WorldWideScience

Sample records for miliaris disseminatus faciei

  1. Lupus miliaris disseminatus faciei report of 4 cases

    Sule R

    1992-01-01

    Full Text Available Lupus miliaris disseminatus faciei is an uncommon disease affecting face. Previously lupus miliaris disseminatus faciei was thought to be a tuberculid; but now it is considered as a granulomatuous variant fo acne rosacea. We report 4 cases; each having lesions on face but in 1 also on body. The cases had erythematous tiny popular lesions of varying chronicity of 4 months to 1 year. Investigations for tuberculosis were negative. Histopathology revealed tuberculoid granuloma. All patients responded to Erythromycin; except 1 required Chloroquine.

  2. Granulomatous rosacea : is it a variant of lupus miliaris disseminatus faciei?

    Kaur S

    2003-03-01

    Full Text Available Granulomatous rosacea, a subtype of rosacea showing non-caseating epithelioid cell granulomas is difficult to differentiate form lupus miliaris disseminatus faciei. Although appearently similar, the clinical and pathologic features, and the natural course of both are different. The similarities and differentiation of rosacea from lupus miliaris disseminatus faciei is discussed.

  3. Granulomatous rosacea : is it a variant of lupus miliaris disseminatus faciei?

    Kaur S

    2003-01-01

    Full Text Available Granulomatous rosacea, a subtype of rosacea showing non-caseating epithelioid cell granulomas is difficult to differentiate form lupus miliaris disseminatus faciei. Although appearently similar, the clinical and pathologic features, and the natural course of both are different. The similarities and differentiation of rosacea from lupus miliaris disseminatus faciei is discussed.

  4. Recurrent lupus miliaris disseminatus faciei: a case report

    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.

  5. Lupus miliaris disseminatus faciei: a distinctive rosacea-like syndrome and not a granulomatous form of rosacea.

    Scheur, van de M.R.; Waal, van der RI; Starink, T.M.

    2003-01-01

    BACKGROUND: Lupus miliaris disseminatus faciei is an eruption of discrete red-brown, dome-shaped papules, histologically characterized by epithelioid cell granulomas. The pathogenesis of the disorder remains controversial. OBJECTIVE: The authors discuss the place of lupus miliaris disseminatus facie

  6. Lupus miliaris disseminatus faciei: report of a new case and brief literature review.

    Rocas, Delphine; Kanitakis, Jean

    2013-01-01

    Lupus miliaris disseminatus faciei (LMDF) is a rare dermatosis with characteristic clinicopathological features but of unknown etiolgy. We report a new typical case of LMDF. A 29-year-old man presented with an asymptomatic, micropapular midfacial eruption. Histological examination revealed a dermal granulomatous reaction with central areas of necrosis and occasionally degenerated hair follicles. Workup for sarcoidosis was negative. A moderate improvement was achieved with systemic treatment with doxycycline. A brief overview of the main features of LMDF is presented. PMID:23552001

  7. Comparison of high-resolution CT findings between miliary metastases and miliary tuberculosis

    To compare the findings of high-resolution computed tomography (HRCT) between patients with miliary metastases and miliary tuberculosis. Between May 1998 and April 2002, 11 patients with miliary metastases and 18 with miliary tuberculosis underwent HRCT, and we reviewed the findings. In miliary metastases, the primary lesions were adenocarcinoma of the lung (n=2), stomach (n=1), or pancreas (n=1), or unknown origin (n=5), and papillary carcinoma of the thyroid (n=2). Two radiologists blinded to the clinical and pathologic data reached a consensus regarding nodule size and margin, their distribution and coalescence, interstitial involvement, and other ancillary HRCT findings. Data were analyzed using the chi-square test. CT scans showed numerous 1 to 5-mm nodules randomly distributed throughout both lungs of all patients. Nodules larger than 1.5 mm in diameter were more often seen in miliary metastases (81.9%). In six (54.5%) patients with miliary metastases and in three (16.7%) with miliary tuberculosis, nodule size varied (p<0.05). Pleural effusion occurred in three (27.3%) patients with miliary metastases and three (16.7%) with miliary tuberculosis. Interlobular septal thickening (100%) and peribronchovascular thickening (63.6%) were more common in miliary metastases than in miliary tuberculosis (p<0.01). Lymph node enlargement was seen in 11 (100%) patients with miliary metastases and five (27.8%) with miliary tuberculosis (P<0.001). At HRCT, lymph node enlargement and both interlobular and peribronchovascular thickening are more commonly observed in miliary metastases than in miliary tuberculosis

  8. Coccidioidomycosis with diffuse miliary pneumonia.

    Sotello, David; Rivas, Marcella; Fuller, Audra; Mahmood, Tashfeen; Orellana-Barrios, Menfil; Nugent, Kenneth

    2016-01-01

    Coccidioidomycosis is a well-known infection in the southwestern United States, and its occurrence is becoming more frequent in endemic areas. This disease can have a significant economic and medical impact; therefore, accurate diagnosis is crucial. In conjunction with patient symptoms, residence in or travel to an endemic area is essential for diagnosis. Diagnosis is usually made with serology, culture, or biopsy and confirmed with DNA probe technology. Pulmonary disease is the most common presentation and is seen in almost 95% of all cases. One-half to two-thirds of all Coccidioides infections are asymptomatic or subclinical. Most pulmonary infections are self-limited and do not require treatment except in special populations. When treatment is warranted, itraconazole and fluconazole are frequently used. Diffuse miliary pneumonia is uncommon and is especially rare in immunocompetent patients. Herein we describe a rare presentation of miliary coccidioidomycosis in a nonimmunocompromised patient. PMID:26722164

  9. Miliary pattern in neonatal pneumonia

    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.)

  10. Erythromelanosis follicularis faciei et colli: Relationship with keratosis pilaris

    Augustine M

    2008-01-01

    Full Text Available Erythromelanosis follicularis faciei et colli (EFF is an unusual condition characterized by the triad of hyperpigmentation, follicular plugging and erythema of face and neck. This is less common in women and familial case reports are few. We report EFF in three siblings in an Indian family, two of whom are females. The possibility of this condition being genetically related to keratosis pilaris as well as being a variant of keratosis rubra pilaris is also discussed.

  11. Tinea faciei caused by Trichophyton mentagrophytes in a 20-day-old neonate.

    Malhotra, Sita; Malhotra, Suresh Kumar; Aggarwal, Yukti

    2015-12-01

    Although candidiasis in newborns is not uncommon, superficial dermatophyte infections of infants is quite rare. The causative agents of neonatal tinea reported in various case studies have been Trichophyton rubrum, Microsporum canis, Microsporum gypseum, and Trichophyton violaceum. To the best of our knowledge, no case report of neonatal tinea faciei caused by Trichophyton mentagrophytes has been reported earlier. PMID:26904450

  12. Tinea faciei caused by Trichophyton mentagrophytes in a 20-day-old neonate

    Sita Malhotra; Suresh Kumar Malhotra; Yukti Aggarwal

    2015-01-01

    Although candidiasis in newborns is not uncommon, superficial dermatophyte infections of infants is quite rare. The causative agents of neonatal tinea reported in various case studies have been Trichophyton rubrum, Microsporum canis, Microsporum gypseum, and Trichophyton violaceum. To the best of our knowledge, no case report of neonatal tinea faciei caused by Trichophyton mentagrophytes has been reported earlier.

  13. Hypercalcaemia: atypical presentation of miliary tuberculosis

    So, Edison; Bolger, Dennis Thomas

    2014-01-01

    We report an unusual case of miliary tuberculosis in a 77-year-old Filipino man with hypertension, diabetes mellitus, nephrolithiasis status-post left nephrectomy, presenting with 1 month of fever, generalised weakness and weight loss. Laboratory data were significant for anaemia, hypercalcaemia and acute kidney injury. Chest radiograph showed ground glass opacities and interstitial infiltrates. Extensive workup was performed to evaluate fever and hypercalcaemia. Malignancy, hormonal and sept...

  14. Erythromelanosis follicularis faciei et colli: Relationship with keratosis pilaris

    Augustine M; Jayaseelan E

    2008-01-01

    Erythromelanosis follicularis faciei et colli (EFF) is an unusual condition characterized by the triad of hyperpigmentation, follicular plugging and erythema of face and neck. This is less common in women and familial case reports are few. We report EFF in three siblings in an Indian family, two of whom are females. The possibility of this condition being genetically related to keratosis pilaris as well as being a variant of keratosis rubra pilaris is also discussed.

  15. Teleradiology : detectability of pneumothorax and miliary tuberculosis

    To evaluate the clinical utility of the teleradiology system using the information super highway communication network. Two radiologists selected 101 cases of pneumothorax and 20 cases of miliary tuberculosis. There were scanned and transmitted to our hospital at a speed of 640 Kbps and displayed on a video monitor with a resolution of 1280 pixels/line x 1024 lines. Four radiologists divided into three groups:read the images group A read the images without image processing;group B read the images with image processing, group C read the radiographic films on the view box. The authors compared sensitivity and specificity between the groups and checked their statistical significance using the Chi-square test. According to the location of the pleural line, we divided the pneumothorax into four types:continve on this live type 1, pleural line confined to the apex;type 2, to the upper half;type 3, to the lower half;type 4, to the upper through lower half. We then compared sensitivity between the Three groups. In the pneumothorax group, the average sensitivity of group A, B and C was 79%, 90% and 96%, and average specificity was 99%, 99% and 94%, respectively. There were statistically significant differences in seasitivity between group A and B and between group B and C (p<0.017). There were no statistically significant difference in specificity between group A and B or between group B and C. In the miliary tuberculosis group, the average sensitivity of group A, B and C was 73%, 78%, and 90%, and average specificity was 95%, 95% and 100%, respectively. With regard to sensitivity and specificity, there was no statistically significant difference between group A and B or between group B and C but there was a statistically significant difference between group A and C (p<0.017). According to the location of the pneumothorax, for all types, the sensitivity of group A was less than that of group B and group B was less than that of group C. All groups showed reduced observer

  16. Disseminated histoplasmosis simulating miliary tuberculosis: a case report

    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)

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

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

    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,...

  18. Asymptomatic pons tuberculoma in an infant with miliary tuberculosis

    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)

  19. Tuberculosis verrucosa cutis (TBVC)--foot with miliary tuberculosis.

    Padmavathy, L; Lakshmana Rao, L; Ethirajan, N; Ramakrishna Rao, M; Subrahmanyan, E N; Manohar, U

    2007-07-01

    Tuberculosis Verrucosa Cutis (TBVC) or warty tuberculosis is a variant of cutaneous tuberculosis in patients with good cell mediated immunity (CMI) to Mycobacterium Tuberculosis, while Miliary Tuberculosis is associated with very poor CMI. Two widely different clinical presentations in the same patient are very rare and being reported. PMID:17886704

  20. Bronchoscopic lung biopsy for diagnosis of miliary tuberculosis

    Aggarwal A

    2005-01-01

    Full Text Available Background: Miliary tuberculosis is often treated empirically in India in the absence of a positive diagnosis based on sputum examination. We investigated the role of fiberoptic bronchoscopy for diagnosis of this disease. Methods : Records of patients undergoing fiberoptic bronchoscopy and bronchoscopic lung biopsy, and diagnosed to have miliary tuberculosis, over a four year period were evaluated. Two to four lung biopsy specimens were obtained from each patient and examined microscopically after Hematoxylin-eosin and Zeihl-Neelson staining. Results : Thirty one patients of miliary tuberculosis (19 men and 12 women underwent fiberoptic bronchoscopy during the study period. No endobronchial abnormality was noted in any patient. Bronchoscopic lung biopsy yielded adeqaute specimen in all but one patient. Granulomatous inflammation was noted in 21 (67.7% patients on histopathological evaluation of biopsy specimens; of them, acid-fast bacilli were demonstrated in one patient. One patient (3.2% had normal alveolar architecture. In the other 8 patients (25.8%, nonspecific pulmonary interstitial inflammation and/or mild fibrosis were seen. Bronchial wash specimens showed acid-fast bacilli in only one patient; this patient also had granulomatous inflammation on lung biopsy. All patients tolerated bronchoscopy well and there were no procedure-related complications. Conclusion: Bronchoscopic lung biopsy is a safe procedure and an effective method of establishing diagnosis of miliary tuberculosis in a majority of patients with this disease. Bronchial washings do not provide significant additional information in this regard.

  1. MRI findings of miliary tuberculosis of the brain

    To evaluate MRI(Magnetic Resonance Imaging) findings of miliary tuberculosis of the brain Six patients with miliary tuberculosis of the brain diagnosed by characteristic clinical or laboratory findings were studied with spin echo MRI before and after contrast enhancement. We retrospectively evaluated MRI findings according to the appearance, distribution, location, and enhancement pattern of the granulomas as well as associated other abnormalities. In six patients, contrast-enhanced MRI of the brain showed numerous punctate, contrast enhancing lesions scattered throughout the brain. Unenhanced MRI failed to demonstrate small granulomas except a few small foci of high signal intensity on T2-weighted images. The shapes of enhancing granulomas were homogeneous nodular enhancement in 86% of cases and small ring enhancement in 14%. 98% of granulomas were smaller than 3-mm and 2% were larger. Although several lesions were located in the basal ganglia, thalamus, and brain stem, the majority were located in the subpial and subarachnoid space. There was no significant difference in distribution of granulomas between the supratentorial and the infratentorial areas. Other associated abnormalities were focal meningitis in five cases and focal cerebritis in one. On chest radiograph, all patients had miliary tuberculosis in the lungs. Contrast-enhanced T1-weighted MR imaging showed numerous round, very small enhancing lesions scattered throughout the brain. The majority of lesions were located in the subpial and subarachnoid space. Contrast-enhanced T1-weighted images are helpful in the detection and diagnosis of miliary disseminated tuberculous granulomas and meningitis

  2. MRI findings of miliary tuberculosis of the brain

    Choi, Chang Lak; Song, Chang June; Ahn, Young Jun; Youn, Wan Gyu; Jung, Youn Sin; Cho, June Sik [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

    1996-07-01

    To evaluate MRI(Magnetic Resonance Imaging) findings of miliary tuberculosis of the brain Six patients with miliary tuberculosis of the brain diagnosed by characteristic clinical or laboratory findings were studied with spin echo MRI before and after contrast enhancement. We retrospectively evaluated MRI findings according to the appearance, distribution, location, and enhancement pattern of the granulomas as well as associated other abnormalities. In six patients, contrast-enhanced MRI of the brain showed numerous punctate, contrast enhancing lesions scattered throughout the brain. Unenhanced MRI failed to demonstrate small granulomas except a few small foci of high signal intensity on T2-weighted images. The shapes of enhancing granulomas were homogeneous nodular enhancement in 86% of cases and small ring enhancement in 14%. 98% of granulomas were smaller than 3-mm and 2% were larger. Although several lesions were located in the basal ganglia, thalamus, and brain stem, the majority were located in the subpial and subarachnoid space. There was no significant difference in distribution of granulomas between the supratentorial and the infratentorial areas. Other associated abnormalities were focal meningitis in five cases and focal cerebritis in one. On chest radiograph, all patients had miliary tuberculosis in the lungs. Contrast-enhanced T1-weighted MR imaging showed numerous round, very small enhancing lesions scattered throughout the brain. The majority of lesions were located in the subpial and subarachnoid space. Contrast-enhanced T1-weighted images are helpful in the detection and diagnosis of miliary disseminated tuberculous granulomas and meningitis.

  3. A case of anxiety associated with miliary tuberculosis

    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

  4. Extensive marrow necrosis due to miliary tuberculosis: A case report

    Tummidi Santosh

    2015-01-01

    Full Text Available Bone marrow necrosis (BMN is a rare clinicopathologic entity caused by hypoxemia after the failure of microcirculation that frequently manifests with bone pain, fever, and peripheral cytopenia. In most reported cases of BMN resulting from extrapulmonary tuberculosis (TB, the presence of marrow granulomas, pulmonary infiltrates and/or extrapulmonary involvement are common. We report a case of an extensive BMN from miliary TB whose initial presentation was only mild anemia and multiple bone lesions.

  5. Action of γ-radiation on bioluminescence of Noctiluca miliaris

    Results of the study in the action of various doses of irradiation on the bioluminescence of Noctiluca miliaris are presented. The doses are found that stimulate the bioluminescence and the dose - effect curves are obtained. It has been shown that stimulation of Noctiluca luminescence by γ-radiation is not of a constant character and extinguishes after a period of time determined by a dose rate

  6. Recurrent pneumothorax: A rare complication of miliary tuberculosis

    Nafees Ahmad Khan

    2011-01-01

    Full Text Available Context: Recurrent pneumothorax is common in cavitory pulmonary tuberculosis, but it is extremely rare in miliary tuberculosis. Case Report: A 25 year old female patient presented to us with the complains of shortness of breath since 3 days. She was also having fever and cough since 3 months. Chest roentgenogram (PA view on admission showed a left sided pneumothorax with miliary mottling. An intercostals tube drainage was done on the left side resulting in relief of symptoms. Two days post intercostals tube drainage chest X ray (PA view showed complete resolution of pneumothorax, and intercostals tube was removed. Patient was discharged on antitubercular drugs. After 1 month patient again presented to us with severe breathlessness, on repeat chest X ray pneumothorax again developed on left side, urgent intercostals tube drainage was done, and patient relieved immediately. Patient was kept in the hospital for 12 days and, and was discharged after intercostals tube removal. Conclusion: If a patient of miliary tuberculosis presents with shortness of breath diagnosis of pneumothorax should be considered.

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

    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 average. (author). 17 refs., 1 tab., 3 figs

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

    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.

  9. Radiographic findings of miliary tuberculosis: difference in patients with and those without associated acute respiratory failure

    To determine the differences in the radiography findings of miliary tuberculosis between patients with and without associated acute respiratory failure (ARF). We retrospectively 32 patients in whom miliary tuberculosis had been diagnosed, and assigned them to one of two groups: with ARF (n=10), and without ARF (n=22). Chest radiographic findings such as presence of miliary modules, consolidation, ground-glass opacity (GGO), pleural effusion, small calcified nodules and linear opacities were assessed, the size and profusion of nodules in each of four zones were analyzed and scored using the standard radiographs of the international labor organization, and the extent of consolidation and GGO were scored according to the percentage on involved lung. We compared the radiologic findings between the two groups. Ground-glass opacity, consolidation, and pleural effusion were seen more frequently in miliary tuberculosis patinets with ARF than in those without ARF. Although the size and profusion of nodules were similar in both groups (p>0.05), consolidation and ground-glass opacity in cases of miliary tuberculosis with ARF were significantly more extensive than in those without ARF (p<0.005). GGO and consolidation were more extensive in miliary tuberculosis patients with ARF. A finding of ground-glass opacity in miliary tuberculosis patients might be an early indication of developing ARF

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

    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.)

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

    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.)

  12. A rare case of non-small cell carcinoma of lung presenting as miliary mottling.

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

    2013-03-01

    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

  13. Tuberculous Enteritis: A Rare Complication of Miliary Tuberculosis.

    Figueroa, Danisha; Guzman, Nilmarie; Isache, Carmen

    2016-01-01

    Tuberculous enteritis is a clinical rarity even in immunocompromised patients. We present a case of miliary tuberculosis with gastrointestinal involvement. A 47-year-old homosexual male from Philippines with no significant medical history presented with productive cough, night sweats, subjective fevers, shortness of breath, watery diarrhea, and 25-pound weight loss in past one year. On physical exam he was afebrile, mildly hypotensive, tachycardic, and tachypneic, but saturating well on room air. He was cachectic with oral thrush and bilateral fine rales. Chest X-ray revealed a miliary pattern. His sputum AFB smear was strongly positive. PCR and sputum culture were positive for Mycobacterium tuberculosis. He was started on Rifampin, Isoniazid, Ethambutol, and Pyrazinamide. He was found to be HIV positive with an absolute CD4 count of 4 cells/μL. Due to persistent diarrhea, stool was sent for AFB culture and grew M. tuberculosis. He responded well to treatment with resolution of symptoms. Tuberculous enteritis occurs in about 2% of the patients with pulmonary tuberculosis. Although it is uncommon, it should be considered in patients with active pulmonary tuberculosis and abdominal complaints. A presumptive diagnosis of tuberculous enteritis can be made in the setting of active pulmonary tuberculosis with suggestive clinical, endoscopic, and/or radiographic findings. PMID:27022494

  14. Intravitreal Injection of Bevacizumab to Treat a Macular Edema Caused by Leber's Miliary Aneurysm

    Takeyama, Masayuki; Iwaki, Masayoshi; Zako, Masahiro

    2012-01-01

    Purpose Leber's miliary aneurysm is a variant of Coats’ disease and similar to type 1 idiopathic macular telangiectasia. A recent report showed that an intravitreal injection of bevacizumab (IVB) was effective in an adult patient with type 1 idiopathic macular telangiectasia. We describe our experience with an adult patient with a macular edema caused by Leber's miliary aneurysm, which had not been resolved by prior retinal laser photocoagulation, who underwent IVB. Methods We investigated th...

  15. Miliary nodules due to secondary pulmonary hemosiderosis in rheumatic heart disease

    2011-01-01

    Pulmonary hemosiderosis is defined as the clinical and functional consequence of iron overload of the lungs, which usually occurs due to recurrent intra-alveolar bleeding. It can manifest as miliary mottling and should be entertained in the differential diagnosis of patients presenting with miliary nodules on chest radiography, especially those with mitral stenosis. The management of secondary pulmonary hemosiderosis secondary to valvular heart disease includes valvuloplasty and/or valve repl...

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

    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)

  17. Miliary Osteoma Cutis of the Face: A Case

    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.

  18. Miliary nodules due to secondary pulmonary hemosiderosis in rheumatic heart disease.

    Agrawal, Gyanendra; Agarwal, Ritesh; Rohit, Manoj Kumar; Mahesh, Venkat; Vasishta, Rakesh Kumar

    2011-02-28

    Pulmonary hemosiderosis is defined as the clinical and functional consequence of iron overload of the lungs, which usually occurs due to recurrent intra-alveolar bleeding. It can manifest as miliary mottling and should be entertained in the differential diagnosis of patients presenting with miliary nodules on chest radiography, especially those with mitral stenosis. The management of secondary pulmonary hemosiderosis secondary to valvular heart disease includes valvuloplasty and/or valve replacement. The radiological opacities may disappear with successful treatment of the underlying valvular disease in many patients. However, they may persist with no physiological impairment to the patient. Here, we present a 32-year-old man with mitral stenosis who presented with fever and miliary shadows on chest radiography, which was ultimately diagnosed as secondary pulmonary hemosiderosis. PMID:21390194

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

    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

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

    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.

  1. CT and pathologic correlation acute miliary pulmonary tuberculosis

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

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

    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.)

  3. Uncommon presentation of cryptogenic organizing pneumonia with miliary pattern in the thorax

    A 28-year-old female with worsening dyspnea showed miliary nodules of 2 mm in diameter on chest X-ray and high-resolution CT (HRCT). Histological evaluation and clinical outcome revealed an uncommon presentation of cryptogenic organizing pneumonia. (orig.)

  4. Miliary brain metastasis presenting with calcification in a patient with lung cancer: a case report

    Inomata Minehiko

    2012-09-01

    Full Text Available Abstract Introduction Miliary brain metastasis is an extremely rare form of brain metastasis which can present with atypical imaging findings. We report the case of a patient with miliary brain metastasis of lung cancer showing calcification in metastatic lesions. Case presentation A 68-year-old Japanese woman was diagnosed with lung adenocarcinoma. Brain computed tomography revealed multiple small calcified lesions in both cerebral hemispheres. Mutation of the epidermal growth factor receptor gene (exon 21, L858R in lung cancer cells was detected, and treatment with gefitinib was initiated. A partial response was observed; however, the patient was readmitted to our hospital because of regrowth of the primary lesion and complaints of nausea, headache, and difficulty walking. Brain magnetic resonance imaging revealed scattered tiny nodules enhanced by gadolinium. A diagnosis of leptomeningeal carcinomatosis was made on the basis of cerebrospinal fluid cytology. The patient’s general status worsened, and she died 356 days after the day of first medical examination. Upon autopsy, the brain was found to be edematous and swollen. Lung carcinoma cells were diffusely disseminated on the meningeal surface. Metastatic foci of small nodular form, accompanied by calcifications, were also found in the brain parenchyma. We diagnosed miliary metastasis of lung carcinoma. Conclusions To the best of our knowledge, this is the third report of calcified miliary brain metastasis confirmed by autopsy. We describe calcified lesions that increased in size during the clinical course of nine months. Brain computed tomography findings that reveal multiple small calcified lesions in patients with malignancy should raise suspicion of miliary brain metastasis.

  5. BIO-CONVENTIONAL BLEACHING OF KRAFT-AQ PULP OF A. CADAMBA BY CRUDE XYLANASES FROM COPRINELLUS DISSEMINATUS MLK-03 AND EFFECT OF RESIDUAL ENZYME ON EFFLUENT LOAD

    Mohan Lal

    2011-04-01

    Full Text Available A new thermo-alkali-tolerant crude xylanase from Coprinellus disseminatus decreased kappa number by 34.38% and improved brightness and viscosity by 1.6 and 6.47% respectively after XE1-stage during prebleaching of Anthocephalus cadamba kraft-AQ pulp. At 2.4% chlorine demand, crude xylanase in a XECEHH (X= enzymatic prebleaching stage, E= extraction stage, C= chlorination stage, H= hypochlorite stage bleaching sequence improved pulp brightness, tensile index, burst index, and double fold numbers by 3.66%, 4.78%, 6.38%, and 11.11%, respectively with a reduction in viscosity (10.59% and tear index (10.77% compared to the control. Combined bleach effluent of the XECEHH sequence mitigated adsorable organic halides (AOX by 21% and increased chemical oxygen demand (COD, bio-chemical oxygen demand (BOD, and colour by 67.18%, 84.78%, and 97.53%, respectively, compared to the control. Residual enzymes that entered during enzymatic prebleaching stage decreased AOX, COD, BOD, and colour of combined effluent of the XECEHH bleaching sequence progressively and on 6th day, and these were reduced by 23.78%, 0.04%, 15.00%, and 0.61%, respectively, compared to the control.

  6. Miliary brain metastases from papillary adenocarcinoma of the lung – unusual MRI pattern with histopathologic correlation

    Miliary brain metastases are very rarely described in the literature but if they are, they are quite obvious on magnetic resonance imaging (MRI) and enhance after intravenous administration of the contrast medium. The authors presented a case of miliary metastatic spread to the brain which was invisible on computed tomography and hardly visible on MRI, i.e. as countless, tiny, slightly T1-hyperintense foci that did not enhance. The authors discussed a few T1-hyperintense brain lesions which did not include metastases (except for metastatic melanoma which was a radiological suggestion after brain MRI). Autopsy revealed papillary adenocarcinoma of the lung with numerous metastatic lesions in both cerebral and cerebellar hemispheres and the meninges

  7. Subclinical miliary Mycobacterium bovis following BCG immunotherapy for transitional cell carcinoma of the bladder

    Choi, Chang-ho Ryan; Lee, Sang Oh; Smith, Geoff

    2014-01-01

    The authors present an unusual case of a 51-year-old man who developed relatively mild non-specific symptoms following intravesical BCG instillation for superficial transitional cell carcinoma of the bladder, with radiological investigations demonstrating typical features of miliary tuberculosis (TB). Transbronchial biopsy showed small foci of poorly formed granuloma suggestive of Mycobacterium infection. The patient's respiratory symptoms only became apparent 7 days after discharge having ha...

  8. Miliary tuberculosis in a patient with systemic lupus erythematosus with abscess formation in the upper extremities

    Ateş, Aşkın; ÖLMEZ, Ümit; Düzgün, Nurşen; ÖNÜR, Neriman Defne

    2003-01-01

    A 53-year-old man with arthritis and fever was admitted to hospital. He had been followed with systemic lupus erythematosus for the last seven years.He was on corticosteroid therapy. Laboratory work–up revealed tuberculous abscesses on bothhands and the patient died of respiratory failure due to miliary tuberculosis on the fourth day of anti – tuberculous therapy. It should be kept in mind that tuberculosis is frequently encountered in the systemiclupus erythematosus patient population due to...

  9. [Syndrome of inappropriate secretion of antidiuretic hormone associated with miliary tuberculosis].

    Ando, T; Tanaka, T; Saeki, A; Ogawa, K; Honda, K; Sasamoto, M; Hara, M

    1997-03-01

    An 82-year-old man with the chief complaint of anorexia was referred on suspicion of pulmonary tuberculosis. He had undergone thyroidectomy because of thyroid cancer 5 years ago, had taken levothyroxine sodium, and had kept plasma level of thyroidal hormone within normal range. He had never pointed out hyponatremia. On laboratory findings on admission, serum natrium level was 125 mEq/l. A chest X-ray film showed the infiltration in both lower lung fields, and a chest CT scan revealed a miliary pattern in both lungs. Tubercle bacilli were detected from the sputum by the Ziehl-Neelsen staining. Antituberculous drugs were started. On 5th hospital day, he developed consciousness disturbance, and the serum level of natrium and osmolarity was 103 mEq/l and 250 mOsm /kgH2O, respectively, while plasma ADH level was increased to 5.9 pg/ml, and urine level of natrium and osmolarity was 123 mEq/l and 394 mOsm/kgH2O, respectively. His mental disturbance and hyponatremia gradually improved by supplementing NaCl. We diagnosed this case as SIADH associated with miliary tuberculosis. SIADH should be considered when hyponatremia was occurred in the case of miliary tuberculosis. PMID:9103826

  10. Miliary tuberculosis: a severe opportunistic infection in juvenile systemic lupus erythematosus patients

    Priscilla S. Freire

    2016-06-01

    Full Text Available Abstract Introduction One of the main issues in juvenile systemic lupus erythematosus (JSLE patients is infection, such as tuberculosis (TB. Of note, SLE patients are susceptible to pulmonary and extrapulmonary TB. However, to our knowledge, this contagious disease was rarely reported in pediatric lupus population, particularly diffuse or miliary TB. Therefore, from January 1983 to December 2011, 5,635 patients were followed-up at our Pediatric Rheumatology Unit and 285 (5% of them met the American College of Rheumatology classification criteria for SLE. Case reports Four (1.4% of our JSLE patients had disseminated TB and were described herein. All of them were female gender, received BCG vaccination and did not have a history of TB household contact. The median of current age at TB diagnosis and the period between JSLE and TB diagnosis were 17 years old (range 14-20 and 5.5 years (range 2-7, respectively. All patients developed miliary TB during the course of the disease. The median of SLE Disease Activity Index 2000 (SLEDAI-2K was 4 (2-16 and the patients were treated with immunosuppressive agents (glucocorticoid, azathioprine and/or intravenous cyclophosphamide. Two of them presented sepsis and TB diagnosis was only established at autopsy, especially with lungs, central nervous system and abdominal involvements. Anti-TB therapy (isoniazid, rifampicin and pyrazinamide was indicated in the other two TB cases, however they deceased. Discussion Miliary TB is a rare and severe opportunist infection in pediatric lupus population. This study reinforces the importance of routine searches for TB in JSLE patients.

  11. The bloom of the dinoflagellate (Noctiluca miliaris) in the North Eastern Arabian Sea: Ship and Satellite study

    Matondkar, S.G.P.; Basu, S.; Parab, S.G.; Pednekar, S.; Dwivedi, R.M.; Raman, M.; Goes, J.I.; Gomes, H.

    Feb. N. miliaris is characterized by the presence of the symbiont Pedimonas noctilucae. This organism shows a predominantly green colouration due to the presence of high chlorophyll b along with chlorophyll a. Time series of OCM I and OCM II images...

  12. Lung Adenocarcinoma with Pulmonary Miliary Metastases and Complex Somatic Heterozygous EGFR Mutation

    Alexandre Schaller

    2014-11-01

    Full Text Available The pretreatment detection of an activating mutation of EGFR is now routinely performed in metastatic nonsquamous non-small cell lung cancer (NSCLC. The therapeutic impact of such a detection is major, as patients with advanced NSCLC exhibiting a mutation of exon 19 or 21 will benefit from EGFR-tyrosine kinase inhibitors (TKI. The presence of an EGFR resistance mutation, such as T790M in EGFR-TKI-naïve patients, is seldom looked for and is related either to a germinal mutation or to somatically mutated subclones. It has a negative predictive impact. We present the case of a patient with a lung papillary adenocarcinoma and miliary intrapulmonary metastases whose tumor displays a somatic complex heterozygous EGFR mutation, combining L858R (exon 21 and a primary resistance mutation T790M (exon 20, both detected by direct sequencing.

  13. Disseminated tuberculosis with paradoxical miliary tuberculomas of brain in a child with rickets

    Nehal H Patel

    2013-01-01

    Full Text Available Intracranial tuberculomas continue to be a serious complication of central nervous system tuberculosis. Multiple central nervous system tuberculoma is commonly associated with human immunodeficiency virus (HIV infection. The development of intracranial tuberculomas has been thought to be caused by hematogenous spread of tubercle bacilli on the surface of brain parenchyma from the primary site of infection. Here, we describe the case of a 5-year-old male child with severe protein energy malnutrition (Marasmus having large cervical lymphadenopathy and severe nutritional rickets with deformity at presentation. The child developed convulsions 20 days after initiation of antituberculous drugs, and neuroimaging confirmed multiple miliary tuberculomas of brain as primary etiology for the convulsions.

  14. Peripheral ulcerative keratitis associated with chronic malabsorption syndrome and miliary tuberculosis in a child

    Tarun Arora

    2015-01-01

    Full Text Available A 16-year-old girl presented with pain, redness, watering, and blurring of vision in her right eye. Slit lamp examination revealed the presence of peripheral ulcerative keratitis (PUK and nodular scleritis. On clinical examination, the patient had stunted growth, low body mass index, and enlarged axillary nodes. Giardia cysts were present in the stool sample and histopathology of axillary lymph nodes showed caseating necrosis suggestive of tuberculosis (TB. A diagnosis of PUK with chronic malabsorption syndrome secondary to giardiasis and miliary TB was made. Oral metronidazole, anti-tubercular treatment, high protein diet and vitamin supplements were started. Topical steroids were started for peripheral ulcerative lesions following, which the PUK resolved.

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

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

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

    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.

  17. Diurnal observations on the behavioral ecology of Gymnothorax moringa (Cuvier) and Muraena miliaris (Kaup) on a Caribbean coral reef

    Abrams, R. W.; Abrams, M. D.; Schein, M. W.

    1983-09-01

    Activities of muraenids, primarily Gymnothorax moringa and Muraena miliaris, were observed on a Caribbean coral reef with a view to further understanding their role in the reef ecosystem. Other muraenid species included in the total of 198 sightings were Echidna catenata, Enchelycore nigricans, and an unidentified brown moray. The five species were unequally distributed among three basic habitats (sand, coral head, reef rock) available on the reef. Nine particular holes accounted for 52.5% of the total sightings, although hundreds of other seemingly appropriate sites were available. The eels (except M. miliaris) were transient with respect to given holes and particular sections of the reef. While some G. moringa were sighted in the same holes for several consecutive days, M. miliaris individuals remained in the same coral heads throughout the 6-week study period. Muraenids observed in this study showed high tolerances for and were tolerated by other fishes (including other morays) and invertebrates on the reef. They appeared to be opportunistic, roving predators and were not strictly nocturnal. Distinct behavioral interactions and displays between muraenids and reef fish were observed.

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

    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.

  19. Diagnosis and management of miliary tuberculosis: current state and future perspectives [Retraction

    Ray S

    2015-09-01

    Full Text Available Ray S, Talukdar A, Kundu S, Khanra D, Sonthalia N. Ther Clin Risk Mngmt. 2013;9:9–26.The editor of the Indian Journal of Medical Research has brought to our attention the unacknowledged re-use of significant portions of text in the above article. The source of much of the text appears to be from:Sharma SK, Mohan A, Sharma A. Challenges in the diagnosis and treatment of miliary tuberculosis. Indian J Med Res. 135, May 2012, pp 703–730.Dr Ray comments thus: “Regarding the similarities found we want to clarify that this apparent plagiarism is not an intentional act and likely to be factual error. In any way, we do not want to undermine scientific pursuit or vitiate the investigational spirit of hard work and creativity. Please be informed that the different portions of the review were written by different co-authors and most of them were postgraduate students at that time. It seems that they have taken materials/ideas from previously published source unaware of the issues of plagiarism.” This retraction relates to this paper

  20. A Case of Sarcoidosis with Unusual Radiographic Findings that Developed 5 Years after Silicone Augmentation Mammoplasty Complicated by Miliary Tuberculosis during Corticosteroid Treatment

    Tomoko Miyashita

    2011-01-01

    Full Text Available A 54-year-old woman with a past history of silicone augmentation mammoplasty was admitted with fever and dyspnea with diffuse interstitial shadows on computed tomography (CT. Although radiological findings were atypical, we diagnosed sarcoidosis by laboratory, microbiological, and bronchoalveolar lavage fluid analysis. Corticosteroids ameliorated the condition, but she had recurrent of fever and CT revealed miliary nodules while interstitial shadows disappeared. Liver biopsy showed that noncaseating granuloma and Ziehl-Neelsen stain was positive. We diagnosed miliary tuberculosis which developed during corticosteroid therapy. Antituberculotic therapy resulted in favorable outcome. Possibility exists that onset of sarcoidosis was induced by mammoplasty, namely, human adjuvant disease.

  1. Miliary pattern of brain metastases – a case report of a hyperacute onset in a patient with malignant melanoma documented by magnetic resonance imaging

    Miliary brain metastases are a rare condition but associated with an exceedingly poor prognosis. We present the case of a patient suffering from malignant melanoma with an acute progressively worsening of neurological symptoms up to the loss of consciousness. The magnetic resonance imaging (MRI) demonstrated a new onset of disseminated, miliary spread of central nervous system metastases from a malignant melanoma within 4 days. We report on a 57-year-old woman suffering from metastatic malignant melanoma positive for BRAF-V600E mutation who developed an acute onset of neurological symptoms. The patient received vemurafenib and dacarbacin as chemotherapeutic regime for treatment of malignant melanoma. After admission to our hospital due to progressive disturbance of memory and speech difficulty a magnetic resonance tomography (MRI) was performed. This showed no evidence of cerebral tumour manifestation. The symptoms progressed until a loss of consciousness occurred on day five after admission and the patient was admitted to our intensive care unit for orotracheal intubation. No evidence for infectious, metabolic or autoimmune cerebral disorders was found. Due to the inexplicable acute worsening of the neurological symptoms a second MRI was performed on day five. This revealed a new onset of innumerable contrast-enhancing miliary lesions, especially in the grey matter which was proven as metastases from malignant melanoma on histopathology. This case describes an unique hyperacute onset of tumour progression correlating with an acute deterioration of neurological symptoms in a patient suffering from miliary brain metastasis from BRAF positive malignant melanoma

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

    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.

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

    BASU Subhajit; MATONDKAR SG 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 ofNAS (20°N-17°N and 64°E-70°E),during the spring-inter-monsoon cruise ofSagar 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 NaC1),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%NaC1 (w/v),and (2.82-9.49)× 102 cells/mL at 25% (w/v) NaC1 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) NaC1,and (0.4-7)× 104 CFU/mL at 25% NaC1 (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,Bacillusflexus,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.

  4. Diffuse calcification of the urinary system and miliary tuberculosis due to delayed diagnosis of genitourinary tuberculosis: a case report.

    Hairong Chen

    2015-02-01

    Full Text Available Genitourinary tuberculosis (GUTB is difficult to diagnose in the earlier stage owing to the non-specific symptoms. Usually, renal tuberculous involvement is unilateral and the imaging finding is renal calcification, but associated calcifications of bilateral ureter and bladder are rare. We report a 66-year-old man who presented with diffuse calcification of the urinary system (including bilateral pelvicalyceal system, both ureters and bladder and disseminated miliary tuberculosis due to GUTB. He had been misdiagnosed with urinary tract infection and urinary lithiasis for two years before the diagnosis of GUTB was confirmed by microbiological examination of the urine. This case highlights the importance of maintaining a high index of clinical suspicion for GUTB.

  5. Uncommon presentation of cryptogenic organizing pneumonia with miliary pattern in the thorax; Ungewoehnliche Manifestation einer kryptogen organisierenden Pneumonie mit miliarem Verschattungsmuster im Thorax

    Langen, H.J.; Biewener, C. [Missionsaerztliche Klinik, Radiologische Abteilung, Wuerzburg (Germany); Ruediger, T. [Universitaet Wuerzburg, Pathologisches Institut, Wuerzburg (Germany); Jany, B. [Missionsaerztliche Klinik, Abteilung fuer Innere Medizin, Wuerzburg (Germany)

    2008-03-15

    A 28-year-old female with worsening dyspnea showed miliary nodules of 2 mm in diameter on chest X-ray and high-resolution CT (HRCT). Histological evaluation and clinical outcome revealed an uncommon presentation of cryptogenic organizing pneumonia. (orig.) [German] Bei einer 28-jaehrigen Patientin mit zunehmender Dyspnoe wurden auf der Thoraxroentgenaufnahme und in der hochaufloesenden CT (HRCT) homogen verteilte monomorphe miliare Fleckschatten von ca. 2 mm Durchmesser nachgewiesen. Die histologische Sicherung und der klinische Verlauf ergaben eine kryptogen organisierende Pneumonie, die sich bildmorphologisch ungewoehnlicherweise nur mit miliaren Knoetchen manifestierte. (orig.)

  6. Observações anatômicas sôbre a larva de Thoropa miliaris (Amphibia, Leptodactylidae

    Rudolf Barth

    1956-12-01

    Full Text Available Die kaulquappe von Thoropa miliaris lebt in mittleren Lagen des Itatiáia-Gebirges (Staat Rio de Janeiro, in etwa 1650 m Hoebe, auf fast senkracht stehenden Felsplatten, ueber die staendig eine sehr duenne Schicht Wasser herablaeuft. Die Tiere haben keinen Flossensaum; der zwei- bis dreimal koerperlange Schwanz ist fast drehrund und besitzt an Stelle eines Flossensaumes nur einen ventralen Kiel, der die Schlaengelbewegung gegen den Wasserstrom unterstuetzt. Auch die juengsten Stadien haben keine aeusseren kiemen, sondern innere in einer Atemhoehle, deren Ausgang sich auf der linken Seite in der Mitte des Koerpers befindet. Die Tiere heften sich an den Steinen vermittels ihres sehr grossen Mundapparates fest. Die Lippen tragen zwei oder drei Reihen starker Keratin-Haken, die durch laufende Neubildung ersetzt werden. Die arbeitenden Spitzenzaehne des Hornschnabels in der Mundhoehle werden ebenfalls durch fortgesetztes Wachstum erneuert. Die Saugscheibenwirkung des Mundes wird durch ein Muskelpaar bedingt, das einerseits am Parasphenoid- und am Sphenethmoidknorpel, andererseits mit seinen unteren Buendeln am Prodentale (Spitze des Meckel'schen Knorpels, mit seinem oberen vermittels je zweier Sehnen am Promaxillare ansetzt. Durch die kontraktion dieser Muskeln wird das Prodentale nach oben und dann nach hinten, das Promaxillare (mit Gelenkstellen am Prointermaxillare und Pronasale nach oben und dann nach vorne gedreht. Hierdurch treten die beiden Kegel des Hornschnabels in die Mundhoehle, da sie den beiden Knorpeln fest aufsitzen. Bei starker Kontraktion werden die Knorpel auseinander gedrueckt und vergroessern die Mundhoehle. Wenn die Lippen, unterstuetzt von den Hakenreihen, fest dem Stein aufliegen, ergibt sich ein Unterdruck in der Mundhoehle, der genuegt, um die Larven auf der Unterlage festzuhalten. Das Loesen des Saugnapfes erfolgt durch die kontraktion einer Gruppe kleiner Muskelbuendel, die einerseits am Unterrand des Prodentale

  7. Significance of localized miliary subdiaphragmatic seeding and size of initial postsurgical residual in patients with epithelial ovarian cancer

    Objective: Despite multimodality treatment regimens the survival rates for patients with stage III epithelial ovarian cancer have shown minor improvement in the last decade and remain poor. An analysis of the results of our trimodality treatment regimens was undertaken to identify prognostic factors for progression-free survival (PFS) and to correlate these with patterns of failure. Materials and Methods: Between May 1985 and December 1994, 52 patients with FIGO stage III ovarian cancer underwent maximum cytoreductive surgery, followed by chemotherapy (1-10 cycles, median: 6) and external beam irradiation. Radiation treatment consisted of whole abdominal irradiation (30 Gy), pelvic boosts (21,6 Gy), diaphragmatic boosts (12 Gy) and paraaortic nodal boosts (12 Gy) if the latter were involved. Patient age ranged from 31-79 years (median: 59). Follow-up for all patients was from 1-127 months (median: 25) and 38-127 months (median: 76) for patients at risk. Factors analysed for their impact on PFS and patterns of failure included postsurgical size and site of residual tumor, age, tumor grade, unilateral or bilateral ovarian involvement, presence of ascites, number of cycles of chemotherapy, and completion of radiotherapy. Results: Actuarial survival and PFS rates at 5 years were 30% and 29%. The presence of localized miliary seeding at the dome of the right diaphragm (MDS; 14 patients) as well as residual disease >2 cm after surgical debulking (6 patients) strongly influenced PFS. Patients with MDS or >2 cm residual disease had a PFS of 0% with a median survival of 6 and 8 months, respectively. These results were significantly worse (p=0.0006) than those obtained for the 16 patients with no macroscopic tumor or the 15 patients with macroscopic residuals 2 cm residual (67%) compared with patients who had no or 2 cm) were found to be strongly prognostic and are associated with a high incidence of distant failure. If our finding of the prognostic significance of MDS can

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

    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.

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

    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,

  10. Remotely Searching for Noctiluca Miliaris in the Arabian Sea

    Werdell, P. Jeremy; Roesler, Collin S.; Goes, Joaquim I.

    2014-01-01

    Reversing monsoonal winds in the Arabian Sea result in two seasons with elevated biological activity, namely the annual summer Southwest Monsoon (SWM; June to September) and winter Northeast Monsoon (NEM; November to March) [Wiggert et al., 2005]. Generally speaking, the SWM and NEM create two geographically distinct blooms [Banse and English, 2000; Levy et al., 2007]. In the summer, winds from the southwest drive offshore Ekman transport and coastal upwelling along the northwestern coast of Africa, which brings nutrient-rich water to the surface from below the permanent thermocline [Bauer et al., 1991]. In the winter, cooling of the northern Arabian Sea causes surface waters to sink, which generates convective mixing that injects nutrients throughout the upper mixed layer [Madhupratap et al., 1996]. This fertilization of otherwise nutrient-deplete surface waters produces one of the most substantial seasonal extremes of phytoplankton biomass and carbon flux anywhere in the world [Smith, 2005].

  11. Intravesical BCG therapy as cause of miliary pulmonary tuberculosis.

    Rosati, Yuri; Fabiani, Andrea; Taccari, Tommaso; Ranaldi, Renzo; Mammana, Gabriele; Tubaldi, Alberto

    2016-03-01

    Immunotherapy with intravesical bacillus Calmette-Guérin (BCG) is considered the most effective adjuvant to endoscopic resection of bladder urothelial carcinoma in the therapeutic management of non-muscle invasive (NMIBC) at intermediate and high risk of recurrence and progression (pTa - pT1 and high-grade carcinoma in situ, CIS). Despite its proven efficacy, this type of treatment can determine local and systemic side effects of moderate or severe gravity, with the histological diagnosis of epithelioid granulomas in different organs, even in the absence of microbiological positivity of BCG. The immunotherapy with BCG is usually well tolerated and the virulence of the attenuated BCG is very low in immuno-competent patients, although only 16% of patients are able to receive all the instillations of the maintenance period (3 years) of treatment provided by the protocols, precisely because of side effects. Minor side effects usually resolve within a few hours or days. They develop in 3-5% of patients and usually consist of local infectious complications. Manifestations of BCG dissemination, such as vascular and ocular complications, are much less common, while BCG-disseminated infections, with granulomatous pneumonia or hepatitis present, are quite rare, representing 0.5-2% of the complications recorded. We present the clinical case of granulomatous lung and possibly liver infection caused by BCG in a patient aged 56 years being treated for several weeks with intravesical BCG for NIMBC pT1 high grade associated with CIS. PMID:26616461

  12. Locating Noctiluca miliaris in the Arabian Sea: An optical proxy approach

    Thibodeau, P.S.; Roesler, C.S.; Drapeau, S.L.; Matondkar, S.G.P.; Goes, J.I.; Werdell, P.J.

    to low oxygen regeneration in the interior deep water as well as upwelling driving deep low-oxygen waters to the surface around the perimeter (Wajih et al. 2006). Recent and significant reductions in snow coverage in the Himalayas as well as extremely...

  13. PCR use in miliary tuberculosis presenting with acute respiratory distress syndrome.

    Riachy, Moussa Albert

    2011-01-01

    A 30-year-old pregnant woman admitted to the hospital for rapidly progressive dyspnoea, non-productive cough and altered general status evolving over 1-month period. Her vital signs showed a low blood pressure 90/60 mm Hg, pulse rate 100 beats/min, respiratory rate 32 breaths/min and oxygen saturation on room air of 88%. Laboratory findings showed haemoglobin 9.7 g/dl, white blood cells 15 000/mm(3) (neutrophils 82%), C reactive protein 74 mg/l, alkaline phosphatase 320 U/l, alanine aminotransferase 62 IU/l, aspartate aminotransferase 120 IU/l, γ glutamyl transpeptidase 125 U/l; brain natriuretic peptide 25.4 pg/ml, procalcitonine >2, lactate dehydrogenase 1618 U/l. Chest radiographics showed diffuse bilateral micronodular pulmonary infiltrates and CT of the chest confirmed 1-3 mm diffuse bilateral micronodular infiltrates with ground glass opacities. Complete investigation including bronchoalveolar lavage (BAL) for any viral, bacteriologic, acid-fast bacilli and full serum antibodies panel were all negative. DNA amplification for mycobacterium using PCR on the BAL rapidly rectified the diagnosis of tuberculosis. PMID:22694890

  14. PCR use in miliary tuberculosis presenting with acute respiratory distress syndrome

    Riachy, Moussa Albert

    2011-01-01

    A 30-year-old pregnant woman admitted to the hospital for rapidly progressive dyspnoea, non-productive cough and altered general status evolving over 1-month period. Her vital signs showed a low blood pressure 90/60 mm Hg, pulse rate 100 beats/min, respiratory rate 32 breaths/min and oxygen saturation on room air of 88%. Laboratory findings showed haemoglobin 9.7 g/dl, white blood cells 15 000/mm3 (neutrophils 82%), C reactive protein 74 mg/l, alkaline phosphatase 320 U/l, alanine aminotransf...

  15. Human envenomation by an aglyphous colubrid snake, Liophis miliaris (Linnaeus, 1758)

    Santos-Costa, María Cristina; Di Bernardo, Marcos

    2001-01-01

    In Brazil, some snakes of the family Colubridae usually regarded as not venomous, are responsable by serious and even so fatal accidents. Some opisthoglyphous snakes that occur in southern Brazil. as Philodrias olfersii (Lichtenstein, 1823), Boiruna maculata (Boulenger, 1896), Phalotris lemniscatus trilineatus Boulenger. 1889 and Thamnodynastes strigatus (Günther, 1858) deserve greatest attention because they have already caused human envenomation as reported by many authors (Hoge, 1952; Lema...

  16. Pulmonary Embolism following Cessation of Infliximab for Treatment of Miliary Tuberculosis

    Brian Lee

    2014-01-01

    Full Text Available We report a case of a 41-year-old male who presented with tachycardia and swelling of his left arm six weeks after he started antituberculosis treatment and stopped his rheumatoid arthritis infliximab treatment. He was diagnosed with pulmonary embolism by chest CT and initially treated with warfarin, which interacted with his antituberculosis treatment. This presentation of deep vein thrombosis and pulmonary embolism as part of immune reconstitution inflammatory syndrome has not been previously reported for infliximab treated patients.

  17. Pulmonary Embolism following Cessation of Infliximab for Treatment of Miliary Tuberculosis

    Moosavy, Farid

    2014-01-01

    We report a case of a 41-year-old male who presented with tachycardia and swelling of his left arm six weeks after he started antituberculosis treatment and stopped his rheumatoid arthritis infliximab treatment. He was diagnosed with pulmonary embolism by chest CT and initially treated with warfarin, which interacted with his antituberculosis treatment. This presentation of deep vein thrombosis and pulmonary embolism as part of immune reconstitution inflammatory syndrome has not been previously reported for infliximab treated patients. PMID:25530902

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

    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.

  19. Blooms of Noctiluca miliaris in the Arabian Sea - An in situ and satellite study

    Gomes, H.R.; Goes, J.I.; Matondkar, S.G.P.; Parab, S.G.; Al-Azri, A.R.N.; Thoppil, P.G.

    for India’s first ocean color sensor, the Ocean Color Monitor (OCM-I), on board the satellite IRS-P4. In addition to detailing the community structure of phytoplankton, it documented for the first time ever the appearance of large-scale blooms of Noctiluca... mounted on a Sea Bird Electronics s CTD Rosette. Clean techniques (Knap et al., 1996) were used in all sampling. Sensors mounted on the CTD Rosette provided vertical profiles of salinity, tem- perature and dissolved oxygen. The depth of the euphotic zone...

  20. Unusual blooms of green Noctiluca miliaris (Dinophyceae) in the Arabian Sea during the winter monsoon

    Gomes, H.R.; Matondkar, S.G.P.; Parab, S.G.; Goes, J.I.; Pednekar, S.; Al-Azri, A.R.N.; Thoppil, P.G.

    Institute of Oceanography, Goa, India, in winter and in SIM, from 2003, onward, in support of the develop- ment of bio-optical algorithms for India ’s first ocean color sensor, the Ocean Color Monitor, on board the satellite IRS- P4 has provided the first... AL. 349 Plate 1. Sampling locations for cruises (a1) CR-1-JAN-2003, (a2) CR-2-MAR-2003, (a3) CR-3-MAR-2004, (a4) CR- 4-DEC-2004, and (a5) CR-5-MAR-2007 superimposed on 8-day composites of Sea-viewing Wide Field-of-view Sensor and Aqua...

  1. Retrieved bacteria from Noctiluca miliaris (green) bloom of the northeastern Arabian Sea

    Basu, S.; Matondkar, S.G.P.; Furtado, I.

    . # Identifi cation supported by 16S rDNA sequence homology having accession numbers JN315891 – JN315893. Pigmentations are denoted by W: White, LY: Lime yellow, PC: pale cream, B: Beige, BR: Brick red, LO: Light orange; Endospores as T: terminal, Ts: sub...

  2. Study of ecological consequence of the bloom (Noctiluca miliaris) in off shore waters of the Northern Arabian Sea

    Dwivedi, R.M.; Chauhan, R.; Solanki, H.U.; Raman, M.; Matondkar, S.G.P.; Madhu, V.R.; Meenakumari, B.

    , NO. 4, AUGUST 2012 306 Schools of flying fishes and large size squids were observed during night at one bloom station in March 2007 (FORV-253). Also, on one occasion baby sharks were found swimming inside the bloom patch. These observations...

  3. El “Tentamen medicum de morbo miliari infantum, muguet, millet, blanchet, gallico idiomate appellate" (1786, de Francisco Sanponts

    Romero Maroto, Martín

    1997-06-01

    Full Text Available A medical text on aphtae, writed in 1786 and printed in 1788, is analized. Its author was the catalan physician Francisco Sanponts y Roca (1756-1821. This work was awarded with the first prize by the Société Royal de Médecine from Paris, in a competition to study and solve the problem of the wide diffusion of Aphtae (Muguet among the orphanages' children. This was the first description of this disease in Spain. The author was influenced by the antisystematic mentality and by the anatomoclinical empiricism; he widely refers to Van Swieten and Nils Rosen, besides other 65 authors. Through his references he proved that he was well informed about the European medicine and pediatrics, although he was not apparently acquainted with the work of Underwood, the first known description of this disease, that was published two years earlier.

    Se analiza un texto de 1786 impreso en 1788, cuyo autor es el médico catalán Francisco Sanponts y Roca (1756-1821, que mereció el primer premio de la Real Sociedad de Medicina de París en un certamen convocado para estudiar y solucionar el problema planteado por la amplia difusión del Muguet entre los niños acogidos en hospicios. Se trata de la primera descripción de la enfermedad hecha en España y el autor, influido por la mentalidad antisistemática y el empirismo anatomoclínico, cita de forma amplia a Van Swieten y a Nils Rosen, entre 67 autores, con lo que demuestra estar al corriente de la medicina y la pediatría europeas, aunque aparentemente desconoce el trabajo de Underwood, publicado dos años antes de la elaboración del suyo, que representa la primera descripción conocida de esta enfermedad.

  4. Red tide of Noctiluca miliaris off south of Thiruvananthapuram subsequent to the ‘stench event’ at the southern Kerala coast

    Sahayak, S.; Jyothibabu, R.; Jayalakshmi, K.J.; Habeebrehman, H.; Sabu, P.; Prabhakaran, M.P.; Jasmine, P.; Shaiju, P.; Rejomon, G.; Threslamma, J.; Nair, K.K.C.

    that the causative organisms for the stench and fish kill were Cochlodinium sp. and Gonyaulax diegensis. Later, detailed study on samples collected from all along the southern Malabar Coast reported it was due a holococolithophore bloom. In the present communication...

  5. Culturable bacterial flora associated with the dinoflagellate green Noctiluca miliaris during active and declining bloom phases in the Northern Arabian Sea

    Basu, S.; Deobagkar, D.D.; Matondkar, S.G.P.; Furtado, I.

    by the micro-flora during both the phases of the bloom, decaying phase microflora showed a comparatively lower resistance to the antibiotics tested. During the active phase highest resistance of micro-flora was to the antibiotics Nalidixic acid (94...’. Phenotypic characterization All isolates were subjected to a battery of 103 phenotypic/metabolic tests. Key phenotypic characters of cell morphology, gram’s reaction, endospore staining, catalase, oxidase, anaerobic growth in thioglycollate broth, Nitrate...

  6. CHOROIDAL TUBERCLES IN ISOLATED TUBERCULOUS MENINGITIS

    Tharun Tom

    2016-04-01

    Full Text Available Choroidal tubercles are the most common manifestation of intraocular tuberculosis and results from the haematogenous spread of mycobacteria in miliary tuberculosis. However, its presence without the evidence of miliary tuberculosis is a rare entity. We present a case of isolated tuberculous meningitis with choroidal tubercles, who had no features of miliary tuberculosis.

  7. 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

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

    2011-01-01

    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 tratamento. 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...

  8. A checklist of gilled mushrooms (Basidiomycota: Agaricomycetes) with diversity analysis in Hollongapar Gibbon Wildlife Sanctuary, Assam, India

    Girish Gogoi; Vipin Parkash

    2015-01-01

    Hollongapar Gibbon Wildlife Sanctuary is comprised of five distinct compartments.  A total of 138 species of gilled mushrooms belonging to 48 genera, 23 families, five orders of the class Agaricomycetes, division Basidiomycota, have been collected and analyzed. The order Agaricales was was found with the highest number of species (113), followed by Russulales (14), Polyporales (5), Cantharellales (4) and Boletales (2). The species Coprinellus disseminatus and Megacollybia rodmani have shown t...

  9. Clinical and radiological deterioration in a patient with AIDS

    Paradoxical clinical deterioration of miliary tuberculosis, characterized by pulmonary and abdominal manifestations, is reported in a patient with the acquired immunodeficiency syndrome, after initiation of treatment with highly active antiretroviral therapy. Paradoxical reaction was attributed to partial restoration of cell-mediated immunity related to highly effective antiretroviral therapy. Because tuberculosis has a high prevalence in HIV patients and tuberculosis is often characterized by miliary spreading of disease in these patients, it is important to recognize this phenomenon. (orig.)

  10. Long-term sequelae of Farmer's lung disease in HRCT: a 14-year follow-up study of 88 patients and 83 matched control farmers

    The aim of this study was to compare high-resolution computed tomography (HRCT) findings of long-term farmer's lung (FL) patients and control farmers. We studied 88 FL patients and 83 matched control farmers with a mean follow-up time of 14 years. Emphysematous, fibrotic, and miliary changes were recorded by HRCT. The pattern of emphysema and location and distribution of other findings were evaluated in detail. Emphysema was found in 20 (23%) FL patients and in 6 (7%) controls (p=0.005). Recurrences of FL attacks increased (p=0.021) the risk of emphysema. Prevalence of fibrosis (17 vs 10%, p=0.16) and miliary changes (11 vs 4%, p=0.06) did not differ significantly in patients and controls. Among FL patients, emphysematous, fibrous, and miliary changes were more pronounced at the base than in the upper parts of the lung (p<0.02). In slice analysis, the pattern of emphysema was more polymorphous (p=0.001) and the distribution of fibrotic and miliary changes was more variable among FL patients than controls. Emphysema in HRCT is more common in FL patients than matched control farmers, and the occurrence is increased by recurrences of FL. Emphysematous, fibrous, and miliary changes in FL patients HRCT are multiform and predominate in the lower parts of the lung. (orig.)

  11. A Case of Choroidal Tubercles

    Chaoran Zhang

    2004-01-01

    Purpose: To report a case of choroidal tubercles in a miliary tuberculosis boy.Method: Clinical features description.Results: A 14-year-old boy was found to have multifocal choroidal tubercles. Angiography was performed. He was followed up for 12 months. The choroidal lesions regressed after using anti-tuberculosis drugs for 8 months. Pigment changes remained. Conclusion: Tuberculosis may present as a posterior segment inflammation. In miliary tuberculosis, choroid is also a target tissue. Eye Science 2004;20:23-24.

  12. Dicty_cDB: Contig-U13289-1 [Dicty_cDB

    Full Text Available ) Coprinellus disseminatus strain C3... 166 1e-39 CU928162_3278( CU928162 |pid:none) Escherichia...nsis str. LM... 165 2e-39 CP000542_3873( CP000542 |pid:none) Verminephrobacter eiseniae EF01... 16... 34 4.7 BX571867_145( BX571867 |pid:none) Photorhabdus luminescens subsp. ... 34 4.7 CP000013_76( CP000013 |pid:none) Borrelia garin...orrhagic septicemia virus... 34 6.1 AL844505_65( AL844505 |pid:none) Plasmodium falciparum 3D7 chrom...) Prochlorococcus marinus str. MIT... 34 6.1 AF143862_2( AF143862 |pid:none) Viral hemorrhagic septicemia

  13. A checklist of gilled mushrooms (Basidiomycota: Agaricomycetes with diversity analysis in Hollongapar Gibbon Wildlife Sanctuary, Assam, India

    Girish Gogoi

    2015-12-01

    Full Text Available Hollongapar Gibbon Wildlife Sanctuary is comprised of five distinct compartments.  A total of 138 species of gilled mushrooms belonging to 48 genera, 23 families, five orders of the class Agaricomycetes, division Basidiomycota, have been collected and analyzed. The order Agaricales was was found with the highest number of species (113, followed by Russulales (14, Polyporales (5, Cantharellales (4 and Boletales (2. The species Coprinellus disseminatus and Megacollybia rodmani have shown the highest (8.26 and the lowest density (0.05, respectively.  A total of 24 species, e.g., Termitomyces albuminosus, Marasmius curreyi, Marasmiellus candidus, Leucocoprinus medioflavus, Mycena leaiana, Hygrocybe miniata, Collybia chrysoropha, Gymnopus confluens were common with frequency percentage of 11.9, whereas Megacollybia rodmani with less frequency percentage (2.4 was found only in few quadrates of the sanctuary.  The highly abundant species were Termitomyces medius (91.7 and Coprinellus disseminatus (86.8, and less abundant species were Psilocybe wayanadensis (1.0 and Lepiota sp. (1.0 in the study site.  The order of the species richness index (R compartment wise was 2>3>4>5>1. Both the Shannon diversity index and Simpson diversity index of agarics was maximum (1.88, 0.98 in compartment 2, whereas minimum (1.72, 0.95 in compartment 1 and 5, respectively.  Moreover, the compartment 2 was found very much similar with compartment 3 and very less similar with compartment 1. 

  14. Disseminated candidiasis 18 years after renal transplantation

    Bismay, K.; Mathew, A.; R. Rajesh; Kurian, G.; Unni, V. N.; Kavita, R. D.; Sreehari, S.

    2012-01-01

    Although mucocutaneous candidiasis is a common infection in renal transplant recipients, disseminated candidiasis is rare. Candida pnemonia causing miliary mottling on X-ray chest with the central nervous system involvement is still rarer. We report an unusual case with disseminated candidiasis that presented 18 years after renal transplantation and improved on conventional antifungal therapy; the relevant literature is reviewed.

  15. NCBI nr-aa BLAST: CBRC-GACU-08-0023 [SEVENS

    Full Text Available CBRC-GACU-08-0023 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 7e-91 47% ...

  16. NCBI nr-aa BLAST: CBRC-MDOM-03-0298 [SEVENS

    Full Text Available CBRC-MDOM-03-0298 ref|NP_001138703.1| G protein-coupled receptor 81 [Canis lupus fa...miliaris] gb|ACJ03849.1| G-protein coupled receptor 81 [Canis lupus familiaris] NP_001138703.1 1e-154 76% ...

  17. NCBI nr-aa BLAST: CBRC-OLAT-01-0032 [SEVENS

    Full Text Available CBRC-OLAT-01-0032 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 7e-61 41% ...

  18. NCBI nr-aa BLAST: CBRC-DRER-11-0014 [SEVENS

    Full Text Available CBRC-DRER-11-0014 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 1e-93 52% ...

  19. NCBI nr-aa BLAST: CBRC-MMUS-03-0082 [SEVENS

    Full Text Available CBRC-MMUS-03-0082 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 0.0 87% ...

  20. NCBI nr-aa BLAST: CBRC-RNOR-23-0122 [SEVENS

    Full Text Available CBRC-RNOR-23-0122 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 0.0 86% ...

  1. NCBI nr-aa BLAST: CBRC-OPRI-01-0260 [SEVENS

    Full Text Available CBRC-OPRI-01-0260 ref|NP_001138703.1| G protein-coupled receptor 81 [Canis lupus fa...miliaris] gb|ACJ03849.1| G-protein coupled receptor 81 [Canis lupus familiaris] NP_001138703.1 1e-146 75% ...

  2. NCBI nr-aa BLAST: CBRC-OPRI-01-1433 [SEVENS

    Full Text Available CBRC-OPRI-01-1433 ref|NP_001041572.1| G protein-coupled receptor 44 [Canis lupus fa...miliaris] emb|CAJ77887.1| G-protein coupled receptor [Canis lupus familiaris] NP_001041572.1 1e-133 66% ...

  3. NCBI nr-aa BLAST: CBRC-CPOR-01-1448 [SEVENS

    Full Text Available CBRC-CPOR-01-1448 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 1e-141 93% ...

  4. NCBI nr-aa BLAST: CBRC-PCAP-01-0075 [SEVENS

    Full Text Available CBRC-PCAP-01-0075 ref|NP_001138703.1| G protein-coupled receptor 81 [Canis lupus fa...miliaris] gb|ACJ03849.1| G-protein coupled receptor 81 [Canis lupus familiaris] NP_001138703.1 1e-64 83% ...

  5. NCBI nr-aa BLAST: CBRC-LAFR-01-3130 [SEVENS

    Full Text Available CBRC-LAFR-01-3130 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 0.0 91% ...

  6. NCBI nr-aa BLAST: CBRC-CFAM-06-0037 [SEVENS

    Full Text Available CBRC-CFAM-06-0037 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 0.0 100% ...

  7. NCBI nr-aa BLAST: CBRC-TTRU-01-0756 [SEVENS

    Full Text Available CBRC-TTRU-01-0756 ref|NP_001138703.1| G protein-coupled receptor 81 [Canis lupus fa...miliaris] gb|ACJ03849.1| G-protein coupled receptor 81 [Canis lupus familiaris] NP_001138703.1 1e-171 86% ...

  8. NCBI nr-aa BLAST: CBRC-DNOV-01-3056 [SEVENS

    Full Text Available CBRC-DNOV-01-3056 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 6e-38 86% ...

  9. NCBI nr-aa BLAST: CBRC-TTRU-01-0899 [SEVENS

    Full Text Available CBRC-TTRU-01-0899 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 0.0 86% ...

  10. NCBI nr-aa BLAST: CBRC-PVAM-01-1222 [SEVENS

    Full Text Available CBRC-PVAM-01-1222 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 0.0 92% ...

  11. NCBI nr-aa BLAST: CBRC-MEUG-01-1732 [SEVENS

    Full Text Available CBRC-MEUG-01-1732 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 1e-178 83% ...

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

    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

  13. Pulmoner Alveoler Mikrolitiazis: Altı Olgu Bildirisi

    YALIN, T.; Arslan, A; SELÇUK, M.; TANIK, A.

    2010-01-01

    Pulmonary alveolar microlithiasis : Six Case Reports Pulmonary alveolar microlithiasis is a rare hereditary disease of unknown etiology, characterized by intraalveolar calcified microgranules. The roentgenographic differen-tial diagnosis should include miliary tuberculosis, sarcoidosis, pulmonary hemoside-rosis, histoplasmosis, pneumoconiosis, ornithosis and pulmonary adenomatosis. In this study, we report six cases of pulmonary alveolar microlithiasis, four of which are from the sam...

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

    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

  15. Tuberculosis of the Gallbladder

    2000-01-01

    Analysis of 5 patients with gallbladder tuberculosis who had open cholecystectomy and review of literature have shown that, although still rare it presents as a part of systemic miliary tuberculosis, abdominal tuberculosis, isolated gallbladder tuberculosis and as acalculus cholecystitis in anergic patients. There are no pathognomonic signs, the diagnosis depends on suspicion of tuberculosis, peroperative findings and histological examination.

  16. Pulmonary alveolar microlithiasis

    Gayathri Devi, H.J.; K N Mohan Rao; Prathima, K. M.; Das, Jayanth K.

    2011-01-01

    Pulmonary alveolar microlithiasis is a rare disease of unknown cause. We report a case in a young boy who presented with history of failure to thrive and chest X-ray finding suggestive of miliary mottling. Open lung biopsy revealed pulmonary alveolar microlithiasis.

  17. NCBI nr-aa BLAST: CBRC-MLUC-01-0701 [SEVENS

    Full Text Available CBRC-MLUC-01-0701 ref|NP_001138703.1| G protein-coupled receptor 81 [Canis lupus fa...miliaris] gb|ACJ03849.1| G-protein coupled receptor 81 [Canis lupus familiaris] NP_001138703.1 1e-157 74% ...

  18. NCBI nr-aa BLAST: CBRC-DNOV-01-3181 [SEVENS

    Full Text Available CBRC-DNOV-01-3181 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 1e-153 94% ...

  19. NCBI nr-aa BLAST: CBRC-ACAR-01-1165 [SEVENS

    Full Text Available CBRC-ACAR-01-1165 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 6e-76 41% ...

  20. NCBI nr-aa BLAST: CBRC-XTRO-01-1851 [SEVENS

    Full Text Available CBRC-XTRO-01-1851 ref|NP_001041562.1| prostaglandin F receptor (FP) [Canis lupus fa...miliaris] gb|AAZ53353.1| prostaglandin F2-alpha receptor [Canis lupus familiaris] NP_001041562.1 1e-147 73% ...

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

    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

  2. Tuberculous abscess of the pancreas presenting as obstructive jaundice: a case report

    Yoo, Dong Kyun; Cho, June Sik; Shin, Kyung Sook; Kang, Dae Young [College of Medicine, Chungnam National Univ., Taejon (Korea, Republic of)

    2002-06-01

    Pancreatic tuberculosis is very rare, though dissemination to the gastrointestinal tract and mesenteric lymph nodes is common. We describe a case of pancreatic tuberculosis presenting as a cystic mass in the pancreatic head, with biliary obstruction, in a patient with miliary pulmonary tuberculosis. Surgery for the curative treatment of jaundice was performed, and the histopathologic findings indicated that a pancreatic abscess with caseous necrosis was present, consistent with tuberculosis.

  3. October 2014 imaging case of the month

    Sakla S

    2014-10-01

    Full Text Available No abstract available. Article truncated after first page. A 53-year-old man presents with fatigue and dyspnea on exertion. An admission chest radiograph (Figure 1 was obtained. What is the best term or phrase used to describe the salient radiographic abnormality? 1. Diffuse thick-walled cavitary lesions; 2. Interstitial and alveolar pulmonary edema with effusions; 3. Miliary nodules; 4. Patchy consolidation; 5. Tension pneumothorax.

  4. Radiological characterization of disseminated tuberculosis in patients with AIDS

    Feng Feng

    2016-03-01

    Conclusions: Disseminated tuberculosis in patients with AIDS affects multiple sites, and the most commonly affected region is lungs, followed by lymph nodes, spleen and liver, CNS, and others. The radiological features include miliary pattern in lung, spleen, and liver, with dominant distribution of lymphadenopathy and rim enhancement. The focal lesions with rim enhancement at multiple sites highly suggest the diagnosis of disseminated tuberculosis in patients with AIDS.

  5. Isolated Pancreatic/Periampullary Tuberculosis Remains a Diagnosis of Exclusion

    Mallika Tewari

    2009-05-01

    Full Text Available Dear Sir, Although tuberculosis is endemic in this part of the world, isolated pancreatic tuberculosis is extremely rare. Thus, all lesions are first suspected as carcinoma and not tuberculosis unless the clinical features are suggestive of tuberculosis, for example, a history of miliary tuberculosis with enlarged peripancreatic nodes especially in an immunocompromised host. As our patient had none of these findings, we investigated her as one with possible periampullary carcinoma.

  6. Transcriptional Profiling of Mycobacterium tuberculosis Replicating Ex vivo in Blood from HIV- and HIV+ Subjects

    Ryndak, Michelle B.; Singh, Krishna K.; Zhengyu Peng; Susan Zolla-Pazner; Hualin Li; Lu Meng; Suman Laal

    2014-01-01

    Hematogenous dissemination of Mycobacterium tuberculosis (M. tb) occurs during both primary and reactivated tuberculosis (TB). Although hematogenous dissemination occurs in non-HIV TB patients, in ∼80% of these patients, TB manifests exclusively as pulmonary disease. In contrast, extrapulmonary, disseminated, and/or miliary TB is seen in 60-70% of HIV-infected TB patients, suggesting that hematogenous dissemination is likely more common in HIV+ patients. To understand M. tb adaptation to the ...

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

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

    2013-01-01

    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...

  8. Tuberculous abscess of the pancreas presenting as obstructive jaundice: a case report

    Pancreatic tuberculosis is very rare, though dissemination to the gastrointestinal tract and mesenteric lymph nodes is common. We describe a case of pancreatic tuberculosis presenting as a cystic mass in the pancreatic head, with biliary obstruction, in a patient with miliary pulmonary tuberculosis. Surgery for the curative treatment of jaundice was performed, and the histopathologic findings indicated that a pancreatic abscess with caseous necrosis was present, consistent with tuberculosis

  9. The adult respiratory distress syndrome bronchogenic pulmonary tuberculosis.

    R. A. Dyer; Potgieter, P D

    1984-01-01

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

  10. COMPARISON OF DIET AND USE OF BROMELIADS BETWEEN A BROMELICOLOUS AND A BROMELIGENOUS ANURAN AT AN INSELBERG IN THE SOUTHEASTERN OF BRAZIL

    PERTEL WESLEI

    2010-06-01

    Full Text Available Anurans from an inselberg in southeastern Brazil were studied using a sample ofsixty tank of bromeliads Alcantharea sp. We found 153 tadpoles of S. arduous, 21adults of S. arduous, 30 adults of T. miliaris, and two adults of Scinax x-signatus,which were not considered in our analyses. Tadpoles of S. arduous were present in35% of the analyzed plants. Adults of S. arduous (bromeligeneous occurred in 25%of analyzed plants, while adults of T. miliaris (bromelicolous occurred in 30%.Apparently the presence of toe pads in S. arduous allow them to occupy the centerportion of bromeliads, while T. miliaris, which lack pads on their toes, were foundon the base of the plant axils. The number of anuran species and the abundance ofindividuals found were low. This may be a result of the high altitude of our studiedsite or a restriction imposed by the saxicolous environment, such as high temperaturesand low humidity during the day. Both species can be considered generalist feedersdue to their wide variety of ingested prey. Formicidae was their main prey but wasabsent segregation in the bromeliads. Blattodea was very common inside the bromeliadaxils and represented the most signifi cant prey by weight in both frog species. Weconclude that both anurans forage inside and outside of bromeliads. Trophic nichebreadth in S. arduous was larger than in T. miliaris. Even both species being commoninhabitants of the same environment, they demonstrated a marked spatial segregationin the bromeliads. Based on their diet, however, there may be disputes for territoryoutside of the bromeliads.

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

    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.

  12. The effect of chloroquine treatment in addition to steroids in idiopathic pulmonary hemosiderosis

    İmamoğlu, Sebahat; Karakoç, Fazilet; Karadağ, Bülent; Kut, Arif; Dağlı, Elif

    2001-01-01

    Idiopatic pulmonary hemosiderosis is a rare disease characterized by iron deficiency anemia recurrent pulmonary symptoms and transient interstitial infiltrates or a miliary pattern on chest radiography There is no specific treatment for this condition Corticostreoids appear to be helpful in the management of the acute hemorrhagic episodes Chloroquine is thought to be important in treatment of idiopathic pulmonary hemosiderosis because of its lack of toxicity In this report three cases of idio...

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

    G. Kalema-Zikusoka; R. G. Bengis; A.L. Michel; M.H. Woodford

    2005-01-01

    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 gran...

  14. Acrodynia: exposure to mercury from fluorescent light bulbs

    Tunnessen, W.W. Jr.; McMahon, K.J.; Baser, M.

    1987-05-01

    Medical attention was sought for a 23-month-old toddler because of anorexia, weight loss, irritability, profuse sweating, peeling and redness of his fingers and toes, and a miliarial rash. The diagnosis was mercury poisoning, and an investigation of his environment disclosed that he had been exposed to mercury from broken fluorescent light bulbs. Acrodynia resulting from fluorescent bulbs has not been previously reported.

  15. Diagnostic value of CT on hepatic tuberculosis

    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)

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

    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.)

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

    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

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

    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.)

  19. The pathology of tuberculosis caused by Mycobacterium tuberculosis in a herd of semi-free-ranging springbok (Antidorcas marsupialis

    T.A. Gouws

    2009-09-01

    Full Text Available The first detailed description of the pathology of tuberculosis, caused by Mycobacterium tuberculosis, in springbok is reported. The springbok were part of a semi-free-ranging herd kept on the grounds of iThemba Laboratory for Accelerator Based Science (LABS in the Kuils River district of the Western Cape Province, South Africa. Mycobacterium tuberculosis was isolated from three animals out of a total of 33 sampled, with two animals showing tuberculosis lesions. The index case was an adult ewe that showed advanced miliary tuberculosis with marked macroscopic and microscopic lesions in the lungs, pleura and respiratory lymph nodes, and numerous acid-fast bacilli. Six healthy rams were sampled nine months later and a pilot study indicated miliary tuberculosis lesions in one ram, which again were macroscopically most prominent in the lungs, pleura and respiratory lymph nodes. Macroscopic lesions were also noted in the sternal, iliac, prefemoral and retropharyngeal lymph nodes. Microscopy in this animal revealed lesions in the macroscopically affected organs as well as numerous other lymph nodes, and suspected lesions occurred in the testicle and colon. Acid-fast bacilli were scarce to moderate in affected organs. Because of the miliary nature of the lesions in both affected animals, the route of infection could not be established conclusively. The lesions in most affected organs of both animals resembled classical tuberculous granulomas. A main study conducted on healthy animals 19 months after the pilot study failed to find any animal with tuberculosis lesions in the group of 25 sampled, and all were negative for mycobacteria via mycobacterial culture.

  20. Human Immunodeficiency Virus Infection-Associated Mortality during Pulmonary Tuberculosis Treatment in Six Provinces of China

    LAI Yu Ji; LIU Er Yong; WANG Li Ming; Jamie P MORANO; WANG Ning; Kaveh KHOSHNOOD; ZHOU Lin; CHENG Shi Ming

    2015-01-01

    Objective To investigate the risk factors attributable to tuberculosis-related deaths in areas with human immunodeficiency virus (HIV) infection epidemics. Methods A prospective cohort study of newly registered patients in tuberculosis (TB) dispensaries in six representative Chinese provinces was conducted from September 1, 2009 to August 31, 2011. Risk factors for TB-associated death were identified through logistic regression analysis. Results Of 19,103 newly registered pulmonary TB patients, 925 (4.8%) were found to be HIV-positive. Miliary TB and acid-fast bacillus smear-negative TB were more common among these patients. Out of a total of 322 (1.7%) deaths that occurred during TB treatment, 85 (26%) of the patients were co-infected with HIV. Multivariate analysis revealed that HIV infection was the strongest predictor of death [adjusted odds ratio (aOR) 7.86]. Other significant mortality risk factors included presentation with miliary TB (aOR 4.10; 95% confidence interval: 2.14-7.88), ≥35 years of age (aOR 3.04), non-Han ethnicity (aOR 1.67), and farming as an occupation (aOR 1.59). For patients with TB/HIV co-infection, miliary TB was the strongest risk factor for death (aOR 5.48). A low CD4 count (≤200 cells/µL) (aOR 3.27) at the time of TB treatment initiation and a lack of antiretroviral therapy (ART) administration (aOR 3.78) were also correlated with an increased risk of death. Conclusion Infection with HIV was independently associated with increased mortality during TB treatment. Offering HIV testing at the time of diagnosis with TB, early TB diagnosis among HIV/acquired immunodeficiency syndrome patients, and the timely provision of ART were identified as the key approaches that could reduce the number of HIV-associated TB deaths.

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

    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. CT appearances of abdominal tuberculosis

    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.

  3. Assessment of immune response to repeat stimulation with BCG vaccine using in vitro PBMC model

    Kashyap, Rajpal S; Husain, Aliabbas A.; Morey, Shweta H; Panchbhai, Milind S.; Deshpande, Poonam S; Purohit, Hemant J.; Taori, Girdhar M.; Daginawala, Hatim F.

    2010-01-01

    Background Tuberculosis (TB) is one of the most prevalent cause of death due to a single pathogen. Bacillus Calmette Guérin (BCG) is the only vaccine available for clinical use that protects against miliary TB; however, this vaccine has shown variable levels of efficacy against pulmonary TB. In India, a single dose of BCG vaccine is given and there are few countries where repeated doses of BCG are given. The incidence of TB in India is very high inspite of primary vaccination in neonatal peri...

  4. January 2012 case of the month

    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 …

  5. Concurrent occurrence of both intracranial and intramedullary tuberculomas

    Sreeramulu Diguvinti

    2015-06-01

    Full Text Available Tuberculosis involving spinal cord in the form of intramedullary tuberculoma is uncommon, and the concurrent occurrence of cranial and intramedullary tuberculomas is extremely rare. We report a case of disseminated tuberculoma involving brain and spinal cord with miliary tuberculosis in a 32-year-old male presenting with fever, cerebellar signs and motor weakness of both upper and lower extremities. Based on magnetic resonance imaging and polymerase chain reaction, we diagnosed as tuberculoma. He completely recovered with conventional antituberculous treatment and steroids. The follow-up of the patient showed disappearance of signs and symptoms.

  6. Individual movements and population density estimates for moray eels on a Caribbean coral reef

    Abrams, R. W.; Schein, M. W.

    1986-12-01

    Observations of moray eel (Muraenidae) distribution made on a Caribbean coral reef are discussed in the context of long term population trends. Observations of eel distribution made using SCUBA during 1978, 1979 1980, and 1984 are compared and related to the occurrence of a hurricane in 1979. An estimate of the mean standing stock of moray eels is presented. The degree of site attachment is discussed for spotted morays ( Gymnothorax moringa) and goldentail morays ( Muraena miliaris). The repeated non-aggressive association of moray eels with large aggregations of potential prey fishes is detailed.

  7. Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient

    Jaafar, Juanarita; Hitam, Wan Hazabbah Wan; Noor, Raja Azmi Mohd

    2012-01-01

    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye a...

  8. CT appearances of abdominal tuberculosis

    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.

  9. Radiological analysis of image on geriatric pulmonary tuberculosis

    2005-01-01

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

  10. Primary hepatic tuberculosis mimicking intrahepatic cholangiocarcinoma: report of two cases

    2015-01-01

    Hepatic tuberculosis (TB) is usually associated with pulmonary or miliary TB, but primary hepatic TB is very uncommon even in countries with high prevalence of TB. The clinical manifestation of primary hepatic TB is atypical and imaging modalities are unhelpful for differential diagnosis of the liver mass. Image-guided needle biopsy is the best diagnostic method for primary hepatic TB. In the cases presented here, we did not perform liver biopsy because we believed the liver masses were cholangiocarcinoma, but primary hepatic TB was ultimately confirmed by postoperative pathology. Here we report two cases of patients who were diagnosed with primary hepatic TB mimicking mass-forming intrahepatic cholangiocarcinoma. PMID:26236700

  11. Central Nervous System Tuberculosis: An Imaging-Focused Review of a Reemerging Disease

    Morteza Sanei Taheri

    2015-01-01

    Full Text Available 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.

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

    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

  13. Fever of unknown origin in a Swiss-born child: don’t miss tuberculosis!

    Katia Jaton

    2012-01-01

    Full Text Available Tuberculosis incidence is low in Switzer land. We report here on a Swiss-born toddler. Tuberculosis manifested with a fever of unknown origin, mimicking an inflammatory or autoimmune disorder triggering a high dose of corticosteroid treatment. The disease went unrecognized for several weeks until development of a miliary tuberculosis with advanced central nervous system involvement. This case highlights the difficulties encountered in diagnosing tuberculosis and in identifying the origin of this case. It reminds us that this disease must never be forgotten when facing a child with persistent fever who must be screened for, before starting immunosuppressive therapy.

  14. Fever of unknown origin in a Swiss-born child: don’t miss tuberculosis!

    Melanie Cegielski

    2012-02-01

    Full Text Available Tuberculosis incidence is low in Switzer land. We report here on a Swiss-born toddler. Tuberculosis manifested with a fever of unknown origin, mimicking an inflammatory or autoimmune disorder triggering a high dose of corticosteroid treatment. The disease went unrecognized for several weeks until development of a miliary tuberculosis with advanced central nervous system involvement. This case highlights the difficulties encountered in diagnosing tuberculosis and in identifying the origin of this case. It reminds us that this disease must never be forgotten when facing a child with persistent fever who must be screened for, before starting immunosuppressive therapy.

  15. Aerospace Technologies and Applications for Dual Use

    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...... 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....

  16. Hierarchical Markov random-field modeling for texture classification in chest radiographs

    Vargas-Voracek, Rene; Floyd, Carey E., Jr.; Nolte, Loren W.; McAdams, Page

    1996-04-01

    A hierarchical Markov random field (MRF) modeling approach is presented for the classification of textures in selected regions of interest (ROIs) of chest radiographs. The procedure integrates possible texture classes and their spatial definition with other components present in an image such as noise and background trend. Classification is performed as a maximum a-posteriori (MAP) estimation of texture class and involves an iterative Gibbs- sampling technique. Two cases are studied: classification of lung parenchyma versus bone and classification of normal lung parenchyma versus miliary tuberculosis (MTB). Accurate classification was obtained for all examined cases showing the potential of the proposed modeling approach for texture analysis of radiographic images.

  17. Trichophyton species of Arthroderma benhamiae - a new infectious agent in dermatology.

    Nenoff, Pietro; Uhrlaß, Silke; Krüger, Constanze; Erhard, Marcel; Hipler, Uta-Christina; Seyfarth, Florian; Herrmann, Jürgen; Wetzig, Tino; Schroedl, Wieland; Gräser, Yvonne

    2014-07-01

    In Germany, infections due to the zoophilic dermatophyte Trichophyton (T.) species of Arthroderma benhamiae are being more frequently diagnosed. The source of infection of this emerging pathogen overlaps with that of the zoophilic species T. interdigitale. The most common source are guinea pigs. T. species of Arthroderma benhamiae causes inflammatory dermatophytosis in children and adolescents. In addition to tinea capitis, it may cause both tinea corporis, tinea manus and frequently tinea faciei. In Germany, T. species of Arthroderma benhamiae is a frequent zoophilic dermatophyte, which in regions is probably more frequent than Microsporum canis. The mycological identification of the isolates with their yellow stained colonies is based on their macroscopic and microscopic features. However, some exhibit colony features consistent with those of T. interdigitale. These strains only can be identified unambiguously by means of molecular techniques. Using detection methods such as PCR-ELISA or real-time PCR, the dermatophyte can be identified directly from clinical material. Sequencing of the internal transcribed spacer region (ITS) of the ribosomal DNA has been approved as culture confirmation test for T. species of Arthroderma benhamiae. In addition, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF MS) is useful. Widespread dermatophytosis due to T. species of Arthroderma benhamiae, in particular of tinea capitis, requires oral antifungal agents. Terbinafine is most effective, alternatives are fluconazole and itraconazole. PMID:24981469

  18. Evaluation of three-dimensional distribution of foci of diffuse lung diseases with computed tomography

    Niwa, Masamitsu [Nagoya City Univ. (Japan). Medical School

    1998-11-01

    Three-dimensional distribution of foci of diffuse lung disease was evaluated by CT image, and it was examined whether each lung disease could be diagnosed by different distribution. Subjects were 120 cases (idiopathic interstitial pneumonia 15 cases, sarcoidosis 23 cases, miliary tuberculosis 10 cases, diffuse panbronchiolitis 7 cases, chronic pulmonary emphysema 6 cases, pulmonary metastasis 9 cases, SLE 6 cases, PSS 8 cases, dermatomyositis (DM) 6 cases, RA 7 cases, SjS 9 cases and others 14 cases). CT image was obtained from apex to base of lung with 10 mm gapless. The image was divided into three parts in both head-tail direction and back-front direction, and two parts in cortex medulla direction, and the ratio of foci to whole in each part was evaluated in five phases, and the part with the highest ratio was determined as the predominant side. In idiopathic interstitial pneumonia, sarcoidosis, miliary tuberculosis, diffuse panbronchiolitis, chronic pulmonary emphysema, pulmonary metastasis, PSS and DM, the predominant side was confirmed, respectively, and usefulness of differential diagnosis was recognized. Constant distribution wasn't recognized in SLE, RA and SjS, because the state of disease was not always same in the foci of these diseases. (K.H.)

  19. HRCT findings of disseminated small nodular shadow in plain chest x-ray

    High Resolution Computed Tomography (HRCT) was done in 22 cases of disseminated small nodular shadow from plain chest X-ray, which was included in metastatic lesion, Miliary tuberculosis, pneumoconiosis etc. and following results were obtained. Most of metastatic nodule (n=8) showed more than 1.5mm in diameter and the margin of nodule was discrete (n=8) and many cases (n=8) were associated with thickened bronchovascular sheath or interlobular septum and hilar and mediastinal lymphnode enlargement (n=6). One case turned out to be not true nodule in HRCT but revealed thickened interlobular septum and bronchovascular bundles. All cases of miliary tuberculosis (n=8) showed even sized, well marginate and less than 3mm in diameter of nodule without evidence of thickening of bronchovascular bundle or interlobular septum. Ease cases of pneumoconiosis, histiocytosis X, diffuse panbronchiolitis (DPB) showed ill defined nodule and associate finding of DPB was peripheral bronchioloectasis. HRCT is useful method to exact evaluation of nodular lesion and find out associate findings for differential diagnosis of disseminate small nodular shadow in plain chest X-rays

  20. Pulmonary tuberculosis

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

  1. Infecção por Salmonella typhimurium de origem hídrica em garça gigante (Casmerodius albus egretta, em sua vida livre no Estado do Rio de Janeiro

    Maria do Amparo Queiroz de Freitas

    1977-10-01

    Full Text Available De uma mortandade de garças de vida livre, no Estado do Rio de Janeiro, Brasil, foi isolada Salmonella typhimurium por hemocultura de material proveniente de uma ave que se mostrava enferma e que à necrópsia não apresentavam lesões a na tomopa tológicas. A Salmonella typhimurium foi também isolada de água de um lago existente no Jardim Zoológico do Rio de Janeiro, onde as aves tinham acesso permanente. Durante a mortandade das aves foi observada uma hepatite necrótica na qual havia colônias bacterianas, tesões atribuídas a esta salmonelose.In a fatal dissease among wild herons (Casmerodius albus egretta, the authors isolated Salmonella typhimurium from tissues. The observations were made in the city of Rio de Janeiro and the infected fowls showed depression (Fig. 1 and 2. The principal gross lesions ocurred in the liver where hepatomegalia and miliary necrosis were observed (Fig. 3. The microscopic examination of the liver showed miliary necrosis centrally occupied by colonies of bacteria (Fig. 4 and 5. The authors isolated also Salmonella typhimurium from waterofa lake where the fowls had access every day. This is the first observation of infection by Salmonella typhimurium in herons (Casmerodius albus egretta according the literature consulted.

  2. Imaging diagnosis of pulmonary tuberculosis in immunocompromised patients

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

  3. Tuberculosis in patients with end-stage renal disease

    The purpose of our study was to describe the clinical and radiological manifestations of tuberculosis in patients with end-stage renal disease. The medical records, chest radiographs, and CT scans of 42 patients with tuberculosis among 871 consecutive patients with end-stage renal disease were reviewed. Patterns of initial chest radiographs were categorized as primary, postprimary, miliary, or atypical, according to the predominant radiologic findings. Chest radiographs and CT scans revealed pulmonary tuberculosis in 28 patients and extrapulmonary tuberculosis in 15. The pattern of chest radiographs indicative of pulmonary tuberculosis was primary in 12 cases, postprimary in 11, miliary in one, demonstrated atypical infiltrates in three, and was normal in one. Tuberculosis involved the extrathoracic lymph nodes in six cases, the peritoneum in four, the spine in three, and the bone marrow in two. The primary pattern, seen in 12 patients, manifested as pleural effusion or segmental consolidation, and in ten of the twelve the former was dominant. The radiological pattern of pulmonary tuberculosis in end-stage renal disease is often primary, and extrapulmonary involvement is frequent

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

    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.

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

    Park, Tae Won; Kim, Young Girl; Lee, Sam Sun [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1995-02-15

    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.

  6. Study of MRI features of intracranial tuberculosis and its dynamic evolution during antituberculous treatment

    Objective: To explore MRI features of intracranial tuberculosis, and the dynamic evolution of intracranial tuberculosis during antituberculous treatment. Methods: From September 2009 to February 2012, seventy-two patients with intracranial tuberculosis were reviewed retrospectively. Intracranial tuberculosis lesions were divided into 3 categories: pure parenchymal tuberculosis, tuberculous meningitis and hybrid type with both parenchymal tuberculosis and tuberculous meningitis. The MRI characteristics of these lesions were analysed. According to the lesion size, pure parenchymal tuberculosis was divided into 3 subtypes: 0.3 cm or less was defined as miliary, >0.3 cm and <1.0 cm as nodule, greater than or equal to 1.0 cm as tuberculoma. Serial follow-up scans were performed in 36 patients, and dynamic MRI changes in the process of anti-tuberculosis treatment during 3 to 6 months were observed. The disappearance rate of the lesions was calculated and statistically analysed by using Chi-square test. Results: There were 883 lesions in 38 cases with parenchymal tuberculosis. Multiple lesions distributed widely, 423 lesions (47.9%) ≤0.3 cm, 330 lesions (37.4%) between 0.3-1.0 cm, and 130 lesions (14.7%) ≥ 1.0 cm. Twenty-four cases with tuberculous meningitis showed meningeal enhancement at basilar cistern. Ten cases with hybrid type presented both parenchymal tuberculosis and meningitis. Among 36 patients with serial MRI follow-up scans, 22 cases were pure parenchymal tuberculosis. The disappearance rates of military, nodules and tuberculomas were 52.2% (59/113), 33.3% (33/99) and 0, respectively, after 3 months treatment. The disappearance rates were 87.6% (99/113), 50.5% (50/99) and 18.2% (2/11), respectively, after 6 months treatment. Disappearance rate of miliary lesions was obviously higher than that of nodules at both 3 and 6 months, and the difference was statistically significant,(χ2=7.657, 34.786, P<0.01). Nine lesions of parenchymal tuberculosis enlarged

  7. Sediment Burial Intolerance of Marine Macroinvertebrates.

    Hendrick, Vicki J; Hutchison, Zoë L; Last, Kim S

    2016-01-01

    The marine environment contains suspended particulate matter which originates from natural and anthropogenic sources. Settlement of this material can leave benthic organisms susceptible to smothering, especially if burial is sudden i.e. following storms or activities such as dredging. Their survival will depend on their tolerance to, and their ability to escape from burial. Here we present data from a multi-factorial experiment measuring burial responses incorporating duration, sediment fraction and depth. Six macroinvertebrates commonly found in sediment rich environments were selected for their commercial and/or conservation importance. Assessments revealed that the brittle star (Ophiura ophiura), the queen scallop (Aequipecten opercularis) and the sea squirt (Ciona intestinalis) were all highly intolerant to burial whilst the green urchin (Psammichinus miliaris) and the anemone (Sagartiogeton laceratus), showed intermediate and low intolerance respectively, to burial. The least intolerant, with very high survival was the Ross worm (Sabellaria spinulosa). With the exception of C. intestinalis, increasing duration and depth of burial with finer sediment fractions resulted in increased mortality for all species assessed. For C. intestinalis depth of burial and sediment fraction were found to be inconsequential since there was complete mortality of all specimens buried for more than one day. When burial emergence was assessed O. ophiura emerged most frequently, followed by P. miliaris. The former emerged most frequently from the medium and fine sediments whereas P. miliaris emerged more frequently from coarse sediment. Both A. opercularis and S. laceratus showed similar emergence responses over time, with A. opercularis emerging more frequently under coarse sediments. The frequency of emergence of S. laceratus increased with progressively finer sediment and C. intestinalis did not emerge from burial irrespective of sediment fraction or depth. Finally, and perhaps

  8. Sediment Burial Intolerance of Marine Macroinvertebrates.

    Vicki J Hendrick

    Full Text Available The marine environment contains suspended particulate matter which originates from natural and anthropogenic sources. Settlement of this material can leave benthic organisms susceptible to smothering, especially if burial is sudden i.e. following storms or activities such as dredging. Their survival will depend on their tolerance to, and their ability to escape from burial. Here we present data from a multi-factorial experiment measuring burial responses incorporating duration, sediment fraction and depth. Six macroinvertebrates commonly found in sediment rich environments were selected for their commercial and/or conservation importance. Assessments revealed that the brittle star (Ophiura ophiura, the queen scallop (Aequipecten opercularis and the sea squirt (Ciona intestinalis were all highly intolerant to burial whilst the green urchin (Psammichinus miliaris and the anemone (Sagartiogeton laceratus, showed intermediate and low intolerance respectively, to burial. The least intolerant, with very high survival was the Ross worm (Sabellaria spinulosa. With the exception of C. intestinalis, increasing duration and depth of burial with finer sediment fractions resulted in increased mortality for all species assessed. For C. intestinalis depth of burial and sediment fraction were found to be inconsequential since there was complete mortality of all specimens buried for more than one day. When burial emergence was assessed O. ophiura emerged most frequently, followed by P. miliaris. The former emerged most frequently from the medium and fine sediments whereas P. miliaris emerged more frequently from coarse sediment. Both A. opercularis and S. laceratus showed similar emergence responses over time, with A. opercularis emerging more frequently under coarse sediments. The frequency of emergence of S. laceratus increased with progressively finer sediment and C. intestinalis did not emerge from burial irrespective of sediment fraction or depth. Finally

  9. Epidemiology of Superficial Fungal Infections in Guangdong, Southern China: A Retrospective Study from 2004 to 2014.

    Cai, Wenying; Lu, Changming; Li, Xiqing; Zhang, Junmin; Zhan, Ping; Xi, Liyan; Sun, Jiufeng; Yu, Xinbing

    2016-06-01

    Superficial fungal infections are common worldwide; however, the distribution of pathogenic species varies among geographical areas and changes over time. This study aimed to determine the epidemiologic profile of superficial fungal infections during 2004-2014 in Guangzhou, Southern China. Data regarding the superficial mycoses from outpatients and inpatients in our hospital were recorded and analyzed. From the 3367 patients that were enrolled in the study, 3385 samples were collected from skin, hair and nail lesions. Of the 697 positive cultures, dermatophytes were the most prevalent isolates (84.36 %), followed by yeasts (14.92 %) and non-dermatophyte molds (0.72 %). Trichophyton rubrum (56.24 %) was the most common dermatophyte isolated from cases of tinea unguium (83.92 %), tinea pedis (71.19 %), tinea cruris (91.66 %), tinea corporis (91.81 %) and tinea manuum (65.00 %). Trichophyton mentagrophytes (13.35 %) and Microsporum canis (10.19 %) were the predominant species associated with cases of tinea faciei (54.55 %) and tinea capitis (54.13 %), respectively. Yeasts and molds were identified primarily from other cases of superficial fungal infections. In conclusion, when compared to previous studies in the same area, the epidemiology of superficial mycoses in Guangdong did not significantly change from 2004 to 2014. The prevalence of causative agents and the spectrum of superficial fungal infections, particularly tinea caused by dermatophyte infection, are similar to reports from several specific regions in China and Europe, whereas increasing incidences of Trichophyton mentagrophytes and Microsporum canis occurred in Guangdong, China. PMID:26883512

  10. Epidemiological survey of dermatophytosis in Tehran, Iran, from 2000 to 2005

    Bassiri-Jahromi Shahindokht

    2009-01-01

    Full Text Available Background: Cutaneous fungal infections are common in Tehran, Iran, and causative organisms include dermatophytes, yeasts and non-dermatophyte molds. The prevalence of superficial mycosis infections has risen to such a level that skin mycoses now affect more than 20-25% of the world′s population, making them the most frequent form of infection. Aims: Our aim was to determine the prevalence of superficial cutaneous fungal infections especially dermatophytosis in our Medical Mycology Laboratory in the Pasteur Institute of Iran, Tehran. Methods: A total of 17,573 specimens were collected from clinically suspected tinea corporis, tinea cruris, tinea capitis, tinea faciei, tinea pedis, tinea manuum and finger and toe onychomycosis from 2000 to 2005. Patients were referred to our laboratory for direct examination, fungal culture and identification. The incidence of each species was thus calculated. Results: Dermatophytes remain the most commonly isolated fungal organisms, except from clinically suspected finger onychomycosis, in which case Candida species comprise> 7% of the isolates. Epidermophyton floccosum remains the most prevalent fungal pathogen and increased incidence of this species was observed in tinea cruris. Trichophyton tonsurans continues to increase in incidence. Conclusion: This study identifies the epidemiologic trends and the predominant organisms causing dermatophytosis in Tehran, Iran. These data can be used to ascertain the past and present trends in incidence, predict the adequacy of our current pharmacologic repertoire and provide insight into future developments. Consideration of the current epidemiologic trends in the incidence of cutaneous fungal pathogens is of key importance to investigational effort, diagnosis and treatment.

  11. April 2014 imaging case of the month

    Eric A. Jensen

    2014-04-01

    Full Text Available No abstract available. Article truncated after first page. Clinical History: A 34-year-old woman presented with complaints of abdominal fullness. The patient described a history of several pneumonias, successfully treated with antibiotics. Liver function testing showed a mild transaminitis. Frontal chest radiography (Figure 1 was performed. Which of the following statements regarding the chest radiograph is most accurate? 1. The chest radiograph shows multifocal coarse linear opacities suggesting bronchiectasis; 2. The chest radiograph shows multifocal ground-glass opacity and consolidation; 3. The chest radiograph shows multifocal, somewhat basal predominant linear opacities within diminished lung volumes, suggesting fibrosis; 4. The chest radiograph shows multiple small nodules, suggesting a miliary pattern; 5. The chest radiograph shows symmetric, basal predominant fine linear and reticular abnormalities without architectural distortion...

  12. Post-kala-azar dermal leishmaniasis associated with AIDS

    Bittencourt Achiléa

    2002-01-01

    Full Text Available Post-kala-azar dermal leishmaniasis (PKDL is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

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

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

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

    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.)

  15. 急性血行播散型肺结核X线平片分析%Acute Hematogenous disseminated pulmonary tuberculosis x ray analysis

    王志翔; 周广德

    2015-01-01

    Objective The acute blood line spreads pulmonary tuberculosis clinically in more common, in X even piece diagnosis fills the air with lungs some venereal diseases to confuse in disguised form frequently.This article reported 28 examples, discussed the acute blood line to spread the pulmonary tuberculosis main performance, as well as with silicosis, miliary pneumonia X even piece of distinction diagnosis main points.%急性血行播散型肺结核在临床较为常见,X线平片诊断中经常与肺部一些弥漫性病变相混淆.本文报告28例,讨论了急性血行播散型肺结核的主要表现,以及与矽肺、粟粒性肺炎等肺部弥漫性病变的X平片的鉴别诊断要点.

  16. Current status of new tuberculosis vaccine in children.

    Pang, Yu; Zhao, Aihua; Cohen, Chad; Kang, Wanli; Lu, Jie; Wang, Guozhi; Zhao, Yanlin; Zheng, Suhua

    2016-04-01

    Pediatric tuberculosis contributes significantly to the burden of TB disease worldwide. In order to achieve the goal of eliminating TB by 2050, an effective TB vaccine is urgently needed to prevent TB transmission in children. BCG vaccination can protect children from the severe types of TB such as TB meningitis and miliary TB, while its efficacy against pediatric pulmonary TB ranged from no protection to very high protection. In recent decades, multiple new vaccine candidates have been developed, and shown encouraging safety and immunogenicity in the preclinical experiments. However, the limited data on protective efficacy in infants evaluated by clinical trials has been disappointing, an example being MVA85A. To date, no vaccine has been shown to be clinically safer and more effective than the presently licensed BCG vaccine. Hence, before a new vaccine is developed with more promising efficacy, we must reconsider how to better use the current BCG vaccine to maximize its effectiveness in children. PMID:27002369

  17. [Association between severe tuberculosis in children and previous BCG immunization in a national referral hospital, Peru 1990-2000].

    Llanos-Tejada, Félix; del Castillo, Hernán

    2012-03-01

    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 total 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. PMID:22510912

  18. Hepatic tuberculosis mimicking Klatskin tumor: A diagnostic dilemma

    Arora Raman

    2008-07-01

    Full Text Available Tubercular involvement of liver is rare and usually occurs in association with pulmonary or miliary tuberculosis, as diffuse involvement without recognizable pulmonary tuberculosis or rarely in a localized form, which presents as a tuberculoma or tubercular abscess. We report the case of a 22-year-old boy presenting with features of obstructive jaundice and a clinico-radiological picture highly suggestive of a perihilar cholangiocarcinoma (Klatskin tumor, but found to have tubercular involvement of porta hepatis. We review the literature on this unusual presentation, highlight the considerable diagnostic challenge such cases can pose, and also emphasize the need to consider tuberculosis in differential diagnosis of lesions involving the porta hepatis, particularly in areas endemic for the disease.

  19. Herpes simplex virus type 1 hepatitis due to primary infection in a pancreas-kidney transplant recipient.

    Feugeas, J; Mory, S; Jeulin, H; Velay, A; Pertek, J-P; Ladriere, M; Losser, M-R

    2016-07-01

    Herpes simplex Virus (HSV) hepatitis is a rare complication of HSV-1 primary infection, with a delayed diagnosis, affecting mainly immunocompromised patients. We describe a case of HSV-1 hepatitis after primary infection occurring in the postoperative days after a pancreas-kidney transplantation. The patient presented with an unusual evolution of a persistent severe hepatitis associated with a persistent viremia (Quantitative Polymerase Chain Reaction) despite an adequate intravenous (iv) antiviral treatment. Abdominal computed tomography scan showed a miliary hepatitis. The diagnosis of HSV-1 hepatitis was confirmed by immuno-chemistry on liver biopsy. The donor was negative for anti-HSV antibodies, excluding contamination by the graft. This case report emphasizes a rather seldom risk of care-associated viral infections, predominantly in immunocompromised patients. PMID:27155056

  20. Pediatric thyroid carcinoma with lung metastases: A case of 7-years' follow-up by chest x-ray and scintigram

    Kim, Ok Hwa; Kim, Choon Yul; Bahk, Yong Whee [Catholic University Medical College, Seoul (Korea, Republic of)

    1989-08-15

    Miliary lung metastasis is well known in thyroid carcinoma. However, thyroid carcinoma itself is very rare in children. We have seen a case of papillary adenocarcinoma of the thyroid in a 12 year old boy. He had extensive nodular lung metastasis on the chest x-ray, which were confirmed by 131-I scintigraphy and biopsy of a cervical lymph node. Radioactive iodine therapy was instituted for 5 years and nodular lung metastasis effectively disappeared on the follow-up chest x-rays. A lung scintigraphy with 131-I, however, showed residual uptake in the lung suggesting that scintigraphy is more sensitive and, therefore useful for evaluating the management of the thyroid carcinoma.

  1. Rare presentation of gall bladder tuberculosis in a non immuno-compromised patient

    Pawan Kumar

    2015-06-01

    Full Text Available The gall bladder is least common intraabdominal organ to be involved by tuberculosis. It is either part of systemic miliary tuberculosis or abdominal tuberculosis. Isolated gall bladder tuberculosis is even rarer, can presents either as calculus or acalculus cholecystitis. Gall bladder tuberculosis presenting as a localized perforation with a sinus formation into anterior abdominal wall is unreported complication in a non immuno-compromised person. A 48-year old female presented with a gradually increasing swelling in right hypochondrium. Abdominal ultrasound showed superficial collection over right hypochondrium with intraperitoneal extension. Computed tomography showed localized gall bladder perforation with extension to the abdominal wall. Patient underwent emergency exploration and cholecystectomy with excision of sinus tract and drainage of abdominal wall abscess. Histopathological examination showed granulomatous cholecystitis suggestive of tuberculosis of gall bladder with extension into the sinus tract. She had an uneventful recovery and was treated with 6-month antitubercular therapy after surgery.

  2. Post-kala-azar dermal leishmaniasis associated with AIDS

    Bittencourt Achiléa

    2003-01-01

    Full Text Available Post-kala-azar dermal leishmaniasis (PKDL is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

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

    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)

  4. Challenges to treatment of leukemia in HIV-positive children.

    Stefan, D Cristina; Dippenaar, Anel; De Bruin, Gerhard; Uys, Ronelle; van Toorn, Ronald

    2012-12-01

    We describe the challenges to treatment of leukemia in three cases of human immunodeficiency virus (HIV)-infected children with multiple infections and complications. Two of the three patients had acute myeloid leukemia and the other one acute lymphoblastic leukemia. Two of the patients were known with HIV infection; the third was diagnosed on admission. All patients received antiretroviral therapy with standard doses of lamivudine, stavudine and efavirenz or lopinavir/retonavir. All three were diagnosed with Mycobacterium tuberculosis on one or more occasions: pulmonary or miliary involvement or tuberculous meningitis. One patient developed spinal paraplegia and needed an urgent laminectomy. Later he recovered almost completely. The interaction between antiretroviral and antituberculosis treatments combined with chemotherapy, antibiotics and supportive care is not known. Despite the severity and the complexity of several associated diseases, the outcome of the patients was rewarding and encouraging. PMID:22421805

  5. Snakes killed on the roads in the state of Santa Catarina, southern Brazil

    Ivo Rohling Ghizoni-Jr

    2009-06-01

    Full Text Available Roads cause diverse impacts to ecosystems, including habitat loss and fragmentation, alteration of the natural landscape and death of animals. However, little is known about the impact of this mortality on the animal populations. The snake fauna of the state of Santa Catarina is the least studied of southern Brazil. In this work we present data on 165 snakes of 38 species found dead on the roads of the state between 2003 and 2008, which corresponds to 50% of the snake species in relation to the expected occurrence for the state of Santa Catarina. The four most frequent species were Philodryas patagoniensis (n = 22; 13.33%, Liophis miliaris (n = 21; 12.72%, P. aestiva (n = 13; 7.87% and Bothrops jararaca (n = 12; 7.27%, which represent together about 41% of the snakes found dead on the roads. We extend the known distribution of Imantodes cenchoa by about 60km southward.

  6. [Advanced pulmonary alveolar microlithiasis].

    Triebel, H J; von Hülst, M; Schofer, M

    1987-09-01

    A severe course of microlithiasis alveolaris pulmonum in a 28-year old patient is described. The disease, which had progressed to a very advanced stage at the time of examination, produced in the plain radiograph of the thorax an extensive, homogeneous, ground-glass like shadow of practically all organs of the thorax. The typical miliary (spot-like) shadow ("sandstorm lung") is visible only in the lateral and apical parts of the lung. CT revealed massive calcareous deposits which increased in craniocaudal and ventrodorsal direction. Bullous metaplasia of the lung was particularly striking in the apical region. No effective therapy is known so far. A combined heart and lung transplantation might be the only therapy that could prolong the patient's life. PMID:3659783

  7. Advanced microlithiasis alveolaris pulmonum

    Triebel, H.J.; Schofer, M.; Huelst, M. v.

    1987-09-01

    A severe course of microlithiasis alveolaris pulmonum in a 28-year old patient is described. The disease, which had progressed to a very advanced stage at the time of examination, produced in the plain radiograph of the thorax an extensive, homogeneous, ground-glass like shadow of practically all organs of the thorax. The typical miliary (spotlike) shadow ('sandstorm lung') is visible only in the lateral and apical parts of the lung. CT revealed massive calcareous deposits which increased in craniocaudal and ventrodorsal direction. Bullous metaplasia of the lung was particularly striking in the apical region. No effective therapy is known so far. A combined heart and lung transplantation might be the only therapy that could prolong the patient's life.

  8. Histologic diagnoses of tissues from two nineteenth century Habsburgs.

    Józsa, László G

    2008-03-01

    This study describes the histological alterations of the internal organs of Prince Joseph Habsburg (1776-1847) and his first wife, Alexandra Pavlovna Romanova (1783-1801). Both corpses were mummified and the internal organs were stored separately in rosemary oil, in metal vessels. Royal Prince Joseph Habsburg died on 13 January 1847. The microscopic study confirms focal subacute glomerulonephritis (type Berg) with IgA precipitate on the glomerular mesangium and Bowmann's capsule. To the best of this author's knowledge, this is the first case in the paleopathological literature in which the subacute IgA glomerulonephritis could be confirmed immunohistochemically. Gout (urate nephropathy), severe arteriosclerosis, prostate adenoma and purulent prostatitis could also be diagnosed. The Prince's first wife, Alexandra Pavlovna Romanova, died in childbirth at age 18 years, along with her newborn daughter. Histological examination of Alexandra's organs revealed severe fibrocaseous and miliary tuberculosis, with dissemination to the lymph nodes, liver and spleen. PMID:18831390

  9. Marijuana Smoking in Patients With Leukemia.

    Khwaja, Sara; Yacoub, Abraham; Cheema, Asima; Rihana, Nancy; Russo, Robin; Velez, Ana Paula; Nanjappa, Sowmya; Sandin, Ramon L; Bohra, Chandrashekar; Gajanan, Ganesh; Greene, John N

    2016-07-01

    Worldwide, marijuana (cannabis) is a widely used drug. The incidence of marijuana smoking is increasing and is second only to tobacco as the most widely smoked substance in the general population. It is also the second most commonly used recreational drug after alcohol. Some adverse effects of marijuana smoking have been documented; however, the number of studies on the pulmonary effects of marijuana in individuals with leukemia is limited. In our case series, we report on 2 men with acute myeloid leukemia with miliary nodular lung patterns on computed tomography of the chest due to heavy marijuana use. We also report on 2 patients with acute lymphocytic leukemia who had a history of smoking marijuana and then developed lung opacities consistent with mold infection. PMID:27556668

  10. Clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei infection

    LU Pu-xuan; ZHU Wen-ke; ZHAN Neng-yong; LIU Yan; CHEN Xin-chun; YE Ru-xin; CAI Li-sheng; ZHU Bo-ping

    2006-01-01

    Objective To investigate the clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei (PM) infection. Methods A total of 12 patients with AIDS complicated with disseminated PM infection were collected and the symptoms, signs, laboratory examination results and image manifestations of these patients were analyzed retrospectively. Results (1) The diagnosis of PM infection in all the 12 cases were confirmed by peripheral blood culture.All the 12 cases (100%) had irregular fever (38-41 ℃) and enlarged lymph nodes, 8 cases (66%) had skin rashes; 8 cases (66%) had hepatomegaly; 9 cases (75%) had splenomegaly while 8 cases (66%) had anemia. (2) Imaging manifestation: Five cases manifested bilateral pulmonary disseminated miliary nodular shadows or lattice signs; 1 case showed enlarged hilar lymph node and 2 zases showed patchy shadow with pleuritis. One case presented sub-pleural curve line shadow at the posterior part of the right lower lung,and adhesion between the intestinal wall and intestinal mesentery in mass form in the abdomen by CT examination. Conclusion Patients suffering from AIDS (CD4T lymphocytes <50/μ L) with impaired immunity might be susceptible to complication of disseminated PM infection, which presents mainly damage of multiple organs and symptoms such as fever; enlargement of liver,spleen and lymph nodes, as well as specific skin maculopapular rashes. Imaging manifestations in the lungs were revealed as miliary nodular shadows and lattice-like shadows. Intensified abdominal CT might reveal presence of several enlarged postperitoneal lymph nodes and intestinal adhesion in shape of "cakes".

  11. Ultrasonographic and CT findings of hepatosplenic tuberculosis

    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

  12. Epidemiological Aspects of Dermatophytosis in Khuzestan, southwestern Iran, an Update.

    Rezaei-Matehkolaei, Ali; Rafiei, Abdollah; Makimura, Koichi; Gräser, Yvonne; Gharghani, Maral; Sadeghi-Nejad, Batool

    2016-08-01

    Dermatophytosis is among the most common superficial mycoses in Iran. The purpose of this report was to update the clinical and mycological features of human dermatophytosis in the Khuzestan, southwestern Iran. In the framework of a one-year survey, a total of 4120 skin, hair and nail samples obtained from the outpatients with symptoms suggestive of tinea were analyzed by using direct microscopy, culture and molecular identification methods. Strains isolated from cultures were subjected to amplification of the nuclear rDNA ITS regions in a PCR assay followed by an early established RFLP analysis. For confirmation of species identification, 100 isolates as representatives of all presumable species were subjected to ITS sequencing. Infection was confirmed in 1123 individuals (27.25 %) in the age range of 1-89 years by direct microscopy and/or culture including 603 males versus 520 females. Frequencies of infections were the highest and the lowest in age groups of 21-30 and 11-20 years, respectively. Tinea corporis was the most prevalent clinical manifestation followed by tinea cruris, tinea capitis, tinea manuum, tinea pedis, tinea unguium, tinea faciei and tinea barbae. Trichophyton interdigitale (58.7 %) was the most dominant isolate followed by Epidermophyton floccosum (35.4 %), Microsporum canis (3 %), T. rubrum (1.5 %), T. species of Arthroderma benhamiae (0.5 %), T. tonsurans (0.3 %) and T. violaceum (0.3 %). Other species included M. gypseum, M. fulvum and T. verrucosum (each one 0.1 %). Such a high occurrence of infection with T. interdigitale, which has not been reported from Iran, is due to the use of accurate molecular methods based on new species concept in dermatophytes. The prevalence of dermatophytoses caused by zoophilic species remarkably increased and Trichophyton species of A. benhamiae has emerged as a new agent of dermatophytosis in southwestern Iran, while infections due to anthropophilic species, except E. floccosum, took a

  13. Habitat selection by anurofauna community at rocky seashore in coastal Atlantic Forest, Southeastern Brazil.

    Pontes, R C; Santori, R T; Gonçalves e Cunha, F C; Pontes, J A L

    2013-08-01

    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 years 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. Bromeliads were the preferential habitat used by anurans. The nocturnal habit was predominant for all species and during diurnal searches, the specimens were found sheltered in bromeliads axils. The number of calling males as well as amphibian abundance was associated with the rainiest and warmest period of the year. The species S. littoreus was observed in breeding activity in the majority of sample period. Adult calling males of T. miliaris were observed especially in the rainy season. Rainfall and temperature combined are positively correlated to the total number of captured amphibians. However, individually, rainfall was not significantly correlated, while temperature was positively correlated with the amphibian abundance. Water storage capacity by bromeliads was correlated to characteristics and size of the plant. In the rainy season, the

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

    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

  15. Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient

    Juanarita Jaafar; Wan Hazabbah Wan Hitam; Raja Azmi Mohd Noor

    2012-01-01

    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye and 6/120 (pinhole 3/60) in the left eye. Anterior segment in both eyes was unremarkable. Funduscopy showed bilateral optic disc swelling with presence of multiple foci of choroiditis in the peripheral retina. The vitreous and retinal vessels were normal. Chest radiography was normal. CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis. This patient was managed with infectious disease team. She was started on HAART and anti-TB treatment was continued. She completed anti-TB treatment after 9 months without any serious side effects. During follow up the visual acuity in both eyes was not improved. However, funduscopy showed resolving of disc swelling and choroiditis following treatment.

  16. Successful Treatment of Demodex gatoi with 10% Imidacloprid/1% Moxidectin.

    Short, Jeanmarie; Gram, Dunbar

    2016-01-01

    Demodex gatoi is a transmissible, short-bodied mite found in the stratum corneum of cats. It is known to cause moderate to intense pruritus, often manifested as self-induced alopecia and excoriations. 10% imidacloprid/1% moxidectin (a) is a monthly, topical solution indicated for the treatment and/or prevention of fleas, heartworms, intestinal parasites, and ear mites. A household of cats was presented for pruritus that ranged from mild to severe in 8 of the 13 felines. The most common clinical signs included miliary-type papular dermatitis and focal areas of erythema associated with alopecia. Multiple skin scrapings of each animal revealed Demodex gatoi mites in only two cats. Weekly topical administration of 10% imidacloprid/1% moxidectin was used on all cats in the household for a total of ten doses. Skin scrapings following treatment were negative, and all cats in the house improved. Based on the successful treatment of this small number of cats, weekly application of 10% imidacloprid/1% moxidectin should be considered for the clinical resolution of cats affected by D. gatoi. PMID:26606209

  17. Abnormal chest shadow on CT in immunosuppressed patients

    Tanaka, Nobuyuki; Matsumoto, Tsuneo; Nakamura, Hiroshi (Yamaguchi Univ., Ube (Japan). School of Medicine) (and others)

    1992-12-01

    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 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).

  18. Tuberculous endocarditis.

    Liu, Alexander; Nicol, Edward; Hu, Yanmin; Coates, Anthony

    2013-08-10

    Mycobacterium tuberculosis (TB) is a major cause of death globally. TB is capable of infecting every organ in the body, and the heart is no exception. Tuberculous endocarditis (TBE) was first reported in 1892 and subsequently many other cases have been described, highlighting the significant morbidity and mortality associated with this manifestation of TB. TBE usually presents with miliary tuberculosis and most early cases were diagnosed on autopsy. With increasing application of prosthetic valve replacements in the treatment of infective endocarditis (IE), TB infections have begun to affect these as well as native valves. With the introduction of TB culture methods and drug therapy, the prognosis has improved. HIV and drug resistance are likely to make the management of TBE more difficult in the future. Large scale studies, both prospective and retrospective, are required to ascertain the true incidence of TBE whilst development of novel anti-TB therapy is also required to combat resistance. We present the first extensive literature review on TBE in over 75 years. PMID:23021600

  19. Avian mycobacteriosis in psittacines: a retrospective study of 123 cases.

    Palmieri, C; Roy, P; Dhillon, A S; Shivaprasad, H L

    2013-02-01

    One hundred and twenty-three cases of mycobacterioses were diagnosed in psittacine birds from a total of 9,241 submissions for necropsy examination or histopathology made to the California Animal Health and Food Safety Laboratory System between 1990 and 2007. The species affected most commonly were Amazon parrots (Amazona spp.)(n = 32; 26%) and grey-cheeked parakeets Brotogeris pyrrophterus (n = 23; 18.7%). The main gross findings on necropsy examination were enlarged and mottled pale livers and spleens and thickening of the small intestinal wall with numerous pale miliary nodules on the mucosa. Microscopical examination revealed infiltration of foamy macrophages and giant cells containing acid-fast bacteria in various organs. The gene encoding mycobacterial 65 kDa heat shock protein (hsp65) was amplified by nested polymerase chain reaction (PCR) from DNA extracted from 22 cases. The species of Mycobacterium involved was determined by analysis of restriction endonuclease patterns of the PCR products. Mycobacterium genavense was detected in 19 cases and Mycobacterium avium in two cases. One parrotlet (Touit spp.) had a mixed infection of both species of mycobacteria. It is concluded that M. genavense is the primary cause of mycobacteriosis in psittacine birds and the potential for zoonotic disease should be considered, especially for immunocompromised owners. PMID:22884283

  20. August 2012 imaging case of the month

    Gotway MB

    2012-08-01

    Full Text Available No abstract available. Article truncated at 150 words. Clinical History: A 48-year-old non-smoking man presented with a history of slowly progressive shortness of breath and recent onset of a headache. Frontal chest radiography (Figure 1 was performed.Figure 1: Frontal chest radiography shows normal cardiomediastinal contours with bilateral peri- and infrahilar predominant ground-glass opacity with a background of linear and reticular abnormalities.Which of the differential diagnostic considerations listed below is the most likely consideration for the chest radiographic abnormality?1.Pneumococcal pneumonia 2.Lung carcinoma3.Idiopathic pulmonary fibrosis4.Pulmonary alveolar proteinosis5.Miliary tuberculosisCorrect!Answer: 4. Pulmonary alveolar proteinosisThe frontal chest radiograph shows bilateral increased lung attenuation consisting of ground-glass opacity and a background of linear and reticular abnormalities. Pneumococcal pneumonia is a possibility, but this infection most commonly presents either with an air-space pneumonia pattern [homogeneous lung opacity with air bronchograms extending towards the pleural surface] or with a bronchopneumonia pattern [patchy …

  1. Stroke in a patient with tuberculous meningitis and HIV infection

    Maria Bruna Pasticci

    2013-02-01

    Full Text Available Abstract. Tuberculous meningitis (TBM is a devastating disease. TBM occurs more commonly in HIV infected patients. The influence of HIV co-infection on clinical manifestations and outcome of TBM is not well defined. Yet, some differences have been observed and stroke has been recorded to occur more frequently. This study reports on an HIV infected Caucasian female with lung, meningeal tuberculosis and stroke due to a cortical sub-cortical ischemic lesion.TBM was documented in the absence of neurologic symptoms. At the same time, miliary lung TB caused by multi-susceptible Mycobacterium tuberculosis was diagnosed. Anti-TB therapy consisting of a combination of four drugs was administered. The patient improved and was discharged five weeks later. In conclusion, TBM and multiple underling pathologies including HIV infection, as well as other risk factors can lead to a greater risk of stroke. Moreover, drug interactions and their side effects add levels of complexity. TBM must be included in the differential diagnosis of HIV infected patients with stroke and TBM treatment needs be started as soon as possible before the onset of vasculopathy.

  2. Demographic And Risk Factors Related To Military Tuberculosis

    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.

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

    Durak, Hatice E-mail: hdurak@kordon.deu.edu.tr; Aktogu, Serir; Degirmenci, Berna; Sayit, Elvan; Ertay, Tuerkan; Dereli, Sevket

    1999-08-01

    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 (FEV{sub 1}) (r=.806) and forced vital capacity (FVC) (r=.781). Retention was more marked in sarcoidosis compared with tuberculosis (0.025

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

    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

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

    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.

  6. Pulmonary benign metastasizing leiomyoma: a case report and literature review.

    Chen, Shi; Liu, Rui-Ming; Li, Tian

    2014-06-01

    Benign metastasizing leiomyoma (BML) is a rare condition that occurs in all age groups and that is particularly prevalent among women of late childbearing age. All patients have a history of uterine leiomyoma and/or myomectomy, often associated with distant metastases from the uterus, which commonly occurs in the lung. We report the case of a 32-year-old young woman suffering from chest stuffiness, labored respiration and weakness after a myomectomy performed one month earlier. The chest CT showed a diffuse miliary shadow in both sides of her lungs, but serum tumor markers such as CA125, CA199, carcinoembryonic antigen (CEA), neuron specific enolase (NSE), and CYFRA21-1 were normal. The patient underwent a lung biopsy by thoracoscopic surgery after four weeks of anti-TB treatment; there were no significant changes in the chest CT. H&E staining showed that the tumor cells had characteristics of smooth muscle cell differentiation. Immunohistochemical staining showed a low tumor cell proliferation index, which indicated that the likelihood of a malignancy was not high. There was no expression of CD10, indicating a diagnosis of pulmonary benign metastasizing leiomyoma (PBML). Smooth muscle actin (SMA) and desmin as specific markers of smooth muscle and the estrogen receptor (ER) and progesterone receptor (PR) were all strongly positive, which is characteristic of PBML. The patient was given the anti-estrogen tamoxifen for 3 months. With no radiological evidence of disease development and further distant metastasis, the patient will continue to be followed. PMID:24977035

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

    G. Kalema-Zikusoka

    2005-09-01

    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.

  8. Study of tuberculous meningitis by CT

    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.)

  9. Pancreatite esclero-gomosa simulando sindrome cancerosa da cabeça do pâncreas

    A. Penna de Azevedo

    1944-06-01

    Full Text Available Em um homem de 49 anos de idade, observou-se um sindrome de tumor da cabeça do pâncreas. Realizada a intervenççao cirúrgica foi verificada a presença de uma formaão dura de aspecto fibroso, medindo 9 x 7,5 x 6,5 cm. O exame microscópico mostrou tratar-se de uma pancreatite indurativa associada à presença de gomas miliares, infiltração de eosinófilos e lesões produtivas dos vasos sanguíneos, correspondendo ao aspecto dos processo esclerogomosos sifilíticos do pâncreas.A tumor of the head of the pancreas is reported ina a male, 49 years old, which corresponded to a nodule of fibrous tissue measuring 9 x 7,5 x 6,5 cm. Microscopically, a chronic interstitial pancreatitis associated to miliary gummata, eosinophilic infiltration and proliferation of blood vessels was found and the diagnosis of siphilitic pancreatitis was done.

  10. Radiological patterns of childhood pulmonary tuberculosis in Khartoum state

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

  11. Prime-boost bacillus Calmette-Guérin vaccination with lentivirus-vectored and DNA-based vaccines expressing antigens Ag85B and Rv3425 improves protective efficacy against Mycobacterium tuberculosis in mice.

    Xu, Ying; Yang, Enzhuo; Wang, Jianguang; Li, Rui; Li, Guanghua; Liu, Guoyuan; Song, Na; Huang, Qi; Kong, Cong; Wang, Honghai

    2014-10-01

    To prevent the global spread of tuberculosis (TB), more effective vaccines and vaccination strategies are urgently needed. As a result of the success of bacillus Calmette-Guérin (BCG) in protecting children against miliary and meningeal TB, the majority of individuals will have been vaccinated with BCG; hence, boosting BCG-primed immunity will probably be a key component of future vaccine strategies. In this study, we compared the ability of DNA-, protein- and lentiviral vector-based vaccines that express the antigens Ag85B and Rv3425 to boost the effects of BCG in the context of immunity and protection against Mycobacterium tuberculosis in C57BL/6 mice. Our results demonstrated that prime-boost BCG vaccination with a lentiviral vector expressing the antigens Ag85B and Rv3425 significantly enhanced immune responses, including T helper type 1 and CD8(+) cytotoxic T lymphocyte responses, compared with DNA- and protein-based vaccines. However, lentivirus-vectored and DNA-based vaccines greatly improved the protective efficacy of BCG against M. tuberculosis, as indicated by a lack of weight loss and significantly reduced bacterial loads and histological damage in the lung. Our study suggests that the use of lentiviral or DNA vaccines containing the antigens Ag85B and Rv3425 to boost BCG is a good choice for the rational design of an efficient vaccination strategy against TB. PMID:24773322

  12. Scrotal inflammation: characteristic US patterns

    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-up of the patients undergoing medical therapy

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

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

    2013-01-01

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

  14. Dermabrasion-Loo-punch-excision technique for the treatment of acne-induced osteoma cutis.

    Fulton, J E

    1987-06-01

    Three patients with chronic osteoma cutis secondary to acne vulgaris were treated with the dermabrasion-Loo-punch-excision technique. Under regional nerve block with lidocaine-bipuvacaine (50:50) a uniform dermabrasion was performed across the entire face, including the hairline and 1 cm below the jawline. This exposed the foci of osteoma cutis. Then the appropriate sized Loo punch (usually the 2.0- or the 2.5-mm punch) was used to excise the bluish-gray miliary lesions. The majority of the foci were removed in one operation. Following excision, the lesions were closed with 7-0 prolene suture. To prevent crust formation postoperatively, Aloe-vera-soaked polyethylene oxide gel dressings (Vigilon) were changed twice daily following an ice water compress. Sutures were removed rapidly in 5 to 7 days to prevent the appearance of suture lines. Although one patient required an additional procedure, the cosmetic results were excellent. Only a few small residual blue "dot" lesions remained in these three cases. PMID:2953769

  15. Tuberculose hepática pseudotumoral Pseudotumoral hepatic tuberculosis

    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.

  16. HIV-Tuberculosis: A Study of Chest X-Ray Patterns in Relation to CD4 Count

    Mahesha Padyana

    2012-01-01

    Full Text Available Background : Fight against human immunodeficiency virus (HIV is incomplete without addressing problems associated with difficult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. Aim: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. Materials and Methods : Prospective cohort study was conducted in a tertiary hospital in South India from September 2009 to July 2011 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. Results : 27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33% among CD4 less than 200 as compared to CD4 more than 200 (14%. Infiltration (39% followed by consolidation (30%, cavity (11%, and lymphadenopathy (9% seen with CD4 less than 200. Infiltration (37.5% followed by cavity (25% and miliary (25% with CD4 above 200. Bilateral (68.5% and mid and lower zones or all zone involvement more commonly seen. Conclusion : In patients with CD4 lower than 200 noncavitory infiltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIV positive patients.

  17. Tuberkulosis Perinatal Bermanifestasi sebagai Tuberkulosis Milier dan Meningitis

    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.

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

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

    2011-12-01

    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 abundance 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 m(2). Haddadus binotatus had the highest density (1.1 ind/100 m(2)). 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. PMID:21971595

  19. Tuberculous meningitis in a Filipino maid.

    Sheu, J J; Yuan, R Y; Lu, J J; Chung, C L; Hsu, C Y

    1999-11-01

    Tuberculous meningitis, while not uncommon in Taiwan, has not been reported among foreign workers. We report the first case of tuberculous meningitis in a 37-year-old Filipino maid in Taiwan, who presented with headache, fever and vomiting. She had been well before this episode and the small screening films of the chest radiograph obtained on her arrival in Taiwan 15 months previously, and every 6 months thereafter showed no evidence of tuberculosis. The suspicion of tuberculous meningitis was delayed until disturbance of consciousness manifested and a standard chest radiograph showed a diffuse miliary pattern in both lung fields. A cerebrospinal fluid sample that was sent for a polymerase chain reaction-based assay specific for Mycobacterium tuberculosis showed a positive result. The patient recovered with sequelae of mildly incoherent speech and urinary incontinence after antituberculous medication and short-course steroid treatment. Clinicians should be aware of the possibility of tuberculous meningitis in foreign workers with complaints of fever and headache. Because high-quality chest radiographs are a prerequisite for early detection of pulmonary tuberculosis, we recommended that standard posterior-anterior chest radiographs should be obtained as part of the routine health examination for foreign workers. PMID:10705697

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

    Kalema-Zikusoka, G; Bengis, R G; Michel, A L; Woodford, M H

    2005-06-01

    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. PMID:16137132

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

    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-γ (IFN-γ producing spot-forming cells (SFC to tetanus toxoid 2–3 months later. The frequency of IFN-γ producing SFC to polioviruses 1–3 also trended higher among infants who received BCG vaccination at birth. The frequency of IFN-γ+/tumor necrosis factor-α (TNF-α+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.

  2. Nevoid basal cell carcinoma syndrome:a case report%痣样基底细胞癌综合征

    陈芳; 薛燕宁; 盛珉旻; 闵仲生

    2013-01-01

    报告1例痣样基底细胞癌综合征.患者男,72岁.因全身出现散在褐色皮疹30余年就诊.皮肤科检查:胸腹部、背部、四肢散在数十个粟粒至蚕豆大小、形状不规则的褐色斑块,境界清楚,表面粗糙,轻微隆起.双手掌可见数个黄豆大小界限清楚的红斑.腹部皮损组织病理检查示基底细胞癌.结合临床、组织病理检查结果,诊断为痣样基底细胞癌综合征.%A case of nevoid basal cell carcinoma syndrome is reported. The 72-year-old male patient presented with brown skin rash that had scattered all over his body for more than 30 years. Dermatology examination showed dozens of the brown miliary to bean-sized plaques on the chest, abdomen, back and limbs, which were clearly circumscribed, on the surface and slightly raised, a number of soybean -like erythemas appeared on the palms with clear edges. On the abdomen the histopathological examination revealed basal cell carcinoma. The clinical and histopathological results are consistent with the diagnosis of nevoid basal cell carcinoma syndrome.

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

    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

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

    Ligia R. S. Kerr-Pontes

    1997-08-01

    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.

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

    Carlos F.D. Rocha

    2011-12-01

    Full Text Available 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 abundance 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.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 relativa 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

  6. Computed tomographic demonstrations of HIV seropositive pulmonary tuberculosis and their relationship with CD4+T-lymphocyte count

    ZHANG Yu-zhong; LI Hong-jun; CHENG Jing-liang; WU Hao; BAO Dong-ying

    2011-01-01

    Background Factors of cell-mediated immunity and allergy together play their roles in the pathogenesis of pulmonary tuberculosis (PTB) and its prognosis. The purpose of this study was to investigate the computed tomographic demonstrations of HIV seropositive PTB and the relationship between its pathogenesis and CD4+ T-lymphocyte count.Methods The documented CT images of a total of 44 patients with HIV seropositive PTB, definitely diagnosed by etiological or pathological examinations, their clinical data and their CD4+ T-lymphocyte count were retrospectively reviewed.Results There were 15 cases of miliary tuberculosis, accounting for 34.1% of the total cases; 15 cases of nodular tuberculosis, 34.1%; 6 cases of ground-glass opacity, 13.6%; 5 cases of cord-liked fiber shadows, 11.4%; 16 cases of flaky and flocculating shadows, 36.4%; 5 cases of cavitation, 11.4%; 5 cases of tumor shadows, 11.4%; 2 cases of pleural thickening, 4.5% and 11 cases of pleural effusion, 25.0%; 1 case of calcification, 2.3%; 16 cases of lymphadenectasis,36.4%. The foci were located around the pulmonary hilum, anterior segment of superior lobe, basal segment of inferior lobe, medial lobe and lingual lobe. CD4+ T-lymphocyte count was closely related to the imaging demonstrations of HIV seropositive PTB.Conclusions CT scanning can demonstrate various signs of PTB. CD4+ T-lymphocyte level determines the variety of imaging demonstrations of HIV seropositive PTB and its prognosis.

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

    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%, 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

  8. Múltiplos tuberculomas intracerebrais na vigência de terapia específica para tuberculose pulmonar: a propósito de um caso Intracranial tuberculomas developing during treatment of pulmonary tuberculosis: case report

    MARIA LÚCIA VELLUTINI PIMENTEL

    2000-06-01

    Full Text Available A forma clássica de apresentação da neurotuberculose é a meningite. Os tuberculomas cerebrais são formas raras de neurotuberculose e resultam da disseminação hematogênica de focos distantes de infecção pelo Mycobacterium tuberculosis. Aproximadamente 1% dos pacientes com tuberculose do sistema nervoso central desenvolve tuberculomas intracranianos, poucas semanas ou meses após o início da quimioterapia tuberculostática. A involução das lesões é lenta e não necessariamente significa resistência medicamentosa ou falta de aderência ao tratamento. Descrevemos o caso, diagnosticado e tratado na 25ª Enfermaria da Santa Casa da Misericórdia do Rio de Janeiro, de um paciente imunocompetente que apresentou meningite e tuberculomas múltiplos do sistema nervoso central, durante o tratamento específico de tuberculose miliar. A literatura é revisada e o diagnóstico, terapêutica e possíveis mecanismos imunológicos são discutidos.The classical presentation of neurotuberculosis is meningitis. Intracranial tuberculomas are a rare manifestation of neurotuberculosis and are due to hematogenous dissemination of distant focuses of Mycobacterium tuberculosis infection. Around 1% of patients with central nervous system tuberculosis develop intracranial tuberculomas some weeks or months after the beginning of the specific treatment with tuberculostatic chemotherapy. The involution of the lesions is slow and does not mean drug resistance nor lack of adequate treatment. We describe the case, diagnosed and treated at the 25th Infirmary of Santa Casa da Misericórdia do Rio de Janeiro, of an immunocompetent male patient who developed meningitis and multiple intracranial tuberculomas during the specific treatment of miliary tuberculosis. The literature is revised and the diagnosis, treatment and possible immunological mechanisms are discussed.

  9. Comparison of Coccidioides immitis serological antibody titres between forms of clinical coccidioidomycosis in horses.

    Higgins, Jill C; Pusterla, Nicola; Pappagianis, Demosthenes

    2007-01-01

    A retrospective study was performed to determine if there is an association between serological Coccidioides immitis antibody titres (IgG) and form/severity of coccidioidal disease in horses, and to identify trends in survival and treatment success based on the form of the disease. Data were obtained on horses with positive serological titres tested at the Coccidioidomycosis Serology Laboratory, School of Medicine, University of California, Davis from 1981 to 2004. Thirty-nine cases in which a diagnosis of coccidioidomycosis had been made were selected for inclusion. Six distinct categories were identified including abortion (n=6), miliary/interstitial pneumonia (n=6), pneumonia with thoracic effusion (pleural or pericardial) (n=11), disseminated (n=10), osteomyelitis (n=3) and external abscessation (n=3) both without pulmonary disease. Statistical differences in titre distribution were found between the abortion category and the pulmonary category (P=0.003), the abortion category and pneumonia with thoracic effusion (P=0.001), the abortion category and disseminated disease (P=0.001), and the pulmonary form and pneumonia with effusion (P=0.001). The other categories had overlapping titre results. Higher serological antibody titres seemed to be associated with a poorer prognosis for survival. Categories with the highest titres, disseminated (geometric mean titre=104) and pneumonia with thoracic effusion (geometric mean titre=226), were overwhelmingly fatal (19/21 known deaths) due to severe clinical disease. The categories with lower titres, abortion (geometric mean titre=4), bone involvement only (geometric mean titre=13) and cutaneous (geometric mean titre=5), had a better survival rate (10/12 known survivors) and less severe clinical disease. Measurement of serological titre may be a useful diagnostic aid in establishing form and severity of disease and thus inform prognosis. PMID:16249106

  10. Thoracic radiographic features of silicosis in 19 horses.

    Berry, C R; O'Brien, T R; Madigan, J E; Hager, D A

    1991-01-01

    Clinical records and thoracic radiographs of 19 horses with a confirmed pathologic diagnosis of silicosis were reviewed. These horses had histories of varying degrees of chronic weight loss, exercise intolerance, and respiratory distress. At the time of presentation, two horses were asymptomatic. Ten horses were geldings and nine were female. The mean age of the 19 horses was 10.7 +/- 5.5 years. Fourteen horses were identified as being from the Monterey-Carmel Peninsula of midcoastal California. An abnormal, structured interstitial pulmonary pattern was identified on thoracic radiographs in each horse. The interstitial pulmonary changes were classified as miliary (13 horses), reticulonodular (4), or linear interstitial (2), and were best visualized dorsally and caudodorsally. In addition to the abnormal interstitial pulmonary pattern, areas of pulmonary consolidation were evident caudodorsally in seven horses. Other thoracic radiographic features included: hilar lymphadenopathy (4 horses), pleural effusion/thickening (4), cranial mediastinal lymphadenopathy (2), hyperinflation (1), and a discrete pulmonary mass (1). Necropsy findings in eight horses and results of lung biopsies in an additional five horses showed a diffuse, multifocal, granulomatous pneumonia with areas of pulmonary fibrosis. Cellular infiltrates included predominantly macrophages with intracellular and/or extracellular crystalline material, occasional lymphocytes, and giant cells. Similar cellular changes were also identified, during necropsy, in the hilar and tracheobronchial lymph nodes in each of the eight horses, although gross enlargement of the lymph nodes was present in only six horses. The radiographic and pathologic findings of these 19 horses are consistent with chronic or the accelerated forms of silicosis that are recognized in humans. PMID:1941758

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

    A. Jamzad

    2009-11-01

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

  12. Paradoxical tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS in HIV patients with culture confirmed pulmonary tuberculosis in India and the potential role of IL-6 in prediction.

    Gopalan Narendran

    Full Text Available BACKGROUND: The incidence, manifestations, outcome and clinical predictors of paradoxical TB-IRIS in patients with HIV and culture confirmed pulmonary tuberculosis (PTB in India have not been studied prospectively. METHODS: HIV+ patients with culture confirmed PTB started on anti-tuberculosis therapy (ATT were followed prospectively after anti-retroviral therapy (ART initiation. Established criteria for IRIS diagnosis were used including decline in plasma HIV RNA at IRIS event. Pre-ART plasma levels of interleukin (IL-6 and C-reactive protein (CRP were measured. Univariate and multivariate logistic regression models were used to evaluate associations between baseline variables and IRIS. RESULTS: Of 57 patients enrolled, 48 had complete follow up data. Median ATT-ART interval was 28 days (interquartile range, IQR 14-47. IRIS events occurred in 26 patients (54.2% at a median of 11 days (IQR: 7-16 after ART initiation. Corticosteroids were required for treatment of most IRIS events that resolved within a median of 13 days (IQR: 9-23. Two patients died due to CNS TB-IRIS. Lower CD4(+ T-cell counts, higher plasma HIV RNA levels, lower CD4/CD8 ratio, lower hemoglobin, shorter ATT to ART interval, extra-pulmonary or miliary TB and higher plasma IL-6 and CRP levels at baseline were associated with paradoxical TB-IRIS in the univariate analysis. Shorter ATT to ART interval, lower hemoglobin and higher IL-6 and CRP levels remained significant in the multivariate analysis. CONCLUSION: Paradoxical TB-IRIS frequently complicates HIV-TB therapy in India. IL-6 and CRP may assist in predicting IRIS events and serve as potential targets for immune interventions.

  13. Space: A non-limiting resource in the niches of some abundant coral reef gastropods

    Reichelt, R. E.

    1982-06-01

    Given the importance attributed to the occupation of space in benthic coral reef communities, this study asks the question: are any particular microhabitat types limiting resources for an assemblage of worm-eating gastropods on Heron reef (Great Barrier Reef). Microhabitat resource use was measured on three occasions, separated by 12 and 20-month periods. The gastropod populations were typical of those of other Indo-Pacific sites with respect to mean shell size and density. Fluctuations in species' size and density are assumed to have not significantly influenced availability of microhabitat resources. Gastropods occurred mainly in the structurally complex “refuge” microhabitats during the day and showed an increased abundance in smooth, exposed, “foraging” microhabitat nocturnally. Nassarius gaudiosus is the most extreme microhabitat specialist diurnally and the most extreme microhabitat generalist nocturnally. A similar, although less pronounced trend was exhibited by other gastropod species. Microhabitat niche overlap was high for Conus coronatus, C. miliaris, C. flavidus, Vasum turbinellus and N. gaudiosus at night and was also high during the day for all these species except N. gaudiosus, which showed little overlap with other gastropod species diurnally. Using gastropod abundance data from all samples, and independently derived microhabitat abundance data, multiple regression analysis demonstrated: 1) A significant relationship between the abundances of N. gaudiosus, C. coronatus, and C. flavidus and the abundance of microhabitat 2 (sand under rocks=“refuge”). 2) No positive association between gastropod abundance and the abundance of microhabitat 7a (thin layer of algal-bound sand on reef limestone). Only N. gaudiosus is abundant in microhabitat 2. Therefore it is concluded that, with some exceptions, microhabitat abundance does not have a significant influence, directly or indirectly, on gastropod abundance. It is possible that density

  14. Congenital Tuberculosis: The Diagnostic Value of Chest X-ray Film%先天性肺结核:胸片在诊断中的价值

    徐晔; 甘兰丰; 余世才; 林兰荣

    2001-01-01

    Objective To evaluate plain chest film in the diagnosis of congenital tuberculosis. Materials and Methods X-ray findings in 5 cases with congenital tuberculosis, proved with bacteriology or autopsy and encountered during 1992~1999 at the authors' hospital, were retrospectively analyzed. Results Though the pulmonary X-ray manifestations were complex and variable, two patterns were considered to be comparatively characteristic: (1) diffuse miliary pattern, and (2) wide-spread patch-nodular pattern. Conclusion Chest X-ray film plays a very important role in the diagnosis of congenital tuberculosis, providing physicians with radiological clues leading to the correct diagnosis.%目的 探讨胸部X线片在先天性肺结核中的诊断价值。 材料与方法 对1992年10月~1999年4月经细菌学检查或尸解证实的先天性肺结核5例进行分析。 结果 肺部X线表现虽复杂多变,但有两种形式的表现仍具有一定的特征性:(1)弥漫性粟粒病变; (2)广泛分布的斑片-结节病变。 结论 胸部X线片在先天性肺结核的诊断中具有十分重要的作用,它常能首先提出诊断,引导临床及时确诊和治疗,降低死亡率。

  15. The role of FDG-PET/CT in the detection of recurrent colorectal cancer

    Votrubova, Jana; Belohlavek, Otakar; Jaruskova, Monika [Na Homolce Hospital, PET Centre, Prague (Czech Republic); Oliverius, Martin [Institute of Clinical and Experimental Medicine, Prague (Czech Republic); Lohynska, Radka [University Hospital Motol, Department of Radiotherapy and Oncology, Prague (Czech Republic); Trskova, Kristina [Na Homolce Hospital, Department of Oncology, Prague (Czech Republic); Sedlackova, Eva [General Teaching Hospital and 1st Faculty of Medicine, Department of Oncology, Prague (Czech Republic); Lipska, Ludmila [Thomayer' s Teaching Hospital and 1st Faculty of Medicine, Department of Surgery, Prague (Czech Republic); Stahalova, Vladimira [Na Bulovce Teaching Hospital, Institute of Radiation Oncology, Prague (Czech Republic)

    2006-07-15

    The conventional diagnostic techniques used to assess recurrence of colorectal cancer (CRCR) often yield unspecific findings. Integrated FDG-PET/CT seems to offer promise for the differential diagnosis of benign and malignant lesions. The aim of this study was to compare the value of FDG-PET and PET/CT in the detection of CRCR subsequent to colonic resection or rectal amputation. The population for this retrospective study comprised 84 patients with suspected CRCR. The sensitivity, specificity and accuracy of PET and PET/CT were calculated for (a) intra-abdominal extrahepatic recurrences, (b) extra-abdominal and/or hepatic recurrences and (c) all recurrences, and tumour marker levels were analysed. The sensitivity, specificity and overall accuracy of PET in detecting intra-abdominal extrahepatic CRCR were 82%, 88% and 86%, respectively, compared with 88%, 94% and 92%, respectively, for PET/CT. The corresponding figures for detection of extra-abdominal and/or hepatic CRCR were 74%, 88% and 85% for PET and 95%, 100% and 99% for PET/CT. Considering the entire population, the sensitivity, specificity and overall accuracy of PET were 80%, 69% and 75%, respectively, compared with 89%, 92% and 90%, respectively, for PET/CT. FDG-PET/CT examination correctly detected 40 out of a total of 45 patients with CRCR. Two of five patients with falsely negative FDG-PET/CT findings had local microscopic recurrences and one had miliary liver metastases. Of 39 patients without CRCR, three showed false positive FDG-PET/CT results. Two of these cases were due to increased accumulation in inflammatory foci in the bowel wall, while one was due to haemorrhaging into the adrenal gland. FDG-PET/CT appears to be a very promising method for distinguishing a viable tumour from fibrous changes, thereby avoiding unnecessary laparotomy. (orig.)

  16. 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

    Félix Llanos-Tejada

    2012-03-01

    Full Text Available 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 revisaron 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.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 total 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.

  17. Extrapulmonary tuberculosis: Mycobacterium tuberculosis strains and host risk factors in a large urban setting in Brazil.

    Teresa Gomes

    Full Text Available BACKGROUND: Factors related to the development of extrapulmonary forms of tuberculosis (EPTB are still poorly understood, particularly in high-endemic countries like Brazil. The objective of the paper is to determine host and Mycobacterium tuberculosis (MTB strain-related factors associated with the development of EPTB in Espírito Santo state, Brazil. METHODS AND FINDINGS: We conducted a retrospective laboratory-based surveillance study of new tuberculosis (TB cases diagnosed in Espírito Santo state, Brazil between 1998 and 2007. We genotyped 612 isolates of MTB from 606 TB patients using spoligotyping and IS6110-restriction fragment length polymorphism (RFLP typing and compared sociodemographic and clinical characteristics of patients with pulmonary TB (PTB and EPTB. Among 606 patients, 464 (77% had PTB, 79 (13% had EPTB, 51 (8% had both, and 12 (2% had miliary TB. The IS6110 RFLP analysis demonstrated that 250 (41% isolates belonged to clustered RFLP patterns, 27 (11% of which were from EPTB. We identified 73 clusters including 35 (48% composed of 2 isolates each. By spoligotyping, 506 (83% MTB isolates fell into known patterns and 106 (17% fell into patterns with no family assignment; 297 (48% isolates belonged to the Latin-American Mediterranean family. Higher school level (4-7 years OR: 0.16 95% CI 0.34-0.73 and > 8 years of education, OR 0.06 95% CI 0.009-0.50 white ethnicity (OR: 2.54 95% CI 1.03-6.25 and HIV infection (OR: 16.83 95% CI 5.23-54.18 were associated with EPTB. No specific strain lineage or percentage of clustering was associated with EPTB. CONCLUSIONS: These results demonstrate that risk factors for EPTB are related more to host than to MTB strain lineage characteristics.

  18. Tuberculosis: From an incurable scourge to a curable disease - journey over a millennium

    Surendra K Sharma

    2013-01-01

    Full Text Available Globally, tuberculosis (TB still remains a major public health problem. India is a high TB burden country contributing to 26 per cent of global TB burden. During 1944-1980, TB became treatable and short-course chemotherapy emerged as the standard of care. When TB elimination seemed possible in the early 1980s, global human immunodeficiency virus (HIV infection/acquired immunodeficiency syndrome (AIDS pandemic resulted in a resurgence of TB. Widespread occurrence of multidrug-resistant and extensively drug-resistant TB (M/XDR-TB is threatening to destabilize TB control globally. Atypical clinical presentation still poses a challenge. Disseminated, miliary and cryptic TB are being increasingly recognized. Availability of newer imaging modalities has allowed more efficient localization of lesions and use of image guided procedures has facilitated definitive diagnosis of extrapulmonary TB. Introduction of liquid culture, rapid drug-susceptibility testing (DST, molecular diagnostic methods has helped in rapid detection, speciation and DST profiling of Mycobacterium tuberculosis isolates. While treatment of TB and HIV-TB co-infection has become simpler, efforts are on to shorten the treatment duration. However, drug toxicities and drug-drug interactions still constitute a significant challenge. Recently, there has been better understanding of anti-TB drug-induced hepatotoxicity and its frequent confounding by viral hepatitis, especially, in resource-constrained settings; and immune reconstitution inflammatory syndrome (IRIS in HIV-TB. Quest for newer biomarkers for predicting a durable cure, relapse, discovery/repurposing of newer anti-TB drugs, development of newer vaccines continues to achieve the goal of eliminating TB altogether by 2050.

  19. Seasonal Cycles in Abundance of Major Holozooplankton in the Innermost Part of Onagawa Bay, Northeast Japan

    Uye, Shin-ichi

    1982-01-01

    1976年6月から1978年5月までの2年間、宮城県女川湾の奥部で主要動物プランクトンの季節変動を調査した。1.合計26種の橈脚類(Copepoda)が同定され、そのうちAcartia clausiがほとんどの季節で最優占であった。特に本種はParacalanus parvusとともに主として夏-秋期に多く出現した。Eurytemora pacifica と Pseudocalanus minutusは主として冬-春期に多く出現した。Oithona similisは春-夏期に多かった。多くの種はほとんど周年にわたって出現し、本邦南部の浅い内湾域で観察される様な顕著な季節的消長を示す種は少なかった。2.5種の枝角類(Cladocera)が出現し、各々の種は顕著な季節約消長を示した。3.鞭毛虫(Mastigophora)の一種のヤコウチュウ(Noctiluca miliaris)、ヒドロ虫類(Hydrozoa)、矢虫類(Chaetognatha)や尾虫類(Appendicularia)は主として夏-秋期に多く出現した。...

  20. Reducing the activity and secretion of microbial antioxidants enhances the immunogenicity of BCG.

    Shanmugalakshmi Sadagopal

    Full Text Available BACKGROUND: In early clinical studies, the live tuberculosis vaccine Mycobacterium bovis BCG exhibited 80% protective efficacy against pulmonary tuberculosis (TB. Although BCG still exhibits reliable protection against TB meningitis and miliary TB in early childhood it has become less reliable in protecting against pulmonary TB. During decades of in vitro cultivation BCG not only lost some genes due to deletions of regions of the chromosome but also underwent gene duplication and other mutations resulting in increased antioxidant production. METHODOLOGY/PRINCIPAL FINDINGS: To determine whether microbial antioxidants influence vaccine immunogenicity, we eliminated duplicated alleles encoding the oxidative stress sigma factor SigH in BCG Tice and reduced the activity and secretion of iron co-factored superoxide dismutase. We then used assays of gene expression and flow cytometry with intracellular cytokine staining to compare BCG-specific immune responses in mice after vaccination with BCG Tice or the modified BCG vaccine. Compared to BCG, the modified vaccine induced greater IL-12p40, RANTES, and IL-21 mRNA in the spleens of mice at three days post-immunization, more cytokine-producing CD8+ lymphocytes at the peak of the primary immune response, and more IL-2-producing CD4+ lymphocytes during the memory phase. The modified vaccine also induced stronger secondary CD4+ lymphocyte responses and greater clearance of challenge bacilli. CONCLUSIONS/SIGNIFICANCE: We conclude that antioxidants produced by BCG suppress host immune responses. These findings challenge the hypothesis that the failure of extensively cultivated BCG vaccines to prevent pulmonary tuberculosis is due to over-attenuation and suggest instead a new model in which BCG evolved to produce more immunity-suppressing antioxidants. By targeting these antioxidants it may be possible to restore BCG's ability to protect against pulmonary TB.

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

    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.

  2. Thoracic radiographic features of silicosis in 19 horses

    Clinical records and thoracic radiographs of 19 horses with a confirmed pathologic diagnosis of silicosis were reviewed. These horses had histories of varying degrees of chronic weight loss, exercise intolerance, and respiratory distress. At the time of presentation, two horses were asymptomatic. Ten horses were geldings and nine were female. The mean age of the 19 horses was 10.7 +/- 5.5 years. Fourteen horses were identified as being from the Monterey-Carmel Peninsula of midcoastal California. An abnormal, structured interstitial pulmonary pattern was identified on thoracic radiographs in each horse. The interstitial pulmonary changes were classified as miliary (13 horses), reticulonodular (4), or linear interstitial (2), and were best visualized dorsally and caudodorsally. In addition to the abnormal interstitial pulmonary pattern, areas of pulmonary consolidation were evident caudodorsally in seven horses. Other thoracic radiographic features included: hilar lymphadenopathy (4 horses), pleural effusion/thickening (4), cranial mediastinal lymphadenopathy (2), hyperinflation (1), and a discrete pulmonary mass (1). Necropsy findings in eight horses and results of lung biopsies in an additional five horses showed a diffuse, multifocal, granulomatous pneumonia with areas of pulmonary fibrosis. Cellular infiltrates included predominantly macrophages with intracellular and/or extracellular crystalline material, occasional lymphocytes, and giant cells. Similar cellular changes were also identified, during necropsy, in the hilar and tracheobronchial lymph nodes in each of the eight horses, although gross enlargement of the lymph nodes was present in only six horses. The radiographic and pathologic findings of these 19 horses are consistent with chronic or the accelerated forms of silicosis that are recognized in humans

  3. [TUBERCULOSIS ANNUAL REPORT 2014--(1) Summary of Statistics on Tuberculosis Notification and Foreign-born Tuberculosis Patients].

    2016-02-01

    This brief is the first of a series of documents based on the Tuberculosis Annual Report 2014. It includes a summary of tuberculosis (TB) statistics, including data on foreign-born TB patients notified and registered in Japan in 2014. For the first time, the number of newly notified cases (all forms of TB) fell below 20,000. In 2014, a total of 19,615 patients were notified, a rate of 15.4 per 100,000 population The number of sputum-smear positive pulmonary. TB patients notified was 7,651, a rate of 6.0 per 100,000 population. The number of patients with latent TB infections increased slightly from 7,147 in 2013 to 7,562 in 2014. The proportion of miliary TB cases has constantly increased over the past 10 years, especially among women aged 80 years and older. The number of foreign-born TB patients continued to increase from 1,064 in 2013 to 1,101 in 2014. In 2014, new foreign-born TB patients aged 20-29 years accounted for 44.1% of all new TB patients in that age group. Among foreign-born TB patients, half were from the Philippines (26.5%) and China (23.5%). However, the number of patients from Vietnam and Nepal is increasing. Among foreign-born TB patients, 28% were regular employees, 26% were students, and 20% were unemployed. The changing trend in the nationality of foreign students entering Japan may at least partially explain the differences in TB burden among foreign-born patients, by country of birth. As we expect to see the proportion of foreign-born TB patients continue to rise, more tailored case identification and treatment support activities are needed. PMID:27263231

  4. An optical system for detecting and describing major algal blooms in coastal and oceanic waters around India

    Gokul, Elamurugu Alias; Shanmugam, Palanisamy

    2016-06-01

    An optical system is developed with the aim to detect and monitor three major algal blooms (including harmful algal blooms "HABs") over ecologically relevant scales around India and to strengthen algal forecasting system. This system is designed to be capable of utilizing remote sensing, in situ, and radiative transfer techniques to provide species-specific data necessary for increasing capabilities of an algal forecasting system. With the ability to measure in-water optical properties by means of remote sensing and in situ observations, the optical system developed infers the desired phytoplankton signal from spectral distributions and utilize these data in a numerical classification technique to generate species-specific maps at given spatial and temporal scales. A simple radiative transfer model is adopted for this system to provide a means to optimally interpolate to regions with sparse in situ observation data and to provide a central component to generate in-water optical properties from remotely sensed data. For a given set of inherent optical properties along with surface and bottom boundary conditions, the optical system potentially provides researchers and managers coverage at different locations and depths for tracking algal blooms in the water column. Three major algal blooms focused here include Noctiluca scintillans/miliaris, Trichodesmium erythraeum, and Cochlodinium polykrikoides, which are recurring events in coastal and oceanic waters around India. Because satellite sensors provide a synoptic view of the ocean, both spatially and temporally, our initial efforts tested this optical system using several MODIS-Aqua images and ancillary data. Validation of the results with coincident in situ data obtained from either surface samples or depth samples demonstrated the robustness and potential utility of this approach, with an accuracy of 80-90% for delineating the presence of all three blooms in a heterogeneous phytoplankton community. Despite its

  5. Postmortem Investigations Following Human Immunodeficiency Virus Infection

    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

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

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

    2000-02-01

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

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

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

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

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

    2006-12-01

    miliaris with higher amounts of zeaxanthin, β-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.

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

    Herdiman T. Pohan

    2004-12-01

    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

  10. [A case diagnosed with chronic granulomatous disease after disseminated infection following BCG vaccination].

    Delibalta, Güler; Seringeç, Murat; Öncül, Oral

    2015-07-01

    BCG (Bacillus Calmette-Guérin) vaccine is a widely used vaccine with the recommendation of World Health Organization to protect children against miliary tuberculosis (TB) and TB meningitis. Severe side effects related to this vaccine mostly manifest in the presence of underlying immunosuppressive disease. In this report, an infant case with unknown chronic granulomatous disease (CGD) who developed disseminated BCG infection after administration of BCG vaccine, was presented. High fever, left axillary lymphadenopathy and hepatosplenomegaly have developed in a 3-month 28-day female infant, without a known health problem, following BCG vaccination. The acid-fast bacilli (ARB) was isolated from the material of excised lymph node cultivated in Löwenstein-Jensen medium, and the isolate was identified as Mycobacterium bovis. Mycobacterium tuberculosis complex DNA was detected in the axillary lymph node sample by polymerase chain reaction. Anti-tuberculous treatment included 20 mg/kg of rifampicin+10 mg/kg of isoniazid+15 mg/kg of ethambutol+30 mg/kg of streptomycin was started. The patient was then further evaluated for immunodeficiency and on the basis of the results of dihydroamine and LAD (lymphocyte adhesion defect) tests, diagnosed as autosomal recessive CGD. Based on the anamnesis, there was no known immunodeficiency history both in the case during neonatal period and her family members. Interferon-gamma therapy, which is recommended for the patients with CGD living in endemic areas, was initiated. Our patient's fever dropped at the 15th day of anti-tuberculosis treatment, and she was discharged on the 35th day and continued to receive treatment at home. The patient was followed up at outpatient clinic and had no additional complaints; her hepatosplenomegaly was back to normal at the third month. As a result, since BCG vaccine is contraindicated in CGD carriers, newborns with a family history of CGD should be immunologically examined and BCG vaccine should be