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Sample records for miliaris disseminatus faciei

  1. Lupus miliaris disseminatus faciei

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    Gupta Dinesh

    1996-01-01

    Full Text Available Lupus miliaris disseminatus faciei also known as acne agminata is a rare disease affecting face in adults. Previously, it was thought to be a tuberculid; and its relation with rosacea is undefined. We report a case who had multiple yellowish brown to erythematous small papular lesions and many pitted atrophic scars on the face of 8 months duration. Investigations for tuberculosis were negative. Histopathology revealed tuberculoid granuloma.

  2. Lupus miliaris disseminatus faciei report of 4 cases

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    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.

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

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    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.

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

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    Kaur S; Kanwar A; Thami G; Mohan H; Arya S

    2003-01-01

    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.

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

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    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.

  6. Recurrent lupus miliaris disseminatus faciei: a case report

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    Zonunsanga

    2015-01-01

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

  7. 67Gallium Scan Findings in Miliary Tuberculosis

    International Nuclear Information System (INIS)

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

  8. Miliary pattern in neonatal pneumonia

    International Nuclear Information System (INIS)

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

  9. Miliary Crohn's disease: early or different?

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    Scapa, E; Marcus, E L; Kaufman, S; Vinograd, I; Reif, R; Eshchar, J

    1993-04-01

    We describe what we take to be the eighth case of miliary Crohn's disease since 1967 with a view to the possibility that miliary Crohn's disease is a disease different from Crohn's disease, and not just an early stage. Miliary Crohn's disease might be a different disease because (a) miliary tubercles are seen so rarely on the serosal surface of the bowel, (b) the 100% chance of finding crowded, typical granulomas in the bowel wall, and (c) the anatomic distribution of the lesion. PMID:8505494

  10. Miliary tuberculosis: HRCT findings in 14 patients

    International Nuclear Information System (INIS)

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

  11. Dermatophytic blepharitis due to Microsporum gypseum. An adult variety of tinea faciei with dermatophytoma

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    Edoardo Torres – Guerrero

    2015-01-01

    Full Text Available Tinea faciei, is a facial superficial mycosis. The most frequent etiological agents are Microsporum canis, Trichophyton rubrum and T. tonsurans. We report a 40 year-old woman, with an eight days history of an erythematous plaque on her superior right eyelid. Hyphae and dermatophytoma were easily visualized in KOH examination, and Microsporum gypseum was isolated.

  12. Teleradiology : detectability of pneumothorax and miliary tuberculosis

    International Nuclear Information System (INIS)

    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 erage 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 performance in the detection of pneumothorax and miliary tuberculosis when reading a transmitted image on the monitor-workstation compared with reading conventional radiographs on the view box. To improve the clinical utility of the teleradiology system, a higher resolution workstation and adequate image processing are required

  13. Bronchoscopic lung biopsy for diagnosis of miliary tuberculosis

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    Aggarwal A; Gupta D; Joshi K; Jindal S

    2005-01-01

    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 microscopicall...

  14. Disseminated histoplasmosis simulating miliary tuberculosis: a case report

    International Nuclear Information System (INIS)

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

  15. Tinea faciei due to microsporum canis in children: a survey of 46 cases in the District of Cagliari (Italy).

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    Atzori, Laura; Aste, Natalia; Aste, Nicola; Pau, Monica

    2012-01-01

    Dermatophytoses are frequent in children, but involvement of the facial skin has peculiar aspects that should be considered a separate entity: tinea faciei. Microsporum canis infection in tinea faciei has not been widely documented. To review cases of tinea faciei due to M. canis in children diagnosed at the Dermatology Clinic, University of Cagliari. Between 1990 and 2009, all children with dermatophyte infections of the facial skin were recruited for the study after parental consent. Diagnosis was made through direct microscopic and cultural examination. Age, sex, clinical form, illness duration, identified dermatophyte, source of infection, and treatment were recorded. Forty-six cases of tinea faciei due to M. canis in children aged 11 months to 15 years (29 male/17 female) were diagnosed. In 42 (91.3%) children, the illness was the result of contact with pets, and 4 (8.7%) cases resulted from contact with children affected by tinea capitis due to M. canis. Clinical manifestations were typical ringworm in 34 (74%) patients, whereas in 12 (26%) cases, atypical forms mimicking atopic dermatitis, impetigo, lupus erythematosus, and periorificial dermatitis were observed. In 18 (39%) cases, involvement of the vellus hair follicle was documented as ectothrix invasion. Topical or systemic antifungal therapy was effective in all patients. Tinea faciei shows a complex spectrum of differential diagnosis and age-related variations with respect to other superficial dermatophytosis. M. canis is the main organism responsible in children residing in Cagliari, capitol city of Sardinia, Italy. Close collaboration with veterinary and educational programs within infant communities are required for adequate prevention. PMID:22011084

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

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

    2015-04-01

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

  17. Action of ?-radiation on bioluminescence of Noctiluca miliaris

    International Nuclear Information System (INIS)

    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 ?-radiation is not of a constant character and extinguishes after a period of time determined by a dose rate

  18. Bronchoscopic lung biopsy for diagnosis of miliary tuberculosis

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    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.

  19. A case of anxiety associated with miliary tuberculosis

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    Alosaimi FD

    2014-06-01

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

  20. Misdiagnosed zoophile tinea faciei and tinea corporis effectively treated with isoconazole nitrate and diflucortolone valerate combination therapy.

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    Czaika, Viktor A

    2013-05-01

    There have been few published reports on the human transmission of Trichophyton mentagrophytes, a zoophilic fungus frequently occurring in pets. Here we report on 2 girls, living with a pet dwarf rabbit, who presented with inflammatory skin lesions positive for T. mentagrophytes and subsequently diagnosed as zoophile tinea faciei and tinea corporis. The patients were successfully treated with systemic terbinafine and 2-week therapy with Travocort cream containing isoconazole nitrate 1% and diflucortolone valerate 0.1%. PMID:23574022

  1. High-resolution CT findings of miliary pulmonary tuberculosis

    International Nuclear Information System (INIS)

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

  2. Perioral dermatitis.

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    Lipozen?i?, Jasna; Hadžavdi?, Suzana Ljubojevi?

    2014-01-01

    Perioral dermatitis is a relatively common inflammatory facial skin disorder that predominantly affects women. It is rarely diagnosed in children. A typical perioral dermatitis presentation involves the eruption of papules and pustules that may recur over weeks to months, occasionally with fine scales. The differential diagnosis includes seborrheic dermatitis, systemic lupus erythematosus, acne vulgaris, lupus miliaris disseminatus faciei, polymorphous light eruption, steroid-induced rosacea, granulomatous perioral dermatitis, contact dermatitis (allergic and irritant), and even basal cell carcinoma. The histopathology is similar to that of rosacea, with a perivascular and perifollicular lymphohistiocytic infiltrate and sebaceous hyperplasia. The etiology of perioral dermatitis is unknown, but the uncritical use of topical corticosteroids often precedes skin lesions. Physical sunscreens with high sun protection factors may cause perioral dermatitis in children. PMID:24314386

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

    International Nuclear Information System (INIS)

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

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

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    Ballaekere Jayaram Subhashchandra

    2013-03-01

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

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

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

    2008-12-15

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

  6. Miliary Osteoma Cutis of the Face: A Case

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    Selma Emre

    2014-03-01

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

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

    International Nuclear Information System (INIS)

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

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

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    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)

  9. Diagnosis and management of miliary tuberculosis: current state and future perspectives

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    Ray S

    2013-01-01

    Full Text Available Sayantan Ray, Arunansu Talukdar, Supratip Kundu, Dibbendhu Khanra, Nikhil SonthaliaDepartment of Medicine, Medical College and Hospital, Kolkata, West Bengal, IndiaAbstract: Tuberculosis (TB remains one of the most important causes of death from an infectious disease, and it poses formidable challenges to global health at the public health, scientific, and political level. Miliary TB is a potentially fatal form of TB that results from massive lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli. The epidemiology of miliary TB has been altered by the emergence of the human immunodeficiency virus (HIV infection and widespread use of immunosuppressive drugs. Diagnosis of miliary TB is a challenge that can perplex even the most experienced clinicians. There are nonspecific clinical symptoms, and the chest radiographs do not always reveal classical miliary changes. Atypical presentations like cryptic miliary TB and acute respiratory distress syndrome often lead to delayed diagnosis. High-resolution computed tomography (HRCT is relatively more sensitive and shows randomly distributed miliary nodules. In extrapulmonary locations, ultrasonography, CT, and magnetic resonance imaging are useful in discerning the extent of organ involvement by lesions of miliary TB. Recently, positron-emission tomographic CT has been investigated as a promising tool for evaluation of suspected TB. Fundus examination for choroid tubercles, histopathological examination of tissue biopsy specimens, and rapid culture methods for isolation of M. tuberculosis in sputum, body fluids, and other body tissues aid in confirming the diagnosis. Several novel diagnostic tests have recently become available for detecting active TB disease, screening for latent M. tuberculosis infection, and identifying drug-resistant strains of M. tuberculosis. However, progress toward a robust point-of-care test has been limited, and novel biomarker discovery remains challenging. A high index of clinical suspicion and early diagnosis and timely institution of antituberculosis treatment can be lifesaving. Response to first-line antituberculosis drugs is good, but drug-induced hepatotoxicity and drug–drug interactions in HIV/TB coinfected patients create significant problems during treatment. Data available from randomized controlled trials are insufficient to define the optimum regimen and duration of treatment in patients with drug-sensitive as well as drug-resistant miliary TB, including those with HIV/AIDS, and the role of adjunctive corticosteroid treatment has not been properly studied. Research is going on worldwide in an attempt to provide a more effective vaccine than bacille Calmette–Guérin. This review highlights the epidemiology and clinical manifestation of miliary TB, challenges, recent advances, needs, and opportunities related to TB diagnostics and treatment.Keywords: Mycobacterium tuberculosis, human immunodeficiency virus, diagnostic tests, biomarkers, antituberculosis drugs, vaccine

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

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    Gyanendra Agrawal

    2011-02-01

    Full Text Available 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.

  11. Muerte por tuberculosis milliar / Death from miliary tuberculosis

    Scientific Electronic Library Online (English)

    Haidee, Marrero Rodríguez.

    2013-05-01

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

  12. CT and pathologic correlation acute miliary pulmonary tuberculosis

    International Nuclear Information System (INIS)

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

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    2009-01-01

    A large-scale, ongoing study conducted by the National Institute of Oceanography, India, from 2003 onward in support of India’s ocean color program, has documented for the first time ever the appearance of extensive blooms of Noctiluca miliaris...

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

    Energy Technology Data Exchange (ETDEWEB)

    Bonse, G.; Neuhaus, R.; Gunkel, L.V.

    1985-03-01

    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.

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

    International Nuclear Information System (INIS)

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

  16. Tinea Faciei Caused by Trichophyton mentagrophytes (Molecular Type Arthroderma benhamiae ) Mimics Impetigo : A Case Report and Literature Review of Cases in Japan.

    Science.gov (United States)

    Kimura, Utako; Yokoyama, Kae; Hiruma, Masataro; Kano, Rui; Takamori, Kenji; Suga, Yasushi

    2015-01-01

    A 36-year-old female elementary schoolteacher presented with aggregated serous papules surrounded by mild erythema, extending from both nasal wings/nostrils down to the upper lip. No improvement was seen following treatment of the lesions with topical antibiotics for impetigo. Potassium hydroxide (KOH) direct microscopy confirmed the presence of mycelia, and the infection was diagnosed as tinea faciei. The isolate was identified as Trichophyton mentagrophytes using morphological analysis and as Arthroderma benhamiae using genetic analysis. Here we describe that case and summarize the clinical features of other cases of A. benhamiae infection in Japan that have been reported in the literature. PMID:25855021

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Amyloid angiopathy causing widespread miliary haemorrhages within the brain evident on MRI

    International Nuclear Information System (INIS)

    The case of a 70-year-old woman with cerebral amyloid angiopathy (CAA) is presented. MRI of the head showed widespread miliary foci of haemorrhage within the cerebrum and cerebellum, with some additional linear lesions within the cerebral cortex and patchy lesions in the white matter. This is in contrast to the more usual pattern of intracranial haemorrhage in CAA, i. e., a lobar haematoma. (orig.)

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    2012-01-01

    The bloom of Noctiluca miliaris (a dinoflagellate) which appears in the form of a green tide was studied from 2003-2011. This bloom covered a large area of the Arabian Sea from the west coast of India to the coast of Oman. The bloom was easily...

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

    Scientific Electronic Library Online (English)

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

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

  1. Case for diagnosis / Caso para diagnostico

    Scientific Electronic Library Online (English)

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

    2013-08-01

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

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

    Scientific Electronic Library Online (English)

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

    2009-03-01

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

  3. Development of miliary tuberculosis during the course of adult-onset Still’s disease: Case report

    OpenAIRE

    Murat Turgay, Halil Kurt

    2011-01-01

    Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disease with unknown etiology. Here, a 30-year-old man who developed miliary tuberculosis during the course of AOSD was presented due to very rare coincidence of these two diseases. The diagnosis of military tuberculosis was documented by bone marrow biopsy and culture. The patient’s clinical findings improved with anti-tuberculosis treatment and steroids. J Microbiol Infect Dis 2011;1(1):38-41.

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

    Directory of Open Access Journals (Sweden)

    Swaminathan S

    2007-01-01

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

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Julio César Mantilla

    2007-12-01

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

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

    Scientific Electronic Library Online (English)

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

    2011-08-01

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

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

    Scientific Electronic Library Online (English)

    Luis Miguel, Sosa; Luz Libia, Cala; Julio César, Mantilla.

    2007-12-01

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

  9. Revisão de 45 casos de tuberculose miliar em adultos - estudos clínicopatológicos / Clinical and pathological review on 45 cases of miliary tuberculosis in adults

    Scientific Electronic Library Online (English)

    Adrelirio José Rios, Gonçalves; Lucia Emi, Suzuki; Adilson Sarmet, Moreira; Sonia Regina Carvalho, Faray; Sonia Mana, Tavares; Francisco Duarte, G. Neto; Robson José da Silva, Souza; Albanita Prado, Viana; Tercia Teles de, Castro.

    1972-04-01

    Full Text Available Os autores apresentem uma revisão de 45 casos de tuberculose viiliar em adultos, sendo que 42 foram selecionados de urn total de 4.000 necropsias. Uma correlação clínico-patológica é feita senão nitidamente evidenciado c baixo grau de suspeita clinica da doenca e a relativa freqüência desta infecção [...] em Hospitais Gerais conseqüente à mimetização com outras patologias. Uma classificação histovatológica da condição é feita, assim como os principais órgãos atingidos são assinalados. Discussão a respeito dos mecanismos patogênicos é tentada. Finalizam com uma revisão a respeito dos problemas gerais envolvidos na tuberculose miliar. Abstract in english The aa. studied 45 cases of miliary tuberculosis in adults; 42 were selected from a total of 4.900 necropsies. A clinical-pathological correlation was made showing its relative frequency in a General Hospital as well as a low incidence of clinical suspicion of this disease due to its mimmetitation w [...] ith other pathological conditions. A histopathological classification was proposed by the aa. and the frequency of the organs involved was mentioned. A ternptative explanation about the pathogenic mechanism of the disease was considered. A review of the general problems involved with miliary tuberculosis is also considered.

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

    Science.gov (United States)

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

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Krambovitis Elias

    2008-03-01

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

  12. Aneurisma miliar de Leber associado à síndrome de tração vítreomacular: relato de caso / Leber's miliary aneurysms associated with vitreomacular traction syndrome: case report

    Scientific Electronic Library Online (English)

    Luciano Sólia, Násser; Herbert Paulo de, Almeida; Leandro Cabral, Zacarias; Suel, Abujamra; André Marcelo Vieira, Gomes.

    2007-10-01

    Full Text Available Telangiectasias retinianas são anormalidades vasculares primárias e idiopáticas caracterizadas por dilatações irregulares e incompetência dos vasos retinianos com variados graus de exsudação intra e sub-retiniana. O objetivo desse relato é documentar uma rara associação entre aneurisma miliar de Leb [...] er e síndrome de tração vítreomacular bem caracterizada à angiofluoresceinografia e tomografia de coerência óptica. O tratamento realizado foi fotocoagulação com laser de argônio nos aneurismas perimaculares e cirurgia de vitrectomia posterior via pars plana, o que resultou em melhora consistente da acuidade visual. O caso relatado confirma a importância da tomografia de coerência óptica em estudar a interface vítreorretiniana e suas alterações, o que permitiu abordagem completa da doença em questão. Abstract in english Retinal telangiectasias are idiopatic vascular abnormalities of the retina characterizad by irregular dilatation of the retinal vessels, intraretinal and subretinal exsudation. The aim of this article is to describe the uncommon association of Leber's miliary aneurysms and vitreomacular traction syn [...] drome in a female patient. The diagnosis was established with angiofluoresceinography and optic coherence tomography. The patient was treated with focal photocoagulation with argon green laser directed to the perimacular aneurysms and pars plana posterior vitrectomy. The visual acuity showed great improvement after a four-month follow-up. The present report supports the importance of optic coherence tomography in cases where the vitreoretinal interface must be evaluated, including vascular pathologies, which allowed us to offer a better treatment to this patient.

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

    Scientific Electronic Library Online (English)

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

    2014-02-01

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

  14. Self regressing skin-colored papules with acneiform scarring over the face.

    Science.gov (United States)

    Mandal, Rajesh Kumar; De Sarkar, Arup; Ghosh, Sudip Kumar

    2014-08-01

    Lupus miliaris disseminata faciei is a chronic inflammatory dermatosis of unknown etiology, which mostly involves the face in young adults. Earlier attempts had been made to relate it to tuberculosis, rosacea, and sarcoidosis without any strong evidence. For the past few years it has been considered as a distinct entity by various authors and was given a new nomenclature, "facial idiopathic granulomas with regressive evolution" (FIGURE). We also support this new nomenclature and present a young man with facial idiopathic granulomas and scarring consistent with this diagnosis. PMID:25148286

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

    Scientific Electronic Library Online (English)

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

    2011-12-01

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

  16. Aneurismas miliares de Leber Leber's miliary aneurysm

    Directory of Open Access Journals (Sweden)

    L. Berástegui

    2008-11-01

    Full Text Available Caso clínico: Varón de 45 años con sensación de escotoma en campo visual derecho. En la imagen del fondo de ojo aparecen dilataciones aneurismáticas con exudación lipídica en arcada temporal superior e inferior. La angiofluoresceingraf??a muestra dilatación vascular y extravasación tardía de colorante. Discusión: La enfermedad de Leber es una vasculopatía retiniana primaria caracterizada por múltiples aneurismas asociados a exudados lipídicos intrarretinianos. El compromiso visual depende de la afectación macular por exudados. El diagnóstico diferencial comprende al resto de vasculopatías retinianas primarias y aneurismas secundarios a otras patologías. El tratamiento es la fotocoagulación con láser argon de los aneurismas.Case report: A 45-year-old man was referred to us with a scotoma sensation in his right visual field. Funduscopic examination showed aneurysmal dilatations with lipid exudation in the superior and inferior temporal retinal arcades in his right eye. Angiofluorography showed vascular dilatations and late dye leakage. Discussion: Leber’s disease is a primary retinal vasculopathy characterized by several aneurysms associated with intraretinal lipid exudates. Visual compromise depends on macular involvement by the exudates. Differential diagnosis must be established with other primary retinal vasculopathies and secondary aneurysms. Treatment consists of argon laser photocoagulation of the aneurysms.

  17. Aneurismas miliares de Leber / Leber's miliary aneurysm

    Scientific Electronic Library Online (English)

    L., Berástegui; J., Andonegui.

    2008-11-01

    Full Text Available Caso clínico: Varón de 45 años con sensación de escotoma en campo visual derecho. En la imagen del fondo de ojo aparecen dilataciones aneurismáticas con exudación lipídica en arcada temporal superior e inferior. La angiofluoresceingrafía muestra dilatación vascular y extravasación tardía de colorant [...] e. Discusión: La enfermedad de Leber es una vasculopatía retiniana primaria caracterizada por múltiples aneurismas asociados a exudados lipídicos intrarretinianos. El compromiso visual depende de la afectación macular por exudados. El diagnóstico diferencial comprende al resto de vasculopatías retinianas primarias y aneurismas secundarios a otras patologías. El tratamiento es la fotocoagulación con láser argon de los aneurismas. Abstract in english Case report: A 45-year-old man was referred to us with a scotoma sensation in his right visual field. Funduscopic examination showed aneurysmal dilatations with lipid exudation in the superior and inferior temporal retinal arcades in his right eye. Angiofluorography showed vascular dilatations and l [...] ate dye leakage. Discussion: Leber’s disease is a primary retinal vasculopathy characterized by several aneurysms associated with intraretinal lipid exudates. Visual compromise depends on macular involvement by the exudates. Differential diagnosis must be established with other primary retinal vasculopathies and secondary aneurysms. Treatment consists of argon laser photocoagulation of the aneurysms.

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

    Directory of Open Access Journals (Sweden)

    A. Modjtabai

    1969-01-01

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

  19. Polycyclic Annular Lesion Masquerading as Lupus Erythematosus and Emerging as Tinea Faciei Incognito

    Science.gov (United States)

    Kye, Heesang; Kim, Dai Hyun; Seo, Soo Hong; Ahn, Hyo Hyun; Kye, Young Chul

    2015-01-01

    Tinea incognito is a dermatophytic infection induced by immunosuppressive agents that lacks the classic features of a typical fungal infection. Although the treatment of tinea incognito is simple and relatively easy, its clinical manifestation varies and can masquerade as various skin disorders, causing misdiagnosis and thus preventing prompt and appropriate treatment. Here, we report an interesting case of tinea incognito occurring after topical steroid administration in an immunosuppressed patient with dermatitis artefacta. A 40-year-old female patient who had been taking systemic glucocorticoid for 4 years for chronic inflammatory demyelinating polyneuropathy presented with itching multiple erythematous erosive lesions on the face and upper chest for 2 months. Initial biopsy produced nonspecific findings. The skin lesion was aggravated and became polycyclic and erythematous; after azathioprine was added, her chronic inflammatory demyelinating polyneuropathy became aggravated. A second biopsy confirmed hyphae in the cornified layer. Complete remission was achieved after admonishing oral terbinafine and topical amorolfine. PMID:26082592

  20. Haematological changes associated with miliary tuberculosis of the bone marrow.

    Science.gov (United States)

    Lombard, E H; Mansvelt, E P

    1993-04-01

    The peripheral blood and bone marrow findings in 25 patients found to have tuberculous granulomata on bone marrow examination were examined to determine whether specific haematological findings are associated with tuberculous infiltration of the bone marrow. All the patients had one abnormality or more on their full blood count. The presence of a peripheral lymphopaenia was the single factor common to all 25 patients studied. The peripheral lymphopaenia was only associated with bone marrow lymphopaenia in 14% of patients. Other findings of note were an association of peripheral monocytopaenia and absence of giant cells in the granulomata, and decreased iron stores in almost a third of the total number of patients. The relevance of the lymphopaenia, monocytopaenia and decreased iron stores are discussed and we propose that the absence of a peripheral lymphopaenia makes it very unlikely that there will be tuberculous localization in the bone marrow. PMID:8324206

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    2008-01-01

    ) conducted by the NIO shows this may also be the case in the western Arabian Sea. Satellite chl a data indicate that the largest winter blooms were formed in late Jan and persisted until mid March north of 201N, where winter convective mixing is the strongest... heat from the surface layer and cause salinity, they drive convective mixing in the northern large e aria- these winter blooms (Banse and McClain, 1986), which was perturbations. A large-scale and ongoing study being Contents lists available at Science...

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

    OpenAIRE

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

    2012-01-01

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

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    2014-01-01

    environmental and/or ecological conditions that favor this species has been hampered by the lack of concurrent environmental and biological observations on time and space scales relevant to ecologic and physiologic processes. We present a bio-optical proxy for N...

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    2013-01-01

    a wide range of salinities (0 percent to 25 percent 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...

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    2012-01-01

    of bloom; rather remarkably higher catches resulted from long line operations in the bloom waters. Space-time variability in dissolved oxygen was studied to explain the observed preference of fish in the bloom waters....

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    2005-01-01

    was 0.6 mg m ? 3 in the bloom region, which was relatively less compared to the other coastal st a tions (av. 0.9 mg m ? 3 ). Primary produ c tion was also lower in the bloom area (217 mgC m ? 2 d ? 1 ) compared with other coastal... of Trivandrum (off Thumba ? lat. 8 ?19 minuteN, long. 76 ?30 minuteE). On the calm sea surface, the bloom mostly existed as large patches, with a length o f 9 ? 11 km and a width of 2 ? 4 km (Figure 1 a ). The bloom was located along...

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    2013-01-01

    bloom were approx. 2-3-fold higher in comparison to non-bloom waters and ranged from 3.20×10 sup(5) to 6.84×10 sup(5) cfu ml sup(-1). An analysis of the dominant heterotrophs associated with Noctiluca bloom resulted in phylogenetic and a detailed...

  9. Diagnóstico genotípico y fenotípico de tuberculosis ósea y miliar en un paciente positivo para HIV en Bogotá, Colombia / Phenotypic and genotypic diagnosis of bone and miliary tuberculosis in an HIV+ patient in Bogotá, Colombia

    Scientific Electronic Library Online (English)

    Leonardo F., Jurado; Martha I., Murcia; Patricia, Hidalgo; John E., Leguizamón; Lorena R., González.

    2015-03-01

    Full Text Available La tuberculosis se considera la causa más frecuente de muerte producida por un solo agente infeccioso. El diagnóstico de la tuberculosis extrapulmonar no siempre es posible mediante los métodos convencionales debido al lento crecimiento del bacilo y a la naturaleza paucibacilar de las muestras, por [...] lo que es necesario recurrir a las técnicas moleculares. El riesgo de tuberculosis, así como la mortalidad, aumenta en los pacientes con infección por HIV, en quienes el compromiso extrapulmonar es más frecuente. Se describe el caso de un hombre mestizo de 56 años de edad con sospecha de padecer tuberculosis, que asistió a consulta en el Hospital San Ignacio de Bogotá y relató haber tenido dolor en una lesión ulcerada localizada en el tercio distal del antebrazo derecho durante los dos meses anteriores y en quien se confirmó la infección por HIV. El examen histológico de los tejidos óseo y pulmonar demostró la presencia de granulomas múltiples, células gigantes y fibrosis. Tanto los cultivos como la reacción en cadena de la polimerasa en la secuencia de inserción 6110 ( insertion sequence , IS6110) fueron positivos. Los aislamientos de Mycobacterium tuberculosis recuperados fueron sensibles a los medicamentos antituberculosos de primera línea. Abstract in english Tuberculosis is the single most frequent cause of death by an infectious agent worldwide. Diagnosis of extra-pulmonary tuberculosis is not always possible through conventional methods, due to the long time required for cultures and the paucibacillary nature of samples; hence the need of rapid molecu [...] lar methods. HIV infection increases the risk of tuberculosis, and HIV/tuberculosis coinfection is associated with higher mortality. We describe the case of a 56-year old mestizo male patient suspected of having tuberculosis who consulted the San Ignacio Hospital in Bogotá with a two-month history of a painful ulcerated lesion over the distal third area of the right forearm and in whom HIV coinfection was confirmed. Bone and pulmonary histological examination evidenced multiple granulomas, giant cells and fibrosis. Cultures and IS6110-PCR from lung and bone tissues were positive for Mycobacterium tuberculosis complex. Mycobacterium tuberculosis isolates were sensitive to first line drugs.

  10. An unusual case of prostate tuberculosis: a case report

    Science.gov (United States)

    Abdulsalam, Ahmad Jasem; Abdulsalam, Mohammad Adel

    2015-01-01

    Introduction Tuberculosis of the prostate is a rare complication of miliary tuberculosis. Case presentation We report a 32-year-old Iranian male diagnosed with a case of miliary tuberculosis affecting the prostate. The patient was admitted to the hospital with convulsions. Computerized tomography increased the clinical suspicion of miliary tuberculosis extending to the prostate where a trans-rectal urethral biopsy was obtained. The biopsy revealed multiple necrotizing granulomata suggestive of tuberculosis. Conclusion A strong clinical suspicion and availability of sophisticated tests with confirmation by biopsy, polymerase chain reaction, and culture are needed in order to avoid misdiagnosis of complicated miliary tuberculosis cases. PMID:25999770

  11. A Case of Dermatophytic Blepharitis

    Directory of Open Access Journals (Sweden)

    Mustafa Kulaç

    2008-07-01

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

  12. Clinical and radiological deterioration in a patient with AIDS

    International Nuclear Information System (INIS)

    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.)

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

    Directory of Open Access Journals (Sweden)

    Das C

    2005-01-01

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

  14. Taxonomy Icon Data: dog [Taxonomy Icon

    Lifescience Database Archive (English)

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

  15. Pulmoner Alveoler Mikrolitiazis: Alt? Olgu Bildirisi

    OpenAIRE

    Yalin, T.; Arslan, A.; Selc?uk, 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...

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

    OpenAIRE

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

    1995-01-01

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

  17. HRTC in military lung disease

    International Nuclear Information System (INIS)

    Purpose: To analyze high resolution CT (HRCT) features of a miliary pattern in different diseases. Material and methods: Eight HRCT studies with a miliary lung pattern were retrospectively reviewed with the diagnoses tuberculosis (n=3), Candida albicans (n=1), sarcoidosis (n=3), and metastatic adenocarcinoma (n=1). Results: In all cases, HRCT showed diffusely disseminated nodules up to 3 mm. In 2 cases of tuberculosis and 1 of sarcoidosis, the lesions predominated in the upper/middle lung zones. In the case of metastatic adenocarcinoma the nodules were more sparse in the lung periphery while in 1 case of sarcoidosis, HRCT revealed a predominance of the lesions in the outer third of the lungs. Cyst-like lesions of 1-2 mm were observed in 2/3 cases of tuberculosis and in metastatic adenocarcinoma. Notably thickened interlobular septa and interlobar fissures were each seen in 2/3 cases of sarcoidosis. In general, a random relationship of miliary nodules to secondary lobular structures and bronchovascular bundles was observed, despite the co-existence of centrilobular, subpleural and paraseptal nodules. Conclusion: HRCT features that potentially contribute in making a differential diagnosis are: (a) A peripheral distribution of nodules, an increased number of thickened interlobular septae, and a notable thickening of interlobar fissures, all of which are indicative of sarcoidosis; and (b) multiple cyst-like lesions which should direct attention to tuberculous or metastatirect attention to tuberculous or metastatic origin. The predominance of miliary nodules in relation to cephalocaudal axis, their margin and size are not helpful features to the differential diagnosis of diseases presenting a miliary pattern. (orig.)

  18. Dermatophytoses in a desert district of Western Rajasthan

    Directory of Open Access Journals (Sweden)

    Karmakar Sanchita

    1995-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-15

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

  1. Metastatic melanoma in the thorax: report of 130 patients.

    Science.gov (United States)

    Chen, J T; Dahmash, N S; Ravin, C E; Heaston, D K; Putman, C E; Seigler, H F; Reed, J C

    1981-08-01

    Early detection of metastatic melanoma has become more important as newer and more effective therapeutic regimens are used. Between 1970 and 1980, 1,600 patients were treated at one institution for malignant melanoma. Of these, 260 (16.3%) developed thoracic metastasis. Satisfactory chest radiographs were available for analysis in 130 of 260 patients. The patterns of the intrathoracic metastasis include multiple pulmonary nodules (52 patients), solitary nodule (26), miliary pattern (two), mediastinal and/or hilar adenopathy (nine), pleural effusion (three), lytic bony lesions (one), extra-pleural mass (one), and combined lesions (36). Both the staging of melanoma and the radiographic pattern of thoracic metastasis seemed to prognosticate the survival rate of these patients. Miliary metastasis and bone destruction implied a grave prognosis. Patients with a solitary lung nodule had the best survival experience. Immunotherapy, chemotherapy, and surgery of selected distal metastases significantly improved the survival of most of these patients. PMID:6789636

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

    Directory of Open Access Journals (Sweden)

    Kim Woo

    2006-10-01

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

  3. Pulmonary Strongyloides stercoralis infection

    Science.gov (United States)

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

    2014-01-01

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

  4. Choroidal Tuberculoma in Two Cases With Multiple Intracranial Tuberculomas

    OpenAIRE

    Arpaci, Baki; Tug?cu, Betu?l; Soysal, Aysun; Yu?ksel, Burcu; S?en, Aysu; Kocabiyik, Nihal

    2011-01-01

    We report two cases of concurrent choroidal and multiple intracranial tuberculomas which is rare. A 45-year-old man presented to the hospital with a history of miliary tuberculosis, headache, and blurred vision on his left eye. The other case, a 25-year-old woman complained of coughing, back pain, night sweats, headache, nausea and vomiting. Their neurological examination were unremarkable except the presence of a choroidal lesion in one of their eyes, and brain MRIs revealed peripheral ring ...

  5. Acute Fibrinous and Organizing Pneumonia Following Hematopoietic Stem Cell Transplantation

    OpenAIRE

    Lee, Sang Min; Park, Jae-jung; Sung, Sun Hee; Kim, Yookyung; Lee, Kyoung Eun; Mun, Yeung-chul; Lee, Soon Nam; Seong, Chu Myong

    2009-01-01

    A 60-year-old man presented with cough, sputum, and dyspnea. He had a history of acute myeloid leukemia and hematopoietic stem cell transplantation with chronic renal failure. Chest CT scans showed miliary nodules and patchy consolidations. Histological examination revealed numerous fibrin balls within the alveoli and thickening of the alveolar septum, both of which are typical pathological features of acute fibrinous and organizing pneumonia (AFOP). We report the first case of AFOP following...

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

    Directory of Open Access Journals (Sweden)

    Amir Hossein Sarrami

    2010-12-01

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

  7. Hepatobiliary tuberculosis in western India

    OpenAIRE

    Amarapurkar Deepak; Patel Nikhil; Amarapurkar Anjali

    2008-01-01

    Tuberculous involvement of liver as a part of disseminated tuberculosis is seen in up to 50-80% cases, but localized hepatobiliary tuberculosis (HBTB) is uncommonly described. During 6 years, a total of 280 consecutive patients with TB were evaluated prospectively for the presence and etiology of liver involvement. Cases with miliary TB or immunosuppression and cases receiving anti-tuberculosis drugs prior to presentation to our unit were excluded (38 cases). Details of clinical, bioch...

  8. Isolated Pancreatic Tuberculosis Mimicking Malignancy in an Immunocompetent Host

    OpenAIRE

    Dhyan Rajan; Pooja Raghavan

    2012-01-01

    Despite the high prevalence of tuberculosis (TB) worldwide, pancreatic TB is rare. When present, pancreatic TB is frequently associated with miliary TB, often in immunocompromised hosts. Pancreatic TB may present as a pancreatic abscess, acute or chronic pancreatitis, and cystic or solid pancreatic masses. We present a case of an immunocompetent patient who presented with two discrete pancreatic masses and was subsequently diagnosed with isolated pancreatic TB. This case suggests that clinici...

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

    OpenAIRE

    Dye, Christopher

    2013-01-01

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

  10. A Multi-valent Vaccinia Virus-based Tuberculosis Vaccine Molecularly Adjuvanted with Interleukin-15 Induces Robust Immune Responses in Mice

    OpenAIRE

    Perera, Pin-Yu; Derrick, Steven C.; Kolibab, Kristopher; Momoi, Fumiki; Yamamoto, Masafumi; Morris, Sheldon L.; Waldmann, Thomas A.; Perera, Liyanage P

    2009-01-01

    Tuberculosis caused by Mycobacterium tuberculosis is responsible for nearly two million deaths every year globally. A single licensed vaccine derived from Mycobacterium bovis, bacille Calmette-Guerin (BCG) administered perinatally as a prophylactic vaccine has been in use for over 80 years and confers substantial protection against childhood tuberculous meningitis and miliary tuberculosis. However, the BCG vaccine is virtually ineffective against the adult pulmonary form of tuberculosis that ...

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

    OpenAIRE

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

    2012-01-01

    We report, for the first time, an incidental finding of Calodium hepaticum infestation in a sub-adult female Cape ground squirrel (Xerus inaurus). Post mortem examination of the squirrel revealed severe haemoperitoneum, splenomegaly and hepatomegaly with miliary white spots distributed diffusely throughout the hepatic parenchyma. Histologically the portal tracts in the liver showed granulomatous inflammation with fibrosis and numerous giant cells. Occasional adult worms were identified and th...

  12. Tuberculous pseudotumor of the liver

    International Nuclear Information System (INIS)

    Tuberculosis of the liver in association with generalized miliary tuberculosis is not an uncommon clinical entity. A solitary tuberculous liver abscess, however, is rare. Two such cases, in which there was no clinical evidence of extrahepatic tuberculosis, are reported. The similarities between this condition and other causes of hepatic lesions are discussed, with particular emphasis placed on the imaging patterns of various diagnostic imaging procedures

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Pulmonary Strongyloides stercoralis infection

    OpenAIRE

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

    2014-01-01

    The 17-year-old male patient presented with fever, weakness, dyspnea and weight loss. His chest radiography demonstrated diffuse reticulonodular density, and high-resolution lung tomography indicated diffuse micronodules and prevalent ground-glass pattern. The findings were consistent with miliary involvement. The patient underwent examinations for rheumatology, immunology, cytology and infectious conditions. His immune system was normal and had no comorbidities or any history of immunosuppre...

  15. CT and MRI manifestations of hepatic tuberculosis

    International Nuclear Information System (INIS)

    Objective: To assess CT, MR manifestations and diagnostic value in hepatic tuberculosis. Methods: CT findings in 12 cases and MR findings in 4 cases with hepatic tuberculosis proved by surgery or biopsy were retrospectively analyzed. Results: (1) CT findings: one case of serohepatic type of hepatic tuberculosis was multiple-nodular lesions in the sub-capsule of liver. Parenchymal type were in 10 cases, including multiple, miliary, micro-nodular and low-density lesions with miliary calcifications in 2 cases, singular, low-density mass with multiple flecked calcifications in 3 cases, multiple cystic lesions in 1 case, multiple micro-nodular and low-density lesions fusing into multi-loculated cystic mass or 'cluster' sign in 3 cases, and singular, macro-nodular and low-density lesion with multiple miliary calcifications in 1 cases. One case of tuberculous cholangitis showed marked dilated intrahepatic duct with multiple flecked calcifications in the hepatic porta. (2) MR findings in 4 cases were hypointense on both T1WI and T2WI in one case, hypointense on T1WI and hyperintense on T2WI in 3 cases. Enhanced MR in 3 cases showed slightly peripheral enhancement or with multilocular enhancement. Conclusions: Various types of hepatic tuberculosis had their different imaging findings. The typical CT and MR findings could suggest the diagnosis

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

    Directory of Open Access Journals (Sweden)

    Ghabili Kamyar

    2011-05-01

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

  17. Diagnostic value of CT on hepatic tuberculosis

    International Nuclear Information System (INIS)

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

  18. COMPARISON OF DIET AND USE OF BROMELIADS BETWEEN A BROMELICOLOUS AND A BROMELIGENOUS ANURAN AT AN INSELBERG IN THE SOUTHEASTERN OF BRAZIL / Comparación de la dieta y el uso de bromelias entre anuros en un afloramiento rocoso en el sudeste de Brasil

    Scientific Electronic Library Online (English)

    WESLEI, PERTEL; ROGÉRIO L., TEIXEIRA; RODRIGO B., FERREIRA.

    2010-06-30

    Full Text Available Se estudiaron los anuros que usan las rosetas de 60 bromelias del género Alcantharea, en un afloramiento rocoso del sudeste de Brasil. Se encontraron 153 larvas y 21 adultos de Scinax arduous, 30 adultos de Thoropa miliaris, y dos individuos de Scinax x-signatus, éstos últimos no se incluyeron en lo [...] s análisis. Las larvas de S. arduous se encontraron en el 35% de las plantas analizadas. Los adultos de S. arduous se presentaron en el 25% de las plantas estudiadas, mientras que los adultos de T. miliaris se encontraron en el 30% de las plantas. Aparentemente, la presencia de ventosas en las patas de S. arduous permite que los individuos de esta especie ocupen la porción central de las bromelias, en tanto que los individuos de T. miliaris, los que carecen de dichas ventosas en sus patas, ocupan las axilas inferiores de las hojas de las bromelias. El número de especies de anuros y la abundancia de individuos fue relativamente baja. Esto puede ser el resultado de la apreciable altitud del área estudiada o por las restricciones impuestas por el ambiente saxícola del área investigada, la cual se caracteriza por presentar elevadas temperaturas y baja humedad durante el día. Ambas especies pueden ser consideradas como consumidores generalistas. Los formícidos constituyeron la principal presa en número, aunque éstos no se registraron en las rosetas de las bromelias. Por su parte, los Blattodea fueron muy comunes dentro de las bromelias, los cuales representaron una presa más importante en peso para las dos especies de anuros. Se puede concluir que ambas especies de anuros forrajean en la parte interna como en la externa de las bromelias. El nicho trófico de S. arduous demostró ser más amplio. Aunque ambas especies de anuros son habitantes comunes del mismo ambiente, éstas presentan una marcada segregación espacial en las bromelias. No obstante, teniendo como base su dieta, las dos especies de anuros disputan territorio por fuera de las bromelias. Abstract in english Anurans from an inselberg in southeastern Brazil were studied using a sample of sixty tank bromeliads Alcantharea sp. We found 153 tadpoles of S. arduous, 21 adults of S. arduous, 30 adults of T. miliaris, and two individuals of Scinax x-signatus, which were not considered in our analyses. Tadpoles [...] of S. arduous were present in 35% 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 allows them to occupy the center portion of bromeliads, while T. miliaris, which do not have pads on their toes, used the base of the plant axils for residency. The number of anuran species and the abundance of individuals found were low. This may be a result of the high altitude of our studied site or a restriction imposed by the saxicolous environment, such as high temperatures and low humidity during the day. Both species can be considered generalist feeders due to their wide variety of ingested prey. Formicidae was their main prey but was absent inside the bromeliads. Blattodea was very common inside the bromeliad axils and represented the most significant prey by weight in both frog species. We can conclude that both anurans forage inside and outside of bromeliads. The trophic niche breadth in S. arduous was larger than in T. miliaris. Even though both species are common inhabitants of the same environment, they demonstrated a marked spatial segregation in the bromeliads. Based on their diet, however, there may be disputes for territory outside of the bromeliads.

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

    Science.gov (United States)

    Werdell, P. Jeremy; Ooesler, Collin S.

    2012-01-01

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

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

    Scientific Electronic Library Online (English)

    T.A., Gous; M.C., Williams.

    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 Weste [...] rn 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.

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

    Directory of Open Access Journals (Sweden)

    M.C. Williams

    2010-09-01

    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.

  2. Polyadenylylation of sea urchin histone RNA sequences in transfected COS cells.

    OpenAIRE

    Nordstrom, J. L.; Hall, S L; Kessler, M. M.

    1985-01-01

    The region of pSV2neo that encompasses the simian virus 40 early polyadenylylation signal was replaced with a DNA fragment that spans the 3' end of a sea urchin (Psammechinus miliaris) histone H2A gene. This clone, pMK2.H2A(3'), was used to transfect COS cells. RNA analysis revealed that transcripts from pMK2.H2A(3') were polyadenylylated at a site 85 nucleotides downstream from the expected 3' end of mature H2A mRNA. Nucleotide sequencing showed that the site of poly(A) addition was located ...

  3. Tuberculosis Can Mimic Lung Cancer: A Case Series

    Directory of Open Access Journals (Sweden)

    Levent Dalar

    2013-03-01

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

  4. HRCT findings of chest complications in patients with leukemia

    International Nuclear Information System (INIS)

    High-resolution CT (HRCT) findings of several chest complications occurring in leukemic patients were reviewed. Although most entities show non-specific HRCT findings including ground-glass opacity and air-space consolidation, characteristic findings are observed in several pulmonary complications including Pneumocystis carinii pneumonia, fungal infections, miliary tuberculosis, leukemic infiltration, pulmonary edema, bronchiolitis obliterans, and bronchiolitis obliterans organizing pneumonia. A combination of these characteristic HRCT findings and the information obtained from the clinical setting may help in achieving a correct diagnosis of chest complications occurring in leukemic patients. (orig.)

  5. HRCT findings of chest complications in patients with leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Nobuyuki; Matsumoto, Tsuneo; Miura, Gouji; Emoto, Takuya; Matsunaga, Naofumi [Department of Radiology, Yamaguchi University School of Medicine (Japan)

    2002-06-01

    High-resolution CT (HRCT) findings of several chest complications occurring in leukemic patients were reviewed. Although most entities show non-specific HRCT findings including ground-glass opacity and air-space consolidation, characteristic findings are observed in several pulmonary complications including Pneumocystis carinii pneumonia, fungal infections, miliary tuberculosis, leukemic infiltration, pulmonary edema, bronchiolitis obliterans, and bronchiolitis obliterans organizing pneumonia. A combination of these characteristic HRCT findings and the information obtained from the clinical setting may help in achieving a correct diagnosis of chest complications occurring in leukemic patients. (orig.)

  6. Fatal congenital tuberculosis due to a Beijing strain in a premature neonate.

    Science.gov (United States)

    Abalain, M L; Petsaris, O; Héry-Arnaud, G; Marcorelles, P; Couturaud, F; Dobrzynski, M; Payan, C; Gutierrez, C

    2010-06-01

    Congenital tuberculosis (TB) remains a rare disease but is fatal if untreated. Early detection is difficult because of the non-specific nature of the symptoms in TB during pregnancy and infancy. This report summarizes a case of congenital TB in a very premature infant, born at 25 weeks gestation. Miliary TB was diagnosed in the mother when the neonate was 20 days old. Antituberculous therapy allowed a rapid improvement in the mother. The infant died at 27 days old. A Beijing genotype strain of Mycobacterium tuberculosis was isolated both in the mother, from pulmonary and urine specimens, and in the infant, from peritoneal fluid. PMID:20203217

  7. CT appearances of abdominal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-15

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

  8. Macronodular hepatic tuberculosis associated with portal vein thrombosis and portal hypertension

    International Nuclear Information System (INIS)

    Tuberculosis (TB) of the liver is usually associated with miliary spread. Macronodular TB of the liver is rare. A case of macronodular TB of the liver in a 31-year-old woman causing portal vein thrombosis and portal hypertension is presented. Ultrasound and CT appearances are described. There was coexistent ileo-caecal TB with extensive mesenteric and retroperitoneal lymphadenopathy. Macronodular TB should be considered in the differential diagnosis when a patient presents with multiple calcified masses in the liver with portal vein thrombosis and portal hypertension. Copyright (2005) Blackwell Science Pty Ltd

  9. Concurrent occurrence of both intracranial and intramedullary tuberculomas

    Directory of Open Access Journals (Sweden)

    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.

  10. CT appearances of abdominal tuberculosis

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  12. Anurans in bromeliads, Parque Estadual da Serra do Brigadeiro, state of Minas Gerais, southeastern Brazil

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    Lacerda, J. V. A.

    2009-01-01

    Full Text Available This study presents a list of anurans associated to bromeliads in Parque Estadual da Serra do Brigadeiro,state of Minas Gerais, southeastern Brazil. It also brings information regarding the type of association between theseanurans and plants. We recorded eight species belonging to five genera and two families, Cycloramphidae and Hylidae.The most abundant species was Scinax gr. perpusillus, followed by Scinax aff. perereca, Dendropsophus minutus,Bokermannohyla circumdata, Hypsiboas faber, Thoropa miliaris, Hypsiboas polytaenius and Dendropsophus elegans.Most species observed occupying bromeliads uses these microhabitats only as diurnal shelter. Scinax gr. perpusilluswas the only classified as bromeligenous, depending upon the plants to complete its reproductive cycle.

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

    Scientific Electronic Library Online (English)

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

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

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

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    Verónica Mancilla

    2008-01-01

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

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

    International Nuclear Information System (INIS)

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

  16. Diagnostic challenge of tuberculosis of the elderly in hospital: experience at a university hospital in Saudi Arabia.

    Science.gov (United States)

    Dahmash, N S; Fayed, D F; Chowdhury, M N; Arora, S C

    1995-09-01

    We studied retrospectively 80 elderly patients who had been admitted to hospital with tuberculosis (TB) between January 1988 and June 1993. There were 64 with pulmonary TB and 16 with miliary tuberculosis (MTB). The mean age was 70+/-7.5 years (range 60-88 years) with 56% over 70 years of age. Underlying disease preceding TB was present in 86.3% patients. In the majority of patients clinical manifestations were subtle. Chest X-ray showed involvement of lower lung fields and miliary shadowing in 71.2% (33/80) and 20% (16/80) patients, respectively. The organism was detected in expectorated sputum specimens in 62.5% (50/80). Of the specimens obtained by flexible fibreoptic bronchoscopy (FOB), 61% were positive for acid-fast bacilli (AFB) by films and culture. Drug-induced adverse effects were observed in 17.6% (6/34). In 18 patients (22.5%), the diagnosis of TB was delayed or missed. The overall mortality of 21% (9/43) included seven patients with MTB and two with pulmonary TB. TB was the direct cause of death in the former and a significant contributory cause in the latter. PMID:8666859

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

    International Nuclear Information System (INIS)

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

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

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    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.

  19. Tuberculosis among atomic bomb survivors

    International Nuclear Information System (INIS)

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

  20. Pulmonary tuberculosis

    International Nuclear Information System (INIS)

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

  1. Clinical/usefulness of gallium-67 lung scan in diffuse interstitial lung diseases of various etiology

    International Nuclear Information System (INIS)

    Gallium-67 lung scan was performed in fourty four patients with diffuse interstitial lung diseases of various etiology to investigate clinical usefulness of this examination. The series included cryptogenic fibrosing alveolitis (13), pneumonitis due to collagen disease (5), sarcoidosis (4), hypersensitivity pneumonitis (4), lymphangitis carcinomatosa (4), drug-induced pneumonitis (4), pneumoconiosis (3), miliary tuberculosis (2), eosinophylic granuloma (1) and others (4). In twenty five cases pathologic findings of specimens obtained by transbronchial lung biopsy were compared with gallium scan findings. Diffuse lung diseases characterized by granuloma formation such as hypersensitivity pneumonitis, sarcoidosis and miliary tuberculosis were associated with prominent 67Ga accumulation. All patients with lymphangitis carcinomatosa showed abnormal 67Ga scan. In nine out of thirteen patients with cryptogenic fibrosing alveolitis 67Ga accumulation was observed in the lung region where, roentgenologically, micronodular or ground-glass shadow was present. On the other hand, the lung region with honeycomb appearance was not associated with 67Ga accumulation. There was no close correlation between pathologic findings and Ga-study in general, however, most of the cases whose specimens had inflammatory cells more than grade +2 showed abnormal Ga-study. The follow-up study of the scan was useful for the assesment of the effect of therap for the assesment of the effect of therapy. (author)

  2. [Fever, pleural effusion and osteolytic lesion in a patient with HIV infection].

    Science.gov (United States)

    Aláez, J I; Repáraz, J; Castiello, J; Uriz, J; Barber, M; Sola, J

    2007-01-01

    We present the case of a 28 year old patient who came for consultation on a fever of up to 40.8 degrees C, pleuritic pain on the right side and the appearance of a painful mass in the lower left extremity of four days evolution. Computerised axial tomography (CAT) showed the existence of a condensation in the middle lobe of the right lung with associated pleural effusion and bilateral miliary pattern. The echographic study of the lower left extremity showed a mass of soft parts with a cystic aspect with destruction of the cortical of the fibula and osseous destruction. Magnetic resonance confirmed the presence of osteomyelitis in the left fibula and of an abscess; Mycobacterium tuberculosis was also isolated in three samples of sputum that led to a diagnosis of disseminated tuberculosis with miliary lung affectation, peroneous osteomyelitis and tuberculous abscess of the soft parts. Anti-tuberculosis treatment was started (riphampicine, isoniacide and pirazinamide) followed, two weeks later, with antiretroviral treatment (AZT, 3TC and NVP). The patient developed a clinical picture of generalised cutaneous eruption that disappeared following the replacement of the riphampicine by etambutol. Due to the persistence of the mass of soft parts following five weeks of anti-tuberculosis treatment, we proceeded to surgical draining of the abscess. The subsequent evolution was favourable, with the patient remaining asymptomatic one month after hospital discharge. PMID:17898823

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

    Scientific Electronic Library Online (English)

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

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

  4. The red face revisited: connective tissue disorders.

    Science.gov (United States)

    Kazandjieva, Jana; Tsankov, Nikolai; Pramatarov, Kyrill

    2014-01-01

    Red face is not a rare finding in patients with connective tissue disorders. The malar eruption is the most frequent cutaneous manifestation of systemic lupus erythematosus (LE). This condition is more apparent among fair-skinned individuals, and it usually appears after sun exposure. A very important clinical sign is that nasolabial folds remain free of any erythematous or other changes. With subacute cutaneous LE, sun exposure can provoke a red face that resembles the malar eruption of systemic LE. The typical clinical findings of chronic cutaneous LE are the discoid lesions. There is a clinical form of chronic cutaneous LE called erythema perstans faciei. This form is purely erythematous, and it usually appears on the face. Other rare "red face" forms of chronic cutaneous LE are LE tumidus and LE telangiectaticus. Red face is not typical of systemic sclerosis, but facial telangiectasias are frequent, especially with CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome. The differential diagnoses of other red face manifestations are easy due to the additional findings. Telangiectasias are accompanied by calcinosis, sclerodactyly, digital ischemia, and Raynaud disease. Many studies mention telangiectasias as markers of the severity of the systemic sclerosis, the disease duration, any pulmonary arterial hypertension, and any esophageal involvement. Purple- or violet-colored upper eyelids are the hallmark and one of the first clinical signs that is helpful for the diagnosis of dermatomyositis. This violaceous to dusky erythema can extend over the whole face and the upper aspects of the trunk. Erythematous changes on the face that are different from those of the heliotrope sign which occurs with dermatomyositis may be observed in both sun-exposed skin and non-sun-exposed skin. Malar and facial erythema, linear extensor erythema, V-sign or shawl sign, and other photodistributed eruptions can also appear. PMID:24314389

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

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    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.

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

    International Nuclear Information System (INIS)

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

  7. Choroidal Tuberculoma in Two Cases With Multiple Intracranial Tuberculomas

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    Baki ARPACI

    2011-12-01

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

  8. Distant metastases in papillary thyroid cancer. A review of 91 patients

    International Nuclear Information System (INIS)

    Of 731 patients with papillary thyroid cancer, 91 had metastases outside regional lymph nodes. The most common site was intrathoracic, occurring in 73 of the 91 patients. Miliary, micronodular pulmonary metastases, with iodine 131 (I-131) uptake and curable by I-131 treatment were encountered in seven patients. It has not been established whether this was a transient stage in additional patients. In 38 patients rounded, macronodular pulmonary metastases were found. Another 21 patients had unilateral pulmonary infiltration and mediastinal enlargement. Pulmonary infiltrations may be hematogenic, or may possibly occur via regional, mediastinal lymph nodes. Mortality within 1 year of the diagnosis of distant metastases exceeded 50%. Occurrence of distant metastases showed a slight but highly significant association with male sex, advanced age, and advanced local tumor stage. Better prognostic determinants are, however, required if adequate therapy of the individual patient with papillary thyroid cancer is to be achieved

  9. Sepsis tuberculosa gravissima: Una presentación infrecuente en paciente con tratamiento inmunosupresor Severe disseminated tuberculosis in a patient on immunosuppressive treatment: Report of one case

    Directory of Open Access Journals (Sweden)

    Rafael Silva

    2011-06-01

    Full Text Available Patients on immunosuppressive therapy are at increased risk of developing tuberculosis. We report a 39-year-old female with an ulcerative colitis receiving prednisone, azathioprine and azulfidine that was admitted to hospital due to fever, anemia, diarrhea and hematochezia. A chest CT scan showed multiple miliary micronodular images diffusely distributed and mediastinal enlarged lymph nodes with central necrosis, suggestive of disseminated tuberculosis. Antituberculous treatment was started but discontinued and the patient was treated as a bronchiolitis obliterans with methylprednisolone pulses and discharged. She was readmitted in shock one week later and died. After her death cultures for Mycobacterium tuberculosis were informed as positive. The clinical picture of the patient is known as sepsis tuberculosa gravissima.

  10. Sepsis tuberculosa gravissima: Una presentación infrecuente en paciente con tratamiento inmunosupresor / Severe disseminated tuberculosis in a patient on immunosuppressive treatment: Report of one case

    Scientific Electronic Library Online (English)

    Rafael, Silva; Juan, Jara; Tulio, Soto; Pedro, Sepúlveda.

    2011-06-01

    Full Text Available [...] Abstract in english Patients on immunosuppressive therapy are at increased risk of developing tuberculosis. We report a 39-year-old female with an ulcerative colitis receiving prednisone, azathioprine and azulfidine that was admitted to hospital due to fever, anemia, diarrhea and hematochezia. A chest CT scan showed mu [...] ltiple miliary micronodular images diffusely distributed and mediastinal enlarged lymph nodes with central necrosis, suggestive of disseminated tuberculosis. Antituberculous treatment was started but discontinued and the patient was treated as a bronchiolitis obliterans with methylprednisolone pulses and discharged. She was readmitted in shock one week later and died. After her death cultures for Mycobacterium tuberculosis were informed as positive. The clinical picture of the patient is known as sepsis tuberculosa gravissima.

  11. October 2012 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Gotway MB

    2012-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Lisbeth Platzer M

    2006-06-01

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

  13. April 2014 imaging case of the month

    Directory of Open Access Journals (Sweden)

    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...

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

    Scientific Electronic Library Online (English)

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

    2006-06-01

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

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

    Scientific Electronic Library Online (English)

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

    2014-12-01

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

  16. Combination therapy of disseminated coccidioidomycosis with caspofungin and fluconazole

    Directory of Open Access Journals (Sweden)

    Ja Kim Min

    2006-02-01

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

  17. Chylous effusions

    Directory of Open Access Journals (Sweden)

    Tomi? Ilija

    2003-01-01

    Full Text Available This paper presents 4 patients with chylothorax, and one patient with bilateral chylothorax and chyloperitoneum. The chylous effusions were of benign etiology, developed as a complication of miliary tuberculosis (1 patient, after L-2 vertebral body fracture (1 patient, and idiopathic (2 patients. The diagnosis was confirmed by the presence of chylomicrons and high content of triglycerides in the effusion, ranged 11,9-29,1 mmol/l. Lymphangiography showed multiple abnormalites of lymphatic system, the obstruction of ductus thoracicus, dilatation and convulsion of lymphatic channels, but the site of lymphatic leak was not detected. The treatment included an extended period of pleural and peritoneal drainage with total parenteral nutrition (1 patient, pleurodesis using Corynebacterium parvum (2 patients, and surgical partial parietal pleurectomy with continous drainage (1 patient. The treatment was successful in all patients.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  20. Radiologic observation of renal tuberculosis

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Bayesian estimation of streptomycin pharmacokinetics.

    Science.gov (United States)

    Thomson, A H; Coote, J; MacPherson, L; Gordon, J

    1992-12-01

    Streptomycin dose requirements were determined in an 83-year-old man with renal impairment who was being treated for miliary tuberculosis. Concentration measurements were interpreted using a Bayesian parameter estimation program. Estimated creatinine clearance (1.1 L/h) was used as a starting value for streptomycin clearance, and volume was initially assumed to be 0.3 L/kg. Bayesian estimates of clearance were close to the starting value and declined from 1.4 L/h to 0.9 L/h during the course of therapy. Volume was higher than the initial estimate (0.4-0.5 L/kg), possibly due to the patient having a low albumin and being underweight. Satisfactory concentrations were maintained for several weeks with doses of 500 mg every 36-48 h. PMID:1485376

  3. Bromeliad treefrogs as phoretic hosts of ostracods

    Science.gov (United States)

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

    2014-06-01

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

  4. Radiodiagnostic errors by X-ray pictures of the chest taken at bed resting patients

    International Nuclear Information System (INIS)

    The roentgenological findings of 383 cases have been compared with the anatomical and pathological diagnosis of the autopsy report. In 29% the radiodiagnosis was incorrect. About 70% of the X-ray examinations had to be carried out succenturiately at bed side in bedridden patients. The error rate of the interpretation of these examinations was higher than in examinations under standardized conditions. Especially, carcinomatous lymphangiosis, miliary tuberculosis and pulmonary embolism can be diagnosed badly in those incomplete X-ray pictures caused by the clinical situation of the bed resting patients. The publication analyses the most common errors in the diagnosis of cardiac and pulmonary diseases, and they will be demonstrated in examples. (orig.)

  5. POCIT portable optical communicators: VideoBeam and EtherBeam

    Science.gov (United States)

    Mecherle, G. Stephen; Holcomb, Terry L.

    1999-12-01

    LDSC is developing the POCITTM (Portable Optical Communication Integrated Transceiver) family of products which now includes VideoBeamTM and the latest addition, EtherBeamTM. Each is a full duplex portable laser communicator: VideoBeamTM providing near-broadcast- quality analog video and stereo audio, and EtherBeamTM providing standard Ethernet connectivity. Each POCITTM transceiver consists of a 3.5-pound unit with a binocular- type form factor, which can be manually pointed, tripod- mounted or gyro-stabilized. Both units have an operational range of over two miles (clear air) with excellent jam- resistance and low probability of interception characteristics. The transmission wavelength of 1550 nm enables Class I eyesafe operation (ANSI, IEC). The POCITTM units are ideally suited for numerous miliary scenarios, surveillance/espionage, industrial precious mineral exploration, and campus video teleconferencing applications.

  6. Chronic berylliosis of the lungs

    International Nuclear Information System (INIS)

    A case is reported, detected by postmortem examination, of chronic berylliosis of the lungs in a 49 year old man, resulting from a short-term exposure 29 years previously in a vacuum melting plant. After a toxic pneumonia of undiagnosed aetiology and subsequent incorrect interpretation of pulmonary changes as miliary tuberculosis and finally as sarcoidosis, the occupational disease was only recognized 20 years after onset. After increasing cardiorespiratory insufficiency, death occurred as a result of chronic right heart insufficiency. Against the background of a 10 times higher beryllium content in the lungs than in a reference group of healthy subjects the morphological characteristics of chronic berylliosis were manifested in the form of a secondary aspergillosis of the lungs and a preferred deposition of granulomas in the walls of the bronchi and bronchioli, with consequent extremely severe secondary lung changes which determined the further course of the disease. (author)

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

    Scientific Electronic Library Online (English)

    Achiléa, Bittencourt; Nancy, Silva; Andréa, Straatmann; Victor Luiz Correia, Nunes; Ivonise, Follador; Roberto, Badaró.

    2002-12-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Scientific Electronic Library Online (English)

    Achiléa, Bittencourt; Nancy, Silva; Andréa, Straatmann; Victor Luiz Correia, Nunes; Ivonise, Follador; Roberto, Badaró.

    2003-06-01

    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.

  10. Encefalitis carcinomatosa / Carcinomatous encephalitis

    Scientific Electronic Library Online (English)

    Flavio, Sánchez; Marcelo, Zylberman; Shigeru, Kozima; Gabriela, Tossen; Nebil, Larrañaga; Reinaldo, Chacon.

    2004-12-01

    Full Text Available Se comunica un caso de encefalitis carcinomatosa, en un paciente con diagnóstico de adenocarcinoma de pulmón y síndrome confusional. Esta entidad es poco conocida en relación a otras afecciones neurológicas relacionadas al cáncer. Se discute su presentación clínica, se destaca la necesidad de sospec [...] harla aun luego de obtener una tomografía computada normal y sus típicas imágenes miliares en resonancia magnética. Abstract in english We report a case of carcinomatous encephalitis in a patient with lung adenocarcinoma and confusional syndrome. This is a rare form of brain metastases. We discuss its clinical picture, the importance of suspecting it after a normal computed tomography scan and the miliary typical images at magnetic [...] resonance.

  11. Criptococose palpebral: relato de caso / Palpebral cryptococcosis: case report

    Scientific Electronic Library Online (English)

    Murilo Barreto, Souza; Carlos Sergio Nascimento, Melo; Cristiana Silveira, Silva; Ruth Miyuki, Santo; Suzana, Matayoshi.

    2006-04-01

    Full Text Available Relata-se o caso de uma paciente portadora de síndrome da imunodeficiência adquirida empiricamente tratada com esquema tríplice para tuberculose miliar. Durante a evolução clínica a paciente cursou com lesões comprometendo a pálpebra e conjuntiva tarsal à direita. A hipótese diagnóstica inicial foi [...] de tuberculose ocular com comprometimento conjuntival e palpebral. A biópsia da lesão conjuntival mostrou presença do Criptococcus neoformans. Após o início do tratamento específico com anfotericina B, a paciente apresentou melhora das lesões cutâneas. Abstract in english This paper is about a patient with acquired immunodeficiency syndrome empirically treated for miliary tuberculosis. During the clinical evolution the patient presented lesions compromising the right eyelid and tarsal conjunctiva. The initial diagnostic hypothesis was ocular tuberculosis with conjunc [...] tival and eyelid involvement. The biopsy of the conjuctival lesion identified an encapsulated yeast-like fungus: Criptococcus neoformans. After starting treatment with B anfotericin, the cutaneus lesions cleared.

  12. Criptococose palpebral: relato de caso Palpebral cryptococcosis: case report

    Directory of Open Access Journals (Sweden)

    Murilo Barreto Souza

    2006-04-01

    Full Text Available Relata-se o caso de uma paciente portadora de síndrome da imunodeficiência adquirida empiricamente tratada com esquema tríplice para tuberculose miliar. Durante a evolução clínica a paciente cursou com lesões comprometendo a pálpebra e conjuntiva tarsal à direita. A hipótese diagnóstica inicial foi de tuberculose ocular com comprometimento conjuntival e palpebral. A biópsia da lesão conjuntival mostrou presença do Criptococcus neoformans. Após o início do tratamento específico com anfotericina B, a paciente apresentou melhora das lesões cutâneas.This paper is about a patient with acquired immunodeficiency syndrome empirically treated for miliary tuberculosis. During the clinical evolution the patient presented lesions compromising the right eyelid and tarsal conjunctiva. The initial diagnostic hypothesis was ocular tuberculosis with conjunctival and eyelid involvement. The biopsy of the conjuctival lesion identified an encapsulated yeast-like fungus: Criptococcus neoformans. After starting treatment with B anfotericin, the cutaneus lesions cleared.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

  14. May 2014 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Gotway MB

    2014-05-01

    Full Text Available No abstract available. Article truncated after first page. Clinical History: A 66-year-old woman presented with complaints of cough worsening over the previous several months. Her prior medical history was largely otherwise unremarkable. Frontal chest radiography (Figure 1 was performed for evaluation. Which of the following statements regarding the chest radiograph is most accurate? 1. The chest radiograph shows a solitary pulmonary nodule; 2. The chest radiograph shows multifocal airway thickening and bronchiectasis; 3. The chest radiograph shows multifocal, bilateral cavitary nodules and consolidation; 4. The chest radiograph shows multifocal, somewhat basal predominant linear opacities within diminished lung volumes, suggesting fibrosis; 5. The chest radiograph shows multiple small nodules, suggesting a miliary pattern ...

  15. June 2013 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Gotway MB

    2013-06-01

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

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

    International Nuclear Information System (INIS)

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

  17. Radiodiagnosis of pulmonary lesions in a severe closed chest trauma

    International Nuclear Information System (INIS)

    The results of X-ray examination of 548 persons with a severe closed chest trauma were summed up. Urgent chest X-ray examination included panoramic roentgenography or electroroentgenography of the chest in two projections performed mostly in a special wheelchair without resetting and turning the patients. Dynamic X-ray control was used afterwards. Pulmonary lesions developed most frequently in a closed chest trauma. Roentgenosemiotics of lung contusion was characterized by a variety of symptoms and determined by the nature of a contusion syndrome. Infiltrate like, cavitary, miliary and peribronchial forms of lung contusion should be distinguished by an X-ray picture. In lung rupture, pneumothorax was detected in 33%, pneumohemothorax in 56%, emphysema of the chest soft tissues in 28%, mediastinal emphysema in 4% of the cases

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

    Scientific Electronic Library Online (English)

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

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

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

    Directory of Open Access Journals (Sweden)

    B. Mitchell

    2012-05-01

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

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

    DEFF Research Database (Denmark)

    2008-01-01

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

  1. Recognition of Pneumocystis carinii in foals with respiratory distress

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Willers Denise MC

    2008-02-01

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

  3. Tuberculosis extrapulmonar en nuestro medio: Formas de presentación / Extrapulmonary tuberculosis in our area: Forms of presentation

    Scientific Electronic Library Online (English)

    F. L., Lado Lado; V., Túñez Bastida; A. L., Golpe Gómez; M. J., Ferreiro Regueiro; A., Cabarcos Ortiz de Barrón.

    2000-12-01

    Full Text Available Objetivo: Analizar la distribución de las formas de presentación de tuberculosis extrapulmonar (FPE) en nuestro medio. Material y métodos: Se revisaron los casos de tuberculosis extrapulmonar registrados en la Unidad de Prevención y Control de la Tuberculosis del Área Sanitaria de Santiago de Compos [...] tela en un periodo de tres años. Clasificamos las FPE en: formas extrapulmonares (FE), definida por una localización extrapulmonar; formas mixtas (FM), localización pulmonar y extrapulmonar; formas diseminadas (FD), dos o más localizaciones extrapulmonares; y TB miliares, definida por patrón radiológico miliar y/o enfermedad diseminada en necropsia. Resultados: Se registraron 921 tuberculosis de las cuales 370 (40,2%) fueron extrapulmonares. De ellos 199 eran varones y 171 mujeres. Edad media de 36,9 años (rango, 19 y 68). Se constató infección por el virus de la inmunodeficiencia humana (VIH) en 22 casos (25,9%). La distribución de las FPE fue: FE 307 casos (83,0%): pleural 140 (45,6%), ganglionar 87 (28,3%), intestinal 16 (5,2%), osteoarticular 14 (4,5%), genitourinaria 11 (3,6%), cutánea 11 (3,6%), meníngea 10 (3,3%), otras 18 (5,9%); FM 38 (10,3%); FD 8 (2,1%) y TB miliares 17 casos (4,6%). Los pacientes con infección por el VIH presentaron FE en 17 casos (77,3%) en su mayoría ganglionar (64,7%); FD en 4 (18,2%); y TB miliar en 1 (4,5%). Conclusiones: La tuberculosis extrapulmonar supera las expectativas esperables, no en vano refleja un porcentaje próximo a la localización pulmonar. Ello indica por una parte, un cambio significativo en la presentación clásica de la enfermedad, y por otra una extrema sensibilidad en el diagnóstico localizatorio de la enfermedad. Abstract in english Objetive: To analyse the distribution of the extrapulmonary forms of presentation of tuberculosis (EFP) in our health district. Materials and methods: The medical records of patients diagnosed with extrapulmonary tuberculosis attending the Tuberculosis Prevention and Control Unit of the Santiago Hea [...] lth District were reviewed over a three years period. The classification of EFP was: extrapulmonary forms (EF), disease outside the lung; mixed forms (MF), the presence of both pulmonary and extrapulmonary tuberculosis; disseminated forms (DF), the pressence of two or more extrapulmonary locations; and miliary TB, which was definied by a diffuse pulmonary radiographic pattern or diagnosis was undertaken by necropsy. Results: A total of 921 tuberculosis infected patients were observed, of which 370 (40.2%) were extrapulmonary forms; of these, 199 were men and 171 women (mean age was 36.9 years, range 19-68). The distribution of EFP was: 307 EF (83%) of which 140 (45.6%) were pleural, 87 (28.3%) ganglionary, 16 (5.2%) intestinal, 14 (4.5%) bone and joint, 11 (3.6%) genitourinary, 11 (3.6%) cutaneous, 10 (3.3%) meningeal, and other locations 18 (5.9); MF 38 cases (10.3%); DF 8 cases (2.1%) and miliary TB 1 cases (4.6%). In HIV infected patients 17 EF (77.3%), which were mainly ganglionary (64.7%); 4 DF (18.2%); and 1miliary TB (4.5%) cases were observed. Conclusions: Our findings confirm the high incidence of extrapulmonary TB, similar to the number of pulmonary forms. Our experience shows a significant modification to the classical presentation of the disease, and thus the need for sensitivity in locating the disease.

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

    Scientific Electronic Library Online (English)

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

    2013-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Shahram Kahkouee

    2010-05-01

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

  6. Alterações fundoscópicas e sua associação clínica empacientes com tuberculose, no Distrito Federal / Posterior eye lesions and their clinical association in patients with tuberculosis, in the Federal District, Brazil

    Scientific Electronic Library Online (English)

    Gustavo Federici, Mendes; Rachel Cortinhas, Toríbio; Tomaz Aiza, Alvares; Rosicler Rocha Aiza, Alvares.

    2003-06-01

    Full Text Available OBJETIVO: Avaliar a incidência de lesões de fundo de olho em pacientes com tuberculose no Distrito Federal e identificar fatores de risco para o aparecimento dessas lesões. MÉTODOS: Em estudo prospectivo, foi realizada oftalmoscopia binocular indireta em 292 pacientes com tuberculose sistêmica. Este [...] s pacientes foram avaliados em cinco diferentes Hospitais Regionais do Distrito Federal, entre 1ºde agosto de 1997 e 30 de julho de 1998. Análise multivariada foi aplicada para identificar associações entre a variável "lesão de fundo de olho" e as variáveis "sexo, idade, baciloscopia, HIV, localização da tuberculose, internação dos pacientes, tempo de sintomas, procedência e experiência anterior com tratamento". RESULTADOS: Os resultados deste estudo mostraram incidência de 5,5% de lesões fundoscópicas em pacientes com tuberculose. Análise multivariada mostrou que a co-infecção pelo HIV, internação dos pacientes e tuberculose miliar foram fatores de risco para a presença de lesões de fundo de olho. Quando essas características estiveram presentes simultaneamente, a probabilidade de um indivíduo apresentar estas lesões foi de 66%. CONCLUSÕES: Na avaliação da incidência de lesões de fundo de olho em pacientes com tuberculose, devem ser levadas em consideração certas características individuais, visto que fatores de risco como a co-infecção pelo HIV, tuberculose miliar, e internação, influenciaram na presença destas lesões. Abstract in english PURPOSE: To evaluate the incidence of eye posterior lesions in patients with tuberculosis in the Federal District, Brazil, and to identify the risk factors for the appearance of these lesions. METHODS: In a prospective study, indirect binocular ophthalmoscopy was performed in 292 patients with syste [...] mic tuberculosis. These patients were examined in five different Regional Hospitals of the Federal District, between August 1st, 1997 and July 30th, 1998. A multiple analysis was applied to identify associations between the variable "eye posterior lesion" and the variables "sex, age, bacilloscopy, HIV, tuberculosis site, patient hospitalization, duration of symptoms, origin of the patient and previous experience with treatment. RESULTS: The results showed a 5,5% incidence of posterior lesions in patients with tuberculosis. A multiple analysis showed that HIV co-infection, patient hospitalization and miliary tuberculosis were risk factors for the presence of eye posterior lesions. When these characteristics were simultaneously present, the probability of a patient to present these lesions was 66%. CONCLUSIONS: In the evaluation of the incidence of eye posterior lesions in patients with tuberculosis, certain individual characteristics should be taken in to account, since risk factors, such as HIV co-infection, miliary tuberculosis, and hospitalization, influenced the presence of these lesions.

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

    Science.gov (United States)

    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 height of the plant and the diameter on top view were correlated with the occurrence of amphibians, while during the driest period there was no correlation among variables and the bromeliad usage by amphibians. Recorded species were strongly associated to the Atlantic Forest domain. Nevertheless, the occupation of rocky seashores by anurans may be more associated with the specialized reproductive modes presented by species, since there is no permanent water available in ponds or streams. PMID:24212694

  8. Inoperable bronchial carcinoma complicated by pulmonary tuberculosis

    International Nuclear Information System (INIS)

    The records of 165 patients with lung cancer complicated by pulmonary tuberculosis for the period 1964-1977 were analysed. Adenocarcinoma originating in scars was relatively frequent; squamous cell carcinoma growing in caviting lesions were also found. Advanced cancer (T3 and T4) was present in 124 persons. In 130 patients lung cancer was associated with inactive fibrotic pulmonary tuberculosis, and in 35 with an active tuberculous process, with a positive sputum in 23 patients. Treatment was by radiotherapy with high energy electrons of 35-45 MeV. In 139 the tuberculous lesions was located on the same side as the irradiation fields. Prophylactic chemotherapy on account of inactive tuberculosis was given to 96 patients and withheld from 34. Patients with active tuberculosis received individually dosed intensive chemotherapy starting with a combination of three drugs. There was no manifest difference as regarded tumour regression and survival time between cases of lung cancer with tuberculosis and those without tuberculosis. The same also applied to radiosensitivity. Bacteriologically (and autoptically) confirmed re-activation of an inactive tuberculous process occured in 6 patients who had not received prophylactic chemotherapy; one of them died of acute miliary tuberculosis, four were successfully treated. There was no case of reactivation in patients who had been given prophylactic chemotherapy. (orig./AJ)AJ)

  9. Radiological patterns of childhood pulmonary tuberculosis in Khartoum state

    International Nuclear Information System (INIS)

    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)

  10. Tuberculosis in patients with myelodysplastic syndromes

    International Nuclear Information System (INIS)

    AIM: The purpose of our study was to describe radiological manifestations of tuberculosis in patients with myelodysplastic syndromes. MATERIALS AND METHODS: Chest radiographs and CTs of 12 patients with tuberculosis among 195 consecutive patients with myelodysplastic syndrome, proved by bone marrow biopsy, were reviewed. Six of the 12 patients presented with tuberculosis and were subsequently found to have myelodysplastic syndrome. RESULTS: Chest radiographs and CTs revealed pulmonary tuberculosis in all 12 patients and extrapulmonary tuberculous involvement in six (50%). Initial chest radiographic findings of pulmonary tuberculosis included a primary pattern (n = 6), a post-primary pattern (n = 3), a miliary pattern (n = 1), atypical infiltrates (n = 1) and normal radiograph (n = 1). Tuberculosis involved extrathoracic lymph nodes (n = 5), liver (n = 2), spleen (n = 2), kidney (n 2), bowel (n = 2), pericardium (n = 2) peritoneum (n = 1) and rib (n = 1). CONCLUSION: Tuberculosis is a relatively common cause of infection in patients with myelodysplastic syndromes. The radiological appearance of pulmonary tuberculosis in myelodysplastic syndromes is often a primary pattern, and there is frequently extrapulmonary involvement. Kim, H-C. et al. (2002)

  11. Tuberculosis in patients with myelodysplastic syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyo-Cheol; Goo, Jin Mo; Kim, Hyun Beom; Lee, Joon Woo; Seo, Joon Beom; Im, Jung-Gi

    2002-05-01

    AIM: The purpose of our study was to describe radiological manifestations of tuberculosis in patients with myelodysplastic syndromes. MATERIALS AND METHODS: Chest radiographs and CTs of 12 patients with tuberculosis among 195 consecutive patients with myelodysplastic syndrome, proved by bone marrow biopsy, were reviewed. Six of the 12 patients presented with tuberculosis and were subsequently found to have myelodysplastic syndrome. RESULTS: Chest radiographs and CTs revealed pulmonary tuberculosis in all 12 patients and extrapulmonary tuberculous involvement in six (50%). Initial chest radiographic findings of pulmonary tuberculosis included a primary pattern (n = 6), a post-primary pattern (n = 3), a miliary pattern (n = 1), atypical infiltrates (n = 1) and normal radiograph (n = 1). Tuberculosis involved extrathoracic lymph nodes (n = 5), liver (n = 2), spleen (n = 2), kidney (n 2), bowel (n = 2), pericardium (n = 2) peritoneum (n = 1) and rib (n = 1). CONCLUSION: Tuberculosis is a relatively common cause of infection in patients with myelodysplastic syndromes. The radiological appearance of pulmonary tuberculosis in myelodysplastic syndromes is often a primary pattern, and there is frequently extrapulmonary involvement. Kim, H-C. et al. (2002)

  12. Infections caused by mycobacterium tuberculosis in patients with hematological disorders and in recipients of hematopoietic stem cell transplant, a twelve year retrospective study

    Directory of Open Access Journals (Sweden)

    Al-Jasser Asma

    2007-11-01

    Full Text Available Abstract Background Tuberculous infections in patients with hematological disorders and hematopoietic stem cell transplant vary in incidence, complications and response to treatment. Methods and materials A retrospective study of patients with various benign and malignant hematological disorders and recipients of hematopoietic stem cell transplant who were treated at Riyadh Armed Forces Hospital, Saudi Arabia between January 1991 and December 2002 and who developed tuberculous infections was conducted. Results Tuberculous infections occurred in eighteen patients with hematological disorders and hematopoietic stem cell transplant. The main associated factors were: reduced immunity due to the primary hematological disorder, age more than 50 years and the administration of cytotoxic chemotherapy, steroids or radiotherapy. These infections frequently involved the lungs and predominantly occurred in males and in patients with chronic myeloproliferative disorders, myelodysplastic syndrome and acute myeloid leukemia. In patients treated with intravenous cytotoxic chemotherapy, tuberculous infections tended to occur earlier and also tended to be more disseminated compared to infections occurring in patients treated with oral chemotherapy. Anti-tuberculous treatment was given to 16 patients and it was successful in 15 of these patients. Conclusion Tuberculous infections cause significant morbidity and mortality in patients with various hematological disorders and in recipients of hematopoietic stem cell transplant. The early administration of anti-tuberculous therapy and compliance with drug treatment are associated with successful outcomes while delayed management, drug resistance and the presence of miliary infections are associated with poor prognosis and high mortality rates.

  13. Computed tomography ub abdominal tuberculosis

    International Nuclear Information System (INIS)

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

  14. Thoracic CT findings of behcet disease

    International Nuclear Information System (INIS)

    Objective: To illustrate the thoracic CT findings of Behcet disease and to assess the CT diagnostic role in patients with Behcet disease. Methods: Thoracic CT images and medical records were retrospectively reviewed in 13 patients with thoracic Behcet disease. The diagnosis was based on the criteria set by the international study group for Behcet disease. Results: Of 13 patients, subpleural patchy consolidations were showed in 3, bilateral diffuse ground glass opacities in 3, left low lobe collapse with a right small nodule in 1, subpleural solitary pulmonary nodule in 1, bilateral pleural effusion in 2, mediastinal lymphoadenopathy in 2, diffuse bilateral miliary lung nodules in 1 during treatment. Thoracic vascular involvement was presented in 8 patients, two with superior vena cava thrombosis, one with left subclavicle artery aneurysm, one with left low pulmonary artery aneurysm and mural thrombosis, one with bilateral low pulmonary arteries and left basilar artery aneurysm, three with right pulmonary artery thrombosis in which there were two with left pulmonary artery occlusion and one with left basilar artery branch aneurysm. Conclusions: Thoracic CT findings of Behcet disease are variable and nonspecific. Contrast-enhanced CT scan can be helpful by showing thrombosis of the superior vena cava and pulmonary artery as well aneurysm of the pulmonary artery. (authors)

  15. Study of tuberculous meningitis by CT

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Alonso Soto

    2008-04-01

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

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

    Scientific Electronic Library Online (English)

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

    2008-04-01

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

  18. Innovations in traditional Vietnam.

    Science.gov (United States)

    Waldner, R

    1997-01-01

    In Viet Nam, the 1990 designation of population as a top government concern resulted in a tenfold increase in spending on family planning (FP) and health. The Viet Nam FP Association has developed a number of innovative ways of promoting FP, including a telephone counseling service. The population of Viet Nam has doubled since 1960, and the average per capita income remains very low; thus, condoms and oral contraceptives (OCs) are prohibitively expensive for many families. The FP program provides free condoms, OCs, and IUDs but often runs out of supplies. Need for condoms is estimated at 200 million/year, but the two factories only produce 30 million. OCs are imported from Hungary and have a bad reputation among Vietnamese women. The most commonly used contraceptive is the IUD, but poor quality of care at insertion leads many women to suffer infections. Viet Nam has a high rate of legal abortion, with most procedures occurring in the first month of pregnancy. The FP Association has cautiously introduced sex education in the schools in a pilot program that will be continued nationwide. The Association also opened a special club for young people and one for miliary personnel. These clubs provide contraceptive information along with soft drinks and music. The government's two-child policy is widely accepted but must overcome the obstacles of large family preference in rural areas and of son preference. PMID:12293462

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

    International Nuclear Information System (INIS)

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

  20. Species identification of mixed algal bloom in the Northern Arabian Sea using remote sensing techniques.

    Science.gov (United States)

    Dwivedi, R; Rafeeq, M; Smitha, B R; Padmakumar, K B; Thomas, Lathika Cicily; Sanjeevan, V N; Prakash, Prince; Raman, Mini

    2015-02-01

    Oceanic waters of the Northern Arabian Sea experience massive algal blooms during winter-spring (mid Feb-end Mar), which prevail for at least for 3 months covering the entire northern half of the basin from east to west. Ship cruises were conducted during winter-spring of 2001-2012 covering different stages of the bloom to study the biogeochemistry of the region. Phytoplankton analysis indicated the presence of green tides of dinoflagellate, Noctiluca scintillans (=N. miliaris), in the oceanic waters. Our observations indicated that diatoms are coupled and often co-exist with N. scintillans, making it a mixed-species ecosystem. In this paper, we describe an approach for detection of bloom-forming algae N. scintillans and its discrimination from diatoms using Moderate Resolution Imaging Spectroradiometer (MODIS)-Aqua data in a mixed-species environment. In situ remote sensing reflectance spectra were generated using Satlantic™ hyperspectral radiometer for the bloom and non-bloom waters. Spectral shapes of the reflectance spectra for different water types were distinct, and the same were used for species identification. Scatter of points representing different phytoplankton classes on a derivative plot revealed four diverse clusters, viz. N. scintillans, diatoms, non-bloom oceanic, and non-bloom coastal waters. The criteria developed for species discrimination were implemented on MODIS data and validated using inputs from a recent ship cruise conducted in March 2013. PMID:25638059

  1. Study of tuberculous meningitis by CT

    Energy Technology Data Exchange (ETDEWEB)

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

    1980-04-01

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

  2. 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

    Directory of Open Access Journals (Sweden)

    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.

  3. A novel recombinant BCG-expressing pro-apoptotic protein BAX enhances Th1 protective immune responses in mice.

    Science.gov (United States)

    Li, Guanghua; Liu, Guoyuan; Song, Na; Kong, Cong; Huang, Qi; Su, Haibo; Bi, Aixiao; Luo, Liulin; Zhu, Lin; Xu, Ying; Wang, Honghai

    2015-08-01

    One-third of the world's population is infected with Mycobacterium tuberculosis (MTB). The protective efficacy of bacille Calmette Guérin (BCG) vaccine against tuberculosis (TB) in adults is highly controversial even though the BCG vaccine has been available for more than 90 years. Because BCG is effective against infantile tuberculosis meningitis and miliary tuberculosis in young children and provides cost-effective prevention from tuberculosis for developing countries, it would be desirable to modify the existing BCG vaccine to provide more comprehensive protection. In our study, we constructed a novel recombinant BCG strain expressing pro-apoptotic BAX (rBCG::BAX) and demonstrated that it significantly induced the apoptosis of macrophages infected with rBCG::BAX both in vitro and in vivo. In addition, it significantly enhanced Ag85B-specific IFN-? enzyme-linked immunospot responses, IFN-? secretion, IL-2 secretion and the ratio of Ag85B-specific IgG2b/IgG1, and it significantly decreased Ag85B-specific IL-4. Furthermore, it presumably facilitated antigen presentation by inducing a significant up-regulation in the expression of MHC-II and B7.1 (CD80) co-stimulatory molecules on macrophages. In conclusion, these results suggest that the rBCG::BAX strain elicited predominantly a Th1 protective immune responses and might be a potential tuberculosis vaccine candidate for further study. PMID:25942359

  4. Radiological Follow-up of a Cerebral Tuberculoma with a Paradoxical Response Mimicking a Brain Tumor

    Science.gov (United States)

    Kim, Jeong-Kwon; Lee, Kyung-Hwa; Kim, Seul-Kee

    2015-01-01

    We report a case of a paradoxical response of a tuberculoma in the brain mimicking a brain tumor. A 76-year-old woman presented with a 2 week history of headache, dysarthia, and orthopnea. Brain magnetic resonance images (MRI) revealed two rim-enhancing lesions on the pons and occipital lobe, and chest computed tomography showed randomly distributed miliary nodules. The tentative diagnosis was tuberculosis (TB) of the brain and lung. She complained of right hemiparesis and worsening general weakness after taking the anti-TB medication. On the monthly follow-up images, the enhanced lesions were enlarged with increased perfusion and choline/creatinine ratio, suggesting a high grade glioma. A surgical resection was completed to diagnose the occipital lesion, and the tuberculoma was pathologically confirmed by a positive TB-polymerase chain reaction. The anti-TB medication was continued for 13 months. A follow-up MRI showed decreased size of the brain lesions associated with perilesional edema, and the clinical symptoms had improved. Brain tuberculoma could be aggravated mimicking brain malignancy during administration of anti-TB medication. This paradoxical response can be effectively managed by continuing the anti-TB drugs. PMID:25932302

  5. Demographic And Risk Factors Related To Military Tuberculosis

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Daniel H. Libraty

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Abnormal chest shadow on CT in immunosuppressed patients

    International Nuclear Information System (INIS)

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

  9. Radiological manifestations of pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-08-01

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

  10. Disseminated tuberculosis after extracorporeal shock-wave lithotripsy in an AIDS patient presenting with urosepsis.

    Science.gov (United States)

    Tourchi, Ali; Ebadi, Maryam; Hosseinzadeh, Alireza; Shabaninia, Mahsa

    2014-03-01

    Haematogenous dissemination of undiagnosed urinary tuberculosis after performing extracorporeal shock-wave lithotripsy (ESWL) is extremely rare. Herein, we report a 41-year-old male who presented with urosepsis to the emergency room; catheterization was performed and retention resolved. He had a tattoo on his left arm and a five-year history of intravenous drug use. Blood tests indicated anaemia, leukocytosis, elevated CRP and ESR and mild hyponatraemia; haematuria, moderate bacteriuria and 2+ proteinuria on urinanalysis were observed. Chest X-ray revealed lesions suggestive of miliary tuberculosis, which was confirmed by chest CT scan. Brain CT and MRI suggested brain involvement in the setting of tuberculosis. On further investigations, HIV infection and hepatitis C seropositivity were detected and the patient remained in a coma for five days with a Glasgow Coma Scale of 6/15. Finally, the diagnosis of haematogenous dissemination of tuberculosis following lithotripsy was established. Anti-tuberculosis and anti-retroviral therapy were prescribed and monthly follow-up visits were scheduled. In conclusion, in a patient diagnosed with ureterolithiasis, a thorough history and physical examination, with specific attention to HIV and tuberculosis predisposing factors, should be carried out and preoperative screening tests considering the possibility of urinary tuberculosis are required. Finally, if urinary tuberculosis is detected, ESWL must be postponed until after appropriate treatment of tuberculosis. PMID:23970650

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

    International Nuclear Information System (INIS)

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

  12. Utility of bone marrow aspiration in extrapulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    H. Singh

    2002-08-01

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

  13. Lessons from Mycobacterium avium complex-associated pneumonitis: a case report

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    Zota Victor

    2008-05-01

    Full Text Available Abstract Introduction Mycobacterium avium complex (MAC is an increasingly recognized cause of pulmonary disease in immunocompetent individuals. An acute form of MAC lung disease, MAC-associated pneumonitis, has generally been associated with the use of hot tubs. There is controversy in the literature about whether MAC-associated pneumonitis is a classic hypersensitivity pneumonitis or is a direct manifestation of mycobacterial infection. Case presentation We report the second case in the literature of MAC-associated pneumonitis not related to the use of hot tubs. The source of MAC in a 52-year-old immunocompetent patient was an intrapulmonary cyst containing numerous acid-fast bacilli. The patient developed disseminated miliary nodules throughout both lung fields. Histological examination of resected lung tissue revealed well-formed, acid-fast negative granulomas composed predominantly of CD4+ T-cells and CD68+ histiocytes. The granulomas were strongly positive for tumor necrosis factor-?, a pro-inflammatory cytokine. Conclusion The attempt to classify MAC-associated pneumonitis as either a classic hypersensitivity pneumonitis or a direct manifestation of mycobacterial infection is not particularly useful. Our case demonstrates that MAC-associated pneumonitis is characterized by a vigorous T-helper 1-like, pro-inflammatory, immune response to pulmonary mycobacterial infection. The immunopathology provides a rationale for clinical studies of anti-MAC therapy with the addition of anti-inflammatory agents (for example, corticosteroids to hasten the resolution of infection and symptoms.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-04-15

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

  15. Technetium-99m-methylene Diphosphonate Uptake in Hepatic Necrosis Secondary to Respiratory Failure.

    Science.gov (United States)

    Mahajan, Madhuri Shimpi; Digamber, Negi S; Sharma, Rajkumar

    2013-09-01

    Tc-99m methylene diphosphonate (MDP) bone scintigraphy has long been used for the evaluation of benign as well as malignant skeletal conditions. However, non-osseous tracer uptake on a bone scan is an unusual finding. On one hand, there is a need for awareness of the pathophysiologic basis underlying such uptake, as it may be of critical clinical relevance in the evaluation of the patient. On the other hand, some alterations in biodistribution may be of little clinical significance, but have deleterious consequences on the quality of the bone study. Recognition of these abnormalities will reduce errors and provide important clinical information. We described a case of 57-year-old male patient with history of carcinoma base of tongue, where a 99mTc-MDP bone Scintigraphy was performed for metastasis survey. It revealed avascular necrosis of head of right femur. In addition incidentally demonstrated diffuse increased pathologic uptake of Tc-99m-MDP in the liver and multiple foci in bilateral lungs. This article reviews several possible reasons for such diffuse hepatic uptake. In the present case diffuse hepatic necrosis secondary to respiratory failure due to bilateral miliary pulmonary metastasis is considered to be the cause of the diffuse liver uptake of 99mTc-MDP. PMID:25165422

  16. Thrombotic and nonthrombotic pulmonary arterial embolism: spectrum of imaging findings.

    Science.gov (United States)

    Han, Daehee; Lee, Kyung Soo; Franquet, Tomas; Müller, Nestor L; Kim, Tae Sung; Kim, Hojoong; Kwon, O Jung; Byun, Hong Sik

    2003-01-01

    Along with clinical examination and laboratory tests, imaging plays a key role in the diagnosis of pulmonary embolism. Multi-detector row helical computed tomography (CT) is particularly helpful in the diagnosis of acute pulmonary thromboembolism (PTE) owing to its capacity to directly show emboli as intravascular filling defects. Although parenchymal abnormalities at CT are nonspecific for acute PTE, they may contribute to a correct diagnosis of chronic PTE, the characteristic helical CT features of which are similar to its angiographic features and include webs or bands, intimal irregularities, abrupt narrowing or complete obstruction of the pulmonary arteries, and "pouching defect." Nonthrombotic pulmonary embolism is an uncommon condition but is sometimes associated with specific imaging findings, including discrete nodules with cavitation (septic embolism), widespread homogeneous and heterogeneous areas of increased opacity or attenuation that typically appear 12-24 hours after trauma (fat embolism), and fine miliary nodules that subsequently coalesce into large areas of increased opacity or attenuation (talcosis). Knowledge of appropriate imaging methods and familiarity with the specific imaging features of pulmonary embolism should facilitate prompt, effective diagnosis. PMID:14615562

  17. Tuberkulosis Perinatal Bermanifestasi sebagai Tuberkulosis Milier dan Meningitis

    Directory of Open Access Journals (Sweden)

    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. August 2012 imaging case of the month

    Directory of Open Access Journals (Sweden)

    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 …

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

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    A.L. Michel

    2010-09-01

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

  20. Pott disease, column instrumentation: report of a case (Instrumentación de columna, en Mal de Pott: a propósito de un caso

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    Carpio-Deheza Gonzalo

    2010-11-01

    Full Text Available Less than 1 % of patients with miliary tuberculosis has vertebral tuberculosis or also called Pott Disease. The most important symptomatology is pain, limited function and muscular contracture. When illness is ad- vanced, it presents dorsal hump and neurologic affectation. Now, we present the case of 34 years old feminine patient whom seven months before, she presented pulmonary tuberculosis as a past health with lumbar pain and paresthesia of inferior members such as symptoms. Image studies develop morfophology alterations since T10 to T12. At the beginning, she was treated with Rifampin-Isoniazid-Pyrazinamide-Etambutol, then, she had column instrumentation with a favorable evolution. La tuberculosis vertebral o Mal de Pott, ocurre en menos de 1% de los pacientes, con Tuberculosis Extrapulmonar. Los datos clínicos más comunes son: dolor, limitación funcional, y contractura muscular. En etapas avanzadas presenta una giba dorsal, y alteraciones neurológicas. Ahora presentamos el caso de una paciente femenina de 34 años, con antecedentes de tuberculosis pulmonar de +/- 7 meses atrás, dentro la sintomatología presentada por la misma, se encuentra: dolor lumbar y parestesia en miembros inferiores. La imagenología revela alteraciones morfológicas desde T10-T12. Ha recibido tratamiento médico con RHZE, y posteriormente instrumentación de la columna, presentando una evolución favorable.

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

    Scientific Electronic Library Online (English)

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

    2011-12-01

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

  2. Correlación entre linfocitos CD4 y carga viral en pacientes infectados por el virus de la inmunodeficiencia humana con tuberculosis / Correlation between CD4 lymphocytes and viral load in HIV-TB patients

    Scientific Electronic Library Online (English)

    F. L., Lado Lado; A., Prieto Martínez; E., Losada Arias; A., Cabarcos Ortiz de Barrón; A., Aguilera Guirao; M. L., Pérez del Molino.

    2001-12-01

    Full Text Available Objetivo: Analizar, retrospectivamente, la correlación entre los linfocitos CD4 y la carga viral en 16 pacientes (14 hombres y 2 mujeres) infectados por el virus de la inmunodeficiencia humana (VIH) con tuberculosis activa. Material y métodos: Se organizaron los siguientes grupos o formas clínicas d [...] e presentación en relación con la(s) localización(es) de la enfermedad tuberculosa: pulmonares distinguiendo entre típicas y atípicas según el patrón radiológico; extrapulmonares; mixtas, pulmonar y extarpulmonar; y tuberculosis miliar. Resultados: En 7 casos (44%) la afectación era exclusivamente pulmonar, todas ellas atípicas, en 6 (38%) extrapulmonar, en 2 (12%) mixta y en 1 (6%) miliar. La media de linfocitos CD4 fue de 111,1 (rango 5-360), en 11 (69%) los recuentos era inferiores a 200 cels/mm³. El menor recuento de CD4 se obtuvo en las formas mixtas con una media de 45 cels/mm³ mientras que el mayor recuento se obtuvo en las pulmonares con una media de 128,3 cels/mm³. La media de la carga viral fue de 4.82 log (rango, 0-5,93) siendo el título más elevado el de las formas mixtas, con una media de 5,69 log y el más bajo el de las pulmonares con una media de 4.19 log, sin hallarse correspondencia estadísticamente significativa entre ambos parámetros: linfocitos CD4 y carga viral (coeficiente de correlación - 0,1163) Conclusiones: Aunque no hemos hallado significación estadística, por lo regular, aquellos casos con CD4 más elevados presentaron una menor carga viral y los que tienen CD4 bajos una mayor carga viral. Abstract in english Objective: A retrospective study of the correlation between CD4 lymphocytes and the viral load in 16 HIV-patients with tuberculosis. Material and methods: The clinical forms of presentation of tuberculosis were classified according to the location/s of the disease into: pulmonary, distinguishing bet [...] ween typical pulmonary and atypical according to the radiological pattern; extrapulmonary; mixed forms: pulmonary and extrapulmonary; and miliary tuberculosis. Results: Tuberculosis was exclusively pulmonary in 7 cases (44%), all were atypical; extrapulmonary 6 (38%); mixed 2 (12%); and miliary 1 (6%). The mean CD4 lymphocyte count was 111. 1 (range 5-360), in 11 (69%) the counts were below 200 cells/mm³. The lowest CD4 count was in the mixed forms with a mean of 45 cells/ mm³ whilst the highest was obtained in pulmonary forms with a mean of 128.3 cells/mm³. The mean viral load was 4.82 log (range, 0-5.93), the highest load was for mixed forms with a mean 5.69 log, whereas the lowest load was for pulmonary forms with a mean of 4.19 log. No significant correlation was observed between CD4 lymphocytes and viral load (correlation coefficient - 0.1163), Conclusions: Though no significant correlation was observed, a high CD4 was associated to a low viral load and inversely a low CD4 with a high viral load.

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

    Scientific Electronic Library Online (English)

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

    1092-10-01

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

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

    Directory of Open Access Journals (Sweden)

    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 predominantemente durante a noite. Thoropa miliaris apresentou os maiores valores de CRC (39,0 ± 10,3 mm. As menores espécies foram Euparkerella brasiliensis (16,7 ± 2,2 mm e E. cochranae (16,0 ± 2,7mm. Rhinella ornata apresentou a maior massa corporal média (12,1 ± 7,5 g e E. cochranae (0,4 ± 0,2 g a menor. A massa média total foi de 938,6 g/ha. Nossos resultados corroboram com a tendência de maiores densidades de anuros de folhiço na região Neotropical quando comparado com áreas Tropicais do Velho Mundo, tendendo a serem maiores na América Central do que na América do Sul.

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

    Scientific Electronic Library Online (English)

    J.I., Aláez; J., Repáraz; J., Castiello; J., Úriz; M., Barber; J., Sola.

    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. Abstract in english We present the case of a 28 year old patient who came for consultation on a fever of up to 40.8º C, pleuritic pain on the right side and the appearance of a painful mass in the lower left extremity of four days evolution. Computerised axial tomography (CAT) showed the existence of a condensation in [...] the middle lobe of the right lung with associated pleural effusion and bilateral miliary pattern. The echographic study of the lower left extremity showed a mass of soft parts with a cystic aspect with destruction of the cortical of the fibula and osseous destruction. Magnetic resonance confirmed the presence of osteomyelitis in the left fibula and of an abscess; Mycobacterium tuberculosis was also isolated in three samples of sputum that led to a diagnosis of disseminated tuberculosis with miliary lung affectation, peroneous osteomyelitis and tuberculous abscess of the soft parts. Anti-tuberculosis treatment was started (riphampicine, isoniacide and pirazinamide) followed, two weeks later, with antiretroviral treatment (AZT, 3TC and NVP). The patient developed a clinical picture of generalised cutaneous eruption that disappeared following the replacement of the riphampicine by etambutol. Due to the persistence of the mass of soft parts following five weeks of anti-tuberculosis treatment, we proceeded to surgical draining of the abscess. The subsequent evolution was favourable, with the patient remaining asymptomatic one month after hospital discharge.

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

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    J.I. Aláez

    2007-08-01

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

  7. Thoracic radiographic features of silicosis in 19 horses

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

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

  9. Urogenital tuberculosis: patient classification in seven different groups according to clinical and radiological presentation

    Scientific Electronic Library Online (English)

    Andre A., Figueiredo; Antonio M., Lucon; Cristiano M., Gomes; Miguel, Srougi.

    2008-08-01

    Full Text Available PURPOSE: To describe and classify 80 cases of urogenital tuberculosis in seven groups of similar clinical and radiological presentation. MATERIALS AND METHODS: 80 patients (56 males, 70%; median age 34 years; age range 12 to 75) with urogenital tuberculosis were retrospectively reviewed. The patient [...] s were divided in seven groups: 1) Bilateral parenchymatous renal lesions; 2) No or minimal changes on radiographic examination; 3) Unilateral renal tuberculosis; 4) Contracted bladder; 5) Contracted bladder with renal failure; 6) Tuberculosis on a transplanted kidney; 7) Isolated genital tuberculosis. RESULTS: 1) Seven (8.8%) patients had multiple bilateral parenchymatous renal lesions with fever and malaise, characteristic of miliary tuberculosis. Three of these patients had AIDS. 2) Six (7.5%) cases had an early diagnosis, with minimal or no radiographic lesions. Two did not have any urologic symptoms. 3) Twelve (15%) patients had unilateral renal tuberculosis with partial (1 case) or total non-function kidney. 4) Thirty-seven (46.3%) patients had contracted bladder associated with unilateral partial (1 case) or total non-function kidney. 5) Ten (12.5%) patients had end stage renal disease due to tuberculosis with contracted bladder. 6) Four (5.0%) patients had tuberculosis on a transplanted kidney, with graft loss in half the cases. 7) Four (5.0%) patients had prostate or epididymis tuberculosis without associated renal lesion. CONCLUSIONS: Urogenital tuberculosis is a destructive disease of the urogenital tract with variable clinical and radiographic presentation. A classification according to similar patterns correlating with disease stage is feasible although early diagnosis is the only prevention of the most severe forms.

  10. Urogenital tuberculosis: patient classification in seven different groups according to clinical and radiological presentation

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    Andre A. Figueiredo

    2008-08-01

    Full Text Available PURPOSE: To describe and classify 80 cases of urogenital tuberculosis in seven groups of similar clinical and radiological presentation. MATERIALS AND METHODS: 80 patients (56 males, 70%; median age 34 years; age range 12 to 75 with urogenital tuberculosis were retrospectively reviewed. The patients were divided in seven groups: 1 Bilateral parenchymatous renal lesions; 2 No or minimal changes on radiographic examination; 3 Unilateral renal tuberculosis; 4 Contracted bladder; 5 Contracted bladder with renal failure; 6 Tuberculosis on a transplanted kidney; 7 Isolated genital tuberculosis. RESULTS: 1 Seven (8.8% patients had multiple bilateral parenchymatous renal lesions with fever and malaise, characteristic of miliary tuberculosis. Three of these patients had AIDS. 2 Six (7.5% cases had an early diagnosis, with minimal or no radiographic lesions. Two did not have any urologic symptoms. 3 Twelve (15% patients had unilateral renal tuberculosis with partial (1 case or total non-function kidney. 4 Thirty-seven (46.3% patients had contracted bladder associated with unilateral partial (1 case or total non-function kidney. 5 Ten (12.5% patients had end stage renal disease due to tuberculosis with contracted bladder. 6 Four (5.0% patients had tuberculosis on a transplanted kidney, with graft loss in half the cases. 7 Four (5.0% patients had prostate or epididymis tuberculosis without associated renal lesion. CONCLUSIONS: Urogenital tuberculosis is a destructive disease of the urogenital tract with variable clinical and radiographic presentation. A classification according to similar patterns correlating with disease stage is feasible although early diagnosis is the only prevention of the most severe forms.

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

    Energy Technology Data Exchange (ETDEWEB)

    Sy, W.M.; Seo, I.S.; Vieira, J.; Zaman, M.

    1985-05-01

    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.

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

    Science.gov (United States)

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

    2015-02-10

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

  13. Chest X-rays and associated clinical parameters in pulmonary Tubercolosis cases from the National Tubercolosis Program, Mumbai, India

    Directory of Open Access Journals (Sweden)

    Anirvan Chatterjee

    2012-01-01

    Full Text Available The study was carried out in pulmonary tuberculosis (PTB patients from the local Tuberculosis control programme, Mumbai, India. It examined features of chest X-rays and their correlation with clinical parameters for possible application in suspected multidrug resistant TB (MDRTB and to predict outcome in new and treatment failure PTB cases. X-ray features (infiltrate, cavitation, miliary shadows, pleural effusion, mediastinal lymphadenopathy and extent of lesions were analyzed to identify associations with biological/clinical parameters through univariate and multivariate logistic regression. Failures demonstrated associations between extensive lesions and high glycosylated hemoglobin (GHb levels (P=0.028 and male gender (P=0.03. An association was also detected between cavitation and MDR (P=0.048. In new cases, bilateral cavities were associated with MDR (P=0.018 and male gender (P=0.01, low body mass index with infiltrates (P=0.008, and smoking with cavitation (P=0.0238. Strains belonging to the Manu1 spoligotype were associated with mild lesions (P=0.002. Poor outcome showed borderline significance with extensive lesions at onset (P=0.053. Furthermore, amongst new cases, smoking, the Central Asian Strain (CAS spoligotype and high GHb were associated with cavitation, whereas only CAS spoligotypes and high GHb were associated with extensive lesions. The study highlighted associations between certain clinical parameters and X-ray evidence which support the potential of X-rays to predict TB, MDRTB and poor outcome. The use of Xrays as an additional tool to shorten diagnostic delay and shortlist MDR suspects amongst nonresponders to TB treatment should be explored in a setting with limited resources coping with a high MDR case load such as Mumbai.

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

    International Nuclear Information System (INIS)

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

  15. Scrotal inflammation: characteristic US patterns

    International Nuclear Information System (INIS)

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

  16. Flexible fiberoptic bronchoscopy; Diagnostic yield

    International Nuclear Information System (INIS)

    Fiberoptic bronchoscopy is a minimally invasive procedure with a high diagnostic yield. The aim of this study was to document the usefulness of the procedure in the diagnosis of various respiratory disorders in a Middle East country. Data on all bronchoscopies carried out in Chest Diseases Hospital, Kuwait from January 1996 to December 1998 were retrospectively collected. Out of 968 cases, only 620 (64%) patients had a full follow up. Suspected pulmonary tuberculosis (TB) (51.6%), unresolving pneumonia (16.1%), hemoptysis with a normal chest radiograph (8.4%), lung mass (7.7%) and hilar lymphadenopathy (3.2%) were the most common indications. Eleven percent of patients who underwent bronchoscopy had a normal chest radiograph, the reason being hemoptysis in 75.4%, inhalation injury in 21.8% and suspected upper airway obstruction in 2.9%. In smear negative suspected TB cases, 22.5% proved to have active disease. Acid fast bacillus was identified in bronchoalveolar lavage, either by smear or culture, in 44 (73.3%) patients with suspected pulmonary TB and in 6 (54.5%) patients with miliary shadows. An underlying cause was identified in 28 (28%) patients with unresolving pneumonia. Ninety-four percent of cases with clinical impression of bronchogenic carcinoma could be diagnosed. Transbronchial biopsy was diagnostic in 79% patients with diffuse parenchymal lung disease. No complications other than transient hypoxemia and controllable bleeding were noticed. Generally, the ile bleeding were noticed. Generally, the indications for flexible fiberoptic bronchoscopy remained similar to elsewhere. Unlike western series, the majority of the cases were for the diagnosis of pulmonary infections especially TB. (author)

  17. Hepatobiliary tuberculosis in western India

    Directory of Open Access Journals (Sweden)

    Amarapurkar Deepak

    2008-04-01

    Full Text Available Tuberculous involvement of liver as a part of disseminated tuberculosis is seen in up to 50-80% cases, but localized hepatobiliary tuberculosis (HBTB is uncommonly described. During 6 years, a total of 280 consecutive patients with TB were evaluated prospectively for the presence and etiology of liver involvement. Cases with miliary TB or immunosuppression and cases receiving anti-tuberculosis drugs prior to presentation to our unit were excluded (38 cases. Details of clinical, biochemical and imaging findings and histology/microbiology were noted. Of 242 included cases, 38 patients (15.7%; age 38.1 ± 12.5 years; sex ratio 2.5:1 had HBTB, whereas 20 patients (9%; age 39.3 ± 16.3 years; sex ratio 2.1:1 had other liver diseases. Diagnosis of HBTB was based on caseating granuloma on histology (18/23 procedures, positive smear/culture for acid-fast bacilli (21/39 procedures and positive polymerase chain reaction for Mycobacterium tuberculosis (28/29 procedures when diagnostic procedures were guided by imaging results. Thirty-eight cases with HBTB were classified as follows [patients (n, (%]: (A hepatic TB [20 (52.6%]: (1 granulomatous hepatitis - 10 (26.3%, (2 liver abscesses or pseudotumors - 10 (26.3% and (3 calcified hepatic granuloma - 0 (0%; (B biliary TB [15 (39.4%]: (1 biliary strictures - 2 (5.2%, (2 gall bladder involvement - 1 (2.6% and (3 biliary obstruction due to lymph node masses - 12 (31.5%; (C mixed variety [3 (7.8%]: (1 simultaneous granulomatous hepatitis and biliary stricture - 1 (2.6% and (2 simultaneous lymph node involvement and calcified hepatic granuloma - 2 (5.2%. All the cases responded well to standard anti-tuberculosis therapy. HBTB forms an important subgroup in TB cases. It requires a combination of imaging, histological and microbiological procedures to define the diagnosis. HBTB responds well to treatment.

  18. Relação entre o diagnóstico sorológico (ELISA) e a gravidade da tuberculose pulmonar na infância / Relationship between serological diagnosis (ELISA) and gravity of pulmonary tuberculosis in children

    Scientific Electronic Library Online (English)

    Clemax Couto, Sant' Anna; Leila de Souza, Fonseca; Maria Helena Féres, Saad.

    2001-12-01

    Full Text Available Foram estudadas 48 crianças de 0 a 13 anos através da realização do ensaio imunoenzimático ligado a enzima (ELISA) para pesquisa de anticorpos da classe IgG antiPPD, visando estabelecer correlação entre a resposta imune humoral medida pela sorologia e a gravidade da tuberculose, segundo formas radio [...] lógicas (leve, moderada e grave). A amostra foi composta de 29 crianças com tuberculose e 19 sem tuberculose comunicantes de tuberculose). Os valores médios (medianas) da densidade óptica do teste ELISA foram, respectivamente: 0,098 na forma gânglio-pulmonar (leve), 0,092 na forma pneumônica (moderada) e 0,134 na tuberculose miliar (grave). Nas crianças não tuberculosas com radiografia de tórax normal, o ELISA foi igual a 0,020. Os achados evidenciam valores mais elevados do teste sorológico relacionados à maior gravidade da doença (p= 0,0007). Abstract in english Forty eight children from 0 to 13 years old were submitted to the enzyme-linked immunosorbent assay (ELISA) serological test with a view to detect anti PPD IgG antibodies, for diagnosis of pulmonary tuberculosis and to establish the relationship between immune response and radiological gravity of pu [...] lmonary tuberculosis (mild, moderate and severe). There were 29 children with pulmonary tuberculosis and 19 children without tuberculosis. The median ELISA optical density were: 0.098 in children with primary complex (mild); 0.092 in children with pneumonic pattern (moderate) and 0.134 in children with miliary tuberculosis (severe). These data show higher positive serological test results in severe forms of pulmonary tuberculosis (p = 0.0007).

  19. Relação entre o diagnóstico sorológico (ELISA e a gravidade da tuberculose pulmonar na infância Relationship between serological diagnosis (ELISA and gravity of pulmonary tuberculosis in children

    Directory of Open Access Journals (Sweden)

    Clemax Couto Sant'Anna

    2001-12-01

    Full Text Available Foram estudadas 48 crianças de 0 a 13 anos através da realização do ensaio imunoenzimático ligado a enzima (ELISA para pesquisa de anticorpos da classe IgG antiPPD, visando estabelecer correlação entre a resposta imune humoral medida pela sorologia e a gravidade da tuberculose, segundo formas radiológicas (leve, moderada e grave. A amostra foi composta de 29 crianças com tuberculose e 19 sem tuberculose comunicantes de tuberculose. Os valores médios (medianas da densidade óptica do teste ELISA foram, respectivamente: 0,098 na forma gânglio-pulmonar (leve, 0,092 na forma pneumônica (moderada e 0,134 na tuberculose miliar (grave. Nas crianças não tuberculosas com radiografia de tórax normal, o ELISA foi igual a 0,020. Os achados evidenciam valores mais elevados do teste sorológico relacionados à maior gravidade da doença (p= 0,0007.Forty eight children from 0 to 13 years old were submitted to the enzyme-linked immunosorbent assay (ELISA serological test with a view to detect anti PPD IgG antibodies, for diagnosis of pulmonary tuberculosis and to establish the relationship between immune response and radiological gravity of pulmonary tuberculosis (mild, moderate and severe. There were 29 children with pulmonary tuberculosis and 19 children without tuberculosis. The median ELISA optical density were: 0.098 in children with primary complex (mild; 0.092 in children with pneumonic pattern (moderate and 0.134 in children with miliary tuberculosis (severe. These data show higher positive serological test results in severe forms of pulmonary tuberculosis (p = 0.0007.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Scientific Electronic Library Online (English)

    Félix, Llanos-Tejada; Hernán, del Castillo.

    2012-03-01

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

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

    Scientific Electronic Library Online (English)

    Félix, Llanos-Tejada; Hernán, del Castillo.

    2012-03-01

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

  3. Síndrome de Job asociado a tuberculosis miliar

    Scientific Electronic Library Online (English)

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

    2014-08-01

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

  4. Radiological findings of pulmonary aspergillosis

    International Nuclear Information System (INIS)

    The pulmonary aspergillosis is a group of three separate disease, comprising invasive aspergillosis, aspergilloma, and allergic bronchopulmonary aspergillosis, or a disease process in which one of three entities overlap with another process such as mucoid impaction, pulmonary infiltration with eosinophilia, bronchocentric granulomatosis, microgranulomatous hypersensitivity, or asthma. The radiological findings of 24 cases of pulmonary aspergillosis diagnosed and treated at Seoul National University Hospital during the past 7 years were analyzed retrospectively. The results were as follows: 1. Final diagnosis of 24 cases of pulmonary aspergillosis was aspergilloma in 16 cases, invasive aspergillosis in 2 cases, variant form of allergic bronchopulmonary aspergillosis in 3 cases, and endobronchial aspergillosis in 3 cases. 2. The underlying causes of the aspergilloma were healed tuberculous cavity in 6 cases, bronchiectasis in 8 cases, and no underlying cause were found in 2 cases. All the 16 cases of aspergilloma were correctly diagnosed without difficultly by demonstrating the intracavitary mass or air meniscus. 3. Radiological findings of the invasive aspergillosis in kidney transplant patients were multiple round nodules with early cavitation and formation of aspergilloma which shows slowly progressive cavitation over 13 months in one case, and diffusely scattered miliary nodules with occasional cavitation in the other case. 4. Classic allergic bronchopulmonary asper4. Classic allergic bronchopulmonary aspergillosis were not found in our series but variant form of ABPA was found in 3 young female patients. All the three patients shows some degree of central bronchiectasis and combined aspergilloma was found in 2 cases. 5. Three patients diagnosed as endobronchial aspergillosis-saprophytic infection of aspergillus in the bronchial tree-by bronchoscopic biopsy shows nonspecific radiological findings

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  6. Cutaneous lymphomas: an update. Part 2: B-cell lymphomas and related conditions.

    Science.gov (United States)

    Kempf, Werner; Kazakov, Dmitry V; Mitteldorf, Christina

    2014-03-01

    : Primary cutaneous B-cell lymphomas (PCBCL) are the second most common form of primary cutaneous lymphomas and account for approximately 25%-30% of all primary cutaneous lymphomas. Both forms of low-grade malignant PCBCL, primary cutaneous follicle center lymphoma (PCFCL) and primary cutaneous marginal zone lymphoma of mucosa-associated lymphoid tissue-type (MALT lymphoma) (PCMZL) represent the vast majority of PCBCL and show an indolent slowly progressive course and an excellent prognosis despite a high recurrence rate. Genetic analysis indicates that PCMZL differ from other forms of extranodal MALT lymphomas. The more common class-switched and the non-class-switched form of PCMZL can be distinguished as two distinctive subsets that differ in the cellular composition, IgM expression, and biological behavior with extracutaneous involvement found in the non-class-switched form. Recently, unusual clinical and histological forms of PCMZL and PCFCL manifesting with miliary or agminated lesions have been described that are diagnostically challenging. In contrast to PCMZL and PCFCL, primary cutaneous diffuse large B-cell lymphoma, leg type, and other rare forms of large B-cell lymphomas such as intravascular large B-cell lymphoma have an unfavorable prognosis. There is an emerging group of Epstein-Barr virus (EBV)-driven B-cell lymphoproliferations including posttransplant lymphoproliferative disorders and mucocutaneous ulcer occurring in immunocompromised patients and EBV-associated diffuse large B-cell lymphoma of the elderly arising in the setting of senescence-linked immunodeficiency. This review reports on recent findings expanding the spectrum of clinicopathological features, differential diagnostic aspects, and the pathogenesis of PCBCL and discusses the group of EBV-associated B-cell lymphoproliferations involving the skin. PMID:24658377

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

    Directory of Open Access Journals (Sweden)

    Jara Yorg J.A.

    2006-10-01

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

  8. Postmortem Investigations Following Human Immunodeficiency Virus Infection

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    Andrey V. Bychkov

    2009-04-01

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

  9. Radiographic findings in adult pulmonary tuberculosis

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

    Ramlov, Anne; Tietze, Anna

    2012-01-01

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

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

    Scientific Electronic Library Online (English)

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

    2010-10-01

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

  12. Tuberculosis Frequency in Patients Taking TNF-alpha Blokers

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    Co?kun Do?an

    2012-08-01

    Full Text Available Objective: To evaluate tuberculosis frequency in patients who take tumor necrosis factor alpha (TNF-? inhibitors for Collagen Vascular Disease (CVD.Materials and Methods: Patients who actively use or were planned to use TNF-? inhibitors for CVD between June 2007-February 2010 were prospectively included in the study.All patients had a physical examination, chest x-ray and the Tuberculin Skin Test (TST. Sputum smear and culture for acid fast bacilli (AFB was performed in patients with a suspicious lesion on chest x-ray. During follow-up, physical examination, chest x-ray and sputum smear for AFB in indicated cases were performed every 3 months. Tuberculosis was diagnosed with microbiological, radiological and histopathological methods.In case of pulmonary or extrapulmonary tuberculosis,TNF-? inhibitor medication was stopped and anti-tuberculosis therapy was began.Results: A total of 179 patients were included in the study, 91 were female and 88 were male wth a mean age of 42.8±12.0. In 141 patients, TNF-? inhibitor therapy was begun in the study although 38 were taking TNF-? inhibitor medication at the beginning of the study. The median follow-up period was 17 months and 2 (1.1% patients were diagnosed to have active tuberculosis during the study period. The TST was found to be 5-9 mm in 15% and >10 mm in 53.3% of the patients.There was a successful tuberculosis therapy history in 5 patients and at least 1 BCG scar was seen in 67 patients.In our series, 70.9% of the patients had chemoprophylaxis during the study period and new tuberculosis was diagnosed in 2 patients, consisting of one miliary tuberculosis and one pleural tuberculosis. Tuberculosis was diagnosed in 1.1% of TNF-alpha taking patients in our series. Conclusion: It is recomended that the patients taking anti TNF treatment should be evaluated and followed up regularly for tuberculosis during the treatment.

  13. The diagnostic value of maximum intensity projection reconstructions for diffuse micro nodules of lungs

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of maximum intensity projection (MIP) reconstructions for the diffuse micronodules of the lungs by comparing MIP with HRCT and routine spiral CT scans. Methods: 6 inflated and fixed lung specimens, including coal pneumoconiosis (n = 5) and acute miliary tuberculosis (n = 1), were made and studied after pneumonectomy. In additions, 35 patients were studied in this group. Above-mentioned patients and the lung specimens underwent routine spiral CT scan, HRCT and 1.5-mm-thick spiral CT scan, then MIP reconstructions were generated respectively with 1.5-mm-thick spiral CT. 6 cases of lung specimens were cut into thick sections. Histologic examinations were done on the site where corresponding CT images showed micronodules to verify the findings on CT scan. Results: The comparing study found that three kinds of MIP images were best in showing the presence of micronodules and their distribution characteristics. The results indicated that 5.5-mm-thick MIP and 8.5-mm-thick MIP were superior to routine spiral CT (?2 = 6.125, P = 0.008) and HRCT (?2 = 3.571, P = 0.016) in showing the micronodular presence. There was no remarkable difference between 3.5-mm-thick MIP and routine spiral CT (?2=3125, p=0.070), and so was between 3.5-mm-thick MIP and HRCT (?2=1.800, P=0.063). In showing the infiltrative range of micronodules, 5.5-mm-thick MIP and 8.5-mm-thick MIP images were superior to routinick MIP images were superior to routine spiral CT (?2 = 4.2942, 5.3513, P ?0.05 and HRCT images (?2 = 8.8748, 10.3690, P 22.6661, P > 0.05), but there existed remarkable difference between 3.5-mm-thick MIP and HRCT (?2 = 6.4497, P 2 = 4.00, P < 0.05). Conclusion: MIP reconstruction is superior to routine spiral CT and HRCT scans in showing the existence of lung diffuse micronodules. MIP images are more accurate in showing the range of micronodular infiltration

  14. Tuberculosis in children undergoing hemodialysis

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    Gargah Tahar

    2010-04-01

    Full Text Available Gargah Tahar1, Goucha-Louzir Rim2, Lakhoua Mohamed Rachid11Department of Pediatric Nephrology, 2Department of Nephrology, Charles Nicolle Hospital, Tunis, TunisiaAbstract: Tuberculosis (TB remains a public health problem in Tunisia. Its incidence is higher in immunocompromised hosts than in the general population. In children and during hemodialysis, TB is characterized by the frequency of extrapulmonary localizations and diagnostic difficulties. The aim of this retrospective study is to evaluate the incidence of TB in Tunisian children undergoing hemodialysis and to determine its clinical features as well as the results of chemotherapy.Method: This retrospective study includes seven TB children among 112 children on hemodialysis at the pediatric nephrology department in Charles Nicolle Hospital from 2002 to 2008. The diagnosis of TB was established by a combination of clinical, radiological, biochemical, microbiological, and histological examinations. Treatment with anti-TB drugs, the results of therapy, and the outcome of patients were noted.Results: There were four girls and three boys aged 10 to 16 years (mean, 13 years. They had been on hemodialysis for 2 to 5 years (mean, 3 years. Noted clinical features were weight loss and fever in five cases, chest pain in one case, cervical lymph node in one case, and spinal pain in one case. The organ systems involved were pleural in two cases, pulmonary in one case, peritoneal in one case, cervical lymphatic in one case, and spinal in one case. One patient was treated empirically with a good response. Diagnosis was made by isolation of mycobacterium TB in three cases, by specific histological signs observed in a lymph node biopsy in one case, in peritoneal biopsy in one case, and in discovertebral biopsy in one case. In the remaining patient, the clinical and radiological presentations were compatible with pulmonary TB. All patients received four anti-TB drugs: isoniazid, rifampicin, pyrazinamide, and ethambutol. One patient died with miliary TB. The other patients had favorable outcomes.Conclusions: TB in hemodialysis children has a nonspecific clinical presentation. Extrapulmonary locations are most common. Diagnosis is often difficult, but successful outcomes are possible when made at an early stage.Keywords: child, hemodialysis, tuberculosis

  15. Tuberculosis extrapulmonar: revisión de 102 casos en el Hospital Universitario San Jorge de Pereira, 2000-2004 / Extrapulmonary tuberculosis: a review of 102 cases in Pereira, Colombia.

    Scientific Electronic Library Online (English)

    William, Arciniegas; Dora Luisa, Orjuela.

    2006-03-01

    Full Text Available Introducción. La tuberculosis continúa siendo un problema de salud pública en el mundo. Es necesario conocer su magnitud en cada institución, la oportunidad en el diagnóstico y la utilización de recursos. Objetivo. Determinar las localizaciones y caracterizar la tuberculosis extrapulmonar desde el p [...] unto de vista epidemiológico, clínico, microbiológico, de diagnóstico y de costos hospitalarios de los pacientes egresados en un hospital estatal de III nivel. Materiales y métodos. Estudio descriptivo retrospectivo realizado entre el 2000 y el 2004 mediante la revisión de historias clínicas y archivos de laboratorio de pacientes egresados con diagnóstico de tuberculosis extrapulmonar del Hospital Universitario San Jorge de Pereira, Colombia. Resultados. Se encontraron 102 casos, con promedio de edad de 31,6 años, de los cuales el 62,7% correspondía a hombres. El 70,6% procedía del área urbana y el 59,6% presentó síntomas clínicos mayores a los 15 días de evolución. La forma más frecuente de presentación fue la pleural, con 47 casos, seguida de la meníngea con 19, la ganglionar con 13, la peritoneal con 5, la miliar con 4, la genitourinaria con 4, la faríngea con 4, la articular con 3, la ósea con 2 y la pericárdica con 1 caso. Los métodos de diagnóstico más utilizados fueron la biopsia en 68 casos (66,6%), el clínico en 28 (27,4%). Por medio de baciloscopia con coloración de Zielh Neelsen, se diagnosticó el 3,9%, y con el cultivo de Mycobacterium tuberculosis, el 5,8%. El tiempo de estancia hospitalaria promedio fue de 13 días y el costo promedio fue de $5'784.603 por caso. Fallecieron 15 pacientes, de los cuales el 60% se asoció con sida, y 53,3% con meningitis. Conclusión. Las localizaciones más frecuentes fueron la pleural, la meníngea y la ganglionar. El principal método de diagnóstico fue la biopsia. La estancia prolongada se relacionó con demora en el diagnóstico y sida. La mortalidad fue mayor en los casos de sida y localización meníngea. Abstract in english Introduction. Tuberculosis continues to be a serious public health problem worldwide. At the local institutional level, the magnitude of the problem must be assessed in terms of diagnosis efficiency and adequate use of resources. Objective. to determine the disease focus and to summarize the epidemi [...] ologic, clinical, microbiologic, and diagnostic data, along with associated hospital costs in a third level public hospital. Materials and methods. A retrospective study based on clinical records of 102 patients with extrapulmonary tuberculosis occurring between 2000 and 2004 and discharged from the Hospital Universitario San Jorge in Pereira, Colombia, was carried out. Results. The average patient age was 31.6 years; 62.7% were men and 70.6% were urban dwellers. The most frequent form was pleural TB with 47 cases, followed by the meningeal (19), lymphadenitis (13), peritoneal (5), miliary (4), genitourinary (4), pharyngeal (4), osteoarticular (3), skeletal (2), and pericardial (1) forms. The diagnostic methods were biopsy in 68 cases (66.6%), and clinical diagnosis in 28 (27.4%). Zielh-Neelsen stain diagnosed 3.9% of cases and bacterial culture5.8%. The average hospital stay was 13 days. The average cost was of US $2,410 per case. Fifteen patients died; of these 9 had AIDS and 8 had meningitis. Conclusions. The most frequent extrapulmonary forms were pleural tuberculosis, meningeal tuberculosis and lymphadenitis. The principal diagnostic method was the biopsy. A prolonged hospital stay was associated with a delay in diagnosis and AIDS infection. The highest mortality was associated with AIDS and the meningeal form of tuberculosis.

  16. Clinical application of PET/CT imaging in search of the primary carcinoma

    International Nuclear Information System (INIS)

    Full text: To explore the clinical value of PET/CT scanning in search of the primary carcinoma, we selected 4 patients who were subjected to PET/CT examination during Oct. 2002 to Dec. 2002. The primary lesion in all these patients was not detected. One of them had metastasis to liver, one had metastases in both lungs and the other two were having metastases to the bones. 18F-FDG in doses of 5.55MBq / kg body weight was injected to a fasting patient (at least 6 hours). PET/CT whole body examination was done using Discovery LS-PET/CT (GE Medical System, U.S.A.) 40-60 minutes later. In the first patient with metastasis to liver, primary lesion was localized in the transverse colon near the liver. The PET/CT showed multiple high radioactive uptake lesions of different sizes in the liver. No obvious change in position of the colon uptake was seen on the delayed images. After PET/CT, barium examination showed thinned cavity of the colon near the liver with coarse ankylosis of colon wall just like saw tooth. The mucous membrane was destroyed. Of the two patients with metastases in the bone, first - a 31 years old, was diagnosed to have primary lung cancer with multiple metastases to the liver and the bones. PET/CT showed high radioactive uptake in the inferior left lobe near the hilum with irregular shaped uneven distribution. A round high radioactive uptake area of 1.82 x 1.84 x 1.46cm size was also seen in the right lobe of the liver having clear edge and uneven distributver having clear edge and uneven distribution. The destroyed bones (L-10, L-11, L-12, T-1 and ala ossis i lii) showed high radioactive uptake. Second patient, 57-year male was diagnosed to have malignant lymphoma. PET/CT fusion showed high radioactive uptake in the marrow of whole body. Few destroyed parts of bones were also seen on CT images. Several cervical and the thoracic vertebrae as well as the ninth rib showed irregular radioactive accumulation with clear edges and well-distributed tracer raising the possibility of multiple myeloma or some other blood system disease. The histopathology from the ninth rib showed diffuse cell malignant lymphoma. Fourth patient with metastasis in the lungs was diagnosed to have primary carcinoma of bronchus. PET/CT showed high radioactive uptake in left supraclavicular and upper mediastinal lymph nodes. Miliary focus of high radioactive accumulation was also seen in both lung, especially in the inferior lobe and the lateral basal segment of the left lung. No other abnormal radioactive accumulation was found in the images. PET/CT whole body scan and fusion images give easy diagnosis of primary carcinoma and metastases than PET alone. Meanwhile, we must possess abundant clinical knowledge and analyze every patient systematically, only then we can expand the clinical value of this new modality. (author)

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

    Scientific Electronic Library Online (English)

    Susan M, Pereira; Odimariles Maria Souza, Dantas; Ricardo, Ximenes; Mauricio L, Barreto.

    2007-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Lanamar Aparecida de Almeida

    2011-02-01

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

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

    Scientific Electronic Library Online (English)

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

    2011-02-01

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

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

    Scientific Electronic Library Online (English)

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

    2013-06-01

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

  1. Fase aguda da esquistossomose mansoni

    Scientific Electronic Library Online (English)

    Edward, Tonelli.

    1972-10-01

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

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

    Scientific Electronic Library Online (English)

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

    2012-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Jorge Docampo

    2012-06-01

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

  4. Scientific Electronic Library Online (English)

    Augusto Hasiak, Santo; Celso Escobar, Pinheiro; Margarete Silva, Jordani.

    2003-12-01

    Full Text Available OBJETIVO: Estudar a mortalidade relacionada à tuberculose no Estado de São Paulo segundo causas múltiplas de morte, e suas inter-relações com outras causas básicas. MÉTODOS: Foram estudados os óbitos ocorridos e no Estado de São Paulo, em 1998, tendo como causa a tuberculose. Os dados foram obtidos [...] na Fundação Sistema Estadual de Análise de Dados (SEADE). As causas de morte pelas formas clínicas da tuberculose foram codificadas no agrupamento A15-A19 e suas seqüelas na categoria B90, segundo as disposições da Décima Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde. As causas associadas de morte foram processadas pelo Tabulador de Causas Múltiplas (TCM). Para análise estatística, foram usados o teste de variância, o teste t de Student e qui-quadrado. RESULTADOS: A tuberculose foi considerada a causa básica em 1.644 óbitos, correspondendo ao coeficiente de mortalidade de 4,6/100.000 habitantes. As principais causas associadas forami a insuficiência respiratória (46,9%), pneumonias (16,5%), outros sintomas e sinais especificados relativos aos aparelhos circulatório e respiratório (13,9%), caquexia (12,9%), doenças do sistema circulatório (10,3%), afecções devidas ao uso do álcool (8,4%), septicemias (7,2%) e desnutrição (7,1%). Como causa associada, a tuberculose ocorreu em outras 1.388 mortes. O coeficiente de mortalidade, incluindo a tuberculose como causa básica ou associada, foi de 8,9/100.000 habitantes, praticamente o dobro do valor do coeficiente clássico. As mortes em que a tuberculose foi mencionada como causa associada teve como principal causa básica a Aids (65,3%). As formas clínicas de tuberculose do sistema nervoso e miliar foram mais freqüentes como causas associadas de Aids que nos óbitos devido a outras causas básicas de morte (p Abstract in english OBJECTIVES: The goal of this paper is to investigate mortality related to tuberculosis in the state of São Paulo, southeastern Brazil, according to multiple causes of death and their interrelation with other underlying causes. METHODS: The study investigated deaths related to tuberculosis that occur [...] red in the state of São Paulo in 1998. Data were obtained from the Fundação Sistema Estadual de Análise de Dados (State System for Data Analysis Foundation - SEADE) database. Causes of death by clinical forms of TB were coded in block A15-A19, and by its sequelae in category B90, according to the guidelines proposed by the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems. Tabulador de Causas Múltiplas (Multiple Cause Tabulator - TCM) software was used for processing associated causes of death. Statistical analysis included analysis of variance, Student's t -distribution, and chi-squared tests. RESULTS: TB was the underlying cause of 1,644 deaths, a 4.6/100,000 population mortality rate. Main associated causes were respiratory failure (46,9%), pneumonias (16.5%), other specified symptoms and signs involving circulatory and respiratory systems (13.9%), cachexia (12.9%), diseases of the circulatory system (10.3%), conditions due to alcohol use (8.4%), septicemias (7.2%) and malnutrition (7.1%). Tuberculosis occurred as an associated cause in another 1,388 deaths. The mortality rate including TB as a both underlying and associated cause was 8.9/100,000 population, practically twice the classical rate. Deaths whose associated cause was reported as being TB had as underlying causes: AIDS (65.3%), diseases of the circulatory system (8.9%), neoplasms (7.5%), and diseases of the digestive system (4.8%). Clinical forms of nervous system and miliary TB were more frequent as a cause associated with AIDS than with other underlying causes (p

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

    Directory of Open Access Journals (Sweden)

    Mauricio L. Barreto

    2006-07-01

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

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

    Scientific Electronic Library Online (English)

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

    2006-07-01

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

  7. Development of Pacing, Electrophysiology and Defibrillation in India

    Directory of Open Access Journals (Sweden)

    Mohan Nair

    2002-04-01

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

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

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    Elizabete Abrantes Nunes

    2008-10-01

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

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

    Scientific Electronic Library Online (English)

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

    2008-10-01

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

  10. / Patogenia de las lesiones tuberculosas del sistema nervioso

    Scientific Electronic Library Online (English)

    Mario, Michel Zamora.

    1952-12-01

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