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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

    OpenAIRE

    Gupta Dinesh; Dewan S; Kaur Amarjit; Malhotra S; Kaur Surjit; Gambir M

    1996-01-01

    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.

  3. Lupus Miliaris Disseminatus Faciei

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    Gharami Ramesh Chandra; Shome Kaushik; Mandal Manoj Kumar; Dadgupta Angira

    2002-01-01

    A forty-five year old male presented with acneiform eruptions on his face, biopsy of which revealed the presence of caseating granuloma. The diagnosis was made as lupus miliaris desseminatus faciei, which replased following various therapies. The case is reported for its late onset, persistent and relapsing nature.

  4. Lupus Miliaris Disseminatus Faciei: A Case Report

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    Emel Bülbül Ba?kan

    2013-06-01

    Full Text Available Lupus miliaris disseminatus faciei (LMDF is a chronic, rare inflammatory dermatosis characterized by yellowish-red papules with a smooth surface especially on the face and around the eyelids. Recently, due to its histological appearance and different involvement areas, the predominated idea is that it is a granulomatous reaction against to the hair follicle destruction and ruptured epidermoid cysts. A 32-year-old female patient admitted to our outpatient clinic because of the acne lesions on her face and hands for 2 months. The patient was diagnosed as LMDF with clinical and histopathologic findings. In addition, biopsy of the papules around the eyelids revealed epidermoid cyst structures associated with the granulomas. On the occasion of this case, we revised LMDF, a dermatosis which still causes different ideas about naming and etiopathogenesis, in the light of the literature; we discussed differential diagnosis and we analyzed the association with epidermoid cysts.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. The detection of Propionibacterium acnes signatures in granulomas of lupus miliaris disseminatus faciei.

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    Nishimoto, Junko; Amano, Masahiro; Setoyama, Mitsuru

    2015-04-01

    Lupus miliaris disseminatus faciei (LMDF) is a papular eruption that occurs on adults' faces, predominantly on the lower eyelids. Histologically, the granulomatous lesions are primarily situated around the hair follicles, particularly the superficial region/infundibula. Its etiology remains to be elucidated. Recently, Propionibacterium acnes (P. acnes) has been suspected as a cause of sarcoidosis. In light of the sarcoid-like reactions that are present in LMDF, we hypothesized that P. acnes may also be implicated in granulomas associated with the disease. We evaluated nine DNA samples from granulomatous lesions from the skin of patients with LMDF. We used laser capture microdissection to extract DNA from these regions. Polymerase chain reaction was performed to amplify segments of the 16S ribosomal RNA of P. acnes, and the P. acnes gene was clearly detectable in all nine DNA samples. The gene was also detected in samples from normal-appearing skin, but these bands were faint in all samples. The results of the present study suggest that P. acnes plays a pathogenetic roles in LMDF. PMID:25616106

  10. Miliary pulmonary cryptococcosis

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    Shane Kelly

    2014-10-01

    Imaging features of pulmonary cryptococcosis are generally of well-defined pleural-based nodules and less commonly alveolar infiltrates, lymphadenopathy, pleural effusions or cavitating lesions. Miliary pulmonary infiltrates are an exceptionally rare presentation.

  11. Miliary pulmonary blastomycosis

    International Nuclear Information System (INIS)

    Five patients with proved blastomycosis had a diffuse miliary nodular pattern seen on chest radiographs. These cases are presented to emphasize that blastomycosis may be the cause of a miliary pattern in an endemic area. Documentation requires recovery of the organism from body fluids or tissue since skin and serologic testing are unreliable indicators of active disease. With prompt diagnosis and appropriate treatment, the patient may recover from this form of endogenous disseminated reinfection that otherwise may be fatal, particularly in the immunocompromised host

  12. Leber's miliary aneurysms

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    Alturkistany, Walaa; Waheeb, Saad

    2013-01-01

    Leber's disease is a form of primary retinal telangiectasia characterized by the presence of abnormalities in the retinal vasculature. It is an idiopathic, unilateral condition with male predilection. It is not associated with any other systemic or ocular disease. The disease has a very slow progression and can be complicated by vascular dilatations, neovascularizations, thromboses, retrovitreal hemorrhages, and macular changes. We present a case of Leber's miliary aneurysms in an asymptomati...

  13. Tinea faciei in a newborn due to Trichophyton tonsurans

    OpenAIRE

    Fu, Meihua; Ge, Yiping; Chen, Wei; Feng, Suying; She, Xiaodong; Li, Xiaofang; Liu, Weida

    2012-01-01

    We report here the first case of neonatal tinea faciei caused by Trichophyton tonsurans in mainland China. The mother of the infant had tinea corpris and tinea capitis while the father had tinea incongnito. The infections in the parents were mycologically confirmed to be due to Trichophyton tonsurans. Ttinea faciei in the infant was cured after two-week topical use of amorolfine cream. The mother ceased breastfeeding and took oral terbinafine for 4 weeks. No recurrence was observed in the inf...

  14. ACNE Agminata - Report Of 3 Cases

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    Punia Raj Pal Singh; Kumar Sanjay; Thami Gurvinder P; Mohan Harsh; Nada Ritambhra; Handa Uma

    2000-01-01

    Acne agminata or lupus miliaris disseminatus faciei is a chronic granulomatous inflammatory disorder-affecting adults of both sexes which terminates spontaneously with scarring. Histopathologically, the papules show granulomas consisting of epithelioif cells, Gaint cells, with or without caseation necrosis along with periappendigeal lymphomononuclear cell infiltrate in the dermis. The exact aetiopathogenesis of this condition is still unknown. We report 3 cases of this uncommon dermatoses rec...

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

    International Nuclear Information System (INIS)

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

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

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    Augustine M

    2008-01-01

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

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

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    Shim Young-Soo

    2008-11-01

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

  18. 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

  19. Chronic miliary tuberculosis with tuberculous gummas

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    Thankappan T; Sulochana G

    1990-01-01

    A 25 year old manual labourer presented with recurrent attacks of multiple abscesses and ulcers with generalised lymphadenopathy, hepato-splenomegaly and hypertension. Treatment with anti - tuberculous drugs produced dramatic improvement of the disease of 15 years duration, confirming the diagnosis of chronic miliary tuberculosis and tuberculous gummata in an untreated male.

  20. A case of granulomatous rosacea: sorting granulomatous rosacea from other granulomatous diseases that affect the face.

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    Khokhar, Omar; Khachemoune, Amor

    2004-01-01

    Granulomatous rosacea is a variant of rosacea that may present similar to other granulomatous diseases. We present the case of a 45-year-old woman with a 2-year history of facial erythema with multiple papules and pustules on the cheeks, chin, and glabella. The patient responded to minocycline, resulting in healing 6 months without residual scarring. This patient's clinical and histological presentation and treatment outcome are to our assessment consistent with granulomatous rosacea. However, other clinically and histologically related entities will be discussed. These entities include, but are not limited to, perioral dermatitis, granulomatous periorificial dermatitis, lupus miliaris disseminatus faciei, facial afro-caribbean eruption syndrome, and sarcoidosis. PMID:15347488

  1. Case for diagnosis: childhood granulomatous periorificial dermatitis.

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

    2013-01-01

    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-limited 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. PMID:24068149

  2. Case for diagnosis

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

    2013-01-01

    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-limited 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. PMID:24068149

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

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    Shim Young-Soo; Han Sung Koo; Kim Young Whan; Yoo Chul-Gyu; Yang Seok-Chul; Lee Sang-Min; Lee Ho; Park Eun-Ah; Lee Hyun; Jin Sang-Man; Yim Jae-Joon

    2008-01-01

    Abstract Background Miliary pulmonary nodules are commonly caused by various infections and cancers. We sought to identify the relative frequencies of various aetiologies and the clinical and radiographic predictors of miliary tuberculosis (TB) in patients with miliary pulmonary nodules. Methods We performed a retrospective cohort study of patients who presented with micronodules occupying more than two-thirds of the lung volume, based on computed tomography (CT) of the chest, between Novembe...

  4. Miliary tuberculosis with empyema, a case report

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    Abbas Ali Imani Fooladi

    2010-07-01

    Full Text Available We report a 39 year-old patient who presented with chest pain, malaise, lassitude, anorexia, weight loss, fever, chills, productive coughs, pleural pain in the left thorax area and septic empyema without hemoptysis. Laboratory investigations’ including tuberculosis (TB skin test by PPD, HIV, HBV and HCV serologic tests were negative. The CBC showed anemia and leucocytosis. The ESR was elevated and he had hypoalbuminaemia. Both chest radiograph and high-resolution CT scan showed miliary infiltrates and diffused reticulonodular lung lesions. He was diagnosed with miliary tuberculosis (MTB via direct staining, PCR and culture from open window region washing sample but not from bronco-alveolar lavage. He was treated with antituberculosis drugs.

  5. Miliary tuberculosis with empyema, a case report

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    Abbas Ali Imani Fooladi; Mohammad Javad Hosseini

    2010-01-01

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

  6. 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.

  7. Miliary lung metastases of differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Full text of publication follows. Lungs and bones are the most common distant metastases sites for differentiated thyroid cancer (DTC). Comparing with bone metastases, radioiodine therapy (RAI) has been an effective measure of treating lung metastases especially in micro-nodular (miliary) lung metastases. Management of disease differs considerably and outcome of RAI varies in series reported. The goal of this study was to evaluate characteristics and outcome of RAI in patients with miliary lung metastases of DTC, in our experience. 44 patients (34 F and 10 H), with miliary lung metastases in the first therapeutic 131I whole body scintigraphy (WBS), were retrospectively analysed, between January 2007 and December 2011. Patients with macro-nodular lung metastases and those with bone metastases were excluded. Age, gender, histological findings, diagnostic and therapeutic WBS, CT scan, thyroglobulin levels, RAI activity, evolution after de last RAI course, were studied. Patients were aged 20 to 81 years (mean of 45 years); they all underwent total thyroid surgery before being sent to nuclear medicine department for RAI. Papillary thyroid cancer was the most frequent histological variety (35%), with local lymph node metastases (50%). Miliary was diagnosed on diagnostic WBS in 13/22 cases (59%), CT scan was positive in 15/38 cases (39%). Initial stimulated thyroglobulin (Tg) level was very high in 14/22 cases (63%). All patients benefited hormone suppressive therapy and RAI. A total of 3.7-27.75 GBq (100-750 mCi) 131I was given. Effect of RAI and prognostic values of patient data were examined. Therapeutic efficacy was evaluated based on change in WBS findings and stimulated Tg level after the last RAI course. During follow-up which was between 2 and 5 years (mean: 3 years): 25% had negative WBS with stimulated Tg level under 1 ng/ml. Among all variables studied, a better prognosis would be accomplished in patients without lymph node metastases, in those who had low level of initial stimulated Tg and by early diagnosis during post surgery 131I scanning of radiologically no-apparent metastases. (authors)

  8. 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 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

  9. A case of anxiety associated with miliary tuberculosis

    OpenAIRE

    Alosaimi FD; Alkharboush FA; Altuwariqi MH

    2014-01-01

    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-occurrin...

  10. Miliary Tuberculosis Following Transrectal Ultrasonography (TRUS)-Guided Prostate Biopsy

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    Kim, Chul Jang; Sano, Taichi; Takimoto, Keita

    2011-01-01

    Miliary tuberculosis (TB) after transrectal ultrasonography (TRUS)-guided prostate biopsy is an extremely rare complication. A 75-year-old patient who presented with high fever and cough following TRUS-guided prostate biopsy for his high serum prostate-specific antigen (PSA) level (13.104 ng/ml) was diagnosed with miliary TB after clinical, laboratory, and radiological assessments. Histopathological examination of the prostate revealed TB with acid-fast bacilli. He was treated with chemothera...

  11. 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)

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

    OpenAIRE

    Augustine M; Jayaseelan E

    2008-01-01

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

  13. Asymptomatic pons tuberculoma in an infant with miliary tuberculosis

    International Nuclear Information System (INIS)

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

  14. Clinical features of 80 cases of tinea faciei treated at a rural clinic in Japan.

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    Noguchi, Hiromitsu; Jinnin, Masatoshi; Miyata, Keishi; Hiruma, Masataro; Ihn, Hironobu

    2014-12-01

    From March 2008 through February 2014, 80 patients aged 1-95 years (43 men and 37 women) were diagnosed with tinea faciei by a rural Japanese clinic. The affected sites were the cheek in 42 patients (52.5%), the auricles and area surrounding the auricles in 16 (20.0%), and the mandible in 12 (15.0%); 33 patients (41.2%) had concurrent ringworm in areas other than the face. Twenty-one patients (26.3%) had applied topical steroids to treat a rash. The pathogen responsible for tinea faciei was Trichophyton rubrum in 35 patients (43.7%), T. tonsurans in 19 (23.8%), T. mentagrophytes in 3 (3.8%), T. verrucosum in 2 (2.5%), T. violaceum in 2 (2.5%), Microsporum canis in 17 (21.3%), and M. gypseum in 2 (2.5%). Clinical symptoms were divided into three groups based on the severity of inflammation and the extent of lesions and scored in points. Anthropophilic dermatophytes resulted in a score of 1.82 points for the severity of inflammation and a score of 1.84 points for the extent of lesions while zoophilic dermatophytes resulted in a score of 2.14 points for the severity of inflammation and a score of 1.50 points for the extent of lesions. This indicates that anthropophilic fungi resulted in less inflammation and broader lesions, whereas zoophilic fungi resulted in more intense inflammation and smaller lesions. Patients who had applied topical steroids had a mean score of 1.90 points for the severity of inflammation and a mean score of 2.10 points for the extent of lesions. Patients who had not applied topical steroids had a mean score of 1.95 points for the severity of inflammation and a mean score of 1.59 points for the extent of lesions. The severity of inflammation did not differ significantly. However, lesions were significantly broader in patients who had applied topical steroids than in those who had not applied topical steroids (p < 0.04). The severity of tinea faciei is a useful index for the clinical diagnosis of tinea faciei. PMID:25639303

  15. MRI findings of miliary tuberculosis of the brain

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    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

  17. A case of anxiety associated with miliary tuberculosis

    Directory of Open Access Journals (Sweden)

    Alosaimi FD

    2014-06-01

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

  18. Action of γ-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 γ-radiation is not of a constant character and extinguishes after a period of time determined by a dose rate

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

    International Nuclear Information System (INIS)

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

  20. 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 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

  1. 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.)

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  4. Miliary osteoma cutis of the face: A case report

    Directory of Open Access Journals (Sweden)

    Saadia Bouraoui

    2012-01-01

    Full Text Available Introduction: Miliary osteoma cutis (OC of the face is a rare benign extra skeletal bone formation. For our knowledge, only 23 cases have been reported in the English literature. These lesions may be primary or secondary. They cause diagnostic, therapeutic and cosmetic concern especially in women who are usually concerned. Our purpose is to present a case which is completely documented with the clinical, histological and radiological findings. We also report a possible pathogenic theory according to our histologic findings.Case Report: We report a case of a multiple miliary OC of the face in a 45-year-old woman which suffered from gravidarum acne. These lesions were treated by focal surgical treatment. Conclusions: Based on our histological findings, an osteoblastic metaplasia seems to be a possible pathogenic theory. This metaplasia seems to be secondary to a chronic inflammation. Concerning therapeutic procedures, they are non consensual and debated and are based on surgical or medical treatment. More reports are needed in order to assess the therapeutic management of this disease and its inducing factors.

  5. 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.

    and is validated with microscopy, pigment composition, and spectral absorption. Phytoplankton populations dominated by either diatoms or other dinoflagellates were additionally discerned. N. miliaris populations in full bloom were identified offshore in low...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-15

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

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

    OpenAIRE

    Inomata Minehiko; Hayashi Ryuji; Kambara Kenta; Okazawa Seisuke; Imanishi Shingo; Ichikawa Tomomi; Suzuki Kensuke; Yamada Toru; Miwa Toshiro; Kashii Tatsuhiko; Matsui Shoko; Tobe Kazuyuki; Sasahara Masakiyo

    2012-01-01

    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 recepto...

  8. Miliary Osteoma Cutis of the Face: A Case

    Directory of Open Access Journals (Sweden)

    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.

  9. 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 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)

  10. Locating Noctiluca Miliaris in the Arabian Sea: An Optical Proxy Approach

    Science.gov (United States)

    Thibodeau, Patricia S.; Roesler, Collin S.; Drapeau, Susan L.; Matondkar, S. G. Prabhu; Goes, Joaquim I.; Werdell, P. Jeremy

    2014-01-01

    Coincident with shifting monsoon weather patterns over India, the phytoplankter Noctiluca miliaris has recently been observed to be dominating phytoplankton blooms in the northeastern Arabian Sea during the winter monsoons. Identifying the exact 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. miliaris measured on highly resolved depth scales coincident with hydrographic observations with the goal to identify conducive hydrographic conditions for the bloom. The proxy is derived from multichannel excitation chlorophyll a fluorescence and is validated with microscopy, pigment composition, and spectral absorption. Phytoplankton populations dominated by either diatoms or other dinoflagellates were additionally discerned. N. miliaris populations in full bloom were identified offshore in low-nutrient and low-N : P ratio surface waters within a narrow temperature and salinity range. These populations transitioned to high-biomass diatom-dominated coastal upwelling populations. A week later, the N. miliaris blooms were observed in declining phase, transitioning to very-low-biomass populations of non-N. miliaris dinoflagellates. There were no clear hydrographic conditions uniquely associated with the N. miliaris populations, although N. miliaris was not found in the upwelling or extremely oligotrophic waters. Taxonomic transitions were not discernible in the spatial structure of the bloom as identified by the ocean color Chl imagery, indicating that in situ observations may be necessary to resolve community structure, particularly for populations below the surface.

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

    Directory of Open Access Journals (Sweden)

    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

  12. [Acute miliary tuberculosis or Isambert disease: a case report].

    Science.gov (United States)

    Ziad, T; Nouri, H; Adny, A; Rochdi, Y; Aderdour, L; Raji, A

    2013-01-01

    Pharynx tuberculosis consists in a set of active lesions in granulomatous-type mucosa, resulting from Mycobacterium tuberculosis infection. In an endemic context, this diagnosis should be raised in cases of head and neck disease. A recent observation of a case of acute miliary tuberculosis gave us the opportunity to conduct a literature review of this disorder. This 9-year-old girl presented with dysphagia associated with pharyngeal discomfort, snoring, and hoarseness lasting for 8 months. This pharyngeal syndrome occurred in the context of an impaired general condition. Clinical examination found a diffuse mucosal granulation aspect in the oropharynx. The workup showed an inflammatory syndrome with a strong positive intradermal tuberculin reaction. The biopsy found an aspect of giant cell granuloma with caseous necrosis. The course was favorable on antituberculous chemotherapy. Tuberculosis is a chronic bacterial infection caused by a bacterium belonging to the M. tuberculosis complex. Pharyngeal tuberculosis remains a rare disease, but several epidemiological parameters show an upsurge of this disease, prompting us to report this observation. PMID:23266174

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-11-15

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

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

    International Nuclear Information System (INIS)

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

  15. 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)

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

    Directory of Open Access Journals (Sweden)

    Rudolf Barth

    1956-12-01

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

  17. 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.)

  18. 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.

  19. 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.

  20. The reproductive response of the sea urchins Paracentrotus lividus (G.) and Psammechinus miliaris (L.) to an hyperproteinated macrophytic diet

    OpenAIRE

    Jacquin, Anne-Gaelle; Donval, Anne; Guillou, Jacques; Leyzour, Sandra; Deslandes, Eric; Guillou, Monique

    2006-01-01

    The sea urchins Paracentrotus lividus and Psammechinus miliaris are submitted to the same environmental conditions in the Bay of Brest. The relationship between seasonal changes in food source quality and their gonad production was investigated in reproducing experimentally these conditions. In a first stage two macroalgae (Palmaria palmata and Laminaria digitata) were tested. P. miliaris showed a stronger preference for P. palmata and over a year-long experiment both urchins progressively pr...

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

    International Nuclear Information System (INIS)

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

  2. BCG pneumonitis with a miliary radiological pattern complicating intravesical BCG immunotherapy

    OpenAIRE

    Evangelia Fouka; Nikolaos Angelis; Nikolaos Galanis; Penelope Stefanopoulou

    2010-01-01

    SUMMARY. The case is described of a 42 year-old male who presented with fever, haematuria, hypoxaemia, impaired liver function and a miliary pattern on chest X-ray while receiving intravesical BCG treatment for superficial bladder cancer. Initiation of antituberculous therapy resulted in rapid amelioration of the symptoms and the X-ray findings, and the patient left hospital in a good general state of health. Although M. bovis was not isolated from samples of sputum, bronchioalveolar lavage f...

  3. 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.)

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

    Directory of Open Access Journals (Sweden)

    Mohan Lal

    2011-04-01

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

  5. BCG pneumonitis with a miliary radiological pattern complicating intravesical BCG immunotherapy

    Directory of Open Access Journals (Sweden)

    Evangelia Fouka

    2010-01-01

    Full Text Available SUMMARY. The case is described of a 42 year-old male who presented with fever, haematuria, hypoxaemia, impaired liver function and a miliary pattern on chest X-ray while receiving intravesical BCG treatment for superficial bladder cancer. Initiation of antituberculous therapy resulted in rapid amelioration of the symptoms and the X-ray findings, and the patient left hospital in a good general state of health. Although M. bovis was not isolated from samples of sputum, bronchioalveolar lavage fluid (BALF or bronchial biopsy tissue, the prompt response to antituberculous therapy suggests an infectious aetiology due to microbial dissemination. Pneumon 2010, 23(4:388-391.

  6. [Cryptococcus neoformans meningitis in a HIV negative miliary tuberculosis-suspected patient].

    Science.gov (United States)

    Aydemir, Hande; Pi?kin, Nihal; Oztoprak, Nefise; Celebi, Güven; Tekin, Ishak Ozel; Akduman, Deniz

    2008-07-01

    Cryptococcosis caused by Cryptococcus neoformans has a wide range of clinical presentations, varying from asymptomatic colonization of the respiratory airways to the dissemination of infection into different parts of body. It is more common among immunosupressed patients such as human immunodeficiency virus (HIV) positive ones. In this report we present a case with C. neoformans meningitis and miliary pulmonary infiltrates suggesting pulmonary tuberculosis without HIV infection. A-70-years-old male was admitted to the hospital with mental confusion, 3-weeks history of headache, weight loss, dry cough and fatigue. Physical examination was normal except neck stiffness. Cerebrospinal fluid (CSF) white cell count was 120/mm3 (80% polimorphonuclear cells). Gram staining of CSF revealed poorly stained gram-positive yeast cells. Empirical therapy with lipozomal amphotericin B, ceftriaxone and ampicillin combination was started. When C. neoformans growth was detected on CSF culture, ceftriaxone and ampicillin were discontinued. Patient became conscious at 24th hour of the treatment. Peripheric blood flow-cytometric analysis revealed a significant decrease in absolute CD4+ T lymphocytes, and in CD8+28+ T lymphocytes in addition a significant increase in natural killer cell ratio. Blood immunoglobulin and complement levels were found normal. Cranial magnetic resonance imaging and computerized tomogralphy (CT) of the abdomen were normal, however, chest CT revealed multiple parenchymal millimetric nodular infiltrations on both sides and minimal fibrotic alterations. Acid-fast staining of CSF, tuberculosis culture, tuberculosis PCR results and repeated HIV serology were found negative. Despite the lack of microbiological confirmation, empirical antituberculosis treatment was also started with the suspicion of miliary tuberculosis as the patient had a symptom of long-term dry cough, miliary infiltrations on chest CT, anergic tuberculin skin test and a history of pulmonary tuberculosis in childhood. After two weeks, amphotericin B was changed to oral fluconazole which was continued for an additional eight weeks. Antituberculosis therapy was given for nine months. Control chest CT taken after four months of antituberculosis therapy revealed improvement of the lesions. This presentation emphasizes the fact that cryptococcal infections may develop in HIV negative patients, even together with tuberculosis in certain cases and radiological findings of the two infections may be confusing when both of them invade the lungs. PMID:18822899

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

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    Nehal H Patel

    2013-01-01

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

  8. Miliary tuberculosis with atypical presentation in an immunocompetent young African man.

    Science.gov (United States)

    Albrecht, Nicole; Cottagnoud, Philippe; Chatterjee, Bidisha

    2014-01-01

    We present an atypical case of tuberculosis in an immunocompetent man from west Africa living in Europe. The patient entered the hospital with a painful lump of 3 cm on his right clavicule which he noticed 2 weeks before and back pain. During the examinations for further evaluation his condition deteriorated within short time. Tuberculosis was diagnosed, treatment started but he needed mechanical ventilation at the intensive care unit and had kidney failure. The further evolvement was favourable in the end but needed intensive treatment for over 4 weeks. Tuberculosis cases with such severe evolution are rather known with immunodeficient patients. Extrapulmonary tuberculosis, especially skeletal tuberculosis is seen more frequent in young immunocompetent migrants. The migrating persons seem to be more at risk to get sick than the ones staying in their origin country. We suppose the course of our patient's disease is miliary or septic, of which both are rather rare entities. PMID:24654236

  9. 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.

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

    International Nuclear Information System (INIS)

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

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

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    Swaminathan S

    2007-01-01

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

  12. 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.

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

    Science.gov (United States)

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

    2012-01-01

    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 active TB in the past, there are no guidelines of the test for determining patients who have latent TB infection (LTBI) and no recommendations of TB prophylaxis if there is no evidence of reactivation at present. A 40-year-old male patient presented with fever and aggravated weakness for a week. He was diagnosed with PNH a month ago and took corticosteroid for 3 weeks. In the past, he was diagnosed with pulmonary TB and completely cured after treatment. According to guideline, he was not indicated with TB prophylaxis. However, he caught miliary TB, progressed to acute respiratory distress syndrome. We experience this embarrassing case, and emphasize the need to investigate multicentral TB prevalence and to make the guidelines of anti-TB medication in subgroups of hematologic diseases including PNH. PMID:22554314

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

    Directory of Open Access Journals (Sweden)

    Julio César Mantilla

    2007-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Lee Jihyun

    2012-05-01

    Full Text Available 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 active TB in the past, there are no guidelines of the test for determining patients who have latent TB infection (LTBI and no recommendations of TB prophylaxis if there is no evidence of reactivation at present. A 40-year-old male patient presented with fever and aggravated weakness for a week. He was diagnosed with PNH a month ago and took corticosteroid for 3 weeks. In the past, he was diagnosed with pulmonary TB and completely cured after treatment. According to guideline, he was not indicated with TB prophylaxis. However, he caught miliary TB, progressed to acute respiratory distress syndrome. We experience this embarrassing case, and emphasize the need to investigate multicentral TB prevalence and to make the guidelines of anti-TB medication in subgroups of hematologic diseases including PNH.

  16. 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

  17. Multidrug-Resistant Tuberculosis Presenting as Miliary Tuberculosis without Immune Suppression: A Case Diagnosed Rapidly with the Genotypic Line Probe Assay Method

    OpenAIRE

    Ko, Yousang; Lee, Ho Young; Lee, Young Seok; Song, Junwhi; Kim, Mi-Yeong; LEE, HYUN-KYUNG; Shin, Jeong Hwan; Choi, Seok Jin; Lee, Young-Min.

    2014-01-01

    Miliary tuberculosis (TB) is a rare extrapulmonary form of TB, and there have been only two reports of miliary TB associated with infection with multidrug-resistant (MDR)-TB pathogen in an immunocompetent host. A 32-year-old woman was referred to our hospital because of abnormal findings on chest X-ray. The patient was diagnosed with MDR-TB by a line probe assay and was administered proper antituberculous drugs. After eight weeks, a solid-media drug sensitivity test revealed that the pathogen...

  18. Bio-conventional bleaching of kadam kraft-AQ pulp by thermo-alkali-tolerant xylanases from two strains of Coprinellus disseminatus for extenuating adsorbable organic halides and improving strength with optical properties and energy conservation.

    Science.gov (United States)

    Lal, Mohan; Dutt, Dharm; Tyagi, C H

    2012-04-01

    Two novel thermo-alkali-tolerant crude xylanases namely MLK-01 (enzyme-A) and MLK-07 (enzyme-B) from Coprinellus disseminatus mitigated kappa numbers of Anthocephalus cadamba kraft-AQ pulps by 32.5 and 34.38%, improved brightness by 1.5 and 1.6% and viscosity by 5.75 and 6.47% after (A)XE(1) and (B)XE(1)-stages, respectively. The release of reducing sugars and chromophores was the highest during prebleaching of A. cadamba kraft-AQ pulp at enzyme doses of 5 and 10 IU/g, reaction times 90 and 120 min, reaction temperatures 75 and 65°C and consistency 10% for MLK-01 and MLK-07, respectively. MLK-07 was more efficient than MLK01 in terms of producing pulp brightness, improving mechanical strength properties and reducing pollution load. MLK-01 and MLK-07 reduced AOX by 19.51 and 42.77%, respectively at 4% chlorine demands with an increase in COD and colour due to removal of lignin carbohydrates complexes. A. cadamba kraft-AQ pulps treated with xylanases from MLK-01 to MLK-07 and followed by CEHH bleaching at half chlorine demand (2%) showed a drastic reduction in brightness with slight improvement in mechanical strength properties compared to pulp bleached at 4% chlorine demand. MLK-01 reduced AOX, COD and colour by 43.83, 39.03 and 27.71% and MLK-07 by 38.34, 40.48 and 30.77%, respectively at half chlorine demand compared to full chlorine demand (4%). pH variation during prebleaching of A. cadamba kraft-AQ pulps with strains MLK-01 and MLK-07 followed by CEHH bleaching sequences showed a decrease in pulp brightness, AOX, COD and colour with an increase in mechanical strength properties, pulp viscosity and PFI revolutions to get a beating level of 35 ± 1 °SR at full chlorine demand. PMID:22805918

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

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    Hairong Chen

    2015-02-01

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

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

    OpenAIRE

    Krambovitis Elias; Tsirakis George; Gitti Zoe; Alexandrakis Michael G; Neonakis Ioannis K; Spandidos Demetrios A

    2008-01-01

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-15

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

  2. Zelleriella ubatubensis, sp. n. (Protozoa: Opalinatea: entozoário de Thoropa miliaris (Spix, 1824 (Anura, Leptodactylidae de Ubatuba, São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    I. Gióia

    1983-01-01

    Full Text Available Zelleriella ubatubensis, sp. n. is described. This species was found in the caecal region of the leptodactylid Thoropa miliaris from Ubatuba, SP, Brasil. The cell body has an irregular ellipsoid outline (145.9 µm ± 3.0 x 93.9 µm ± 24. The nucleus (16.7 µm ±0.3 has a fragmented nucleolar mass (more than nine nucleoli. Z. ubatubensis seems to be morphologically similar to Z. caryosoma and Z. foliacea but it differs from them by dimension, chromatin and host. A great number of the observed specimens contained Endamoeba paulista in their cytoplasm.

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

    Science.gov (United States)

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

    1985-01-01

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

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Luciano Sólia Násser

    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 Leber 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.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 syndrome 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.

  6. 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.

  7. Case for diagnosis

    OpenAIRE

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

    2013-01-01

    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-limited disease that heals spontaneously without scarring and specific therapy. Differential diagnoses include perioral dermatitis, granulomatous-rosacea, sarcoidosis, and lupus miliaris disseminatus fac...

  8. 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.

  9. Miliary pulmonary metastases of well-differentiated thyroid carcinoma (medullary excluded) about 10 cases; Les metastases pulmonaires micronodulaires de type miliaire dans le cancer thyroidien bien diff encie (medullaires exclus) a propos de dix cas

    Energy Technology Data Exchange (ETDEWEB)

    Ennibi, G. [Hopital Hassan-2, Service de Medecine Nucleaire, Agadir (Morocco); Ben Rais, N. [Centre Hospitalier Universitaire IBN Sina, Service de Medecine Nucleaire, Rabat (Morocco)

    2007-03-15

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

  10. 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

    Directory of Open Access Journals (Sweden)

    Vitor Emer Egypto Rosa

    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 tratamento. Pacientes com LES têm incidência aumentada de tuberculose, e o acometimento osteoarticular ocorre em 1%-3% desses casos. Manifesta-se com dor, diminuição da mobilidade e aumento do volume 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.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.

  11. 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.

  12. 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,

  13. A case of emphysematous cystitis complicated with miliary tuberculosis

    OpenAIRE

    SOGA, Hideo; Imanishi, Osamu

    2012-01-01

    Summary Background: Emphysematous cystitis occurs mostly in diabetics with poor glycemic control or in immunocompromised patients. In most cases, diabetes mellitus correlates with the occurrence of emphysematous cystitis. The risk of relapse after tuberculosis cure or treatment completion is high among patients with diabetes mellitus. Case Report: A 64-year-old diabetic man suffering from high fever and lower abdominal pain was admitted to the emergency ward. Due to the results of radiographi...

  14. Percutaneous breast implant herniation: a rare complication of miliary TB.

    Science.gov (United States)

    Dale, Adam P; Dedicoat, Martin J; Saleem, Tausif; Moran, Ed

    2015-01-01

    We describe the case of a 46-year-old female patient treated for disseminated tuberculosis (TB) infection involving the lungs, urinary tract and skin. Following initiation of antituberculous therapy, the patient's right breast implant eroded through the overlying skin and was seen to be herniating through the resulting defect. The breast implant was removed under local anaesthetic and histological analysis of the resected tissue demonstrated granuloma formation consistent with periprosthetic TB. Wound healing following implant removal was poor and future breast augmentation surgery was only considered following completion of 12?months anti-TB treatment. This case constitutes the first report in the literature of percutaneous breast implant herniation resulting from periprosthetic infection with TB. A high index of suspicion is required to ensure early detection and timely management of TB and, in cases where periprosthetic pus aspirate is sterile, mycobacterial infection must be actively excluded. PMID:25568276

  15. 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

  16. 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; Choi, Jae Eun

    2015-06-01

    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

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

    OpenAIRE

    James, Timothy Y.; Srivilai, Prayook; Kües, Ursula; Vilgalys, Rytas

    2006-01-01

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

  18. 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...

  19. LCH DIAGNOSED BY FNAC: GROWTH RETARDATION OF CHILD AND CLINICALLY MISDIAGNOSED AS MILIARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Ajay Kr.

    2013-05-01

    Full Text Available ABSTRACT- Langerhans cell histiocytosis (LCH is a rare disor der with multisystem involvement. Hear we report a case of LCH in a five year old chi ld with growth retardation and scalp swelling where FNAC was helpful in achieving a rapid and acc urate diagnosis despite of misdiagnosis at the clinician level. The cytological features are chara cteristic of LCH ie nuclear grooving, nuclear pseud o inclusion in background of eosinophils and plasma c ells. This can also avoid unnecessary biopsy and guide the management. ABBREVIATIONS: LCH- Langerhans cell histiocytosis, FNAC- Fine need le aspiration cytology, LC- Langerhans cell, IHC-Immun ohistochemistry

  20. 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.

    (20 degrees N - 17 degrees N and 64 degrees E - 70 degrees E), during the spring-inter-monsoon cruise of Sagar Sampada 253, in March 2007. Bacterial growth as assessed by most-probable number (MPN) and plate counts, revealed 'variable-physiotypes' over...

  1. 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.

    sequential number for each cruise (which matches the fig- ure number), followed by the date of the cruise. Thus, CR-1- JAN-2003 (3–19 January 2003) during the winter monsoon (Plate 1 image a1) was followed by CR-2-MAR-2003 (27 February to 5 March 2003... that sampled the west coast of India as well as offshore in the central and northwestern part of the Arabian Sea during two consecu- tive seasons: the winter monsoon and the SIM (Plate 1 images a1–a5). Nomenclature used to denote the cruises has GOMES ET...

  2. 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.

    stream_size 69885 stream_content_type text/plain stream_name Deep-Sea_Res_I_55_751.pdf.txt stream_source_info Deep-Sea_Res_I_55_751.pdf.txt Content-Encoding UTF-8 Content-Type text/plain; charset=UTF-8 ARTICLE IN PRESS Arabian a...Direct Deep-Sea Resear Deep-Sea Research I 55 (2008) 751–765 0967-0637/$-see front matter & 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.dsr.2008.03.003 conducted by the National Institute of Oceanography (NIO), Goa, India, since 2003 during the NEM...

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

    Directory of Open Access Journals (Sweden)

    Atukorala Inoshi

    2011-10-01

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

  4. 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.M.; Raman, M.; Goes, J.I; Gomes, H.

    identified by OCM I and OCM II images (as well as SeaWiFs images) and had been sampled by Indian research vessels like the Sagar Kanya and the Sagar Sampada. The bloom persisted for almost 4 months (January-April) and its peak levels were seen from 15 Jan-15...

  5. 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.

    .l-1 of Noctiluca. Chlorophyll concentrations were in a range 0.4-2.0 mg.m sup(-3), which reflect unusually high primary production in the deep waters (greater than 2000 m). A pattern of zooplankton showed unusually high growth in the bloom waters. Fish...

  6. 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.J.; Habeebrehman, H.; Sabu, P.; Prabhakaran, M.P.; Jasmine, P.; Shaiju, P.; Rejomon, G.; Threslamma, J.; Nair, K.K.C.

    kill was noticed on 17 September 2004 along the Trivandrum coast, with foul smell coming from the sea. Many people, especially children, who got exposed the stench, were hospitalized due to vomiting and nausea. Initial reports indicated...

  7. 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.

    to Bacillus (35.29 percent) of Firmicutes. As the bloom declined, Gram-negative forms (61.11 percent) emerged dominant, and these belonged to a diverse γ-proteobacterial population consisting of Shewanella (16.67 percent) and equal fractions of a Cobetia...

  8. 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.

  9. 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.

  10. Clinical and radiological deterioration in a patient with AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Backer, A.I. de [General Hospital Sint-Lucas, Department of Radiology, Ghent (Belgium); Mortele, K.J. [Brigham and Women' s Hospital, Harvard Medical School, Department of Radiology, Division of Abdominal Imaging and Intervention, Boston, MA (United States); Bomans, P.; Vanschoubroeck, I.J. [Ziekenhuisnetwerk Antwerpen, Stuivenberg, Department of Internal Medicine, Antwerp (Belgium); Keulenaer, B.L. de [Royal Darwin Hospital, Intensive Care Unit, Tiwi, NT (Australia); Kockx, M.M. [Ziekenhuisnetwerk Antwerpen, Stuivenberg, Department of Pathology, Antwerp (Belgium)

    2005-11-01

    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.)

  11. 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.)

  12. Findings in computerized axial tomography of tuberculous encephalopathy.

    Science.gov (United States)

    Estañol, B; Lombardo, L; Pérez-Ortega, R; Flores-Barroeta, F

    1981-01-01

    A 24 year-old woman with miliary tuberculosis of the lungs, developed a diffuse encephalopathy with signs of increased intracraneal pressure and without meningitis. A CAT scanner disclosed decreased density of the white matter and multiple nodular lesions enhanced with the infusion of contrast media. To our knowledge, this is the first description of the findings in computerized axial tomography of a patient with miliary tuberculosis and hematogenous dissemination associated to diffuse encephalopathy without meningitis. PMID:7247611

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

    Directory of Open Access Journals (Sweden)

    Girish Gogoi

    2015-12-01

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

  14. GenBank blastn search result: AK240854 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK240854 J065021E17 V01143.1 PMHIS7 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A ... , containing many sequence gaps). (see also ... for allelic sequence.). INV 5e-42 1 -1 ...

  15. GenBank blastx search result: AK059159 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK059159 001-023-D03 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 6e-12 +3 ...

  16. GenBank blastx search result: AK059019 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK059019 001-021-B02 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 7e-16 +2 ...

  17. GenBank blastn search result: AK059019 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK059019 001-021-B02 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 2e-12 Plus Plus ...

  18. GenBank blastx search result: AK058540 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK058540 001-017-B06 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 1e-28 +1 ...

  19. GenBank blastx search result: AK059228 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK059228 001-024-D11 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 4e-26 +3 ...

  20. GenBank blastx search result: AK058741 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK058741 001-019-G08 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 5e-16 +2 ...

  1. GenBank blastx search result: AK059098 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK059098 001-022-C07 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 1e-19 +2 ...

  2. GenBank blastx search result: AK058913 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK058913 001-009-A01 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 7e-29 +1 ...

  3. GenBank blastx search result: AK104901 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK104901 001-046-D02 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 6e-67 +3 ...

  4. GenBank blastx search result: AK059228 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK059228 001-024-D11 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 2e-13 +3 ...

  5. GenBank blastn search result: AK105816 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK105816 001-203-C11 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 3e-17 Plus Plus ...

  6. GenBank blastx search result: AK058686 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK058686 001-019-A10 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 4e-16 +3 ...

  7. GenBank blastx search result: AK058913 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK058913 001-009-A01 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 1e-13 +1 ...

  8. GenBank blastx search result: AK058436 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK058436 001-015-F07 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 3e-15 +1 ...

  9. GenBank blastx search result: AK061605 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK061605 001-030-C05 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 2e-27 +1 ...

  10. Routine examination for tuberculosis is still indicated during bronchoscopy for pulmonary infiltrates

    DEFF Research Database (Denmark)

    Laub, Rasmus Rude; Sivapalan, Pradeesh; Wilcke, Torgny; Svensson, Erik; Clementsen, Paul Frost

    2015-01-01

    , not isolated lympadenopathy, not miliary). Of the 57 patients, 48 were diagnosed by FOB, six by EUS and three by PNLB. M. tuberculosis samples were taken in an estimated 34% of all procedures. CONCLUSION: M. tuberculosis culturing should always be considered when performing FOB in patients with lung...

  11. Disseminated candidiasis 18 years after renal transplantation

    OpenAIRE

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

    2012-01-01

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

  12. 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 ...

  13. Biomass dynamics of exotic Sargassum muticum and native Halidrys siliquosa in Limfjorden, Denmark-Implications of species replacements on turnover rates

    DEFF Research Database (Denmark)

    Pedersen, Morten Foldager; Stæhr, Peter Anton; Wernberg, Thomas; Thomsen, Mads Solgaard

    2005-01-01

    perennial algae and the annual productivity was therefore high (P/B = 12 year-1) and exceeded that of Halidrys (P/B = 5 year-1) and most probably also that of other perennial algae in the system. The major grazer on macroalgae in Limfjorden, the sea urchin Psammechinus miliaris, preferred Sargassum to...

  14. 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 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.)

  15. HRTC in military lung disease

    Energy Technology Data Exchange (ETDEWEB)

    Voloudaki, A.E.; Tritou, I.N.; Magkanas, E.G.; Gourtsoyiannis, N.C. [Crete Univ., Iraklion (Greece). Dept. of Radiology; Chalkiadakis, G.E. [Crete Univ., Iraklion (Greece). Dept. of Thoracic Surgary; Siafakas, N.M. [Crete Univ., Iraklion (Greece). Dept. Medicine

    1999-07-01

    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 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.)

  16. 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. PMID:26029521

  17. Pulmonary Strongyloides stercoralis infection

    Directory of Open Access Journals (Sweden)

    Canan Dogan

    2014-01-01

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

  18. 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

  19. 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%

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

    OpenAIRE

    TCHERNEV, Georgi

    2011-01-01

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

  1. October 2014 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Sakla S

    2014-10-01

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

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

    OpenAIRE

    Kim, Jeong-Kwon; Jung, tae-young; 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 w...

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

    OpenAIRE

    Anirvan Chatterjee; Mistry, Nerges F; Monica P. Tolani; Yatin N. Dholakia; Desiree T.B. D'souza

    2012-01-01

    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 ...

  4. 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.

  5. Magnetic resonance imaging in acute intractional tuberculosis

    International Nuclear Information System (INIS)

    We reported three cases of acute intracranial tuberculosis including miliary tuberculosis, basal meningitis, tuberculomas and neuritis of cranial nerves. All patients had native and contrast enhanced CT and MRI scans. MRI revealed more granulomas and a better imaging contrast in the detection of basal meningitis. Neuritis was diagnosed only with the MRI. MRI scans should be prefered as the imaging procedure in clinically presumed intracranial tuberculosis. (orig.)

  6. 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 negativ...

  7. Acrodynia: exposure to mercury from fluorescent light bulbs

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-05-01

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

  8. 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...

  9. 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.

  10. Value of C reactive protein measurement in tuberculous, bacterial, and viral meningitis.

    OpenAIRE

    de Beer, F. C.; Kirsten, G F; Gie, R. P.; Beyers, N.; Strachan, A F

    1984-01-01

    The value of C reactive protein measurement in the differential diagnosis of meningitis was assessed in a population where tuberculous meningitis is prevalent. C reactive protein was measured serially with a sensitive radioimmunoassay in sera from 31 children with bacterial meningitis, 15 with tuberculous meningitis (6 with miliary tuberculosis), and 28 with viral meningitis. Concentrations of C reactive protein in patients with tuberculous meningitis lay between those of patients with bacter...

  11. 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)

  12. 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.

  13. Diagnostic Usefulness of IFN-Gamma Releasing Assays Compared With Conventional Tests in Patients With Disseminated Tuberculosis.

    Science.gov (United States)

    Yu, Shi Nae; Jung, Jiwon; Kim, Yong-Kyun; Lee, Ju Young; Kim, Sun-Mi; Park, Su Jin; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung-Han

    2015-07-01

    IFN-gamma releasing assays (IGRAs) such as T-SPOT.TB assay and QuantiFERON-TB In-Tube (QFT-GIT) have yielded promising results for the diagnosis of tuberculosis (TB). However, little is known about the usefulness of these assays for diagnosing disseminated TB. We therefore compared their usefulness with traditional tests in patients with disseminated TB. All adult patients with suspected disseminated TB were prospectively enrolled at a tertiary hospital in an intermediate TB-burden country during a 6-year period. Disseminated TB was defined as involvement of the bone marrow or ?2 noncontiguous organs, or presence of miliary lung lesions. A total of 101 patients with confirmed and probable disseminated TB were finally analyzed. Of these 101 patients, 52 (52%) had miliary TB and the remaining 49 (48%) had nonmiliary disseminated TB. In addition, 63 (62%) had no underlying disease. Chronic granuloma with/without necrosis, acid-fast bacillus staining, Mycobacterium tuberculosis PCR, and culture for M tuberculosis were positive in 77% (41/53), 43% (43/101), 70% (67/96), and 72% (73/101), of the patients, respectively. The T-SPOT.TB assay was positive in 90% (91/101) of them. The sensitivity of the T-SPOT.TB assay in patients with miliary TB (90%) was similar to that in patients with nonmiliary TB (90%) (P?>?0.99). In a subgroup analysis of the 58 patients in whom both QFT-GIT and the T-SPOT.TB results were available, the sensitivity of QFT-GIT (67%) was lower than that of T-SPOT.TB (95%) (P?

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-15

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-15

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

  17. CT appearances of abdominal tuberculosis

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Katia Jaton

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Melanie Cegielski

    2012-02-01

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

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

    Science.gov (United States)

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

    1986-12-01

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

  1. 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.

  2. 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.

  3. 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.

  4. 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 therapy. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-02-15

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

  6. 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.

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

    International Nuclear Information System (INIS)

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

  8. Tuberculosis in patients with end-stage renal disease

    International Nuclear Information System (INIS)

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

  9. Imaging diagnosis of pulmonary tuberculosis in immunocompromised patients

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2014-07-01

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

  11. The chest image appearances of penicilliosis marneffei in patients with AIDS

    International Nuclear Information System (INIS)

    Objective: To study the chest image appearances of penicilliosis marneffei (PSM) in patients with acquired immune deficiency syndrome (AIDS). Methods: Chest imaging features of PSM in 36 patients with AIDS were retrospectively analyzed. Results: Radiographic features of infiltrative lesions and focal lung consolidation were found in 14 cases (38.89%), in which 2 cases were with single lung disease (5.56%) and 12 cases with bilateral lung involvement (33.33%). Eight cases had diffuse lesions (22.22%), 10 cases had reticular image patterns (27.78%), 9 cases had nodular patterns (25.00%), 7 cases had ground-glass shadows (19.44%), 6 eases had diffuse miliary lesions (16.67% ), 4 cases had enlarged hilar and enlarged mediastinum lymph nodes (11.11). Cystic lesions was found in 5 cases (13.89%). Four cases had pleural effusion (11.11%), and 2 cases had nodular bump (5.56%). Pericardial effusion and pneumothorax each appeared in 1 case (2.78%). By HRCT, infiltrative lesion and focal lung consolidation were found in 32 patients (88.89%), in which 4 cases were with single lung lesions (11.11%) and 28 cases were with bilateral lung lesions (77.78%). Thirteen cases had diffuse lesions (36.11%), 10 cases had pulmonary interstitial hyperplasia (27.78%), 9 cases had nodular patterns (25.00%), 8 cases had ground-glass shadows(22.22%), 9 cases had diffuse miliary lesions (25.00%), 21 cases had enlarged lymph nodes in the mediastinum (58.33%). Cystic lesions were found in 8 cases (22.22%). Thirteen cases had pleural effusion (36.11%), and 2 cases had nodular bump (5.56%). Pericardial effusion and pneumothorax each appeared in 1 case (2.78%). Conclusion: The image appearances of PSM in patients with AIDS include infiltrative lesions or focal lung consolidation, ground-glass shadow, enlarged hilar and mediastinum lymph nodes, pleural effusion, interstitial involvement or reticular image pattern (pulmonary interstitial hyperplasia), diffuse miliary lesion, and cystic lesion. (authors)

  12. 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 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)

  13. Chylous effusions

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    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.

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

    Directory of Open Access Journals (Sweden)

    Pawan Kumar

    2015-06-01

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

  15. Applications of bacillus Calmette-Guerin and recombinant bacillus Calmette-Guerin in vaccine development and tumor immunotherapy.

    Science.gov (United States)

    Zheng, Yuan-qiang; Naguib, Youssef W; Dong, Yixuan; Shi, Yan-chun; Bou, Shorgan; Cui, Zhengrong

    2015-01-01

    Bacillus Calmette-Guerin (BCG) vaccines are attenuated live strains of Mycobacterium bovis and are among the most widely used vaccines in the world. BCG is proven to be effective in preventing severe infant meningitis and miliary tuberculosis. Intravesical instillation of BCG is also a standard treatment for non-muscle invasive bladder cancer. In the past few decades, recombinant BCG (rBCG) technology had been extensively applied to develop vaccine candidates for a variety of infectious diseases, including bacterial, viral, and parasite infections, and to improve the efficacy of BCG in bladder cancer therapy. This review is intended to show the vast applications of BCG and recombinant BCG (rBCG) in the prevention of infectious diseases and cancer immunotherapy, with a special emphasis on recent approaches and trends on both pre-clinical and clinical levels. PMID:26268434

  16. Coinfection with Mycobacterium tuberculosis and Pneumocystis Jirovecii in immunocompetent young woman.

    Science.gov (United States)

    Ben-Mustapha, I; Belkhouja, Kh; Kheder, S; Mekki, N; Ben Romdhane, K; Hantous, S; Ben Khelil, J; Slim, L Saidi; Barbouche, M Ridha; Besbes, M

    2013-01-01

    Pneumocystis pneumonia is a severe opportunistic infection in immunocompromised patients, caused by Pneumocystis jirovecii (P. jirovecii). The co-infection with community-acquired P. jirovecii and Mycobacterium tuberculosis (M. tuberculosis) is exceptionally described in non immunocompromised patients. We herein report the case of a young woman, with no medical history, who developed an acute respiratory failure due to P. jirovecii pneumonia associated with miliary tuberculosis. An extensive immunological investigation ruled out any acquired or primary immunodeficiency, suggesting that she was most likely immunocompetent. This report shows that such infections are not restricted to immunocompromised hosts. Moreover, it is tempting to speculate that the development of M. tuberculosis infection in this patient could be a risk factor for transition from colonization status of respiratory tract by P. jirovecii to pneumocystosis. PMID:26012211

  17. 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.

  18. An radiography study of pediatric pulmonary cryptococcosis

    International Nuclear Information System (INIS)

    Cryptococcosis is a cosmopolitan mycotic disease caused by a yeast like fungus, Cryptococcus neoformans. Respiratory tract, as portal of entry, is the initial focus of infection. Initial pulmonary lesion may heal with or without dissemination of the disease. Authors reviewed 8 cases of confirmed cryptococcosis during Jan. 1973 to June 1981 at Seoul National University Hospital. The results are as follows: Majority of the cases are below 5 years old. The most common symptoms are fever, abdominal pain and distension, and respiratory symptoms in only 2 cases. The involved organs are liver, lymph node, spleen, meninges, and skin in the order of frequency. Chest P-A roentgenograms show both hilar enlargement with perihilar and basilar, linear and small nodular infiltrations. Miliary nodular lesions and mediastinal lymphadenopathy were also noted

  19. 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

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

    Scientific Electronic Library Online (English)

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

    2009-08-01

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

  2. November 2012 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Gotway MB

    2012-11-01

    Full Text Available No abstract available. Article truncated at end of first page. Clinical History: A 61-year-old non-smoking man presented with a history of dyspnea on exertion; fatigue; and worsening lower extremity edema. Frontal chest radiography (Figure 1 was performed.Figure 1. Frontal chest radiographyWhich of the following statements regarding the chest radiograph is most accurate?1.The frontal chest radiograph is normal 2.The frontal chest radiograph shows a diffuse linear; interstitial pattern3.The frontal chest radiograph shows multilobar consolidation4.The frontal chest radiograph shows numerous thin-walled cysts5.The frontal chest radiograph shows numerous small nodules consistent with a “miliary” pattern…

  3. 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...

  4. The radiographic findings in diagnosis of pulmonary lymphoma

    International Nuclear Information System (INIS)

    Objective: To study the radiographic findings in the diagnosis of pulmonary lymphoma and pseudo lymphoma. Methods: Eight patients with pulmonary lymphoma and 2 with pseudo lymphoma were examined by X-ray film, tomography, and CT. Results: Single or multiple nodules or masses were observed in 8 patients with pulmonary lymphoma, shaggy borders or halo of ground-glass attenuation in 7 patients, 2 patients had multiple patchy infiltrates bilaterally, 2 had diffuse interstitial infiltrates and 1 had miliary nodules. Multiple consolidations with air bronchogram and without hilar and mediastinal lymphadenopathy were observed in 2 patients with pulmonary pseudo lymphoma. Conclusion: Radiographic findings of pulmonary lymphoma were varied, the most common findings were the nodules or masses with shaggy borders or halo of ground-glass attenuation. The specific findings of pulmonary pseudo lymphoma were multiple consolidations with air bronchogram and without hilar and mediastinal lymphadenopathy. The final diagnosis relied on pathology

  5. 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

  6. 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.

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

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    Ivo Rohling Ghizoni-Jr

    2009-06-01

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

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

    International Nuclear Information System (INIS)

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

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

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    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.

  10. 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.

  11. Tuberculous meningoencephalitis with severe neurological sequel in an immigrant child

    Science.gov (United States)

    Yasar, Kadriye Kart; Pehlivanoglu, Filiz; Sengoz, Gonul; Ince, E Rahsan; Sandikci, Semra

    2011-01-01

    Central nervous system tuberculosis (TB) is the most devastating manifestation of TB. It is a challenge for clinicians because of the difficulty in making an early diagnosis and the severe consequences of delayed treatment. The aim of this report is to point out the relation between migration and TB based on a 14-year-old child with tuberculous meningoencephalitis (TBM) of an immigrant family. Migration, crowded living conditions and positive family history contribute to the severe course of TB as TBM and miliary TB forms. TB control may prevent these severe manifestations of the disease among immigrants. Prompt diagnosis with helpful early diagnostic tools like polymerase chain reaction in TBM is crucial due to the high mortality and morbidity. PMID:21716875

  12. Tuberculous meningoencephalitis with severe neurological sequel in an immigrant child

    Directory of Open Access Journals (Sweden)

    Kadriye Kart Yasar

    2011-01-01

    Full Text Available Central nervous system tuberculosis (TB is the most devastating manifestation of TB. It is a challenge for clinicians because of the difficulty in making an early diagnosis and the severe consequences of delayed treatment. The aim of this report is to point out the relation between migration and TB based on a 14-year-old child with tuberculous meningoencephalitis (TBM of an immigrant family. Migration, crowded living conditions and positive family history contribute to the severe course of TB as TBM and miliary TB forms. TB control may prevent these severe manifestations of the disease among immigrants. Prompt diagnosis with helpful early diagnostic tools like polymerase chain reaction in TBM is crucial due to the high mortality and morbidity.

  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. 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.

  15. 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.

  16. Ultrasonographic and CT findings of hepatosplenic tuberculosis

    International Nuclear Information System (INIS)

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

  17. Ultrasonographic and CT findings of hepatosplenic tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-08-01

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

  18. A Molecular Epidemiological Survey of Clinically Important Dermatophytes in Iran Based on Specific RFLP Profiles of Beta-tubulin Gene

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    Mahdi Abastabar

    2013-09-01

    Full Text Available Background: Surveillance of dermatophytosis is essential to determine the likely changes in etiological trends and distribution profile of this infection. In this study beta tubulin gene (BT2, was used as the first time in a PCR-RFLP format to clarify the distribution of dermatophytosis agents in some parts of Iran.Methods: A total of 603 clinical isolates was obtained from 500 patients in Tehran, Isfahan, Mazandaran and Guilan provinces. The isolates were identified using macro/micro-morphological criteria and electrophoretic patterns of PCR amplicons of BT2after digestion with each of the restriction enzymes FatI, HpyCH4V, MwoI and Alw21I.Results: Among the patients, 59.2% were male and 40.8% female. The most prevalent clinical form was tinea pedis (42.4%, followed by tinea cruris (24.2%, tinea unguium (12.3%, tinea corporis (10.8%, tinea faciei (4%, tinea manuum (3.14%, tinea capitis (3% and tinea barbae (0.16%, respectively. Trichophyton interdigitale ranked the first, followed by T. rubrum, Epidermophyton floccosum, Microsporum canis, T. tonsurans, T. erinacei and T. violaceum (each 0.49% and the less frequent species were T. schoenleinii, M. gypseum and T. anamorph of Arthroderma benhamiae (each 0.16%. A case of scalp infection by E. floccosum was an exceptional event in the study. No case of T. verrucosum was found.Conclusion: Trichophyton species and E. floccosum are yet the predominant agents of infection in Iran, while Microsporum species are decreasing. T. interdigitale and Tinea pedis remain as the most causal agent and clinical form of dermatophytosis, respectively. It seems that BT2 can be a useful genetic marker for epidemiological survey of common pathogenic dermatophytes.

  19. Mycology - an update. Part 1: Dermatomycoses: causative agents, epidemiology and pathogenesis.

    Science.gov (United States)

    Nenoff, Pietro; Krüger, Constanze; Ginter-Hanselmayer, Gabriele; Tietz, Hans-Jürgen

    2014-03-01

    Dermatomycoses are caused most commonly by dermatophytes. The anthropophilic dermatophyte Trichophyton rubrum is still the most frequent causative agent worldwide. Keratinolytic enzymes, e.g. hydrolases and keratinases, are important virulence factors of T. rubrum. Recently, the cysteine dioxygenase was found as new virulence factor. Predisposing host factors play a similarly important role for the development of dermatophytosis of the skin and nails. Chronic venous insufficiency, diabetes mellitus, disorders of cellular immunity, and genetic predisposition should be considered as risk factors for onychomycosis. A new alarming trend is the increasing number of cases of onychomycosis - mostly due to T. rubrum - in infancy. In Germany, tinea capitis is mostly caused by zoophilic dermatophytes, in particular Microsporum canis. New zoophilic fungi, primarily Trichophyton species of Arthroderma benhamiae, should be taken into differential diagnostic considerations of tinea capitis, tinea faciei, and tinea corporis. Source of infection are small household pets, particularly rodents, like guinea pigs. Anthropophilic dermatophytes may be introduced by families which immigrate from Africa or Asia to Europe. The anthropophilic dermatophytes T. violaceum, T. tonsurans (infections occurring in fighting sports clubs as "tinea gladiatorum capitis et corporis") and M. audouinii are causing outbreaks of small epidemics of tinea corporis and tinea capitis in kindergartens and schools. Superficial infections of the skin and mucous membranes due to yeasts are caused by Candida species. Also common are infections due to the lipophilic yeast fungus Malassezia. Today, within the genus Malassezia more than 10 different species are known. Malassezia globosa seems to play the crucial role in pityriasis versicolor. Molds (also designated non-dermatophyte molds, NDM) are increasingly found as causative agents in onychomycosis. Besides Scopulariopsis brevicaulis, several species of Fusarium and Aspergillus are found. PMID:24533779

  20. 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.

  1. 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

  2. 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

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

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    Shahram Kahkouee

    2010-05-01

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

  4. A STUDY OF COMPARATIVE ASSESSMENT OF THE EFFICACY & SAFETY OF SERTACONAZOLE 2% CREAM VERSUS TERBINAFINE 1% CREAM IN PATIENTS WITH DERMATOPHYTOSES OF SKIN

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    Vedartham Kishore

    2015-09-01

    Full Text Available BACKGROUND: Sertaconazole , a new broad spectrum fungicidal and fungistatic imidazole antifungal drug is having an added good antipruritic and anti - inflammatory action . This beneficial action of Sertaconazole provides much symptomatic relief to the patients with dermatophytic infections of the skin and thereby it improves the qua lity of life in these patients. AIMS AND OBJECTIVES : To make comparative assessment of the efficacy and safety of Sertaconazole 2% cream and Terbinafine 1% cream in patients with dermatophytoses of skin . MATERIALS AND METHOD S: 40 patients with dermatophyti c infections like tinea corporis , tinea cruris and tinea faciei attending the skin OPD , Government General Hospital , Anantapur were enrolled in this prospective, single blind , randomized study . Patients were randomized into two groups A & B with 20 patients in each group . In the initial ‘Treatment Phase’ , group A patients received the sertaconazole nitrate 2% cream applied topically twice daily for four weeks and group B patients received the Terbinafine hydrochloride 1% cream applied topi cally twice daily for two weeks. In the ‘Follow - up Phase’ i.e. 2 weeks after the completion of treatment phase , all the patients in this study were assessed clinically and mycologically for the relapse of dermatophytic infections. RESULTS: Out of the total 40 patients in this study , 97% of Sertaconazole group patients and 91% of Terbinafine group patients showed significant improvement in their signs and symptoms ( pruritus , erythema , papules , vesicles , scaling and mycological cure as compared to their base line in the treatment phase and in the follow - up phase it was 100% in Sertaconazole group and 95% in terbinafine group . Higher number of patients showed decrease of pruritus in the Sertaconazole group (90% as compared to the Terbinafine group (50% ( p < 0 .05 Sertaconazole vs Terbinafine . Both the drugs were well tolerated and did not show recurrences by the mycological assessment. CONCLUSION : Sertaconazole was better than terbinafine in relieving the signs and symtoms of dermatophytic infections and there is no recurrence of dermatophytic infections in all the patients who used these drugs at the end of follow up phase as per the mycological assessment

  5. 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

  6. 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

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

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    Maria Bruna Pasticci

    2013-02-01

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

  8. 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)

  9. 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

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

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    G. Kalema-Zikusoka

    2005-09-01

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

  11. Histopathology of Disseminated Mycobacterium bovis Infection Complicating Intravesical BCG Immunotherapy for Urothelial Carcinoma.

    Science.gov (United States)

    Larsen, Brandon T; Smith, Maxwell L; Grys, Thomas E; Vikram, Holenarasipur R; Colby, Thomas V

    2015-05-01

    Intravesical instillation of Bacillus Calmette-Guérin (BCG) is a mainstay of adjunctive therapy for superficial bladder cancer. Disseminated BCG infection ("BCG-osis") after this therapy is rare and potentially life-threatening; only isolated case reports detail the histopathologic findings thereof, few of which had a diagnosis confirmed by molecular testing. We report 3 additional cases of BCG-osis complicating BCG therapy, all confirmed by cultures and molecular assays, including the first cases of wedge biopsy-confirmed BCG pneumonia and BCG olecranon bursitis. When suggested by a relevant clinical history, recognition of randomly distributed granulomas in any organ should prompt consideration of BCG-osis and liberal performance of AFB stains, aided by targeted molecular assays. Physicians should maintain a high index of suspicion when miliary infiltrates arise after intravesical BCG instillation, and close multidisciplinary communication is essential. Pathologist awareness of this rare cause of granulomatous inflammation aids recognition of BCG-osis and facilitates prompt initiation of antimycobacterial therapy. PMID:25614462

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

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    Daniel H. Libraty

    2014-01-01

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

  13. 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 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

  14. 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)

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

    Science.gov (United States)

    Kim, Jeong-Kwon; Jung, Tae-Young; Lee, Kyung-Hwa; Kim, Seul-Kee

    2015-04-01

    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

  16. Computed tomography of intracranial tuberculosis

    International Nuclear Information System (INIS)

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

  17. Folliculitis et perifolliculitis capitis abscedens et suffodiens controlled with a combination therapy: Systemic antibiosis (Metronidazole Plus Clindamycin, dermatosurgical approach, and high-dose isotretinoin

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    Georgi Tchernev

    2011-01-01

    Full Text Available Folliculitis et perifolliculitis capitis abscedens et suffodiens is a rare disease of unknown etiology. It is a suppurative process that involves the scalp, eventually resulting in extensive scarring and irreversible alopecia. The condition is also known as ?acne necrotica miliaris? or ?Proprionibacterium? folliculitis. Most often the disease affects men of African-American or African-Caribbean descent between 20 and 40 years of age. The clinical picture is determined by fluctuating painful fistule-forming conglomerates of abscesses in the region of the occipital scalp. The cause of scalp folliculitis is not well understood. It is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include: bacteria (especially Propionibacterium acnes, but in severe cases, also Staphylococcus aureus, Yeasts (Malassezia species and mites (Demodex folliculorum. The initial histopathologic finding is an exclusively neutrophilic infiltration followed by a granulomatous infiltrate. The treatment of the disease is usually difficult and often disappointing. Successful treatment with isotretinoin 1 mg/kg body mass could be achieved only after regular systematic administration in the course of 3-4 months. Here we describe a patient with eruptive purulent form of the disease, which has been controlled with combination therapy: systemic antibiosis with metronidazole and clindamycin, dermatosurgical removal of single nodular formations, and isotretinoin 1 mg/kg body mass for 3-5 months.

  18. Tuberkulosis Perinatal Bermanifestasi sebagai Tuberkulosis Milier dan Meningitis

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    Heda Melinda D. Nataprawira

    2014-10-01

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

  19. Case of calcified intracranial tuberculoma presenting unique MRI findings

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

    1988-05-01

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

  20. Tuberculose hepática pseudotumoral Pseudotumoral hepatic tuberculosis

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    Antonio Nocchi Kalil

    1999-06-01

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

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

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    Yoon Young Kyung

    2009-04-01

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

  2. Vitamin D intoxication caused by ingestion of commercial cat food in three kittens.

    Science.gov (United States)

    Wehner, Astrid; Katzenberger, Julia; Groth, Anna; Dorsch, Roswitha; Koelle, Petra; Hartmann, Katrin; Weber, Karin

    2013-08-01

    Two siblings, a 6-month-old sexually intact male weighing 2.5 kg (cat 1) and a sexually intact female (cat 2) British Shorthair cat weighing 2.3 kg, were examined because of a 3-week history of polyuria, lethargy and laboured breathing. One year previously, another sibling (cat 3) had been presented because of similar, yet more severe, clinical signs at the age of 5 months. Physical examination revealed lethargy, dehydration and polypnoea with slightly increased inspiratory effort. Diagnostic investigation revealed severe hypercalcaemia (cats 1-3), renal azotaemia (cats 1 and 3) and a radiologically generalised miliary interstitial pattern of the lungs (cats 1-3) attributable to hypervitaminosis D caused by ingestion of commercial cat food. Cat 3 was euthanased. Cats 1 and 2 were treated with isotonic saline solution (180 ml/kg IV daily), sucralfate (30 mg/kg PO q12h), terbutaline (only cat 1: 0.1 mg/kg SC q4h), furosemide (1.5 mg/kg IV q8h) and tapering doses of prednisolone. Cat 2 was normal on day 14. Cat 1 had stable renal disease and was followed up to day 672. The radiological generalised military interstitial pattern of the lungs had improved markedly. Excessive cholecalciferol-containing commercially available cat food poses a great hazard to cats. Supportive treatment may result in long-term survival and improvement of radiological pulmonary abnormalities. PMID:23295272

  3. August 2012 imaging case of the month

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    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 …

  4. Demographic And Risk Factors Related To Military Tuberculosis

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    M. Rasolinejad

    2006-05-01

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

  5. 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-up of the patients undergoing medical therapy

  6. 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.)

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

    Science.gov (United States)

    Short, Jeanmarie; Gram, Dunbar

    2016-01-01

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

  8. Mycobacterial antigen detection by immunohistochemistry in pulmonary tuberculosis.

    Science.gov (United States)

    Humphrey, D M; Weiner, M H

    1987-07-01

    A preliminary diagnosis of tuberculosis can be established by the detection of acid-fast bacilli (AFB) and confirmed by culture of the microorganism. To evaluate an alternative method of diagnosis, the distribution of mycobacterial antigens in lung tissue specimens was characterized by an indirect peroxidase-antiperoxidase method and was compared to the detection of AFB by Ziehl-Neelsen stain. Histologic specimens were obtained from 59 hospital patients. Of nine patients with mycobacterial disease, seven had antigen detected in tissue. In two patients with tuberculous pneumonia, the distribution of mycobacterial antigens was approximately the same as that of AFB. In contrast, in four patients with caseating pulmonary granulomas, clumps of mycobacterial antigens were demonstrated in necrotic areas of the granulomas where there were few or no AFB. In one patient with Mycobacterium intracellulare infection, cross-reactive antigens stained weakly. Antigen was not found in tissue from two patients; one had miliary lung granulomas, and the second had mediastinal lymph node granulomas. Mycobacterial antigens were not detected in specimens from 50 control patients with nonmycobacterial diseases. On the basis of this study of 59 cases, immunohistochemical detection of microbial antigens appears to be useful for establishing the mycobacterial etiology of caseating pulmonary granulomas. PMID:3297995

  9. 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.

  10. [Treatment and outcomes of complicated tuberculosis of the respiratory organs in young children].

    Science.gov (United States)

    Chugaev, Iu P; Shna?dshte?n, V M; Charykova, G P; Krivoshe?kina, T V

    1989-01-01

    The main course of tuberculosis chemotherapy was applied to 85 children at the age of 3 months to 3 years. 62.4, 30.6 and 7.0 per cent of the children suffered from tuberculosis of the intrathoracic lymph nodes, primary tuberculosis and miliary tuberculosis, respectively. The children of younger ages were subjected early during the treatment to intensive chemotherapy consisting of intravenous administration of isoniazid in parallel with 2-3 antituberculous drugs applied to 41.2 per cent of the children and of infusion desintoxication therapy applied to 74.1 per cent of the children. The chemotherapy regimen including isoniazid + streptomycin + ethionamide resulted in clinical recovery 10.1 +/- 0.32 months later, in 48.1 per cent of the patients, the tuberculous inflammation completely resolving, in 40.7 per cent it consolidated and in 11.1 per cent it petrificated. 31 patients with the most severe processes were treated, in addition to the above drugs, with rifampicin as rectal suppositories within 87.0 +/- 3.3 days. The clinical recovery was observed in 10.9 +/- 0.22 months (p greater than 0.05); specific inflammation resolution, consolidation and petrification being observed in 41.9, 45.2 and 12.9 per cent of the children, respectively. The morphofunctional indices of T- and B-immunity markedly lowered at the beginning of the treatment returned to normal 3 months earlier in the patients treated with rifampicin. PMID:2798383

  11. SPECTRUM OF EXTRA PULMONARY TUBERCULAR PATIENTS ATTENDING A TERTIARY CARE HOSPITAL

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    Seema Dayal

    2013-01-01

    Full Text Available Background: Extra pulmonary tuberculosis is increasing day by day. Even it has reversed the epidemiological trend of pulmonary tuberculosis. Over the last several years reported EPTB was increasing in absolute numbers and in proportion of all reported cases of tuberculosis, however similar studies from high burden Etawah district with high prevalence of HIV are lacking .Therefore, we have conducted this study to investigate clinical and pathological features of EPTB. Material & Method: The study was conducted on 925 clinically suspective tubercular patients who attended pathology department. They were compared in terms of age, sex, and site. Result: Out of the 925 clinically suspective extra pulmonary tubercular patients, 900 was diagnosed as EPTB patients. Females had higher proportion (51.77% of EPTB than males (48.22%. EPTB was more common in young age (20-29 years in males, where as in females common in (40-49 years age group. Most common site was lymph node (58% followed by Abdominal (13% urogenital (13%osteoarticular (12%, miliary (2%, CNS (1% and skin(1%. Conclusion: Out data suggest that EPTB was relatively common in young age in males and in latter group in females gender. Lymph node tuberculosis was most common site in both males and females. Tuberculosis control programmed may targets these population for EPTB case finding.

  12. 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 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)

  13. 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.

  14. 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.

  15. Tuberculosis en pacientes ancianos: Formas de presentación / Tuberculosis in elderly patients: Forms of presentation

    Scientific Electronic Library Online (English)

    F. L., Lado Lado; V., Tuñez Bastida; A. L., Golpe Gómez; A., Cabarcos Ortiz de Barrón; M. L., Pérez del Molino.

    2002-03-01

    Full Text Available Objetivo: Analizar la distribución de las formas de presentación de tuberculosis (FPT) en pacientes de edad avanzada. Material y métodos: Se revisaron los casos de tuberculosis registrados en la Unidad de Prevención y Control de la Tuberculosis del Área Sanitaria de Santiago de Compostela en un perí [...] odo de seis años. Clasificamos las FPT en: formas pulmonares (P), definida por localización exclusivamente pulmonar; Formas extrapulmonares (FE), caracterizada 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 un total de 278 tuberculosis, 156 (56,2%) eran varones y 122 (43,8%) mujeres. La edad media fue de 75,3 años (rango, 65-95). La distribución de FPT resultó ser: 155 (55,8%) pulmonares; 66 (23,7%) FE de las cuales 27 (41,0%) eran de localización ganglionar, 12 (18,2%) osteoarticular, 8 (12,1%) intestinal, 6 (9,1%) peritoneal, 5 (7,6%) meningea y 8 (12,0%) otras localizaciones; FM 47 casos (16,9%); TB miliares 7 casos (2,5%) y FD 3 casos (1,1%). No se observó ningún caso de pacientes infectados por el virus de la inmunodeficiencia humana. Conclusiones: En estos pacientes, se comprueba una elevada prevalencia de tuberculosis extrapulmonar. Ello nos sugiere, un cambio en la presentación clásica de la enfermedad y una extrema sensibilidad en el diagnóstico localizatorio de la enfermedad. Abstract in english Objetive: To analyse the distribution of the forms of presentation of tuberculosis (TPF) in elderly patients. Material and methods: The medical records of patients diagnosed with tuberculosis attending the Tuberculosis Prevention and Control Unit of the Santiago Health District were reviewed over of [...] six years period. The classification of TPF was: pulmonary forms (P), disease confined to the lung; 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 278 tuberculosis infected patients were observed, 156 (56.2%) were men and 122 (43.8%) women, their mean age was 75.3 years (range 65-95). The distribution of TPF was: 155 (55.8%) P forms; 66 (23.7%) EF, of which 27 (41.0%) were ganglionary location, 12 (18.2%) bone and joint, 8 (12.0%) intestinal, 6 (9.1%) peritoneal, 5 (7.6%) meningeal, and other locations 8 (12.1%); MF 47 cases (16.9%); miliary TB 7 cases (2.5%) and. DF 3 cases (1.1%). None case was observed of HIV infected patient. Conclusions: Our findings confirm high incidence of extrapulmonary TB in elderly patients. Our experience shows a modification to the classical presentation of the disease, and thus the need for sensitivity in locating the disease.

  16. Uptake of iodine-123-a-methyl-l-tyrosine (IMT) in primary bone and soft-tissue tumours

    International Nuclear Information System (INIS)

    Full text: The aim f this study was to determine the suitability of 123I-IMT for (i) visualising primary bone and soft tissue tumours, (ii) distinguishing between benign and malignant tumours and (iii) grading primary bone and soft tissue tumours. The measurement of the regional uptake of IMT provides information on the rate of amino acid transport, in rapidly growing tissues. It has been mainly studied in brain tumours. 8 patients (5 males and 3 females) and aged between 33-88yrs were recruited into the pilot study. 4 with benign bony lesions, 2 with low grade chondrosarcomas and 2 with high-grade neoplasms (one bone and one soft tissue). All underwent planar +/- SPECT imaging commencing 15 minutes post-injection of IMT and the results were compared with standard imaging studies and the histological findings. No abnormal uptake was seen in any of the 4 benign tumours, while intense uptake was seen in the 2 high-grade tumours. Presumed miliary lung metastases in one of these patients were not visualised with IMT. One of the low-grade chondrosarcomas had subtle uptake while the other was normal. Of the seven patients who had Thallium imaging, the IMT results were concordant in 6 and discordant in one with low-grade chondrosarcoma that was mildly positive on IMT and negative on thallium. IMT allows confident differentiation between high grade and low grade or benign bone or soft tissue tumours but does not appear to differentiate between benign and low-grade lesions or offer any significant advantage over conventional thallium imaging for bone and soft tissue tumours in this pilot study. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

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

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    Lauria Francesco N

    2011-09-01

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

  18. Transcriptional profiling of Mycobacterium tuberculosis replicating ex vivo in blood from HIV- and HIV+ subjects.

    Science.gov (United States)

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

    2014-01-01

    Hematogenous dissemination of Mycobacterium tuberculosis (M. tb) occurs during both primary and reactivated tuberculosis (TB). Although hematogenous dissemination occurs in non-HIV TB patients, in ?80% of these patients, TB manifests exclusively as pulmonary disease. In contrast, extrapulmonary, disseminated, and/or miliary TB is seen in 60-70% of HIV-infected TB patients, suggesting that hematogenous dissemination is likely more common in HIV+ patients. To understand M. tb adaptation to the blood environment during bacteremia, we have studied the transcriptome of M. tb replicating in human whole blood. To investigate if M. tb discriminates between the hematogenous environments of immunocompetent and immunodeficient individuals, we compared the M. tb transcriptional profiles during replication in blood from HIV- and HIV+ donors. Our results demonstrate that M. tb survives and replicates in blood from both HIV- and HIV+ donors and enhances its virulence/pathogenic potential in the hematogenous environment. The M. tb blood-specific transcriptome reflects suppression of dormancy, induction of cell-wall remodeling, alteration in mode of iron acquisition, potential evasion of immune surveillance, and enhanced expression of important virulence factors that drive active M. tb infection and dissemination. These changes are accentuated during bacterial replication in blood from HIV+ patients. Furthermore, the expression of ESAT-6, which participates in dissemination of M. tb from the lungs, is upregulated in M. tb growing in blood, especially during growth in blood from HIV+ patients. Preliminary experiments also demonstrate that ESAT-6 promotes HIV replication in U1 cells. These studies provide evidence, for the first time, that during bacteremia, M. tb can adapt to the blood environment by modifying its transcriptome in a manner indicative of an enhanced-virulence phenotype that favors active infection. Additionally, transcriptional modifications in HIV+ blood may further accentuate M. tb virulence and drive both M. tb and HIV infection. PMID:24755630

  19. 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.

  20. 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.)

  1. 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.

  2. 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.

  3. 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 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)

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

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    Yatin N. Dholakia

    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.

  5. Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis

    Science.gov (United States)

    Leca, Daniela A.; Juganariu, Gabriela; Teodor, Andra; Hurmuzache, Mihnea; Nastase, Eduard V.; Anton-Paduraru, Dana T.

    2015-01-01

    Background Tuberculous meningitis (TBM) is the most lethal form of Mycobacterium tuberculosis infection, which has a high rate of neurological complications and sequelae. Objectives Our study offers a real-world infectious disease clinic perspective, being thus representative for the clinical environment of developing countries. Methods We performed a retrospective analysis of the 127 adult and 77 pediatric cases diagnosed with TBM in the Infectious Disease Hospital of the School of Medicine of Iasi, Romania between 2004–2013. Results Definite diagnosis of TBM was established in 31% of children but in only 20% of adults (p = 0.043). A contact with an individual with pulmonary tuberculosis was documented in 30% of children vs. 13% of adults (p = 0.0007). Coma occurred in 19% of patients (similar in children and adults); other consciousness abnormalities were seen in 27% of children and in 72% of adults (p = 0.000001). Cranial nerve palsies occurred prior to therapy in 9% of cases (12% vs 7% of children and adults, respectively, p>0.05), and developed 2–7 days after treatment initiation in 10% (12 vs 9%). CSF cultures were positive for M. tuberculosis in 24% of patients (31% vs. 20%, p>0.05). Overall mortality was 7.35%, similar for children and adults. Yet, permanent neurological sequelae, which were seen in 23% of patients occurred significantly more frequent in children vs. adults (36% vs. 14%, respectively, p = 0.0121). In conclusion, our retrospective analysis on a significant number of cases of TBM identified striking differences between children and adults: while children were in an earlier stage at the admission, they associated a higher frequency of neurological sequelae and miliary pattern, and they were more likely to have normal CSF protein levels and positive cultures of CSF. PMID:26186004

  6. 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%, 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

  7. Unusual radiological findings of adult-onset pulmonary tuberculosis

    International Nuclear Information System (INIS)

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

  8. 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

  9. 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).

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

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    A. Jamzad

    2009-11-01

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

  11. Pulmonary coccidioidomycosis: pictorial review of chest radiographic and CT findings.

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    Jude, Cecilia M; Nayak, Nita B; Patel, Maitraya K; Deshmukh, Monica; Batra, Poonam

    2014-01-01

    Pulmonary coccidioidomycosis is a fungal disease endemic to the desert regions of the southwestern United States, Mexico, Central America, and South America. The incidence of reported disease increased substantially between 1998 and 2011, and the infection is encountered beyond the endemic areas because of a mobile society. The disease is caused by inhalation of spores of Coccidioides species. Individuals at high risk are those exposed to frequent soil aerosolization. The diagnosis is established by direct visualization of mature spherules by using special stains or cultures from biologic specimens. Serologic testing of anticoccidioidal antibodies is used for diagnosis and treatment monitoring. The infection is self-limited in 60% of cases. When the disease is symptomatic, the lung is the primary site of involvement. On the basis of clinical presentation and imaging abnormalities, pulmonary involvement is categorized into acute, disseminated, and chronic forms, each with a spectrum of imaging findings. In patients with acute disease, the most common findings are lobar or segmental consolidation, multifocal consolidation, and nodules. Adenopathy and pleural effusions are also seen, usually in association with parenchymal disease. Disseminated disease is rare and occurs in less than 1% of patients. Pulmonary findings are miliary nodules and confluent parenchymal opacities. Acute respiratory distress syndrome is an infrequent complication of disseminated disease. The acute findings resolve in most patients, with chronic changes developing in approximately 5% of patients. Manifestations of chronic disease include residual nodules, chronic cavities, persistent pneumonia with or without adenopathy, pleural effusion, and regressive changes. Unusual complications of chronic disease are mycetoma, abscess formation, and bronchopleural fistula. Patients in an immunocompromised state, those with diabetes mellitus, pregnant women, and those belonging to certain ethnic groups may show severe, progressive, or disseminated disease. PMID:25019431

  12. The clinical utility of camera-based FDG PET in patients with papillary thyroid cancers

    International Nuclear Information System (INIS)

    We evaluated the usefulness of F-18 FDG gamma camera based PET (CoDe-PET) in patients papillary thyroid cancers (PTC). Twenty patients with PTC (7 males, 13 females and mean age of 44 ranging 19-71) underwent CoDe-PET of the neck and chest using a dual-head gamma camera equipped with coincidence detection circuitry. There were two groups of patients studied. First group, 17 athyrotic patients with PTC underwent CoDe-PET for elevated thyroglobulin and negative I-131 whole body diagnostic scan after total thyroidectomy. Second group, 3 patients with PTC performed CoDe-PET preoperatively. Neck and chest images were obtained and attenuation correction was not made. CoDe-PET images were evaluated visually and compared with the anatomical images or posttherapy I-131 scans if performed. The results of CoDe-PET was positive in 10 of 17. In 3 cases, abnormal FDG uptake were histologically confirmed. One patient underwent radical neck dissection and the other two patients received I-131 ablation therapy. Of the remaining 14 patients, seven were CoDe-PET positive and the other seven were negative. A total of 11 patients received subsequent I-131 ablation therapy, in whom only three have concordant CoDe-PET results with post-therapy I-131 scans. Two with military pulmonary metastases failed to concentrate FDG but neck diseases were detected. In the 2nd group consisting of patients before total thyroidectomy, CoDe-PET detected thyroid cancers in two patients but failed in one in which the size of cancer was 0.5 cm in diameter. In the follow-up of patients with papillary thyroid cancer, CoDe-PET appears useful in detecting residual or recurrent lesions in the neck of patients with elevated serum thyroglobulin levels but negative diagnostic iodine scans. However, CoDe-PET was insensitive in detecting miliary pulmonary metastases and small lesions in the neck

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

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    Susan M Pereira

    2007-09-01

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

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

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

    2014-10-01

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

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

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    Herdiman T. Pohan

    2004-12-01

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

  16. 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.

  17. Tuberculous biliary strictures: uncommon cause of obstructive jaundice

    International Nuclear Information System (INIS)

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

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

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

    2000-02-01

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

  19. 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 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%)

  20. Making wider use of the world's most widely used vaccine: Bacille Calmette-Guerin revaccination reconsidered.

    Science.gov (United States)

    Dye, Christopher

    2013-10-01

    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 negative tuberculin skin test, TST). The duration of protection against pulmonary TB is also variable, but lasts about 10 years on average. These observations raise the possibility that BCG revaccination, following primary vaccination in infancy, could be efficacious among TST-negative adolescents as they move into adulthood, the period of highest risk for pulmonary disease. To inform continuing debate about revaccination, this paper assesses the effectiveness and cost-effectiveness of revaccinating adolescents in a setting with intense transmission-Cape Town, South Africa. For a cost of revaccination in the range US$1-10 per person, and vaccine efficacy between 10% and 80% with protection for 10 years, the incremental cost per year of healthy life recovered (disability-adjusted life years, DALY) in the vaccinated population lies between US$116 and US$9237. The intervention is about twice as cost-effective when allowing for the extra benefits of preventing transmission, with costs per DALY recovered in the range US$52-$4540. At 80% efficacy, revaccination averted 17% of cases. Under the scenarios investigated, BCG revaccination is cost-effective against international benchmarks, though not highly effective. Cost-effectiveness ratios would be more favourable if we also allow for TB cases averted by preventing transmission to HIV-positive people, for the protection of HIV-negative people who later acquire HIV infection, for the possible non-specific benefits of BCG, for the fact that some adolescents would receive BCG for the first time, and for cost sharing when BCG is integrated into an adolescent immunization programme. These findings suggest, subject to further evaluation, that BCG revaccination could be cost-effective in some settings. PMID:23904584

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

    Scientific Electronic Library Online (English)

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

    1997-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Ricardo Luiz M. Martins

    1997-12-01

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

  3. Características clinicopatológicas y distribución del número de autopsias de pacientes fallecidos por coccidioidomicosis en un hospital de referencia del noreste de México / Clinicopathologic Characteristics and Distibution of Number of Autopsies of Patient Death Due to Coccidioidomycosis at a Referral Hospital in Northeastern México

    Scientific Electronic Library Online (English)

    Ana Laura, Calderón-Garcidueñas; Karina, Piña-Osuna; Ana María, Leal-Moreno; Adriana, López-Cárdenas; Ricardo M, Cerda-Flores.

    2004-08-01

    Full Text Available Objetivos: describir las características clinicopatológicas de un grupo de pacientes con coccidioidomicosis (CM) quienes fallecieron en un hospital de referencia del Noreste de México de 1983-2000; conocer si la frecuencia anual y mensual de fallecimientos se presentó de manera uniforme. Material y [...] métodos: en el Hospital de Especialidades 25 del IMSS se seleccionó de un total de 4598 autopsias 31 casos con CM. Se analizó el expediente clínico y el protocolo de autopsia. Para la determinación de la distribución del número de fallecimientos por trimestre se utilizó una tabla de contingencia y la prueba de Kolmogorov-Smirnov. Resultados: de los 31 casos, 10 fueron mujeres y 21 hombres (edad de 4 meses a 60 años). En mujeres, el antecedente más frecuente fue el embarazo (40%) mientras que en hombres lo fueron la insuficiencia renal crónica (38%) y el SIDA (19%). La septicemia, la neumonía y la meningitis fueron las formas de presentación clínica más frecuentes. No se observó variación en la distribución de casos de mortalidad por CM en los 18 años estudiados ni cuando la población se agrupó por trimestres (p>0.05). Conclusiones: la mortalidad por CM fue del 0.67% y no se observó variación en el número de defunciones por esta causa a través del tiempo. La CM debe incluirse en el diagnóstico diferencial de pacientes de esta área endémica que presentan factores de riesgo como embarazo, insuficiencia renal crónica o SIDA, en especial si cursan con cuadros neumónicos con patrón miliar o septicemia con esplenomegalia. Abstract in english Aims: 1. To describe clinical and pathologic characteristics of patients with coccidioidomycosis (CM) who died from 1983-2000 at a hospital in northeastern Mexico, and 2, to know distribution of number of deaths due to CM per year and month. Methods: from 4598 autopsies, 31 cases of CM were selected [...] . Clinical chart and autopsy protocols were examined. Distribution of cases was analyzed by contingence table and Kolmogorov-Smirnov tests. Results: there were 10 women and 21 men (aged 4 months to 60 years). In women, pregnancy was present in 40%ofcases. In men, chronic renal failure (CRF) (38%) and AIDS (19%) were the pathologic conditions most frequently observed. Variation in distribution of cases throughout 18 years was not observed (p > 0.05). Conclusions: mortality due to CM was 0.67% and variation in number of deaths was not found. In this endemic area, CM must be included in differential diagnosis of patients with risk factors such as pregnancy, CRF, and AIDS, especially if associated with pneumonia with miliary pattern or septicemia with splenomegaly.

  4. 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.

  5. 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

  6. Satellite and ship studies of phytoplankton in the Northeastern Arabian during 2000—2006 period

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    Matondkar, S. G. P.; Dwivedi, R. M.; Parab, Sushma; Pednekar, Suraksha; Desa, E. S.; Mascarenhas, A.; Raman, Mini; Singh, S. K.

    2006-12-01

    Sequence of the images from IRS P4 / OCM satellite and extensive shipboard sampling programme are used to understand the seasonal variation of phytoplankton abundance and types in the Northeastern (NE) Arabian Sea and Lakshadweep Sea. An appreciable degree of spatial and temporal variability is observed in chlorophyll a distribution from November to April months, as well as coastal and offshore stations, indicating marked seasonality in phytoplankton distribution in NE Arabian Sea. During November month (fall intermonsoon) average chlorophyll a (Chl a) by fluorometer was (0.799 mgm^-3) and by OCM it was 0.584 mgm^-3. The higher chlorophyll a observed was due to Trichodesmium (cyanobacteria) blooms. During December the average chlorophyll a was 0.34 mgm^-3 also due to Trichodesmium filaments in water column. During January onwards winter cooling led to increase in nutrients which enhanced chlorophyll a value to 0.64 mgm^-3 due to growth of flagellates (as seen by high chlorophyll b besides chlorophyll a) in water column. February, March and April supported moderately high chlorophyll value (0. 3 to 0.5 mgm^-3) due to growth of prasinophytes (as seen by pigment prasinoxanthin) and blooms of the Noctiluca miliaris. Time series monitoring of Noctiluca bloom was also conducted using OCM based chlorophyll images in NE Arabian Sea. During February chlorophyll a retrieved by OCM was 0.3 to 0.9 mgm^-3. Pigment analysis of water samples indicated the equal important of accessory pigment like zeaxanthin, prasinoxanthin, beta-carotene. The relevance of these pigments estimated by HPLC like zeaxanthin (cyanobacteria), fucoxanthin (diatoms), peridinin (dinoflagellates) is presented and discussed. Similarly, exercise is conducted in Lakshadweep waters where Trichodesmium related peak in chlorophyll a was observed during March onwards in OCM data. The average chlorophyll a in NE Arabian Sea at surface during November was (0.726 mgm^-3), December (0.34 mgm^-3), January (0.723 mgm^-3), February (0.344 mgm^-3), March (0.963 mgm^-3) and April 0.665 mgm^-3. Similar trend was observed in primary productivity estimates. The attempt is made to work out seasonality in the productivity of the Arabian Sea using OCM derived chlorophyll and relation of enhancement in productivity due to development of winter blooms in the Arabian Sea. The environmental conditions (temperature, wind, nutrients and mixed layer depth) affecting these blooms responsible for year to year variation in bloom biomass and productivity is also presented in detail.

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

    International Nuclear Information System (INIS)

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

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

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    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.

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

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    Mauricio L. Barreto

    2006-07-01

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

  10. Fase aguda da esquistossomose mansoni

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    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

  11. 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

  12. Development of Pacing, Electrophysiology and Defibrillation in India

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    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.

  13. 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.

  14. Causas múltiplas de morte relacionadas à tuberculose no Estado de São Paulo, 1998 / Multiple-causes-of-death related to tuberculosis in the State of São Paulo, Brazil, 1998

    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

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

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    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.

  16. 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.

  17. Causas múltiplas de morte relacionadas à tuberculose no Estado de São Paulo, 1998 Multiple-causes-of-death related to tuberculosis in the State of São Paulo, Brazil, 1998

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    Augusto Hasiak Santo

    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 (pOBJECTIVES: 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 occurred 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<0,001. CONCLUSIONS: Total reports of TB-related death practically doubled its mortality rate as an underlying cause. The increase in TB mortality was demonstrated to be influenced by the AIDS epidemic.

  18. / Patogenia de las lesiones tuberculosas del sistema nervioso

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    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%).