the hallmark of postprimary tuberculosis and appears in around half of patients. Patchy, poorly defined consolidation in the apical and posterior segments of the upper lobes, and in the superior segment of the lower lobe is also commonly observed. Several complications are associated with tuberculous infection, such as hematogenous dissemination (miliary tuberculosis) or extension to the pleura, resulting in pleural effusion. Late complications of tuberculosis comprise a heterogeneous group of processes including tuberculoma, bronchial stenosis bronchiectasis, broncholithiasis, aspergilloma, bronchoesophageal fistula and fibrosing mediastinitis. Radiology provides essential information for the management and follow up of these patients and is extremely valuable for monitoring complications

  20. [The specific features of the detection, clinical manifestations, and treatment of tuberculosis in the HIV-infected].

    Science.gov (United States)

    Erokhin, V V; Kornilova, Z Kh; Alekseeva, L P

    2005-01-01

    The present study has explored the specific features of the detection, clinical manifestations, and treatment of tuberculosis (TB) in 425 patients with TB and HIV infection. According to the time of joining the infections, the patients with TB and HIV infection are divided into 2 basic groups: 1) HIV infection is primary, TB develops at any stage of HIV infection and 2) TB is primary, HIV injections joins different forms of TB at its any stage. The social makeup of patients with TB/HIV infection is unfavorable: the unemployed, 50%; homeless persons, 26.5%; employees, 5%; workers, 9%; pensioners, 1.5%; the disabled, 5%; pupils, 3%. As compared with Group 2, Group 1 shows more employees and pupils and fewer homeless persons, which is associated with the younger age of patients in this group and their greater social security. In the pattern of clinical forms of tuberculosis in Group 1, there are prevalent forms of primary tuberculosis with lesion of intrathoracic and peripheral lymph nodes (12.8%), acutely progressive disseminated and miliary tuberculosis of the lung and extrapulmonary systems and organs (49%), among them, meningitis accounts for 4%, lesions of the liver, spleen, kidney, and other organs form 17%. In patients with tuberculosis and HIV infection, bacterial isolation has been established in 58% of cases; primary and multidrug resistances have been found in 53 and 8.9%, respectively. Multidrug resistance tends to increase: 2% in 2001, 3.4% in 2002, 4.6% in 2003, and 8.9% in 2004. Bacteria have been more frequently isolated in Group 2 than in Group 1 (81% vs 19%), which is accounted for by the magnitude of destructive changes in them in the presence of infiltrative TB and by the high incidence of fibrocavernous tuberculosis. The patients with TB/HIV infection have a concomitance of 3 infectious diseases: HIV infection, TB, and, in 74% of the patients, sexually transmitted infections (syphilis, chlamydiosis, gonorrhea) that, in accordance with Resolution No. 188 passed by the Government on April 2, 2003, are in the list of infectious diseases constitute a serious hazard to other people. The proportion of TB/HIV patients with drug abuse (65%), hepatitis B and C (47%), and nervous and mental diseases is extremely high, which makes these patients more hazardous to the healthy population. The efficiency of treatment for TB and HIV infection is satisfactory. Continuous therapy for 4 months or more provides positive clinical and X-ray changes in most patients; bacterial isolation ceases in 75%, and decay cavities close in 44% of cases. Abacillation and cavity closures have been observed in 76.3 and 38% and 47 and 14% of cases in Groups 1 and 2, respectively. Six-eight-month therapy with first-line drugs in combination with reserve ones in patients with pulmonary TB and HIV infection is well tolerated and highly effective. A decision on the duration of anti-TB treatment for the HIV infected should be taken into account the program resources and the probability of refusing long-term therapy in 50% of cases. Mortality rates in patients with TB and HIV infection are gradually on the rise and equal to 11.2% of the treated patients in 2001, 5% in 2002, 15.2% in 2003, and 19.6% in 2004. In patients with HIV/TB, the rates are higher than those in patients with TB/HIV and are 19.2 and 14.5%, respectively. Acutely progressive pulmonary TB and miliary TB of the lung and extrapulmonary organs and systems are a cause of death in most (76%) patients with TB/HIV. PMID:16318255

  1. Parameters from the community of leaf-litter frogs from Estação Ecológica Estadual Paraíso, Guapimirim, Rio de Janeiro State, southeastern Brazil

    Scientific Electronic Library Online (English)

    Carlos F.D., Rocha; Davor, Vrcibradic; Mara C., Kiefer; Carla C., Siqueira; Mauricio, Almeida-Gomes; Vitor N.T., Borges Júnior; Fábio H., Hatano; Angélica F., Fontes; Jorge A.L., Pontes; Thais, Klaion; Lívia O., Gil; Monique Van, Sluys.

    1259-12-01

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese Estudamos a comunidade de anuros de folhiço da EstaçãoEcológica Estadual Paraíso, em Guapimirim, estado do Rio de Janeiro, no sudeste do Brasil. Combinamos três métodosde amostragem (plots, transectos e armadilhas de queda) para apresentar dados sobre a composição de espécies, riqueza,abundância rel [...] ativa e densidade. A assembleia local foi composta por 14 espécies de anuros, pertencentes a nove famílias. Haddadus binotatus, espécie de desenvolvimento direto, foi a mais abundante durante o estudo. A densidade de anuros de folhiço estimada com base na amostragem por plots foi de4,3 ind/100m². Haddadus binotatus apresentou a maior densidade (1,1 ind/100m²). Os anuros foram registrados predominantemente durante a noite. Thoropa miliaris apresentou os maiores valores de CRC (39,0 ± 10,3 mm). As menores espécies foram Euparkerella brasiliensis (16,7 ± 2,2 mm) e E. cochranae (16,0 ± 2,7mm). Rhinella ornata apresentou a maior massa corporal média (12,1 ± 7,5 g) e E. cochranae (0,4 ± 0,2 g) a menor. A massa média total foi de 938,6 g/ha. Nossos resultados corroboram com a tendência de maiores densidades de anuros de folhiço na região Neotropical quando comparado com áreas Tropicais do Velho Mundo, tendendo a serem maiores na América Central do que na América do Sul. Abstract in english We studied the leaf-litter frog community of Estação Ecológica Estadual Paraíso, in Guapimirim, Rio de Janeiro State, southeastern Brazil. Herein we combined three sampling methods (large plots, visual encounter surveys and pit-fall traps) to present data on species composition, richness, relative a [...] bundance and densities. The local assemblage of frogs associated to the leaf-litter was composed by 14 species, belonging to nine families. Haddadus binotatus, a direct-developing frog, was the most abundant species in the community. The estimated density of the local leaf-litter frog assemblage based on plot sampling was 4.3 frogs/100 m². Haddadus binotatus had the highest density (1.1 ind/100 m²). Frogs were predominantly found at night. Thoropa miliaris had the largest values of SVL (39.0 ± 10.3 mm), whereas the smallest species were Euparkerella brasiliensis (16.7 ± 2.2 mm) and E. cochranae (16.0 ± 2.7 mm). Rhinella ornata had the highest mean body mass (12.1 ± 7.5 g), and E. cochranae the lowest (0.4 ± 0.2 g). The overall frog mass was 938.6 g/ha. Our data support that higher densities of leaf-litter frogs tend to occur in the Neotropical region compared to the OldWorld tropics, tending to be higher in Central America than in South America.

  2. Bacteriological analysis of induced sputum for the diagnosis of pulmonary tuberculosis in the clinical practice of a general tertiary hospital / Análise bacteriológica do escarro induzido para o diagnóstico de tuberculose pulmonar na prática clínica de um hospital geral terciário

    Scientific Electronic Library Online (English)

    Sabrina Bollmann, Garcia; Christiano, Perin; Marcel Muller da, Silveira; Gustavo, Vergani; Sérgio Saldanha, Menna-Barreto; Paulo de Tarso Roth, Dalcin.

    1092-10-01

    Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese OBJETIVO: Verificar a sensibilidade diagnóstica da análise bacteriológica do escarro induzido (EI) para o diagnóstico de tuberculose (TB) pulmonar e identificar as variáveis clínicas associadas com o diagnóstico confirmado. Além disso, avaliar o rendimento diagnóstico da broncoscopia realizada se a [...] pesquisa de BAAR for negativa no EI. MÉTODOS: Estudo transversal e retrospectivo de pacientes com suspeita de TB pulmonar ativa, encaminhados ao serviço para a indução de escarro. Foram revisados consecutivamente os registros laboratoriais de todos os pacientes submetidos à indução de escarro entre junho de 2003 e janeiro de 2006, assim como o prontuário eletrônico de cada caso. Também foram revisados os resultados bacteriológicos das amostras broncoscópicas coletadas dos pacientes cujos resultados de BAAR em EI foram negativos. RESULTADOS: Dos 417 pacientes estudados, 83 (19,9%) tiveram resultados positivos (BAAR e/ou cultura) no EI. Na análise de regressão logística, os achados radiológicos de cavitação pulmonar (OR = 3,8; IC95%: 1,9-7,6) e de infiltrado de padrão miliar (OR = 3,7; IC95%: 1,6-8,6) associaram-se mais significativamente com o diagnóstico de TB pulmonar. A broncoscopia foi realizada, após resultado de BAAR negativo no EI, em 134 pacientes e acrescentou 25 (64,1%) diagnósticos confirmados de TB pulmonar. CONCLUSÕES: Na prática clínica, a frequência de diagnósticos confirmados de TB pulmonar por EI (19,9%) foi menor do que aquela previamente relatada em ensaios controlados. Cavitação e infiltrado miliar aumentam a probabilidade diagnóstica de TB pulmonar no EI. O uso de broncoscopia quando EI é negativo para BAAR melhora significativamente a sensibilidade para o diagnóstico de TB. Abstract in english OBJECTIVE: To determine the diagnostic sensitivity of bacteriological analyses in induced sputum (IS) for the diagnosis of pulmonary tuberculosis (TB) and to identify the clinical characteristics associated with the confirmed diagnosis, as well as to determine the diagnostic yield of bronchoscopy ca [...] rried out when IS tests negative for AFB in smear microscopy. METHODS: A retrospective, cross-sectional study of patients suspected of having active pulmonary TB and referred to our clinic for sputum induction. We consecutively reviewed the laboratory data of all patients submitted to sputum induction between June of 2003 and January of 2006, as well as their electronic medical records. In addition, the results of the bacteriological analysis of bronchoscopic specimens collected from the patients whose AFB tests were negative in IS were reviewed. RESULTS: Of the 417 patients included in the study, 83 (19.9%) presented IS samples that tested positive for TB (smear microscopy or culture). In the logistic regression analysis, radiological findings of cavitation (OR = 3.8; 95% CI: 1.9-7.6) and of miliary infiltrate (OR = 3.7; 95% CI: 1.6-8.6) showed the strongest association with the diagnosis of pulmonary TB. In 134 patients, bronchoscopy was carried out after negative AFB results in IS and added 25 (64.1%) confirmed diagnoses of pulmonary TB. CONCLUSIONS: In our clinical practice, the frequency of confirmed diagnosis of pulmonary TB using IS (19.9%) was lower than that previously reported in controlled trials. Cavitation and miliary infiltrate increase the diagnostic probability of pulmonary TB using IS. The use of bronchoscopy when IS tests negative for AFB significantly increases sensitivity in the diagnosis of pulmonary TB.

  3. Tuberculose associada à AIDS: situação de região do Nordeste brasileiro Tuberculosis associated with AIDS: the position in a Northeastern region of Brazil

    Directory of Open Access Journals (Sweden)

    Ligia R. S. Kerr-Pontes

    1997-08-01

    Full Text Available OBJETIVO: Investigar os principais aspectos da co-infecção pelo HIV e o Mycobacterium tuberculosis nos pacientes adultos assistidos pelo hospital de referência para doenças infecciosas do Estado do Ceará, Brasil, responsável pela notificação de 89,3% dos casos registrados no Estado, entre 1986-92. METODOLOGIA: Foram coletados dados de prontuários de pacientes maiores de 15 anos, com diagnóstico de AIDS, atendidos em hospital de referência estadual, região Nordeste do Brasil. A análise dos dados seguem o critério do Ministério da Saúde, para definição dessa doença. RESULTADOS: A tuberculose apresentou-se em 30,6% dos pacientes estudados (151/493 e foi diagnosticada até o primeiro ano após o diagnóstico da AIDS em 76,8% dos casos. Observou-se um tendência crescente na proporção de casos de tuberculose entre pacientes com AIDS conforme decresce o nível de escolaridade (INTRODUCTION: The main aspects of the HIV and Mycobacterium tuberculosis coinfection in the adult patients attended by the main reference hospital for infectious diseases in the State of Ceará, Brazil, responsible for the notification of 89.3% of the cases registered in the state between 1986 and 1992 were investigated. METHODOLOGY: Data were collected from the case histories of patients of more than 15 years of age with a diagnosis of AIDS, attended in a state reference hospital in Northeastern Brazil. The analysis of the data obeys the criteria of the Ministry of Health for the definition of this disease. RESULTS: Tuberculosis had been present in 30.6% of the patients studied (151/493 and it was diagnosed by the first year after the AIDS diagnosis in 76.8% of the cases. The proportion of AIDS cases with tuberculosis is significantly greater (p=0,032 among men (94.7% than among women (88.3%. An increased linear trend in the proportion of cases with tuberculosis was noticed in the AIDS cases according to the decrease in level of schooling (p<0,001. The direct baciloscopy of the sputum although considered a high priority exam, was made in only 72.9% of the patients, presenting positive results in 28.3% of these. The extrapulmonary form was detected in 23.9% of the cases and, among those, the miliary form in 25% and the meningitis in 16.7%. These results differ in a significant way (p<0,001 for all from the cases with tuberculosis without HIV infection in adults registered in the state in 1992 (9.8% extrapulmonary, 7.2% miliary and 3.3% meningitis. In most cases, death occurred in the presence of tuberculosis (52.3%, and only 10.6% managed to recover from the tuberculosis. CONCLUSIONS: The premature development of tuberculosis in AIDS patients, the presence of a high percentage of extrapulmonary forms and the high lethality are indicators that the prevention and control measures of these two pathologies cannot be considered separately in this State.

  4. Fiebre, derrame pleural y lesión osteolítica en paciente con infección por VIH Fever, pleural effusion and osteolytic lesion in a patient with HIV infection

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    J.I. Aláez

    2007-08-01

    Full Text Available Presentamos el caso de una paciente de 28 años que consultó por fiebre de hasta 40,8ºC, dolor pleurítico en costado derecho y aparición de una masa dolorosa en la extremidad inferior izquierda de cuatro días de evolución. Mediante tomografía axial computerizada (TAC se objetivó la existencia de una condensación en el lóbulo medio del pulmón derecho con derrame pleural asociado y patrón miliar bilateral. El estudio ecográfico de la extremidad inferior izquierda mostró una masa de partes blandas de aspecto quístico con destrucción de la cortical del peroné y destrucción ósea. La resonancia magnética confirmó la presencia de osteomielitis en el peroné izquierdo y de un absceso de partes blandas asociado. En el material obtenido por punción del citado absceso así como en tres muestras de esputo se aisló Mycobacterium tuberculosis, estableciéndose el diagnóstico de tuberculosis diseminada con afectación pulmonar miliar, osteomielitis peronea y absceso tuberculoso de partes blandas. Se inició tratamiento antituberculoso (rifampicina, isoniacida y pirazinamida seguido, dos semanas después, de tratamiento antirretroviral (AZT, 3TC y NVP. La paciente desarrolló un cuadro de erupción cutánea generalizada que desapareció tras la sustitución de la rifampicina por etambutol. Ante la persistencia de la masa de partes blandas, tras cinco semanas de tratamiento antituberculoso se procedió al drenaje quirúrgico del absceso. La evolución posterior fue favorable, permaneciendo la paciente asintomática al mes de ser dada de alta.We present the case of a 28 year old patient who came for consultation on a fever of up to 40.8º C, pleuritic pain on the right side and the appearance of a painful mass in the lower left extremity of four days evolution. Computerised axial tomography (CAT showed the existence of a condensation in the middle lobe of the right lung with associated pleural effusion and bilateral miliary pattern. The echographic study of the lower left extremity showed a mass of soft parts with a cystic aspect with destruction of the cortical of the fibula and osseous destruction. Magnetic resonance confirmed the presence of osteomyelitis in the left fibula and of an abscess; Mycobacterium tuberculosis was also isolated in three samples of sputum that led to a diagnosis of disseminated tuberculosis with miliary lung affectation, peroneous osteomyelitis and tuberculous abscess of the soft parts. Anti-tuberculosis treatment was started (riphampicine, isoniacide and pirazinamide followed, two weeks later, with antiretroviral treatment (AZT, 3TC and NVP. The patient developed a clinical picture of generalised cutaneous eruption that disappeared following the replacement of the riphampicine by etambutol. Due to the persistence of the mass of soft parts following five weeks of anti-tuberculosis treatment, we proceeded to surgical draining of the abscess. The subsequent evolution was favourable, with the patient remaining asymptomatic one month after hospital discharge.

  5. First reported outbreak of severe spirorchiidiasis in Emys orbicularis, probably resulting from a parasite spillover event.

    Science.gov (United States)

    Iglesias, Raúl; García-Estévez, José M; Ayres, César; Acuña, Antonio; Cordero-Rivera, Adolfo

    2015-02-10

    The importance of disease-mediated invasions and the role of parasite spillover as a substantial threat to the conservation of global biodiversity are now well known. Although competition between invasive sliders Trachemys scripta elegans and indigenous European turtles has been extensively studied, the impact of this invasive species on diseases affecting native populations is poorly known. During winter 2012-2013 an unusual event was detected in a population of Emys orbicularis (Linnaeus, 1758) inhabiting a pond system in Galicia (NW Spain). Most turtles were lethargic and some had lost mobility of limbs and tail. Necropsies were performed on 11 turtles that were found dead or dying at this site. Blood flukes belonging to the species Spirorchis elegans were found inhabiting the vascular system of 3 turtles, while numerous fluke eggs were trapped in the vascular system, brain, lung, heart, liver, kidney, spleen, and/or gastrointestinal tissues of all necropsied animals. Characteristic lesions included miliary egg granulomas, which were mostly found on serosal surfaces, particularly of the small intestine, as well as endocarditis, arteritis, and thrombosis. The most probable cause of death in the 3 turtle specimens which were also examined histologically was a necrotic enteritis with secondary bacterial infection associated with a massive egg embolism. The North American origin of S. elegans, the absence of prior recorded epizootics in the outbreak area, and the habitual presence of its type host, the highly invasive red-eared slider, in this area suggest a new case of parasite spillover resulting in a severe emerging disease. PMID:25667339

  6. Scrotal inflammation: characteristic US patterns

    International Nuclear Information System (INIS)

    During the last 3 years (1987-1990) the authors have performed 562 ultrasound studies of the scrotum in patients ranging 6 months to 76 years of age. All patients were referred with a non-specific clinical suspicion of scrotal pathologies. Only 214/562 patients presenting with signs and symptoms of scrotal inflammation were considered for this study. Among this group of 214 patients, 34 cases of tubercolous epididymo-orchitis were identified. The remaining 180 patients were classified as follows: non specific inflammation 141, other non inflammatory pathology 39. In the group with findings of tubercolosis, all stages of disease were identified, including miliary forms as well as nodular forms. The patients were closely followed during medical terapy or until surgery was performed to study the course of the disease. For each form of disease specific US findings and differential diagnostic criteria were recognized and will be illustrated in this paper. All diagnosis of tubercolosis were confirmed either at surgery or on the basis of successful response to specific chemoterapy. US diagnosis based on the morphologic and echo texture criteria allowed high diagnostic accuracy: in fact in the whole group of 214 patients with inflammatory disease there were only 1 false positive and 1 false negative diagnosis with a sensitivity of 96.9%, a specificity of 89.9% and a diagnostic accuracy of 98.85%. The paper also stresses the importance of US in the short- and long-term follow- of US in the short- and long-term follow-up of the patients undergoing medical therapy

  7. Asociación entre tuberculosis infantil grave e inmunización previa con BCG en un hospital de referencia nacional, Perú 1990-2000 / Association between severe tuberculosis in children and previous BCG immunization in a national referral Hospital, Peru 1990-2000

    Scientific Electronic Library Online (English)

    Félix, Llanos-Tejada; Hernán, del Castillo.

    2012-03-01

    Full Text Available SciELO Public Health | Language: Spanish Abstract in spanish El objetivo del estudio fue determinar la asociación entre la inmunización con BCG y tuberculosis grave (TB). Se realizó un estudio retrospectivo, se incluyó fichas de pacientes atendidos en el servicio de neumología del Instituto Nacional de Salud del Niño de Perú, entre los años 1990-2000. Se revi [...] saron un total de 2106 casos de TB entre los que había 259 casos graves (TB miliar o meningoencefalitis por TB). Del total, 497 casos no tenían antecedente de inmunización con BCG; 202 tenían TB grave y 295 TB no grave (OR= 0,05; IC 95%= 0,03-0,07). En conclusión, los niños con diagnóstico de TB y que han sido inmunizados con BCG, tienen 94% menos riesgo de desarrollar TB grave, en comparación a los niños con diagnóstico no inmunizados con BCG. Abstract in english The objective of the study was to determine the association between BCG immunization and severe tuberculosis (TB). We performed a retrospective study, including medical records from patients of the pneumology department at the National Children’s Institute in Peru, between the years 1990-2000. A tot [...] al of 2106 TB cases were reviewed, from them 259 patients were severe (miliary TB or meningoencephalitic TB). From all, 497 cases did not have history of BCG vaccination, 202 had severe TB and 295 non-severe TB (OR = 0.05, 95% CI = 0.03 to 0.07). In conclusion, children diagnosed with TB and who have been immunized with BCG, has 94% lower risk of developing severe TB, compared to children with TB non-immunized with BCG.

  8. Asociación entre tuberculosis infantil grave e inmunización previa con BCG en un hospital de referencia nacional, Perú 1990-2000 / Association between severe tuberculosis in children and previous BCG immunization in a national referral Hospital, Peru 1990-2000

    Scientific Electronic Library Online (English)

    Félix, Llanos-Tejada; Hernán, del Castillo.

    2012-03-01

    Full Text Available SciELO Peru | Language: Spanish Abstract in spanish El objetivo del estudio fue determinar la asociación entre la inmunización con BCG y tuberculosis grave (TB). Se realizó un estudio retrospectivo, se incluyó fichas de pacientes atendidos en el servicio de neumología del Instituto Nacional de Salud del Niño de Perú, entre los años 1990-2000. Se revi [...] saron un total de 2106 casos de TB entre los que había 259 casos graves (TB miliar o meningoencefalitis por TB). Del total, 497 casos no tenían antecedente de inmunización con BCG; 202 tenían TB grave y 295 TB no grave (OR= 0,05; IC 95%= 0,03-0,07). En conclusión, los niños con diagnóstico de TB y que han sido inmunizados con BCG, tienen 94% menos riesgo de desarrollar TB grave, en comparación a los niños con diagnóstico no inmunizados con BCG Abstract in english The objective of the study was to determine the association between BCG immunization and severe tuberculosis (TB). We performed a retrospective study, including medical records from patients of the pneumology department at the National Children’s Institute in Peru, between the years 1990-2000. A tot [...] al of 2106 TB cases were reviewed, from them 259 patients were severe (miliary TB or meningoencephalitic TB). From all, 497 cases did not have history of BCG vaccination, 202 had severe TB and 295 non-severe TB (OR = 0.05, 95% CI = 0.03 to 0.07). In conclusion, children diagnosed with TB and who have been immunized with BCG, has 94% lower risk of developing severe TB, compared to children with TB non-immunized with BCG

  9. Diffuse lung uptake (DLU) on Ga-67 scintigraph: Clinical, radiologic and pathologic correlation

    International Nuclear Information System (INIS)

    Review, analysis and correlation (clinical, radiologic and pathologic) of 29 consecutive adults (16 drug addicts and/or homosexuals) with DLU on Ga-67 scintigraph were made. Diffuse increased uptake of at least 75% of both lungs was considered as DLU. WFOF cameras were used to obtain 24 to 96 hr. scintigraphs after IV injection of 3-5 mCi of Ga-67 citrate. In 26, tissue diagnosis established: pneumocystis carinii (PC) 15, miliary tuberculosis (TB) 3, sarcoidosis (SR) 3, drug-induced toxicity 2, and toxoplasmosis (TX), primary hyperparathyroidism and nonspecific lymphocytic pneumonia-one each. In two with breast and one with esophageal carcinomas, no lung tissue diagnosis was sought. Concurrent chest x-rays were negative in 16, but in 7/16, lung infiltrate was later documented. An average of 31 days elapsed before x-rays became positive in four with PC, 7 days in two with TB, and 22 days in one with TX. In 13, concurrent x-rays showed lung infiltrate, but in 6, only subtle, localized rather than diffuse infiltrate was noted. Fourteen of 29 had at least two Ga-67 studies. In 12 (7 PC, 2 TB, 3 SR) of 14 whose repeat studies showed significant to total disappearance of DLU, all did well clinically. In two whose initial studies were negative or equivocal, they became clinically worse when the repeat study showed DLU. In three others (2 PC, 1 TX) who died, their single studies recorded intense DLU. DLU on gallium scintigraph indicated a variety of pathology. In 55.2%, gallied a variety of pathology. In 55.2%, gallium scintigraph predated x-ray findings by a few days to weeks. In 20.3%, x-ray findings were only subtle or localized. Scintigraphic changes correlated well with the clinical courses in various diseases

  10. Síndrome de Job asociado a tuberculosis miliar

    Scientific Electronic Library Online (English)

    Ana, Gamberale; Ileana, Moreira; Bruno, Bartoletti; Víctor, Cruz; Liliana, Bezrodnik; Federico, Alberti; Liliana, Castro Zorrilla; Domingo, Palmero.

    2014-08-01

    Full Text Available El síndrome de hiper IgE también denominado síndrome de Job, es una inmunodeficiencia primaria poco frecuente, cuyo modo de herencia puede ser autosómico recesivo o dominante. Se caracteriza por altos niveles de IgE, eosinofilia, abscesos cutáneos, eccema, candidiasis mucocutánea crónica e infeccion [...] es pulmonares recidivantes que contribuyen al desarrollo de neumatoceles y bronquiectasias. El germen más frecuentemente aislado es el Staphylococcus aureus. En la actualidad, ante la mayor supervivencia de los pacientes se han comunicado infecciones oportunistas y linfomas. Existen escasas publicaciones de pacientes con enfermedad por Mycobacterium tuberculosis asociada a síndrome de hiper IgE, por lo que consideramos relevante comunicar el caso de un paciente con antecedentes de una tuberculosis pulmonar, que presentó una tuberculosis miliar con grave compromiso respiratorio, con buena respuesta al tratamiento estándar con drogas de primera línea. Abstract in english The hyper Immunoglobulin E syndrome, also known as Job´s syndrome, is a rare primary immunodeficiency, its mechanisms of inheritance maybe recessive or dominant autosomal. It is characterized by high levels of IgE, eosinophilia, skin abscesses, eczema, chronic mucocutaneous candidiasis and recurrent [...] pulmonary infections all of which contribute to the development of pneumatoceles and bronchiectasis. The most frequently isolated bacteria is Staphylococcus aureus. Currently, despite the highest survival of patients, lymphomas and other opportunistic infections have been reported. There are few reports of patients with Mycobacterium tuberculosis infection associated with hyper IgE syndrome. Therefore it is relevant that we report a case history of a patient with pulmonary tuberculosis, presenting miliary tuberculosis and severe respiratory compromise, who responded positively to standard anti-tuberculous treatment with first line drugs.

  11. Detection of Pulmonary tuberculosis: comparing MR imaging with HRCT

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    Lauria Francesco N

    2011-09-01

    Full Text Available Abstract Background Computer Tomography (CT is considered the gold standard for assessing the morphological changes of lung parenchyma. Although novel CT techniques have substantially decreased the radiation dose, radiation exposure is still high. Magnetic Resonance Imaging (MRI has been established as a radiation- free alternative to CT for several lung diseases, but its role in infectious diseases still needs to be explored further. Therefore, the purpose of our study was to compare MRI with high resolution CT (HRCT for assessing pulmonary tuberculosis. Methods 50 patients with culture-proven pulmonary tuberculosis underwent chest HRCT as the standard of reference and were evaluated by MRI within 24 h after HRCT. Altogether we performed 60 CT and MRI examinations, because 10 patients were also examined by CT and MRI at follow- up. Pulmonary abnormalities, their characteristics, location and distribution were analyzed by two readers who were blinded to the HRCT results. Results Artifacts did not interfere with the diagnostic value of MRI. Both HRCT and MRI correctly diagnosed pulmonary tuberculosis and identified pulmonary abnormalities in all patients. There were no significant differences between the two techniques in terms of identifying the location and distribution of the lung lesions, though the higher resolution of MRI did allow for better identification of parenchymal dishomogeneity, caseosis, and pleural or nodal involvement. Conclusion Technical developments and the refinement of pulse sequences have improved the quality and speed of MRI. Our data indicate that in terms of identifying lung lesions in non-AIDS patients with non- miliary pulmonary tuberculosis, MRI achieves diagnostic performances comparable to those obtained by HRCT but with better and more rapid identification of pulmonary tissue abnormalities due to the excellent contrast resolution.

  12. Prevalence of a septicemia disease in the crested ibis (Nipponia nippon) in China.

    Science.gov (United States)

    Xi, Yongmei; Wood, Chris; Lu, Baozhong; Zhang, Yueming

    2007-06-01

    This study investigated six cases of septicemia in young crested ibises (Nipponia nippon). These birds all died with similar clinical signs, including sudden death, anorexia, diarrhea, and lameness. Immediately after death, the birds were necropsied; a blood sample was taken from heart and tissues were sampled from liver, lung, spleen, peritoneal mucus, and feces for bacteriologic examination. Anatomic observation showed that the main findings common to the sick birds were arthrocele, associated with congestion in the femur, tibiotarsus, and ventral side; swelling in the liver; hemorrhagic pericarditis; miliary tubercles in lung; and fibrous tubercles in the synovial capsule of the knee joint with suppurative abscesses. Through bacterial examination, the colonial type of Escherichia coli strain was represented prominently in cultures of the feces, heart blood, liver, lung, spleen, suppurative mucus of the synovial capsule, and peritoneal exudate. These symptoms suggested that the death of a number of endangered crested ibis within a short period was evidence of septicemia. The bacterial inoculation tests were also conducted using domestic pigeon, native chicken, and mice for the presence of and infection with E coli. The study provided indications of the possible role of E. coli strains as bird pathogens and a potential risk in endangered species. Further work is needed to characterize E. coli strains and the toxin production in this bird. This disease occurrence also adds a note of caution to the continued efforts and interest in the reintroduction of the ibis back into its former wild ranges to ensure that formerly captive individuals do not transmit disease to the wild populations of its own or other sympatric species. PMID:17626495

  13. Extrapulmonary tuberculosis in Peninsular Malaysia: retrospective study of 195 cases.

    Science.gov (United States)

    Nissapatorn, V; Kuppusamy, I; Rohela, M; Anuar, A Khairul; Fong, M Y

    2004-01-01

    During a 2-year retrospective study, 195 non-HIV-infected patients with extrapulmonary tuberculosis (EPT) were diagnosed at the National Tuberculosis Center, Kuala Lumpur, representing 10% of all patients with tuberculosis. Their mean age was 39 (+/- SD) 14 years old (range 14-81). The largest age group was 25-34 years, while 78.5% were less than 50 years of age. The subjects were mainly female (50.3%), Malay (49.2%), married (61.5%), resided in Kuala Lumpur (51.0%), and were unemployed (50.3%). Regarding risk factors, they were smokers and/or alcohol users (21.0%), and injecting drug users (IDUs) (5.1%); they also had history of tuberculosis (3.6%) and contact with TB patients (9.2%). Lymphadenopathy was the most common sign (45.6%) shown in the medical records. 42% of x-ray findings (chest, spine, and hip) showed signs consistent with tuberculosis, while histopathology was the most useful diagnostic tool (52.3%) and lymph node was the most frequent specimen used (35.0%) in this study. The three main sites of involvement were lymph nodes (42.6%), miliary and disseminated (19.5%), and pleura (12.8%). The outcome of this study showed 72.8% of these patients had completed treatment for at least 6 months, whilst, only 4.6% of patients were still undergoing treatment, and unfortunately, 22.6% of them showed non-adherence to anti-tubercular therapy at a duration of less than 6 months. However, no MDR-TB or death cases were reported or registered in this study. PMID:15906632

  14. Distribution and contrast enhanced CT appearance of abdominal tuberculous lymphadenopathy

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    Yang, Zhigang; Sone, Shusuke; Li, Feng; Maruyama, Yuichiro; Watanabe, Tomofumi; Yamaguchi, Yuko [Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine; Min, Pengqiu

    1997-08-01

    To clarify the contrast enhanced CT features and anatomic distribution of the disseminated vs non-disseminated tuberculosis (TB) involving abdominal lymph nodes. The contrast enhanced CT findings of abdominal lymphadenopathy in 25 patients, including disseminated TB associated with miliary TB of the lung (n=5) and non-disseminated TB (n=20), were retrospectively evaluated in a blind review to assess our criteria of morphology, density and location of the involved lymphadenopathy. The enhancement patterns of disseminated TB were not different from those of non-disseminated TB. Ninety-six percent of the patients had peripheral rim enhancement, and 60% showed a multilocular appearance. The enlarged lymph nodes of TB were less than 4 cm in diameter. Lymphadenopathy caused by hematogenous dissemination often accompanied splenic involvement showing multiple low-density foci in the spleen. The predominant sites of lymphadenopathy of disseminated TB were hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric, and both upper and lower portions of the retroperitoneal lymph nodes, whereas non-disseminated TB mainly involved hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric and upper retroperitoneal lymph nodes, excluding the lower retroperitoneal lymph nodes. By combining contrast enhancement patterns and the anatomic distribution of lymphadenopathy shown on the contrast enhanced CT images, reviewers made a correct diagnosis of tuberculosis in 94%, of cases, with a specificity of 95% and sensitivity of 92%. Contrast enhanced CT patterns correlate well with the pathologic features of tuberculous lymphadenopathy. A different anatomic distribution between disseminated and non-disseminated TB involving the lower retroperitoneal lymph nodes was recognized in this study. (author)

  15. Distribution and contrast enhanced CT appearance of abdominal tuberculous lymphadenopathy

    International Nuclear Information System (INIS)

    To clarify the contrast enhanced CT features and anatomic distribution of the disseminated vs non-disseminated tuberculosis (TB) involving abdominal lymph nodes. The contrast enhanced CT findings of abdominal lymphadenopathy in 25 patients, including disseminated TB associated with miliary TB of the lung (n=5) and non-disseminated TB (n=20), were retrospectively evaluated in a blind review to assess our criteria of morphology, density and location of the involved lymphadenopathy. The enhancement patterns of disseminated TB were not different from those of non-disseminated TB. Ninety-six percent of the patients had peripheral rim enhancement, and 60% showed a multilocular appearance. The enlarged lymph nodes of TB were less than 4 cm in diameter. Lymphadenopathy caused by hematogenous dissemination often accompanied splenic involvement showing multiple low-density foci in the spleen. The predominant sites of lymphadenopathy of disseminated TB were hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric, and both upper and lower portions of the retroperitoneal lymph nodes, whereas non-disseminated TB mainly involved hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric and upper retroperitoneal lymph nodes, excluding the lower retroperitoneal lymph nodes. By combining contrast enhancement patterns and the anatomic distribution of lymphadenopathy shown on the contrast enhanced CT images, reviewers made a correct diagnosis of tuberculosis in 94%, of rect diagnosis of tuberculosis in 94%, of cases, with a specificity of 95% and sensitivity of 92%. Contrast enhanced CT patterns correlate well with the pathologic features of tuberculous lymphadenopathy. A different anatomic distribution between disseminated and non-disseminated TB involving the lower retroperitoneal lymph nodes was recognized in this study. (author)

  16. Clinical analysis of 68 patients with pulmonary mycosis in China

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    Luo Bai-ling

    2011-10-01

    Full Text Available Abstract Background Due to the lack of specific clinical manifestations and imaging features, the diagnosis of pulmonary mycosis is difficult. This study aimed to investigate the pathogens, clinical manifestations, imaging features, diagnosis and management of pulmonary mycosis. Methods Data on 68 patients diagnosed as pulmonary mycosis in Xiang Ya hospital from January 2001 to December 2010 were collected and their clinical manifestations, radiographic characterization, diagnostic methods and management were analyzed. Results All patients were diagnosed by pathological examination. Of the 68 cases, 38 (55.9% had pulmonary aspergillosis and 19 (27.9% pulmonary cryptococcosis. Open-lung surgery was performed in 38 patients (55.9%, transbronchial biopsy in 15 (22.0%, and computerized tomography (CT guided percutaneous needle biopsy in 11 (16.2%. Main symptoms were as follows: cough in 51 cases (75.0%, expectoration in 38 (55.9%, hemoptysis in 25 (37.8%, fever in 20 (29.4%, while 6 cases (11.1% were asymptomatic. X-ray and chest CT showed masses or nodular lesions in 52 cases (76.5%, patchy lesions in 10 (14.7%, cavity formation in 15 (22.0%, and diffuse miliary nodules in 1 case. In 51 cases (75.0% misdiagnosis before pathological examination occurred. Surgical resection was performed in 38 patients (55.9%. In 25 patients (36.7% systemic antifungal therapy was administered, and 20 patients (29.4% experienced complete responses or partial responses. Conclusion The main pathogens of pulmonary mycosis are Aspergillus, followed by cryptococcosis. Final diagnosis of pulmonary mycosis mainly depends on pathological examination. The clinical manifestations, imaging features, diagnostic methods and management differ depending on the pathogens. Satisfactory therapy can be obtained by both antifungal and surgical treatment.

  17. Cinco diferentes tipos de imágenes gammagráficas tiroideas en pacientes con enfermedad de graves tratados con 131I en el Paraguay.

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    Jara Yorg J.A.

    2006-10-01

    Full Text Available Thyroid disease is frequent in Paraguay, a country with a prevalence of goiter 48,6% in general population located in the center of South America.Grave’s disease constitutes the most common thyroid hyperfunction observed whose treatment can be carried out with medication (propiltiouracil, metimazol, etc., surgery or iodine 131(131IWe analyzed 70 patients this type of hyperthyroidism treated with the 131I, in its clinical aspect pre and post treatment, ultrasound and nuclear scan findings of the gland thyroid, the hormonal respond Ft4, T3, TSH, thyroid antibodies TPOab, TGab, TRab.Besides the diffuse classic image observed in the thyroid scan and by ultrasonography of the gland, in Grave’s disease, 4 types of images were identified with nodules (multinodular, hot nodule, cold nodule and miliar. The group with diffuse increase in size form was the most numerous (50% continued by the variety multinodular (30%, Marin-Lenhart’s Sx (hot nodule 14%, miliary 3%, and cold nodule 3%.Three months after the treatment with the radioiodine was observed the decrease of the size and thyroid volume in 68% of the patients, thyroid uptake with 131I diminished in 75%. All patients had an increase of weight of 20% and 87% of then were feminineThe signs and symptoms were normalized in 88,5% of the patients. The levels of FT4 were normalized in 73, 8%, T3 in 66%, TSH in 47,7%, TPOab in 83%, TGab in 90%, and TRab in 84%.A received a single dose of 131I was used it in 93% of the patient The cost of the 131I in the Clinic Hospital was half of the cost of the surgery, and at private level the fourth part but cheap.

  18. Radiographic findings of pulmonary tuberculosis in non-AIDS immunocompromised adult patients: comparison with immunocompetent adult patients

    International Nuclear Information System (INIS)

    To compare chest radiographic findings of pulmonary tuberculosis in non-AIDS immunocompromised adult patients with those in immunocompetent patients. Eighty six patients who had pulmonary tuberculosis were included in the study. Of these, 41 were non-AIDS immunocompromised adult patients and 45 were immunocompetent adult patients. Chest radiographs obtained from 86 patients were retrospectively evaluated with regard to the followings; the anatomic distribution and extent of tuberculous lesions, typical or atypical patterns of radiographic findings. We then compared the results in non-AIDS immunocompromised adult patients with those in immunocompetent adult patients. The characteristic manifestation of pulmonary tuberculosis was a tendency of pulmonary lesions to localize in the apico-posterior segments of the upper lobe and the superior segment of the lower lobe in both groups but more wide distribution such as the anterior segment and the lingular segment of the upper lobe and the basal segments of the lower lobe was frequently identified in non-AIDS immunocompromised adult patients, and also bilateral, multi segmental and multi lobular extents were common findings. In immunocompetent adult patients, more common findings were in local exudative and productive lesions and several cavities in preferential sites. Atypical plain radiographic findings were more common in non-AIDS immunocompromised adult patients, and which were multiple cavitary lesions, wide extent of brltiple cavitary lesions, wide extent of bronchogenic spread and tuberculous pneumonia, and miliary disseminations and mass like lesions. Pulmonary tuberculosis in non-AIDS immunocompromised adult patients is characterized by frequent bilateral distribution, wide pulmonary extent, and atypical radiographic findings

  19. Vacina BCG contra tuberculose: efeito protetor e políticas de vacinação BCG vaccine against tuberculosis: its protective effect and vaccination policies

    Directory of Open Access Journals (Sweden)

    Susan M Pereira

    2007-09-01

    Full Text Available OBJETIVO: A vacina BCG é utilizada desde 1921, embora ainda apresente controvérsias e aspectos não esclarecidos. O objetivo do artigo foi analisar aspectos relacionados ao efeito protetor da primeira e segunda doses da vacina BCG e as políticas de vacinação adotadas. MÉTODOS: Foi realizada revisão sistemática da literatura publicada em inglês e espanhol, abrangendo o período compreendido entre 1948 e 2006, na base PubMed. Os principais descritores utilizados foram BCG vaccine, BCG efficacy, BCG e tuberculosis. Os estudos foram agrupados por tipo de desenho, apresentando-se separadamente os principais resultados de ensaios clínicos, estudos de caso-controle e metanálises. RESULTADOS: O efeito protetor da primeira dose da vacina BCG contra a tuberculose na forma miliar ou na meningite é elevado. No entanto, os resultados são discordantes em relação à forma pulmonar, variando de ausência de efeito a níveis próximos a 80%. Estão sendo conduzidas pesquisas sobre novas vacinas candidatas a substituir a BCG ou serem utilizadas como reforço. CONCLUSÕES: Há evidências de que a segunda dose da BCG não aumenta o seu efeito protetor. Apesar de seus limites e da expectativa futura de nova vacina para tuberculose, a vacina BCG mantém-se como importante instrumento no controle dos efeitos danosos da doença, sobretudo em países com taxas de incidência médias e elevadas.OBJECTIVE: The BCG vaccine has been in use since 1921, but still arouses controversy and uncertainties. The objective was to analyze the protective effect of the BCG vaccine in its first and second doses and the accompanying vaccination policies. METHODS: A systematic review of the literature in both English and Spanish was carried out, covering the period 1948 to 2006, using the PubMed database. The main search terms used included BCG vaccine, BCG efficacy, BCG and tuberculosis. The studies were grouped by design, with the main results from the clinic tests, case-control studies and meta-analyses presented separately. RESULTS: The protective effect of the first dose of the BCG vaccine against tuberculosis in its miliary and meningeal forms is high. However, the results vary in relation to the pulmonary form of the disease, with some indicating zero effect and others levels of nearly 80%. Research is being carried out to develop new vaccines that could substitute the BCG or be used as a booster. CONCLUSIONS: There are evidences that the protective effect of the BCG vaccine does not increase with a second dose. In spite of its limitations and the expectation that a new tuberculosis vaccine will be developed in the future, the BCG vaccine remains an important tool in controlling the harmful effects of tuberculosis, particularly in countries with medium or high incidence levels of the disease.

  20. Bacillus Calmette-Guérin (BCG) infection following intravesical BCG administration as adjunctive therapy for bladder cancer: incidence, risk factors, and outcome in a single-institution series and review of the literature.

    Science.gov (United States)

    Pérez-Jacoiste Asín, María Asunción; Fernández-Ruiz, Mario; López-Medrano, Francisco; Lumbreras, Carlos; Tejido, Angel; San Juan, Rafael; Arrebola-Pajares, Ana; Lizasoain, Manuel; Prieto, Santiago; Aguado, José María

    2014-10-01

    Bacillus Calmette-Guérin (BCG) is the most effective intravesical immunotherapy for superficial bladder cancer. Although generally well tolerated, BCG-related infectious complications may occur following instillation. Much of the current knowledge about this complication comes from single case reports, with heterogeneous diagnostic and therapeutic approaches and no investigation on risk factors for its occurrence. We retrospectively analyzed 256 patients treated with intravesical BCG in our institution during a 6-year period, with a minimum follow-up of 6 months after the last instillation. We also conducted a comprehensive review and pooled analysis of additional cases reported in the literature since 1975. Eleven patients (4.3%) developed systemic BCG infection in our institution, with miliary tuberculosis as the most common form (6 cases). A 3-drug antituberculosis regimen was initiated in all but 1 patient, with a favorable outcome in 9/10 cases. There were no significant differences in the mean number of transurethral resections prior to the first instillation, the time interval between both procedures, the overall mean number of instillations, or the presence of underlying immunosuppression between patients with or without BCG infection. We included 282 patients in the pooled analysis (271 from the literature and 11 from our institution). Disseminated (34.4%), genitourinary (23.4%), and osteomuscular (19.9%) infections were the most common presentations of disease. Specimens for microbiologic diagnosis were obtained in 87.2% of cases, and the diagnostic performances for acid-fast staining, conventional culture, and polymerase chain reaction (PCR)-based assays were 25.3%, 40.9%, and 41.8%, respectively. Most patients (82.5%) received antituberculosis therapy for a median of 6.0 (interquartile range: 4.0-9.0) months. Patients with disseminated infection more commonly received antituberculosis therapy and adjuvant corticosteroids, whereas those with reactive arthritis were frequently treated only with nonsteroidal antiinflammatory drugs (p < 0.001 for all comparisons). Attributable mortality was higher for patients aged ?65 years (7.4% vs 2.1%; p = 0.091) and those with disseminated infection (9.9% vs 3.0%; p = 0.040) and vascular involvement (16.7% vs 4.6%; p = 0.064). The scheduled BCG regimen was resumed in only 2 of 36 patients with available data (5.6%), with an uneventful outcome. In the absence of an apparent predictor of the development of disseminated BCG infection after intravesical therapy, and considering the protean variety of clinical manifestations, it is essential to keep a high index of suspicion to initiate adequate therapy promptly and to evaluate carefully the risk-benefit balance of resuming intravesical BCG immunotherapy. PMID:25398060

  1. Following-up the efficiency of 131-Iodine therapy in differentiated thyroid carcinoma (excluding medullary) - Moroccan situation

    International Nuclear Information System (INIS)

    Full text: Since 1985, the department of nuclear medicine of IBN SINA Hospital in the Rabat University hospital centre is the only centre in Morocco, where all patients of differentiated thyroid carcinoma after surgery are treated with 3.7 GBq of Iodine-131. The number of patients on follow-up is more than two thousands. The endemic zone represents the main origin of thyroid carcinoma. The sex ratio (F/M) is 3.5/1; the mean age is 42.5 years. The papillary carcinoma constitutes about 65.5% of the 26% of well-differentiated carcinoma and 12.5 of moderately differentiated carcinoma (MDC). The tumour size at diagnosis was more than 2 cm in 70% of cases. Prognosis factors are the age, the histology and tumour size. After the surgery, the patients receive 131-Iodine therapy (3.7 GBq) and a regular follow-up by clinical examination, neck ultrasonography and thyroglobulin (Tg) blood level. The aim is to obtain a negative whole body scan (WBS) and undetectable Tg. All the patients also receive a suppressive hormone therapy (thyroxin: 2.4 ?g/kg/day). In the same patient, the Tg level is also compared with and without suppression therapy, but taking TSH levels into account. The efficiency of 131-Iodine treatment and the following up, depends on the type of patients: (a) Patients without metastasis: the success of Iodine-131 therapy depended on surgery and it was more than 92% (b) Patients with local metastasis to lymph nodes: the success of 131-Iodine therapy depended of nodals of 131-Iodine therapy depended of nodal status and complete dissection is possible in 70% cases only. (c) Patients with distant metastasis: The efficiency of 131-Iodine therapy depended on the uptake, the homogeneity and the size of metastasis. In lung metastasis, the efficiency of 131-Iodine is about 40-42% (70%: miliary and micro nodules) and only 6.6% in bone metastasis. After treatment, the patients were regularly followed-up clinically till the next WBS and Tg estimation. In some cases, it was interesting to compare WBS and MIBI scintigraphy where the Tg levels were high but no iodine uptake. In Morocco, we have only one university centre with two special rooms of iodine therapy and when Iodine-131 therapy is recommended to a patient, he is to wait for one to two years to receive the same. To optimise the efficiency of Iodine-131 therapy, we must increase the number of centres in our country. (author)

  2. Adiaspiromicose humana. Relato de um caso tratado com cetoconazol

    Directory of Open Access Journals (Sweden)

    Ricardo Luiz M. Martins

    1997-12-01

    Full Text Available É descrito um caso de adiaspiromicose humana, da forma pulmonar disseminada, no qual se empregou o cetoconazol. O paciente, oriundo de Goianésia, GO, referia tosse produtiva, dispnéia e emagrecimento. Doente há dois meses, já fizera uso do esquema tríplice tuberculostático, devido a um radiograma do tórax ter acusado lesões sugestivas de tuberculose miliar. Esse tratamento não surtiu o efeito esperado, pelo que foi ele submetido a uma biópsia pulmonar a céu aberto. A medida permitiu o reconhecimento da natureza fúngica da doença. Passou-se, então, ao emprego do cetoconazol, quando o processo já completara três meses de evolução. Dois meses depois, foi o paciente novamente visto, para controle do tratamento: todas as manifestações respiratórias haviam cessado e um novo radiograma mostrou regressão completa das alterações pulmonares. Apesar disso, é discutida a eficácia do cetoconazol contra C. parvum var crescens, tendo-se em conta o fato de o microrganismo não se reproduzir no hospedeiro.A case of human disseminated pulmonary adiaspiromycosis is reported. The patient, from Goianesia, GO, was admitted to the Brasilia University Hospital, in November 1992, with wet cough, dyspnea and weight loss3/4manifestations that had appeared two months before. Prior to admission, he had been treated for a suspected miliary tuberculosis, because a chest roentgenogram had shown a diffuse reticulonodular infiltrate in both lungs. This therapy brought no improvement to the patient status. An open chest biopsy was then performed, and the microscopic examination of the lung tissue revealed the fungal nature of the disease. Ketoconazole, 400mg/day, was started and the patient discharged from the hospital. He was seen again two months later: the respiratory manifestations had disappeared and a new chest roentgenogram showed complete resolution of the pulmonary lesions. The usefulness of ketoconazole is, however, questioned, since, as there is no multiplication of the fungus in the host organism3/4adiaspiromycosis. is believed to be, usually, a self-healing disease -, the efficacy of this imidazole derivative against the agent in animal tissues remains to be confirmed.

  3. Adiaspiromicose humana. Relato de um caso tratado com cetoconazol

    Scientific Electronic Library Online (English)

    Ricardo Luiz M., Martins; Clarice G. F., Santos; Filomena Rita F.C., França; Mário A.P., Moraes.

    1997-12-01

    Full Text Available É descrito um caso de adiaspiromicose humana, da forma pulmonar disseminada, no qual se empregou o cetoconazol. O paciente, oriundo de Goianésia, GO, referia tosse produtiva, dispnéia e emagrecimento. Doente há dois meses, já fizera uso do esquema tríplice tuberculostático, devido a um radiograma do [...] tórax ter acusado lesões sugestivas de tuberculose miliar. Esse tratamento não surtiu o efeito esperado, pelo que foi ele submetido a uma biópsia pulmonar a céu aberto. A medida permitiu o reconhecimento da natureza fúngica da doença. Passou-se, então, ao emprego do cetoconazol, quando o processo já completara três meses de evolução. Dois meses depois, foi o paciente novamente visto, para controle do tratamento: todas as manifestações respiratórias haviam cessado e um novo radiograma mostrou regressão completa das alterações pulmonares. Apesar disso, é discutida a eficácia do cetoconazol contra C. parvum var crescens, tendo-se em conta o fato de o microrganismo não se reproduzir no hospedeiro. Abstract in english A case of human disseminated pulmonary adiaspiromycosis is reported. The patient, from Goianesia, GO, was admitted to the Brasilia University Hospital, in November 1992, with wet cough, dyspnea and weight loss3/4manifestations that had appeared two months before. Prior to admission, he had been trea [...] ted for a suspected miliary tuberculosis, because a chest roentgenogram had shown a diffuse reticulonodular infiltrate in both lungs. This therapy brought no improvement to the patient status. An open chest biopsy was then performed, and the microscopic examination of the lung tissue revealed the fungal nature of the disease. Ketoconazole, 400mg/day, was started and the patient discharged from the hospital. He was seen again two months later: the respiratory manifestations had disappeared and a new chest roentgenogram showed complete resolution of the pulmonary lesions. The usefulness of ketoconazole is, however, questioned, since, as there is no multiplication of the fungus in the host organism3/4adiaspiromycosis. is believed to be, usually, a self-healing disease -, the efficacy of this imidazole derivative against the agent in animal tissues remains to be confirmed.

  4. Clinical manifestation of HIV/AIDS patients: differences between public and private hospitals in Jakarta

    Directory of Open Access Journals (Sweden)

    Herdiman T. Pohan

    2004-11-01

    Full Text Available The aims of this study is to determine the demographic data, risk factors, clinical presentations, opportunistic/co-infections and its difference between public and private hospitals. A retrospective -descriptive study was conducted in Dr. Cipto Mangunkusumo National General Hospital (public hospital and Medistra Hospital (private hospital, Jakarta. The inclusion criteria were new HIV/AIDS cases admitted in year 2002-2003 and positive HIV serology (Elisa method. Secondary data were collected form medical record. Sixty-six subjects were enrolled in this study (public hospital 30 subjects and private hospital 36 subjects, consist of 59 male (89.4% and 7 female (10.6%. Thirty-seven percent subjects were defined as HIV and 62% AIDS. Risk factors obtained include drug user (59.1%, homosexual (13.6%, heterosexual (21.1%, transfusion (1.5% and maternal-child (perinatal (1.5%. The clinical symptoms mainly present as acute fever (56.2%, weight loss (39.4%, cough (38.8%, shortness of breath (27.2%, chronic diarrhea (22.8%, prolong fever (19.7%, loss of conciousness (15.3%, anorexia (15.3%. Significant differences between public and private hospitals were seen in fever and cough symptoms. Clinical presentation of HIV/AIDS patients during admission were : pneumonia (56%, oral trush (22.6%, anemia (56.5%, leucopenia (32.3%, lymphopenia (55.9%, elevated AST/ALT (66.1%, hypoalbuminemia (46.9%, limphadenopathy (10.6%, brain space occuping lesion (7.6%, encephalopathy (6.0%, pulmonary tb and pleural effusion (10.6%. The opportunistic and co-infections present were candidiasis (25.8%, chronic hepatitis C (24.2%, chronic hepatitis B and C (4.5%, pulmonary tb, lymphadenitis and miliary tb. Candidiasis and pulmonary tb were frequently found in public hospital. In conclusion from this study that clinical manifestation of HIV/AIDS were young man or woman, with one or more possible risk factor, had fever, respiratory complain, loss of body weight, chronic diarrhea, fatique, oral trush, anemia, leucopenia, lymphopenia. Patients admitted in private hospital had varied complain; and patients that admitted in public hospital had more severe and advance condition. (Med J Indones 2004; 13: 232-6Keywords: HIV, AIDS, Clinical Manifestation

  5. Prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis / Fatores prognósticos de letalidade da neurotuberculose em crianças HIV-negativas

    Scientific Electronic Library Online (English)

    Murilo Gimenes, Rodrigues; Jaime, Lin; Marcelo Rodrigues, Masruha; Luiz Celso Pereira, Vilanova; Thais Soares Cianciarullo, Minett.

    2010-10-01

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Identificar elementos prognósticos para a letalidade da neurotuberculose na criança, a partir das manifestações clínicas, dados epidemiológicos e laboratoriais. MÉTODO: Registros de pacientes internados durante o período de 1982 a 2005 foram retrospectivamente avaliados. Os elementos progn [...] ósticos considerados foram: sexo, idade, história de contato íntimo com indivíduo com tuberculose, vacinação com o bacilo de Calmette-Guérin (BCG), teste tuberculínico (PPD), concomitância de tuberculose miliar, convulsões, resultados da análise do LCR e presença de hidrocefalia. RESULTADOS: 141 pacientes com diagnóstico de neurotuberculose foram incluídos. Dezessete por cento dos pacientes foram a óbito. Os fatores associados ao óbito foram história negativa de contágio, ausência de reatividade ao teste de PPD, coma e tempo de internação prolongado. Análise por regressão logística múltipla foi usada para investigar as relações entre os elementos prognósticos e o desfecho óbito. CONCLUSÃO: Os fatores prognósticos na previsão de óbito nos pacientes com neurotuberculose foram a presença de coma no momento do diagnóstico, a ausência de história de contágio e a ausência de reação ao PPD Abstract in english OBJECTIVE: To identify prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis based on clinical, epidemiological, and laboratory findings. METHOD: The clinical records of all in-patients diagnosed with neurotuberculosis from 1982 to 2005 were evaluated retrospe [...] ctively. The following prognostic parameters were examined: gender, age, close contact with a tuberculosis-infected individual, vaccination for bacillus Calmette-Guérin, purified protein derivative (PPD) of tuberculin results, concomitant miliary tuberculosis, seizures, CSF results, and hydrocephalus. RESULTS: One hundred forty-one patients diagnosed with neurotuberculosis were included. Seventeen percent of the cases resulted in death. The factors that were correlated with a negative outcome included lack of contact with a tuberculosis-infected individual, negative PPD reaction, coma, and longer hospitalisation time. A multiple logistic regression analysis was performed to identify which of these factors most often resulted in death. CONCLUSION: Coma at diagnosis, lack of tuberculosis contact, and a non-reactive PPD were the most important predictors of fatality in patients with neurotuberculosis

  6. Postmortem Investigations Following Human Immunodeficiency Virus Infection

    Directory of Open Access Journals (Sweden)

    Andrey V. Bychkov

    2009-04-01

    Full Text Available Background: HIV/AIDS is a global disease and despite intensive research it is one of the main causes of human death. Postmortem studies have proven accurate in determining the various pathologies in these patients. Aims & Objectives: Our aim was to analyze the post mortem results of individuals who died after HIV infection in the same geographical region. We evaluated the most frequent opportunistic diseases and their clinical and morphological outcomes. Methods: We studied case reports and autopsy research data from 32 patients who died after HIV infection in Smolensk, Russian Federation, between 2003 and 2008. All patients had been diagnosed with HIV infection before death, using HIV-specific enzyme linked immunosorbent assay (ELISA and immunoblotting. Autopsy specimens of various organs were examined histologically and microbiologically. Findings: The mean survival period from the moment of detection of seropositivity in all the patients was less than five years. Twelve patients had a parenteral mode of contact, six had been infected by sexual contact, and 14 patients had unknown modes of infection. Most patients (69% had chronic hepatitis C. The main causes of death were various infectious diseases. The most common were generalized miliary tuberculosis and progressive secondary tuberculosis of the lungs. Three (9% patients had tuberculosis of the meninges and five (16% had peritoneal infections, but tuberculous peritonitis had not been diagnosed before death. Six patients had pulmonary tuberculosis and bacterial pneumonia simultaneously. Two (6% patients died from bacterial sepsis as a result of cervical lymphadenitis, and eight (12.5% from abscess-forming pneumonia. The opportunistic infections revealed were Pneumocystis carinii pneumonia (eight patients, cytomegaloviral pneumonia (three, bronchopulmonary aspergillosis (one and mucosal candidiasis (three. In three patients, the causes of death were advanced neoplastic processes: two cases of leukemia and one case of cervical cancer. Conclusions: Tuberculosis was the most widespread among the opportunistic infections, which often had affected the entire lung and had a destructive form. In the morphological picture of tuberculous inflammation, alterative and exudative changes dominated. Moreover, HIV infection had a characteristically broad spectrum of causative agents of pneumonia, including bacteria, viruses, fungi, and protozoa.

  7. Disseminated tuberculosis in a pregnant woman presenting with numerous brain tuberculomas: case report / Tuberculose disseminada em uma paciente grávida apresentando múltiplos tuberculomas cerebrais: relato de caso

    Scientific Electronic Library Online (English)

    Emerson L., Gasparetto; Priscilla, Tazoniero; Arnolfo de, Carvalho Neto.

    2003-09-01

    Full Text Available SciELO Brazil | Language: English Abstract in portuguese A tuberculose é doença infecciosa causada pelo Mycobacterium tuberculosis e tem na forma pulmonar a sua apresentação mais comum. A disseminação da doença é comum em pacientes imunodeprimidos. Entretanto, imunodeficiência relacionada à gravidez suficientemente severa para causar disseminação da micob [...] actéria é rara. Quando a disseminação ocorre, qualquer órgão pode ser afetado e, quando ela se faz para o sistema nervoso central, apresenta-se mais comumente como meningite ou tuberculoma único. Relatamos o caso de uma paciente de 17 anos na 34ª semana de gestação com sintomas pulmonares e hipertensão intracraniana. No dia anterior ao internamento a paciente apresentou episódio súbito de paraparesia e retenção urinária. A paciente evoluiu para parto normal e dez horas após apresentou paraplegia. A radiografia simples e a tomografia de tórax foram compatíveis com tuderculose miliar. A tomografia de crânio mostrou múltiplas lesões hipodensas arredondadas nos hemisférios cerebrais e cerebelares, as quais apresentaram realce anelar após injeção de contraste. A paciente foi submetida à craniotomia com biópsia de uma das lesões, que confirmou o diagnóstico de tuberculoma. Iniciou-se tratamento com regime tríplice e a tomografia de crânio realizada um ano após o diagnóstico foi normal. Abstract in english Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which has the pulmonary form as the most common presentation. Dissemination of the disease is common in immunocompromised patients, but immunodeficiency related to pregnancy severe enough to cause dissemination of the Mycoba [...] cteria is exceedingly rare. When dissemination occurs, any organ may be affected and in central nervous system, the infection presents as meningitis and single brain parenchyma tuberculomas. We report the case of a 17 year-old woman at the 34th week of pregnancy with respiratory and high intracranial pressure symptoms. On the day before admission she had a sudden onset of paraparesis and urinary retention and ten hours after the delivery she presented with paraplegia . The chest X-ray and CT scan were compatible with miliary tuberculosis. The cranial CT scan revealed numerous rounded hypodense lesions located at cerebral and cerebellar hemispheres, which presented ring-like enhancement after contrast injection. The patient underwent a craniotomy with biopsy of the lesions confirming the diagnosis of brain tuberculomas. The three-drug regimen was started and the cranial CT scan performed a year after diagnosis showed no brain lesions. We emphasize the aggressive dissemination of the disease in this case associated with pregnancy and the importance of early diagnosis and institution of therapy resulting in regression of the lesions.

  8. Radiographic findings in adult pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Kang, T. W.; Youn, Y. S.; Won, J. J [Mediacal School, Jeonbug National University, Jeonju (Korea, Republic of)

    1981-12-15

    During the period from March, 1980 to February, 1981 in the Department of Radiology, Jeonbug National University Hospital, we reviewed the radiologic findings of 879 cases newly diagnosed pulmonary tuberculosis and 56 cases diagnosed tuberculous pleural effusion without lung parenchymal lesion on initial chest P-A film in the adult (older than 16 years). The results were as follows. 1. Sex distribution of pulmonary tuberculosis was 668 cases (76%) in male, 211 cases (24%) in female, the average age 44.6, and the highest incidence in the third and sixth decade with similarity. 2. The incidence of pulmonary tuberculosis was highest in the springtime (29.5%) and its peak particularly in May. 3. Classifying the extent of pulmonary tuberculosis into minimal, moderately advanced and far advanced pulmonary tuberculosis, their ratio was 6 : 1.5 : 1 with the concrete date of 553 cases (70.8%), 136 cases (17.4%) and 92 cases (11.8%) respectively. 4. In the case of minimal pulmonary tuberculosis the location of TB-lesion incidence were right upper, left upper and both upper lobes in the ratio of 45 : 27 :28 (%) 5. The radiological findings of pulmonary tuberculosis appeared various, but the ill-defined patchy density of exudative reaction signifying an initial lesion were than the most (35%). 6. As an unusual type of tuberculosis, cavitary TB was 38 cases (4.3%), among them, in 3 cases (7.9%) there appeared air-fluid level. Miliary TB was 8 cases (0.9%), mostly abundant in the youngsters (esp. in the third decade), and female immensely outnumbered male. Tuberculoma was 10 cases (1.4%), female preceded male in the ratio of 7 : 3, and in right upper lobe in the incidence was highest (50%). 7. Without lung parenchymal lesion, the cases to have caused an tuberculous pleural effusion were 56 (6.0%), and in the years of 16 to 29 it was the most frequent with 26 cases (46.4%). 8. With complicated pulmonary tuberculosis, 78 cases (9.5%) showed to combine with other diseases. Among them pleural effusion was 14 cases (1.7%) and pneumothorax 14 cases (1.7%), which were the most frequent. 9. Spread of tuberculosis beyond the lung to other organ was 28 cases (3.1%) and frequent in female characteristically. Among them, bone and joint TB was 16 cases and the most abundant in number, in particular, spine TB was the most frequent with 10 cases (36%)

  9. Prophylactic cranial irradiation in patients with small cell lung cancer. A retrospective study of recurrence, survival and morbidity.

    DEFF Research Database (Denmark)

    Ramlov, Anne; Tietze, Anna

    2012-01-01

    BACKGROUND: Prophylactic cerebral irradiation (PCI) is a standard treatment for all small cell lung cancer (SCLC) patients with response to chemotherapy. The aims of this study were: to evaluate patients undergoing PCI with regard to cerebral recurrence rate, site of recurrence, and overall survival (OS) and to investigate the influence of steroid dose on acute toxicity. MATERIALS AND METHODS: From 2007 to 2010 a total of 118 consecutive patients underwent PCI (25 Gray in 10 fractions). In total, 114/118 received full PCI dose, all 118 were included in the study. Data were analyzed retrospectively with regard to disease stage, treatment, date of PCI, steroid dose during PCI, toxicity, time to recurrence, site of recurrence and time of death. The median follow up time was 16.6months (range 3-54months). RESULTS: Of the 118 patients undergoing PCI, 74 had limited disease (LD-SCLC) and 44 had extensive disease (ED-SCLC). The median age was 65years (range 46-80years). The median overall survival of all patients from the time of diagnosis was 16.0months (CI 95% 13.0-19.0), in LD-SCLC it was 24.0months (CI 95% 19.6-28.3), and in ED-SCLC it was 12.0months (CI 95% 9.6-14.4). Twenty-one patients (17.8%) were diagnosed with cerebral recurrence. Five of these presented with metastatic disease within the limbic system. Of these five patients, four had miliary cerebral disease and one had non-oligometastatic disease. The time from PCI to cerebral recurrence ranged from 4 to 27months. Prednisolone administration varied from 0 to 100mg/day. Forty-eight patients were not treated with steroids, 64.6% of these patients reported acute toxicity. Of the 36 patients receiving 50mg prednisolone, only 22.2% had side effects. The most common symptoms during PCI were nausea and headache. CONCLUSIONS: Twenty-one patients out of 118 developed brain metastases after PCI: five of the twenty-one had metastases located in the limbic system. The study showed that prophylactic steroid use might reduce acute toxicity to PCI. Survival data and recurrence rates are comparable to other clinical studies.

  10. Tuberculous biliary strictures: uncommon cause of obstructive jaundice

    International Nuclear Information System (INIS)

    Tuberculous biliary stricture is a very rare cause of obstructive jaundice. A case of a man who had had pulmonary tuberculosis 20 years ago is reported. He now presented with obstructive jaundice due to multiple strictures just below the confluence of the hepatic ducts and in the right hepatic duct. At surgery, these turned out to be tuberculous in origin. There was also tuberculous involvement of the gall bladder and cystic duct. The commonest differential diagnosis in such cases is cholangiocarcinoma (as in the present case). Imaging helps in defining the extent of bile duct obstruction. Suspicion of the disease and establishing a tissue diagnosis is very important in treating this potentially curable condition, especially with the worldwide resurgence of tuberculosis. Imaging modalities such as US and CT may be useful in demonstrating the dilated bile ducts. As there are no specific radiological features of tuberculous biliary strictures, the radiologist should search for any associated findings in abdominal imaging, especially focal hepatic lesions, abdominal lymphadenopathy and abdominal calcification. Tuberculous hepatic involvement can have miliary, nodular and solitary abscess forms. Solitary tuberculous abscesses may be readily detected by sectional imaging such as US, CT or MRI. Ultrasound appearances encountered include well-defined hypoechoic lesions, mixed hyper/hypoechoic masses or almost solid masses. On CT, tuberculous liver abscesses have been describerculous liver abscesses have been described as having a rosette appearance or being a hypodense mass. Magnetic resonance imaging of a tuberculous solitary mass has been described as hypointense on T1-weighted images and iso- or hypointense on T2-weighted images. However, none of these findings are specific or diagnostic of tuberculous origin and, therefore, the lesions have to be sampled percutaneously to arrive at the correct diagnosis. Abdominal lymphadenopathy (mainly periductal, hepatoduodenal ligament and at the porta hepatis) can be seen in up to 35% of cases of hepatobiliary tuberculosis. Finding calcification on abdominal X-ray is another important observation which is reported to be present in 50% of cases of hepatobiliary tuberculosis. The patterns described are 'chalky' and confluent hepatic calcifications or nodal-type calcifications along the course of the CBD. It is also important to examine a recent chest X-ray as associated chest X-ray abnormalities may be seen in up to 65% of cases of hepatobiliary tuberculosis. The likelihood of having a positive yield of AFB in bile aspirate cytology from ERCP is low. Of the total 12 cases of biliary tuberculosis reported, bile cytology was done in seven, of which only two were positive for AFB. Only one of these 12 cases showed associated hepatic calcification. Copyright (2001) Blackwell Science Pty Ltd

  11. [A predisposing clinical condition for disseminated tuberculosis: hairy cell leukemia].

    Science.gov (United States)

    Arslan, Ferhat; Bat?rel, Ay?e; Ozer, Serdar; Ca?an Akta?, Sabahat

    2013-04-01

    Hairy cell leukemia (HCL), a rare and slow-progressive B-cell lymphoproliferative disease, enhances predisposition to infectious complications, especially to disseminated mycobacterial infections. Although the association between HCL and mycobacterial disease has been established, disseminated Mycobacterium tuberculosis infection has been reported only in a few case series. In this report, a disseminated tuberculosis (TB) case who had been diagnosed as HCL with histopathologic examination of the bone marrow after being investigated for the etiology of fever of unknown origin, was presented. A 56-year-old male patient who was admitted to our clinic with the complaints of three weeks' duration fever, chills, night sweats and cough was hospitalized. On physical examination, the body temperature of the patient who appeared very ill, was 39°C. Dispersed macular rash that turned pale when pressure was applied, was detected on the legs, arms and back. There were no signs of peripheral lymphadenopathy, hepatomegaly or splenomegaly. Laboratory results revealed haemoglobin 10 g/dl, white blood cell count 1000/mm3, thrombocytes 143.000/mm3, erythrocyte sedimentation rate 41 mm/h, CRP 200 mg/L, uric acid 9.5 mg/dl, AST 118 IU/L, ALT 102 IU/L and LDH 429 IU/L. Thorax computed tomography showed mediastinal and bilateral hilary lymphadenopathy. Although preliminary diagnosis was lymphoma, examination of acid-fast bacilli in three days sequential sputum samples and sputum culture for the growth of mycobacteria (Bactec MGIT 960 TB system, Becton Dickinson, Md) were performed to rule out miliary TB. Blood cultures were also performed with non-radiometric fully automated TB hemoculture bottles (Bactec TB, Becton Dickinson, Md). Sputum cultures yielded no mycobacterial growth, however M.tuberculosis growth was detected in blood culture on the 27th day of inoculation. Bone marrow biopsy revealed HCL. However the patient died on the 14th day of hospitalization. In conclusion, disseminated tuberculosis should be considered for differentional diagnosis in patients with HCL or similar hematologic malignancies since TB is endemic in Turkey. PMID:23621735

  12. Monsoon driven changes in phytoplankton populations in the eastern Arabian Sea as revealed by microscopy and HPLC pigment analysis

    Science.gov (United States)

    Parab, Sushma G.; Prabhu Matondkar, S. G.; Gomes, H. do R.; Goes, J. I.

    2006-12-01

    Like the rest of the Arabian Sea, the west coast of India is subject to semi-annual wind reversals associated with the monsoon cycle that result in two periods of elevated phytoplankton productivity, one during the northeast (NE) monsoon (November-February) and the other during the southwest (SW) monsoon (June-September). Although the seasonality of phytoplankton biomass in these coastal waters is well known, the abundance and composition of phytoplankton populations associated with this distinct and predictable seasonal cycle is poorly known. Here we present for the first time, the results of a study on the community structure of phytoplankton for this region, derived from HPLC pigment analysis and microscopic cell counts. Our sampling strategy allowed for large spatial and temporal coverage over regions representative of the coastal and offshore waters, and over seasons that included the NE and the SW monsoon. Monthly observations at a fixed coastal station in particular, allowed us to follow changes in phytoplankton community structure associated with the development of anoxia. Together these measurements helped establish a pattern of seasonal change of three major groups of phytoplankton: diatoms, dinoflagellates and cyanobacteria that appeared to be tightly coupled with hydrographic and chemical changes associated with the monsoonal cycle. During the SW monsoon when nitrate concentrations were high, diatoms were dominant but prymnesiophytes were present as well. By October, as nitrate fell to below detection levels and anoxic conditions began to develop on the shelf below the shallow pycnocline, both diatom and prymensiophytes declined sharply giving way to dinoflagellates. In the well oxygenated surface waters, where both nitrate and ammonium were below detection limits, pico-cyanobacterial populations became dominant. During the NE monsoon, a mixed diatom-dinoflagellate population was quickly replaced by blooms of Trichodesmium erythraeum and Noctiluca miliaris with higher amounts of zeaxanthin, ?-carotene, Chl b and prasinoxanthin. Trichodesmium trichomes were noticed in the water column as early as December when nitrate concentrations became limiting. The low phytoplankton biomass and high ammonium concentrations argue that active grazing populations may be responsible for preventing diatom-dinoflagellate populations from establishing themselves to bloom proportions in the eastern Arabian Sea during the early NE monsoon. Trichodesmium continued its dominance well into May, when nutrient enrichment associated with its death and decay helped simulate the growth of both diatoms and dinoflagellates. Given that anoxic conditions are becoming more pervasive in the eastern Arabian Sea, our observations in particular, those of a shift towards dinoflagellate dominance during the development of anoxia assume particular importance.

  13. Effects of tissue handling and processing steps on PCR for detection of Mycobacterium tuberculosis in formalin-fixed paraffin-embedded samples Efeitos das etapas de tratamento e processamento do tecido na PCR para detecção de Mycobacterium tuberculosis em amostras fixadas em formalina e incluídas em parafina

    Directory of Open Access Journals (Sweden)

    Denise Barcelos

    2008-12-01

    Full Text Available Development and standardization of reliable methods for detection of Mycobacterium tuberculosis in clinical samples is an important goal in laboratories throughout the world. In this work, lung and spleen fragments from a patient who died with the diagnosis of miliary tuberculosis were used to evaluate the influence of the type of fixative as well as the fixation and paraffin inclusion protocols on PCR performance in paraffin embedded specimens. Tissue fragments were fixed for four h to 48 h, using either 10% non-buffered or 10% buffered formalin, and embedded in pure paraffin or paraffin mixed with bee wax. Specimens were submitted to PCR for amplification of the human beta-actin gene and separately for amplification of the insertion sequence IS6110, specific from the M. tuberculosis complex. Amplification of the beta-actin gene was positive in all samples. No amplicons were generated by PCR-IS6110 when lung tissue fragments were fixed using 10% non-buffered formalin and were embedded in paraffin containing bee wax. In conclusion, combined inhibitory factors interfere in the detection of M. tuberculosis in stored material. It is important to control these inhibitory factors in order to implement molecular diagnosis in pathology laboratories.O desenvolvimento e a padronização de métodos confiáveis para a detecção de Mycobacterium tuberculosis em amostras clínicas é um objetivo importante nos laboratórios de todo o mundo. Neste trabalho, fragmentos de pulmão e baço de paciente que morreu com o diagnóstico de tuberculose miliar foram usados para avaliar a influência do tipo de fixador e dos protocolos de fixação e inclusão em parafina na performance da PCR. Fragmentos de tecido foram fixados por quatro h a 48 h, usando formalina não tamponada a 10% ou formalina tamponada a 10% e incluídos em parafina pura ou misturada a cera de abelha. As amostras foram submetidas a PCR para amplificação do gene da beta-actina humana e, separadamente, para amplificação da sequência de inserção IS6110, específica do complexo M. tuberculosis. O resultado da amplificação do gene da beta-actina foi positivo em todas as amostras. Não foram gerados amplicons na PCR-IS6110 em amostras de tecido pulmonar fixadas usando formalina não tamponada a 10% e incluídas em parafina com cera de abelha. Em conclusão, fatores inibitórios combinados interferiram na detecção de M. tuberculosis em material de arquivo. É importante controlar estes fatores inibitórios para poder implementar o diagnóstico molecular em laboratórios de patologia.

  14. Effects of tissue handling and processing steps on PCR for detection of Mycobacterium tuberculosis in formalin-fixed paraffin-embedded samples / Efeitos das etapas de tratamento e processamento do tecido na PCR para detecção de Mycobacterium tuberculosis em amostras fixadas em formalina e incluídas em parafina

    Scientific Electronic Library Online (English)

    Denise, Barcelos; Marcello F., Franco; Sylvia Cardoso, Leão.

    2008-12-01

    Full Text Available O desenvolvimento e a padronização de métodos confiáveis para a detecção de Mycobacterium tuberculosis em amostras clínicas é um objetivo importante nos laboratórios de todo o mundo. Neste trabalho, fragmentos de pulmão e baço de paciente que morreu com o diagnóstico de tuberculose miliar foram usad [...] os para avaliar a influência do tipo de fixador e dos protocolos de fixação e inclusão em parafina na performance da PCR. Fragmentos de tecido foram fixados por quatro h a 48 h, usando formalina não tamponada a 10% ou formalina tamponada a 10% e incluídos em parafina pura ou misturada a cera de abelha. As amostras foram submetidas a PCR para amplificação do gene da beta-actina humana e, separadamente, para amplificação da sequência de inserção IS6110, específica do complexo M. tuberculosis. O resultado da amplificação do gene da beta-actina foi positivo em todas as amostras. Não foram gerados amplicons na PCR-IS6110 em amostras de tecido pulmonar fixadas usando formalina não tamponada a 10% e incluídas em parafina com cera de abelha. Em conclusão, fatores inibitórios combinados interferiram na detecção de M. tuberculosis em material de arquivo. É importante controlar estes fatores inibitórios para poder implementar o diagnóstico molecular em laboratórios de patologia. Abstract in english Development and standardization of reliable methods for detection of Mycobacterium tuberculosis in clinical samples is an important goal in laboratories throughout the world. In this work, lung and spleen fragments from a patient who died with the diagnosis of miliary tuberculosis were used to evalu [...] ate the influence of the type of fixative as well as the fixation and paraffin inclusion protocols on PCR performance in paraffin embedded specimens. Tissue fragments were fixed for four h to 48 h, using either 10% non-buffered or 10% buffered formalin, and embedded in pure paraffin or paraffin mixed with bee wax. Specimens were submitted to PCR for amplification of the human beta-actin gene and separately for amplification of the insertion sequence IS6110, specific from the M. tuberculosis complex. Amplification of the beta-actin gene was positive in all samples. No amplicons were generated by PCR-IS6110 when lung tissue fragments were fixed using 10% non-buffered formalin and were embedded in paraffin containing bee wax. In conclusion, combined inhibitory factors interfere in the detection of M. tuberculosis in stored material. It is important to control these inhibitory factors in order to implement molecular diagnosis in pathology laboratories.

  15. Radiographic findings in adult pulmonary tuberculosis

    International Nuclear Information System (INIS)

    During the period from March, 1980 to February, 1981 in the Department of Radiology, Jeonbug National University Hospital, we reviewed the radiologic findings of 879 cases newly diagnosed pulmonary tuberculosis and 56 cases diagnosed tuberculous pleural effusion without lung parenchymal lesion on initial chest P-A film in the adult (older than 16 years). The results were as follows. 1. Sex distribution of pulmonary tuberculosis was 668 cases (76%) in male, 211 cases (24%) in female, the average age 44.6, and the highest incidence in the third and sixth decade with similarity. 2. The incidence of pulmonary tuberculosis was highest in the springtime (29.5%) and its peak particularly in May. 3. Classifying the extent of pulmonary tuberculosis into minimal, moderately advanced and far advanced pulmonary tuberculosis, their ratio was 6 : 1.5 : 1 with the concrete date of 553 cases (70.8%), 136 cases (17.4%) and 92 cases (11.8%) respectively. 4. In the case of minimal pulmonary tuberculosis the location of TB-lesion incidence were right upper, left upper and both upper lobes in the ratio of 45 : 27 :28 (%) 5. The radiological findings of pulmonary tuberculosis appeared various, but the ill-defined patchy density of exudative reaction signifying an initial lesion were than the most (35%). 6. As an unusual type of tuberculosis, cavitary TB was 38 cases (4.3%), among them, in 3 cases (7.9%) there appeared air-fluid level. Miliary TB was 8 cases (0.9%), mostly abundant in the ys 8 cases (0.9%), mostly abundant in the youngsters (esp. in the third decade), and female immensely outnumbered male. Tuberculoma was 10 cases (1.4%), female preceded male in the ratio of 7 : 3, and in right upper lobe in the incidence was highest (50%). 7. Without lung parenchymal lesion, the cases to have caused an tuberculous pleural effusion were 56 (6.0%), and in the years of 16 to 29 it was the most frequent with 26 cases (46.4%). 8. With complicated pulmonary tuberculosis, 78 cases (9.5%) showed to combine with other diseases. Among them pleural effusion was 14 cases (1.7%) and pneumothorax 14 cases (1.7%), which were the most frequent. 9. Spread of tuberculosis beyond the lung to other organ was 28 cases (3.1%) and frequent in female characteristically. Among them, bone and joint TB was 16 cases and the most abundant in number, in particular, spine TB was the most frequent with 10 cases (36%)

  16. Vacina BCG: eficácia e indicações da vacinação e da revacinação BCG vaccine: efficacy and indications for vaccination and revaccination

    Directory of Open Access Journals (Sweden)

    Mauricio L. Barreto

    2006-07-01

    Full Text Available OBJETIVOS: Revisar aspectos relacionados ao efeito protetor da primeira e segunda doses da vacina BCG e discutir as suas principais indicações e contra-indicações. FONTES DOS DADOS: Utilizando o PubMed, foi realizada uma revisão sistemática da literatura abrangendo um período de, aproximadamente, 50 anos. Os estudos foram agrupados por tipo de desenho, apresentando-se separadamente os principais resultados de ensaios clínicos, estudos de caso-controle e meta-análises. Outros tópicos relevantes, como a BCG e HIV/AIDS, o uso do teste tuberculínico, aspectos relacionados à cicatriz vacinal e ao desenvolvimento de novas vacinas, dentre outros, foram também revistos. SÍNTESE DOS DADOS: A vacina BCG é utilizada desde 1921. Apesar disso, ainda apresenta controvérsias e aspectos não esclarecidos. O efeito protetor da primeira dose da vacina BCG contra a tuberculose na forma miliar ou na meningite é bastante significativa. No entanto, em relação à forma pulmonar, os resultados são discordantes, variando de ausência de efeito a níveis próximos a 80%. Há evidências de que uma segunda dose da BCG não aumenta o seu efeito protetor. Estudos demonstram proteção da vacina contra a hanseníase. Pesquisas sobre novas vacinas que, no futuro, poderão vir a substituir a BCG estão sendo realizadas. CONCLUSÕES:Apesar da expectativa de que, no futuro, venhamos a ter uma nova vacina para a tuberculose, no presente e ainda por muitos anos, a vacina BCG, apesar de suas deficiências, mantém-se como um importante instrumento nos esforços para controle dos efeitos danosos da tuberculose, sobretudo em países em que essa doença ocorre em médias e elevadas taxas de incidência.OBJECTIVES: To review the protective efficacy of the first and second doses of BCG vaccine and to assess its major indications and contraindications. SOURCES OF DATA: A systematic review of the literature was made by searching PubMed and selecting studies carried out in the last 50 years. The studies were grouped according to their design (clinical trials, case-control studies, and meta-analyses and the results were presented separately for each type of study. Other relevant topics such as BCG and HIV/AIDS, use of tuberculin skin test, issues related to vaccine scars and to the development of new vaccines were also reviewed. SUMMARY OF THE FINDINGS: BCG vaccine has been used since 1921. However, the data concerning its use are variable and inconsistent. The protective efficacy of the first dose of BCG vaccine against miliary tuberculosis or tuberculous meningitis is remarkably important. Nevertheless, results regarding pulmonary tuberculosis have been inconsistent, either showing no efficacy or a protective efficacy rate around 80%. There is some evidence that a second dose of BCG vaccine does not increase its protective efficacy. Studies have shown that BCG vaccine protects against leprosy. The development of new vaccines to replace BCG in the future has been investigated. CONCLUSIONS: Despite the hope that a new vaccine against tuberculosis will be available in the future, BCG vaccine, in spite of its deficiencies, is today and will still be for many years to come an important tool in controlling the harmful effects of tuberculosis, especially in countries where this disease has moderate to high levels of incidence.

  17. Incidencia de la resistencia a drogas en tuberculosis y su asociación a comorbilidades en pacientes tratados en un hospital universitario

    Scientific Electronic Library Online (English)

    Pablo Martín, Fescina; Evangelina, Membriani; Leticia, Limongi; Ana, Putruele.

    2013-06-01

    Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish La tuberculosis constituye un problema de salud pública con mayor incidencia en países pobres y presenta dos aspectos a considerar. Las comorbilidades que se comportan como factores de riesgo predisponentes de enfermedad tuberculosa, que pueden complicar su evolución y tratamiento. Por otra parte la [...] resistencia a drogas antituberculosas de primera línea constituye una amenaza para el control de la TB. Con el objetivo de determinar la incidencia de las entidades comórbidas en pacientes con diagnóstico de tuberculosis y la frecuencia de casos con resistencia a drogas se incluyeron en el estudio los pacientes mayores de 16 años con tuberculosis confirmada en el Hospital de Clínicas "San José de San Martín". Se utilizó el programa SSPS 15 para el análisis estadístico. Entre abril de 1997 y marzo del 2010, 687 pacientes fueron tratados por TB confirmada. Las comorbilidades más frecuentes fueron: tabaquismo 14%; enolismo 4.8%; neoplasias 3.3%; EPOC y asma 5.6%; enfermedades hematológicas 2%; enfermedades autoinmunes 3.3%; diabetes 3%; VIH 6.5%; IRC 1.2%. El tabaquismo se presentó más frecuentemente asociado a la forma pulmonar estricta (p = 0.079), a diferencia de las enfermedades autoinmunes y hematológicas que se presentaron como formas miliares (p = 0.001) y VIH como formas mixtas (p = 0.002). La resistencia se presentó más frecuentemente en enfermedades autoinmunes (4%) y HIV (2%), sin valor significativo (p = 0.779). Del total de los pacientes, se detectó un n = 47 (6.8%) con algún tipo de resistencia a las drogas. En los últimos 4 años se detectaron 2 casos de XDR. No se encontró asociación significativa entre los diferentes tipos de resistencias con la presencia de comorbilidades. Sólo se registró un óbito en un paciente con XDR. La presencia de tratamiento previo (p = 0.001) y las formas bacilíferas (p = 0.016) fueron los factores asociados a un incremento de la resistencia. Abstract in english Tuberculosis is a public health problem with a higher incidence in poor countries. There are two aspects to consider: co-morbidities which are risk factors for tuberculosis, complicating its evolution and treatment, and resistance to first line drugs which is a threat to tuberculosis control. The ob [...] jective of the paper was to identify the co-morbidities and the frequency of drug resistance in tuberculosis patients. The study included patients older than 16 years of age with diagnosis of tuberculosis at the Hospital de Clinicas San Jose de San Martin in Buenos Aires. The SSPS 15 program was used for the statistical analysis. From April 1997 to March 2010, 687 patients were treated for confirmed tuberculosis. The most frequent co-morbidities were: tobacco smoking habit 14%; alcoholism 4.8%; cancer 3.3%; COPD and asthma 5.6%; blood diseases 2%; autoimmune diseases 3.3%; diabetes 3%; HIV infection 6.5%; IRC 1.2%. The tobacco smoking habit was more frequently associated to pulmonary tuberculosis (p = 0.079), instead the autoimmune and blood diseases were mostly associated to miliary tuberculosis (p = 0.001) and the HIV infection to tuberculosis in several organs (p = 0.002). Drug resistance was more frequent when autoimmune diseases (4%) and HIV infection (2%) were present, but without reaching statistical significance (p = 0.779). Resistance to at least one drug was present in 47 patients (6.8%). In the last 4 years, 2 cases of extremely drug resistant tuberculosis were detected. There was no significant association between the type of drug resistance and the co-morbidities. Only one death was registered in a patient with extremely drug resistant tuberculosis. Previous treatment (p = 0.001) and sputum positive tuberculosis (p = 0.016) were factors associated to increased drug resistance.

  18. Aspectos tomográficos da tuberculose pulmonar em pacientes adultos com AIDS / Computed tomography findings of pulmonary tuberculosis in adult AIDS patients

    Scientific Electronic Library Online (English)

    Lanamar Aparecida de, Almeida; Mario Flores, Barba; Fernando Alves, Moreira; Sidney, Bombarda; Sebastião André de, Felice; Edenilson Eduardo, Calore.

    2011-02-01

    Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese OBJETIVO: Este trabalho tem como finalidade descrever os achados tomográficos da tuberculose pulmonar em pacientes adultos com AIDS atendidos no serviço de radiologia de um hospital de referência em doenças infecciosas, procurar associações desses achados e a contagem de CD4. MATERIAIS E MÉTODOS: Fo [...] ram estudados 45 pacientes por meio de tomografia computadorizada de tórax durante quatro anos. RESULTADOS: Foram encontrados linfonodomegalia mediastinal e/ou hilar em 31 (68,8%) dos casos, derrame pleural em 29 (64,4%), nódulos centrolobulares de distribuição segmentar em 26 (57,7%), consolidação em 24 (53,3%), confluência de micronódulos em 17 (37,7%), nódulos mal definidos com distribuição centrolobular em 16 (35,5%), padrão de "árvore em brotamento" em 13 (28,9%), espessamento de parede brônquica em 12 (26,6%), cavidade de parede espessa em 10 (22,2%), nódulos miliares em 9 (20%) e bronquiectasias cilíndricas em 6 (13,3%). Dos 45 pacientes, 35 (77,8%) apresentaram CD4 200 cel/mm³. CONCLUSÃO: Concluímos que neste estudo, diversamente do descrito na literatura, linfonodomegalia mediastinal e/ou hilar e consolidação foram significativamente mais frequentes em pacientes com CD4 > 200 cel/mm³. No entanto, linfonodos com centro hipodenso foram mais frequentemente observados em pacientes com severa imunodepressão, ou seja, CD4 Abstract in english OBJECTIVE: The present study is aimed at describing computed tomography findings pulmonary tuberculosis in adult AIDS patients assisted at a radiology unit of a reference infectious diseases hospital, in an attempt to establish the association between such findings and CD4 count. MATERIALS AND METHO [...] DS: Forty-five patients were evaluated by chest computed tomography over a four-year period. RESULTS: Mediastinal and/or hilar lymph node enlargement was found in 31 (68.8%) cases, pleural effusion in 29 (64.4%), centrilobular nodules with segmental distribution in 26 (57.7%), consolidation in 24 (53.3%), confluent micronodules in 17 (37.7%), poorly defined nodules with centrilobular distribution in 16 (35.5%), tree-in-bud pattern in 13 (28.9%), bronchial wall thickening in 12 (26.6%), thick-walled cavity in 10 (22.2%), miliary nodules in 9 (20%), and cylindrical bronchiectasis in 6 (13.3%). Among the 45 patients, 35 (77.8%) presented CD4 count 200 cel/mm³. CONCLUSION: Differently from reports in the literature, the authors conclude that mediastinal and/or hilar lymph node enlargement and consolidation were significantly most frequent in patients with CD4 count > 200 cel/mm³. However, lymph nodes with hypodense center were most often observed in severely immunosuppressed patients with CD4 count

  19. Scientific Electronic Library Online (English)

    Vera Maria Neder, Galesi; Margarida Maria Mattos Brito de, Almeida.

    2007-03-01

    Full Text Available SciELO Brazil and Public Health | Language: Portuguese Abstract in portuguese INTRODUÇÃO: O tratamento de tuberculose é realizado atualmente nos serviços ambulatoriais, ficando a internação recomendada para os casos de maior gravidade ou com problemas sociais. No Município de São Paulo, contudo ainda tem sido internado um número expressivo de doentes de tuberculose. OBJETIVO [...] DO TRABALHO: Estudar as características sociodemográficas e clínico-epidemiológicas dos doentes internados com tuberculose, residentes no Município de São Paulo em 2001. METODOLOGIA: Utilizando como fonte de dados o sistema de informação em tuberculose do Estado, (EPI - TB) programa de registro, acompanhamento e análise de notificações e dados de população do Deinfo/ SEMPLA e FIPE, foram calculados indicadores de morbimortalidade segundo variáveis existentes nas fichas de notificação dos doentes internados. RESULTADOS E DISCUSSÃO: No município de S.Paulo, no ano de 2001, foram internados 2.473 doentes com tuberculose. O coeficiente de internação desses doentes foi de 23,5 casos por 100.000 habitantes, o coeficiente de mortalidade encontrado foi de 4,1 por 100.000 habitantes, tendo ocorrido 485 óbitos e sendo a taxa de letalidade de 17,4%. A taxa de coinfecção Tb/HIV foi de 32,7% entre os internados e de 12,5% entre os não internados, indicando que a epidemia de Aids exerceu forte influência tanto na magnitude quanto na gravidade da situação desses doentes, sendo a maior letalidade (48,4%) a da forma disseminada/miliar, com a maioria de casos em doentes HIV positivos. Entretanto, se excluirmos os casos dos portadores de HIV, a taxa de letalidade ainda se mantém alta, 15,1%, mostrando também a gravidade da tuberculose. CONCLUSÕES: Os resultados mostraram indicadores com valores preocupantes, ficando evidente a importância do acompanhamento dos mesmos para monitorar a situação da tuberculose. RECOMENDAÇÕES: As vigilâncias epidemiológicas municipais devem estabelecer fluxos e estratégias de acompanhamento dos doentes internados com tuberculose principalmente nos grandes centros urbanos, para garantir a continuidade do tratamento e modificar o cenário encontrado. Abstract in english INTRODUCTION: The treatment of tuberculosis is currently carried out in outpatient health services and hospitalization is only recommended for the more severe cases or for those facing social problems. In São Paulo, however, a considerable number of tuberculosis patients are still hospitalized. OBJE [...] CTIVE: To study the socio-demographic and clinical-epidemiological characteristics of hospitalized tuberculosis patients in the city of São Paulo in 2001. SPECIFIC OBJECTIVE: To calculate tuberculosis morbimortality indicators for inpatients. METHODS: Indicators of morbimortality of inpatients were calculated taking as sources, data from the São Paulo state tuberculosis information system - (Epitb) registration program, and the follow-up and analysis of reports and population data from Deinfo/ SEMPLA and FIPE. RESULTS: A total of 2,473 tuberculosis patients were hospitalized in the city of São Paulo in 2001. The hospitalization rate for these patients was 23.5 per 100,000 inhabitants, and the mortality rate found was 4.1 per 100,000 inhabitants with 485 deaths, yielding a fatality rate of 17.4%. DISCUSSION: The TB/HIV co-infection rate was of 32.7% among inpatients and 12.5% among those not hospitalized, showing that the Aids epidemic has caused a considerable impact both in the magnitude and in the severity of the situation of hospitalized tuberculosis patients. The higher fatality rate (48.4%) is of disseminated / miliary tuberculosis, of which the majority occurs in HIV-positive patients. If, however, known HIV-positive cases are excluded, the fatality rate still remains high, i.e. 15%, showing that the severity of cases is not only due to co-infection. CONCLUSIONS: Taking all points into consideration, the indicators showed an alarming situation. RECOMMENDATION: It is recommended that the epidem

  20. Doença pulmonar por Mycobacterium tuberculosis e micobactérias não-tuberculosas entre pacientes recém-diagnosticados como HIV positivos em Moçambique, África / Mycobacterium tuberculosis and nontuberculous mycobacterial isolates among patients with recent HIV infection in Mozambique

    Scientific Electronic Library Online (English)

    Elizabete Abrantes, Nunes; Eduardo Mello, De Capitani; Elizabete, Coelho; Alessandra Costa, Panunto; Orvalho Augusto, Joaquim; Marcelo de Carvalho, Ramos.

    2008-10-01

    Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese OBJETIVO: A micobacteriose é frequentemente diagnosticada entre pacientes infectados pelo HIV. Em Moçambique, onde apenas um pequeno número de pacientes encontra-se sob tratamento anti-retroviral, e a tuberculose tem alta prevalência, existe a necessidade de melhor caracterização destes agentes bact [...] erianos, em nível de espécie, bem como de se caracterizar os padrões de resistência às drogas antituberculosas. MÉTODOS: Em uma coorte de 503 indivíduos HIV positivos suspeitos de tuberculose pulmonar, 320 apresentaram positividade para baciloscopia ou cultura no escarro e no lavado brônquico. RESULTADOS: Bacilos álcool-ácido resistentes foram detectados no escarro em 73% dos casos com cultura positiva. De 277 isolados em cultura, apenas 3 mostraram-se tratar de micobactérias não-tuberculosas: 2 Mycobacterium avium e uma M. simiae. Todos os isolados de M. tuberculosis inicialmente caracterizados através de reação em cadeia de polimerase (RCP) do gene hsp65 foram posteriormente caracterizados como tal através de RCP do gene gyrB. Resistência à isoniazida foi encontrada em 14% dos casos; à rifampicina em 6%; e multirresistência em 5%. Pacientes previamente tratados para tuberculose mostraram tendência a taxas maiores de resistência às drogas de primeira linha. O padrão radiológico mais freqüente encontrado foi o infiltrado intersticial (67%), seguido da presença de linfonodos mediastinais (30%), bronquiectasias (28%), padrão miliar (18%) e cavidades (12%). Os pacientes infectados por micobactérias não-tuberculosas não apresentaram manifestações clínicas distintas das apresentadas pelos outros pacientes. A mediana de linfócitos CD4 entre todos os pacientes foi de 134 células/mm³. CONCLUSÕES: Tuberculose e AIDS em Moçambique estão fortemente associadas, como é de se esperar em países com alta prevalência de tuberculose. Embora as taxas de resistência a drogas sejam altas, o esquema isoniazida-rifampicina continua sendo a escolha apropriada para o início do tratamento. Abstract in english OBJECTIVE: Mycobacteriosis is frequently diagnosed among HIV-infected patients. In Mozambique, where few patients are under antiretroviral therapy and the prevalence of tuberculosis is high, there is need for better characterization of mycobacteria at the species level, as well as for the identifica [...] tion of patterns of resistance to antituberculous drugs. METHODS: We studied a sample of 503 HIV-infected individuals suspected of having pulmonary tuberculosis. Of those 503, 320 tested positive for mycobacteria through sputum smear microscopy or culture of bronchoalveolar lavage fluid. RESULTS: Acid-fast bacilli were observed in the sputum of 73% of the individuals presenting positive cultures. Of 277 isolates tested, only 3 were nontuberculous mycobacteria: 2 were identified as Mycobacterium avium and one was identified as M. simiae. Strains initially characterized as M. tuberculosis complex through polymerase chain reaction restriction analysis (PRA) of the hsp65 gene were later confirmed as such through PRA of the gyrB gene. Among the M. tuberculosis isolates, resistance patterns were as follows: to isoniazid, 14%; to rifampin, 6%; and multidrug resistance, 5%. Previously treated cases showed significantly higher rates of resistance to first-line antituberculous drugs. The most common radiological pattern was interstitial infiltrate (in 67%), followed by mediastinal lymph node enlargement (in 30%), bronchiectasis (in 28%), miliary nodules (in 18%) and cavitation (in 12%). Patients infected with nontuberculous mycobacteria presented clinical profiles indistinguishable from those of other patients. The median CD4 lymphocyte count in this group was 134 cells/mm³. CONCLUSIONS: There is a strong association between tuberculosis and AIDS in Mozambique, as expected in a country with a high prevalence of tuberculosis. Although drug resistance rates are high, the isoniazid-rifampin regimen continues to b

  1. Neurotuberculosis: Hallazgos intracraneanos en RM Neurotuberculosis: Intracranial MRI findings

    Directory of Open Access Journals (Sweden)

    Jorge Docampo

    2012-06-01

    Full Text Available Objetivos. Mostrar nuestra casuística de pacientes con diagnóstico de tuberculosis intracraneana y describir los diferentes tipos de lesiones documentadas en Resonancia Magnética (RM que caracterizan a esta entidad. Materiales y Métodos. Para el presente trabajo fueron seleccionados, de forma retrospectiva, 20 pacientes con hallazgos positivos de tuberculosis intracraneana. Doce eran de sexo masculino y 8 de sexo femenino, con un rango etario de 8 meses a 49 años de edad (edad media: 21 años. El diagnóstico clínico fue realizado con punción lumbar y cultivo de LCR. Once pacientes presentaron serología positiva para VIH. Las RM fueron realizadas en resonadores de 0.5T y 1.5T, complementadas en dos casos con Tomografía Computada (TC de cerebro. A dos pacientes se les realizó difusión (DWI y a un paciente espectroscopía. Resultados. Del total de pacientes (n=20, 14 presentaron compromiso subaracnoideo en la convexidad y 13 compromiso subaracnoideo cisternal basal (afectación leptomeníngea. En 13 se observaron tuberculomas y 11 presentaron angeítis de grandes vasos; mientras que 7 tuvieron angeítis de pequeños vasos, 7 hidrocefalia, 6 infartos parenquimatosos y 1 afectación paquimeníngea. Quince pacientes tenían lesiones combinadas. Conclusión. La localización más frecuente de neurotuberculosis en esta serie fue meníngea con compromiso leptomeníngeo (14 pacientes con afectación subaracnoidea, seguido de afectación cisternal en 13 pacientes y sólo en un caso fue paquimeníngea. La manifestación parenquimatosa más frecuente fue el tuberculoma (granulomas tuberculosos con 13 casos. De estos, 5 presentaron un patrón miliar y sólo uno comportamiento pseudotumoral.Purposes. To report our case series of patients with a diagnosis of intracranial tuberculosis and to describe the different types of lesions characterizing this entity on Magnetic Resonance Imaging (MRI. Materials and Methods. For the present study, we retrospectively selected 20 patients with positive MRI findings of intracranial tuberculosis. Twelve of them were males and 8 were females, with an age range of between 8 months and 49 years (mean age: 21years. Clinical diagnosis was obtained by lumbar puncture and cerebrospinal fluid (CSF culture. Eleven patients presented positive HIV serology. MRIs were performed using 0.5T and 1.5 T scanners and computed tomography (CT of the brain was also performed in two patients. Diffusion-weighted technique was performed in two patients and spectroscopy in one patient. Results. Of the total patients studied (n=20, 14 presented convexity subarachnoid involvement and 13 subarachnoid basal cystern involvement (leptomeningeal involvement, 13 presented tuberculomas, 11 large-vessel angiitis, 7 smallvessel angiitis, 7 hydrocephalia, 6 parenchymatous infarction and one pachymeningeal involvement. Combined lesions were observed in 15 patients. Conclusion. The most frequent location of neurotuberculosis in this series was meningeal with leptomeningeal involvement (14 patients with subarachnoid involvement, followed by cysternal involvement in 13 patients, and only one patient had pachymeningeal involvement. The most frequent parenchymatous finding of tuberculosis was tuberculoma in 13 patients, 5 with a miliary pattern and only one with pseudo-tumoral behavior.

  2. Vacina BCG: eficácia e indicações da vacinação e da revacinação / BCG vaccine: efficacy and indications for vaccination and revaccination

    Scientific Electronic Library Online (English)

    Mauricio L., Barreto; Susan M., Pereira; Arlan A., Ferreira.

    2006-07-01

    Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese OBJETIVOS: Revisar aspectos relacionados ao efeito protetor da primeira e segunda doses da vacina BCG e discutir as suas principais indicações e contra-indicações. FONTES DOS DADOS: Utilizando o PubMed, foi realizada uma revisão sistemática da literatura abrangendo um período de, aproximadamente, 50 [...] anos. Os estudos foram agrupados por tipo de desenho, apresentando-se separadamente os principais resultados de ensaios clínicos, estudos de caso-controle e meta-análises. Outros tópicos relevantes, como a BCG e HIV/AIDS, o uso do teste tuberculínico, aspectos relacionados à cicatriz vacinal e ao desenvolvimento de novas vacinas, dentre outros, foram também revistos. SÍNTESE DOS DADOS: A vacina BCG é utilizada desde 1921. Apesar disso, ainda apresenta controvérsias e aspectos não esclarecidos. O efeito protetor da primeira dose da vacina BCG contra a tuberculose na forma miliar ou na meningite é bastante significativa. No entanto, em relação à forma pulmonar, os resultados são discordantes, variando de ausência de efeito a níveis próximos a 80%. Há evidências de que uma segunda dose da BCG não aumenta o seu efeito protetor. Estudos demonstram proteção da vacina contra a hanseníase. Pesquisas sobre novas vacinas que, no futuro, poderão vir a substituir a BCG estão sendo realizadas. CONCLUSÕES:Apesar da expectativa de que, no futuro, venhamos a ter uma nova vacina para a tuberculose, no presente e ainda por muitos anos, a vacina BCG, apesar de suas deficiências, mantém-se como um importante instrumento nos esforços para controle dos efeitos danosos da tuberculose, sobretudo em países em que essa doença ocorre em médias e elevadas taxas de incidência. Abstract in english OBJECTIVES: To review the protective efficacy of the first and second doses of BCG vaccine and to assess its major indications and contraindications. SOURCES OF DATA: A systematic review of the literature was made by searching PubMed and selecting studies carried out in the last 50 years. The studie [...] s were grouped according to their design (clinical trials, case-control studies, and meta-analyses) and the results were presented separately for each type of study. Other relevant topics such as BCG and HIV/AIDS, use of tuberculin skin test, issues related to vaccine scars and to the development of new vaccines were also reviewed. SUMMARY OF THE FINDINGS: BCG vaccine has been used since 1921. However, the data concerning its use are variable and inconsistent. The protective efficacy of the first dose of BCG vaccine against miliary tuberculosis or tuberculous meningitis is remarkably important. Nevertheless, results regarding pulmonary tuberculosis have been inconsistent, either showing no efficacy or a protective efficacy rate around 80%. There is some evidence that a second dose of BCG vaccine does not increase its protective efficacy. Studies have shown that BCG vaccine protects against leprosy. The development of new vaccines to replace BCG in the future has been investigated. CONCLUSIONS: Despite the hope that a new vaccine against tuberculosis will be available in the future, BCG vaccine, in spite of its deficiencies, is today and will still be for many years to come an important tool in controlling the harmful effects of tuberculosis, especially in countries where this disease has moderate to high levels of incidence.

  3. Development of Pacing, Electrophysiology and Defibrillation in India

    Directory of Open Access Journals (Sweden)

    Mohan Nair

    2002-04-01

    Full Text Available History of cardiac pacing in India dates back to late 1960s. Kar1 reported that cardiac pacing was introduced in India in 1966. Basu2 while discussing on cardiac pacemaking in Calcutta, mentions that the first pacing was performed in April 1967 at the Institute of Post Graduate Medical Education and Research (IPGME&R. Bhatia et al3 started pacemaker implantation at AIIMS, New Delhi in 1968. Their first patient was a doctor from Assam and the pulse generator was supplied by Medtronic Inc. The pulse generator was powered by a mercury-iodide battery which lasted for about 2 ½ years, after which the patient underwent pulse generator replacement. Unfortunately he succumbed to miliary tuberculosis about a year after that. Currently around 8000 pacemakers are being implanted annually in India, in various centers around the country. G.B. Pant Hospital New Delhi has been the pioneering center in the field of Invasive Cardiac Electrophysiology in the country. Bhatia M.L et al9 and Khalilullah M et al 10,11,12,13 were the pioneers in His bundle electrography in the country. Prof. K.K. Sethi was the first to perform catheter ablation in the country. Direct Current ablation was started in 1988 followed by Radio Frequency (RF ablation later on. The number of centres having electrophysiology setup in the country has increased from about 10 in 1997 to around 30 in 2001 (Fig 4. The number of RF ablations being performed in the country has gone up from 800 to 2000 during the same period. Newer insights in the field of atrial fibrillation in rheumatic heart disease have been obtained by electrophysiological studies from the country. Atrial disease due to rheumatic carditis is an important parameter, in addition to valvular involvement in the genesis of atrial fibrillation. Multiple substrates for atrial fibrillation are present in these cases, namely: stretch, fibrosis, raised pressures, increased atrial size and increased anisotropy. Atrial fibrillation in rheumatic heart disease is generally of long duration and affects a younger population. Control of Rate versus Rhythm in Rheumatic Atrial Fibrillation Trial -?CRRAFT? conducted at Mumbai has documented the effectiveness of amiodarone in the treatment of rheumatic atrial fibrillation. Surgical RF pulmonary vein isolation using Thermaline Multi-Electrode Catheter [EP Technologies] has been done in 27 patients with rheumatic atrial fibrillation of more than one year duration. Lesions were as follows: bilateral pulmonary vein isolation, isolation of the left atrial appendage and connection lesion between left atrial appendage and pulmonary veins.Prof. K.K. Talwar, AIIMS, New Delhi and Dr. T.S. Kler, Escorts Heart Institute & Research Centre, New Delhi were the first to implant Implantable Cardioverter Defibrillators (ICD in India. Current annual ICD implantation rates stand at 60 per year.

  4. Fase aguda da esquistossomose mansoni

    Scientific Electronic Library Online (English)

    Edward, Tonelli.

    1972-10-01

    Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O A. faz um estudo panorâmico sobre a fase aguda da esquistossomose mansoni, abordando o quadro clínico e seu diagnóstico, os exames subsidiários, o diagnóstico diferencial, a terapêutica e os aspectos evolutivos. As manifestações clinicas dos períodos de incubação, de estado e de supressão são abor [...] dados. O diagnóstico da fase aguda é baseado em dado epidemiológico, 110 exame fisico e em exames subsidiários. O dado epidemiológico. em geral, é positivo, com menção a banho infectante, comumente 30 a 40 dias antes do início do quadro clínico e ao exame físico, encontramos hipertermia (38 - 4G°C), prostração, micropoliadenia hepatomegalia dolorosa em 95%, dos casos e esplenomegalia em 70% dos casos. Os exames prioritários para o diagnóstico são o exame parasiiológico de fezes seriado, que é positivo para ovos viáveis de S. mansoni e o leucograma seriado, que, geralmente, acusa leucocitose com eosinofilia. Em caso de dúvida ou para complementação diagnostica, podemos recorrer à endoscovia retal, ao oograma e á biópsia hepática. A endoscopia acusa, comumente, mucosa hiperêmica, edemaciada, friável, granulosa, com pontos hemorrágicos e o exame colhido por punção biópsia revela, entre outros achados, granulomas na fase necrótica-exsudativa. O diagnóstico diferencial deve ser feito com as seguintes entidades clínicas: gastroenterites. febre tifóide, disenteria bacilar, amebíase aguda, salmonelose septicêrnica prolongada, devendo, ainda, figurar a tuberculose miliar, abdome agudo, a G.N.D.A., a mononucleose infecciosa, a leptospirose, a hepatite e as poaneurites. A terapeutica é baseada nos cuidados gerais, na córticoterapia e na terapêutica específica. Observamos regressão dramática do quadro toxinfeccioso. nas primeiras 24 a 48 horas com a córticoterapia (prednisona) que tem duração aproximada de 7 a 10 dias. A terapêutica específica (derivado nitrotiazolico = ambilhar e derivado hidroximetílico do miracil D = hycanthone) é empregada após remissão do quadro toxiinfeccioso ou em plena fase aguda; nesta eventualidade os sintomas gerais e os distúrbios intestinais desaparecem a partir do 5.° dia de terapêutica. Quando empregamos ambilhar ou hycanthone, em apenas um esquema terapêutico, observamos 40% de cura; esta cifra atinge a 80-90%, quando repetimos a medicação específica, após verificarmos recidiva. Abstract in english In this panoramic study about the acute phase of schistosomiasis mansoni the author describe its clinical picture and diagnosis, the complementary tests, the author describes its clinical picture and diagnosis, the complementary tests, ical pictures of the incubation, fastigium and suppression perio [...] ds are described. The diagnosis of the acute phase is based on epidemiologic data are often positive, there being mention to an infective bath, usually 30 to 40 days prior to the onset of the disease. Fever (38-40°C) is noticed at the physical examination, as well as prostation and microlymphadenopathy. Enlargement and tenderness of the liver are found in 95 percent and splenomegaly in 70 per cent of the cases. The most important laboratory tests for the diagnosis are: repeated direct examination in stool specimens for the detection of viable S. mansoni eggs, and repeated leukocyte count that generally shows leukocytosis and eosinophilia. When in doubt or for diagnostic complementary one may always recourse to the rectal endoscopy, the ocgrama and the liver biopsy. The endoscopy usually reveals hyperemic, edematous, friable and granulous mucosa with bleeding points. The needle-biopsy of the liver followed by the histopathologic examination of the hepatic tissue discloses granulomas in the necrotic-exudative phase, among other findings. The differential diagnosis must be made with diseases as follows: gastroenteritis, typhoid fever, bacilar disentery, acute amebiasis, and prolonged septicaemic salmonellosis, although one should also include miliary tub

  5. [Comparison of the performances of MTD Gene-Probe® test, BACTEC 960™ system and Löwenstein-Jensen culture methods in the diagnosis of smear-negative tuberculosis cases].

    Science.gov (United States)

    Kundurac?o?lu, Ayperen; Karasu, I??l; Biçmen, Can; Ozsöz, Ay?e; Erbaycu, Ahmet Emin

    2013-07-01

    The aim of this study was to compare the results of nucleic acid amplification-based MTD (Mycobacterium tuberculosis direct test) Gene-Probe® method in samples obtained from acid-fast bacilli (ARB) smear-negative patients with suspected tuberculosis (TB), with the culture results obtained from automated BACTEC 960™ (MGIT) system and Löwenstein-Jensen (LJ) medium. In addition, the contribution of molecular methods in early diagnosis of pulmonary TB and the effect of radiological prevalence of the disease associated with or without cavity to the molecular diagnosis and/or growth time in culture media have been evaluated. A total of 107 patients (86 male, 21 female; mean age: 49.89 ± 17.1 years, age range: 18-81 years) who were clinically and radiologically suspected of having pulmonary TB and/or TB pleurisy, were included in the study. Of the samples 65 (60.7%) were sputum, 32 (29.9%) were bronchial aspiration, 5 (4.7%) were pleural fluid, and 5 (4.7%) were transthoracic fine needle aspiration biopsy materials. Patient samples were cultured in solid LJ media and liquid-based BACTEC 960 system (Becton Dickinson Co., USA) in the same working day. Meanwhile, MTD Gen-Probe test (Gen-Probe Inc., USA) was studied in two separate working days of the week as specified by the laboratory. The samples were incubated until positivity was determined in BACTEC 960 system and/or growth was detected in LJ medium. Negative cultures were incubated for 42 days and were finalized. When mycobacterial growth was determined in the culture, identification of M.tuberculosis complex (MTBC) and differentiation from nontuberculous mycobacteria were performed by conventional methods and BACTEC 460 NAP test. Forty five (42%) patients were diagnosed as pulmonary paranchimal TB (40 were active pulmonary TB, 1 was miliary TB and 4 were culture-negative pulmonary TB), while 4 (3.7%) patients diagnosed as extrapulmonary TB and 58 (57.9%) patients were diagnosed as other pulmonary diseases unrelated with TB. LJ cultures yielded positive results in 32 of 45 (71%) pulmonary TB patients, and BACTEC 960 were found positive in 84.4% (38/45) of those patients. On the other hand the positivity rate of MTD Gen-Probe test was detected as 37.4% (40/107). The sensitivity, specificity, positive and negative predictive values for MTD Gen-Probe test were estimated as 89%, 100%, 100% and 93%, respectively. Those values for BACTEC 960 system were found as 82%, 98%, 97% and 88%, and for LJ culture method as 71%, 100%, 100% and 83%, respectively. Average periods to make a decision for diagnosis of TB by MTD Gen-Probe, BACTEC 960 (MGIT) and LJ culture methods were calculated as 2.36 days, 20.11 days and 32.49 days, respectively. In comparison of the methods in terms of turnaround times, MTD Gen-Probe test was found superior to LJ culture method, however the turnaround times for BACTEC 960 and LJ culture methods were similar. When the clinical data were evaluated, no effect of radiological density of lesion was identified on the diagnosis time of molecular test and time of growth in liquid based automated BACTEC system and/or LJ culture method. However, LJ culture demonstrated earlier reactivity in patients with cavitary lesions. As a result, MTD Gene-Probe test was observed as a reliable and rapid method for the early diagnosis of pulmonary TB patients, early initiation of therapy, prevention of disease progression and transmission. PMID:23971920

  6. Neurotuberculosis: Hallazgos intracraneanos en RM / Neurotuberculosis: Intracranial MRI findings

    Scientific Electronic Library Online (English)

    Jorge, Docampo; Carolina, Mariluis; Nadia, González; Carlos, Morales; Claudio, Bruno.

    2012-06-01

    Full Text Available Objetivos. Mostrar nuestra casuística de pacientes con diagnóstico de tuberculosis intracraneana y describir los diferentes tipos de lesiones documentadas en Resonancia Magnética (RM) que caracterizan a esta entidad. Materiales y Métodos. Para el presente trabajo fueron seleccionados, de forma retro [...] spectiva, 20 pacientes con hallazgos positivos de tuberculosis intracraneana. Doce eran de sexo masculino y 8 de sexo femenino, con un rango etario de 8 meses a 49 años de edad (edad media: 21 años). El diagnóstico clínico fue realizado con punción lumbar y cultivo de LCR. Once pacientes presentaron serología positiva para VIH. Las RM fueron realizadas en resonadores de 0.5T y 1.5T, complementadas en dos casos con Tomografía Computada (TC) de cerebro. A dos pacientes se les realizó difusión (DWI) y a un paciente espectroscopía. Resultados. Del total de pacientes (n=20), 14 presentaron compromiso subaracnoideo en la convexidad y 13 compromiso subaracnoideo cisternal basal (afectación leptomeníngea). En 13 se observaron tuberculomas y 11 presentaron angeítis de grandes vasos; mientras que 7 tuvieron angeítis de pequeños vasos, 7 hidrocefalia, 6 infartos parenquimatosos y 1 afectación paquimeníngea. Quince pacientes tenían lesiones combinadas. Conclusión. La localización más frecuente de neurotuberculosis en esta serie fue meníngea con compromiso leptomeníngeo (14 pacientes con afectación subaracnoidea, seguido de afectación cisternal en 13 pacientes) y sólo en un caso fue paquimeníngea. La manifestación parenquimatosa más frecuente fue el tuberculoma (granulomas tuberculosos) con 13 casos. De estos, 5 presentaron un patrón miliar y sólo uno comportamiento pseudotumoral. Abstract in english Purposes. To report our case series of patients with a diagnosis of intracranial tuberculosis and to describe the different types of lesions characterizing this entity on Magnetic Resonance Imaging (MRI). Materials and Methods. For the present study, we retrospectively selected 20 patients with posi [...] tive MRI findings of intracranial tuberculosis. Twelve of them were males and 8 were females, with an age range of between 8 months and 49 years (mean age: 21years). Clinical diagnosis was obtained by lumbar puncture and cerebrospinal fluid (CSF) culture. Eleven patients presented positive HIV serology. MRIs were performed using 0.5T and 1.5 T scanners and computed tomography (CT) of the brain was also performed in two patients. Diffusion-weighted technique was performed in two patients and spectroscopy in one patient. Results. Of the total patients studied (n=20), 14 presented convexity subarachnoid involvement and 13 subarachnoid basal cystern involvement (leptomeningeal involvement), 13 presented tuberculomas, 11 large-vessel angiitis, 7 smallvessel angiitis, 7 hydrocephalia, 6 parenchymatous infarction and one pachymeningeal involvement. Combined lesions were observed in 15 patients. Conclusion. The most frequent location of neurotuberculosis in this series was meningeal with leptomeningeal involvement (14 patients with subarachnoid involvement, followed by cysternal involvement in 13 patients), and only one patient had pachymeningeal involvement. The most frequent parenchymatous finding of tuberculosis was tuberculoma in 13 patients, 5 with a miliary pattern and only one with pseudo-tumoral behavior.

  7. / Patogenia de las lesiones tuberculosas del sistema nervioso

    Scientific Electronic Library Online (English)

    Mario, Michel Zamora.

    1952-12-01

    Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Mil casos de tuberculose foram revistos neste trabalho. Quanto ao comprometimento de todos os órgãos, foram encontrados 21 casos de tuberculoma do cérebro, 4 do cerebelo e 40 casos de meningite. E' interessante observar que, enquanto em 607 casos de infecção tuberculosa foram encontrados três órgãos [...] envolvidos por caso, quando havia tuberculose do sistema nervoso a relação era de 4:1; como conseqüência, pode-se afirmar que, quando ocorre uma disseminação da tuberculose, há maior probabilidade de infecção do sistema nervoso. Examinando os diferentes órgãos nos casos em que havia lesões do sistema nervoso foi encontrada infecção dos gânglios linfáticos em 18,45%, dos pulmões em 15,13% e das pleuras em 9,25%; em segundo plano vêm o fígado (8,86%), o baço (8,86%) e os rins (6,67%); num terceiro grupo, as suprarrenais (2,58%), a próstata (2,58%), o peritôneo (2,21%) e o pericárdio (2,21%). A afecção dos outros órgãos foi menor. Por essa estatística pode-se dizer que a infecção de gânglios, especialmente dos localizados nos hilos pulmonares, predispõe à infecção do sistema nervoso. Em relação à idade, o máximo de infecção se acha entre 10 e 19 anos. Havia meningite tuberculosa em 40 casos de tuberculose miliar. Abstract in spanish Para efectuar este trabajo, se han revisado 1.000 exámenes post-morten, se habiendo encontrado lesiones tuberculosas en 607 casos (60,7%). La infección del sistema nervioso en estos mismos casos estaba representada por 40 casos de meningitis, 21 tuberculomas del cerebro y 4 del cerebelo. En los 607 [...] casos de tuberculosis se ha visto que la enfermedad ha afectado en una proporción de tres órganos por paciente. Cuando se hace esta misma comparación en los que han presentado lesiones en el sistema nervioso, se ve que la proporción es de cuatro, hecho que permite afirmar que, cuando la infección tuberculosa es más diseminada y mayor el número de órganos afectados, mayores son las probabilidades de extensión del proceso al sistema nervioso. Examinando los diferentes órganos en los 65 casos con lesiones en sistema nervioso, se nota un gran predominio de la infección en los gânglios (18,45%), principalmente en los ganglios del hilio pulmonar, hecho que facilita la infección del cerebro y de las meninges, por Ias relaciones anatómicas de dichos órganos con los grandes vasos por los que se realiza la diseminación hematógena. Además, las adenitis hiliares van a la caseosis en una alta proporción de casos (40% en 40 de meningitis tuberculosa presentados en este relato). En relación a la edad, el mayor número de casos se hallaron entre los 10 a los 19 años. Abstract in english In this work, 1,000 cases of tuberculosis are reviewed. In relation to the infection of all organs, 21 cases of tuberculomata of the brain, 4 of the cerebellum and 40 cases of meningitis were found. It was interesting to find out that, while in 607 cases of tuberculous infection there were 3 organs [...] per case involved, when there was tuberculosis of the nervous system the relation was 4 to 1; as a consequence, we can affirm that, when there is a dissemination of tuberculosis, there are more chances of infection of the nervous system. On examining the different organs that were affected on the nervous system cases, we found infection of the lymphatic glands on 18.45%, lungs 15.13% and pleuras 9.25%; in the second place comes the liver with 8.86%, spleen 8.86%, kidneys 6.64%; in a third group the adrenals with 2.58%, prostate 2.58%, peritoneum 2.21% and pericardium 2.21%. In the rest of organs the rate of infection was lesser. From this statistics, we can state that the infection of the ganglia, especially the ones that are located on the hila of the lungs, predisposes to the infection of the nervous system. In relation to age, the maximum of infection was between 10 and 19 years. In 40 cases of tuberculous meningitis, we found miliary tuberculosis in 14 (35%).

  8. [Fifty years of research on tuberculosis. Lessons I have learnt during 50 years and topics to be investigated in the future].

    Science.gov (United States)

    Shimao, T

    2000-07-01

    I have engaged in the research on tuberculosis for 50 years, and lessons I have learnt during this period could be summarized in the following ten topics. First is great research achievements by our predecessors on the establishment of so-called primary infection theory on the pathogenesis of TB, planning of TB control principles based on the theory and development of new technologies used for TB control, such as mass miniature X-ray examination and BCG vaccination in 1920s and 1930s. TB control law was enforced in 1951, and the modern TB programme was initiated. Second, the field is a treasure house of interesting data. Several interesting data on TB soon after the World War II in Tokyo and a rural area were collected and analyzed from the mass health examination. Third, looking at the increase of tuberculin positivity with age, it was found that the tuberculin negativity decreased as the exponential function of age, and the current concept of the annual risk of TB infection was already developed in late 1940s. It was 18.1% in male and 11.6% in female in Tokyo in late 1940s. Based on this concept, age specific TB mortality was analyzed by the type of TB, and the rates of miliary TB and TB meningitis were similar to the rate of newly infected to the total population, while the rate of all forms could be divided into early and late death as shown in Fig. 1. Fourth, I suffered from TB by myself from 1951 to 1953, receiving first thoracoplasty in two stages under local anaesthesia, then right upper lobectomy and segmentectomy of superior segment of right lower lobe. From this experience, I learnt a lot about the psychology and suffering of TB patients. Fifth, the importance of recognition of real magnitude of the problem in such a disease as TB in which many TB cases did not aware of their disease. The answer to this was the first TB prevalence survey in 1953 using stratified random sampling method, and based on the results of the survey, the mass health examination originally focussed on youth was expanded to the total adult population of Japan. Sixth, TB could be reduced rapidly by applying appropriately planned control programme. In big enterprises, the application of intensive case-finding programme brought about the rapid decline of severe TB cases, contributed to the increase of the productivity of the enterprises, thus to the rapid increase of GDP of whole Japan, and the growing spiral between the improvement of health and the economic development was formed by successful TB control. In addition to the mass health examination, BCG vaccination and spread of appropriate treatment in the original TB control law, the registration and case management system and the more extensive application of hospitalization for infectious cases were introduced in early 1960s. Observing the proportion of TB care expenditure to the national medical expenditure, it was 28% in 1954, and it dropped down to 0.4% in recently as shown in Fig. 2. The decline of TB in Japan during 1950s and 1960s was one of fastest in the world. Seventh, there had been marked differences in the prevalence of TB as well as the coverage and quality of TB programmes in several areas of Japan though it was often said that Japan is homogeneous country. To know the real status in various areas of Japan, a chart to express graphically the magnitude of TB and coverage and quality of TB programmes was developed (Fig. 3), and it was finally refined to the current form. Eighth difficulty in changing existing programmes, and we are grateful for kind cooperation of Niigata Prefecture for making several new attempts. Ninth, it has been needed to observe TB problems from global standpoint, and it was actually done through participation to the bilateral cooperation projects on TB control and conducting the international training courses sponsored by JICA. Tenth, TB is a pertinacious disease. As shown in Fig. (ABSTRACT TRUNCATED) PMID:10944893