WorldWideScience

Sample records for active pulmonary tuberculosis

  1. Spontaneous pneumothorax due to recently diagnosed active pulmonary tuberculosis

    OpenAIRE

    Carrillo, Leonidas; 1 Facultad de Medicina, UNMSM. Lima, Perú. 2 Hospital Nacional Arzobispo Loayza, Ministerio de Salud. Lima, Perú.; Pintado, Silvia; Hospital Nacional Edgardo Rebagliati Martins, EsSalud. Lima, Perú.; Cueva, Luis; Facultad de Medicina, UNMSM. Lima, Perú.

    2011-01-01

    We describe the case of a male patient aged 17, Lima student who had no history of known tuberculosis contact, nonreactive HIV ELISA, diagnosed 21 days befote admission with active pulmonary tuberculosis, sputum smear 3 +, who was started with first line antituberculosis drugs. He was admitted to the hospital for pleural chest pain of sudden onset, and moderate dyspnea; on physical examination there was abolition of vocal vibrations, absence of breath sounds and hyperresonance in right hemith...

  2. Determinants of active pulmonary tuberculosis in Ambo Hospital, West Ethiopia

    Directory of Open Access Journals (Sweden)

    Tenna Ephrem

    2015-02-01

    Full Text Available Objectives: The aim of this study was to determine factors associated with active pulmonary tuberculosis seen in cases in Ambo Hospital, Ethiopia.Design: A facility-based prospective case-control study.Setting: Patients attending Ambo Hospital from 01 December 2011 to 29 March 2012.Participants: The sample included 312 adult patients attending Ambo Hospital. The main outcome measure was presence of active pulmonary tuberculosis (TB.Explanatory measures: Age, gender, occupation, educational status, marital status, place of residence, patient history of TB, family history of TB, human immunodeficiency virus (HIV infection, smoking, alcohol intake, khat chewing, body mass index (BMI, employment, diabetes, history of asthma, previous history of worm infestation, history of hospitalisation, number of adults living in the household (HH, person per room, housing condition.Results: A total of 312 study participants, including 104 active pulmonary tuberculosis (PTB cases (cases and 208 non-active PTB cases (controls, were recruited for the present study. Having one or more family member with a history of TB (OR = 4.4; 95% CI: 1.50–12.90, marital status (OR = 7.6; 95% CI: 2.2–12.6, male gender (OR = 3.2; 95% CI: 1.4–7, rural residence (OR = 3.3; P = 0.012, being a current or past smoker (OR = 2.8; 95% CI: 1.1–7.2, BMI < 18.5 (OR = 2.1; 95% CI: 1.03–4.2, HIV infection (OR = 8.8; 95% CI: 2.4–23.8 and a history of worm infestation (OR = 6.4; 95% CI: 2.6–15.4 remained significant independent host-related factors for active PTB.Conclusion: Patients who came from a compound with more than two HHs were more likely to develop active PTB than those who came from a compound with only one HH. Those who lived in houses with no windows were more likely to develop active PTB than those who lived in houses with one or more windows, had a family history of TB, lived in rural areas. Sex of the patient was a predicting factor. Not being the owner of the house

  3. Pulmonary Tuberculosis in Children

    Directory of Open Access Journals (Sweden)

    Keshtkar Jahromi

    2014-09-01

    Full Text Available Tuberculosis (TB is the most common cause of infection-related death worldwide. Children represent 5 to 15% of all TB cases around the world and are more frequently infected and more easily affected by the most severe forms of the disease such as meningitis and disseminated form .Here, we reviewed TB in children with impact on the routes of transmission, clinical manifestations, treatment, control, and prophylaxis. Electronic databases (PubMed, Scopus were searched from June1995 to May 2014 by using key words (pulmonaryTB,epidemiology,transmission,clinical manifestations,treatment,control, and prophylaxis . Pulmonary tuberculosis may manifest in several forms, including endobronchial TB with focal lymphadenopathy, progressive pulmonary disease, pleural involvement, and reactivated pulmonary disease . Symptoms of primary pulmonary disease in the pediatric population are often insignificant. Gastric aspirates are used instead of sputum in children younger than 6 years. BCG vaccination is used in many parts of the world and the major role of vaccination is the prevention of life-threatening illness such as disseminated TB and meningitis in children.Treatment is the same as for adults. Most people infected with M .tuberculosis do not develop active disease. In healthy individuals, the lifetime risk of developing infection to disease is 5-10%. Reactivation of TB often occurs in older children and adolescent and is more common in patients who acquire TB at age 7 years and older.

  4. Loss of Receptor on Tuberculin-Reactive T-Cells Marks Active Pulmonary Tuberculosis

    OpenAIRE

    2007-01-01

    BACKGROUND: Tuberculin-specific T-cell responses have low diagnostic specificity in BCG vaccinated populations. While subunit-antigen (e.g. ESAT-6, CFP-10) based tests are useful for diagnosing latent tuberculosis infection, there is no reliable immunological test for active pulmonary tuberculosis. Notably, all existing immunological tuberculosis-tests are based on T-cell response size, whereas the diagnostic potential of T-cell response quality has never been explored. This includes surface ...

  5. Prevalence of pulmonary tuberculosis in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Sudin Koshy

    2016-09-01

    Results: 18 patients had evidence of pulmonary tuberculosis. 5 patients had active disease and 13 patients had evidence of healed pulmonary tuberculosis. The prevalence of pulmonary tuberculosis was 8.3%. This is much higher than the prevalence in the Indian population which is 13-25 per thousand. Of the 5 patients who had active disease 3 patients were on leflunamide for 1 year or more. On analysis it was found that patients on leflunamide were at an increased risk of developing tuberculosis (p <0.001 and the risk estimate showed an odds ratio of 14.2. Conclusions: Prevalence of pulmonary tuberculosis in the study population was found to be 8.3%. In countries with high prevalence of latent and active tuberculosis, rheumatoid arthritis patients should be carefully monitored for pulmonary tuberculosis before and during the treatment with immunosuppressive drugs. [Int J Res Med Sci 2016; 4(9.000: 3729-3732

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

    Directory of Open Access Journals (Sweden)

    Mathias Streitz

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

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

    Directory of Open Access Journals (Sweden)

    Parakkal Jovvian George

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

  8. Control measures to trace ≤ 15-year-old contacts of index cases of active pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Cláudia Di Lorenzo Oliveira

    2015-10-01

    Full Text Available This was descriptive study carried out in a medium-sized Brazilian city. In ≤ 15-year-old contacts of index cases of active pulmonary tuberculosis, we assessed compliance with the Brazilian national guidelines for tuberculosis control. We interviewed 43 contacts and their legal guardians. Approximately 80% of the contacts were not assessed by the municipal public health care system, and only 21% underwent tuberculin skin testing. The results obtained with the Chi-square Automatic Interaction Detector method suggest that health care teams have a biased attitude toward assessing such contacts and underscore the need for training health professionals regarding tuberculosis control programs.

  9. Prevalence, risk factors and social context of active pulmonary tuberculosis among prison inmates in Tajikistan.

    Directory of Open Access Journals (Sweden)

    Daniel E Winetsky

    Full Text Available SETTING: Tuberculosis (TB is highly prevalent in prisons of the former Soviet Union. OBJECTIVE: To understand the behavioral, demographic and biological factors placing inmates in Tajikistan at risk for active TB. DESIGN: We administered a behavioral and demographic survey to 1317 inmates in two prison facilities in Sughd province, Tajikistan along with radiographic screening for pulmonary TB. Suspected cases were confirmed bacteriologically. Inmates undergoing TB treatment were also surveyed. In-depth interviews were conducted with former prisoners to elicit relevant social and behavioral characteristics. RESULTS: We identified 59 cases of active pulmonary TB (prevalence 4.5%. Factors independently associated with increased prevalence of active TB were: HIV-infection by self-report (PR 7.88; 95%CI 3.40-18.28, history of previous TB (PR 10.21; 95%CI 6.27-16.63 and infrequent supplemental nutrition beyond scheduled meals (PR 3.00; 95%CI 1.67-5.62. Access to supplemental nutrition was associated with frequency of visits from friends and family and ability to rely on other inmates for help. CONCLUSION: In prison facilities of Tajikistan, HIV-infection, injection drug use and low access to supplemental nutrition were associated with prevalent cases of active pulmonary TB. Policies that reduce HIV transmission among injection drug users and improve the nutritional status of socially isolated inmates may alleviate the TB burden in Tajikistan's prisons.

  10. Interferon-gamma treatment kinetics among patients with active pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Olanisun Olufemi Adewole

    2013-01-01

    Full Text Available Introduction: Interferon-γ (IFN-γ is essential for defence against Mycobacterium tuberculosis; however, levels in patients with active tuberculosis (TB and changes during treatment have not been documented in our tuberculosis patients in Nigeria, hence this study has been carried out. Objective: To determine variations, treatment kinetics, and predictive value of IFN-γ levels during treatment of active tuberculosis. Design: Patients with pulmonary tuberculosis were recruited and subsequently followed up for 3 months during treatment with anti-TB. Peripheral blood was collected for IFN-γ assays, C-reactive protein and others followed by a Mantoux test. IFN-γ levels produced by stimulation with TB antigens were determined by ELISA and repeated measurement of IFN-γ were done at 1 and 3 months of anti-TB therapy. Chi Associations and correlations between IFN-γ were determined. Regression analysis was done to determine association between serial IFN-γ and treatment outcome. Results: We recruited 47 patients with active tuberculosis with a mean age of 34.8 ± 3.6 years and M:F ratio of 1.12:1. Six (11% were HIV positive. The mean level of IFN-γ induced by TB antigens was 629 ± 114.1 pg/ml, higher for HIV-negative PTB patients compared with HIV-positive PTB patients, 609.78 ± 723.9 pg/ml and 87.88 ± 130.0 pg/ml, respectively, P-value = 0.000. The mean level of IFN-γ induced by TB antigen increased significantly from 629 ± 114.1 pg/ml to 1023.46 + 222.8 pg/ml, P-value = 0.03 and reduced to 272.3 ± 87.7 pg/ml by the third month on anti-TB drugs, P-value = 0.001. Negative correlation was observed between the mean of baseline and chest X-ray involvement, P = 0.03. There was no significant correlation between sputum smear grade with baseline and follow-up IFN-γ levels. Three-month IFN-γ level among cured patients were higher than those with treatment failure, regression analysis showed that it does not predict outcome. Conclusion: IFN

  11. Radioiodine uptake in inactive pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Bakheet, S.M.; Powe, J.; Al Suhaibani, H. [Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Hammami, M.M.; Bazarbashi, M. [Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

    1999-06-01

    Radioiodine may accumulate at sites of inflammation or infection. We have seen such accumulation in six thyroid cancer patients with a history of previously treated pulmonary tuberculosis. We also review the causes of false-positive radioiodine uptake in lung infection/inflammation. Eight foci of radioiodine uptake were seen on six iodine-123 diagnostic scans. In three foci, the uptake was focal and indistinguishable from thyroid cancer pulmonary metastases from thyroid cancer. In the remaining foci, the uptake appeared nonsegmental, linear or lobar, suggesting a false-positive finding. The uptake was unchanged, variable in appearance or non-persistent on follow-up scans and less extensive than the fibrocystic changes seen on chest radiographs. In the two patients studied, thyroid hormone level did not affect the radioiodine lung uptake and there was congruent gallium-67 uptake. None of the patients had any evidence of thyroid cancer recurrence or of reactivation of tuberculosis and only two patients had chronic intermittent chest symptoms. Severe bronchiectasis, active tuberculosis, acute bronchitis, respiratory bronchiolitis, rheumatoid arthritis-associated lung disease and fungal infection such as Allescheria boydii and aspergillosis can lead to different patterns of radioiodine chest uptake mimicking pulmonary metastases. Pulmonary scarring secondary to tuberculosis may predispose to localized radioiodine accumulation even in the absence of clinically evident active infection. False-positive radioiodine uptake due to pulmonary infection/inflammation should be considered in thyroid cancer patients prior to the diagnosis of pulmonary metastases. (orig.) With 4 figs., 1 tab., 9 refs.

  12. Interleukin 17-Producing γδT Cells Increased in Patients with Active Pulmonary Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Meiyu Peng; Zhaohua Wang; Chunyan Yao; Lina Jiang; Qili Jin; Jing Wang; Baiqing Li

    2008-01-01

    Although it has been known that y8 T cells may play an important role in the immune response to infection of Mycobacterium tuberculosis (M. tb), the mechanisms by which the T8 T cells participate in the innate and/or acquired immunity to tuberculosis (TB) have not been full elucidated. In the present study, 27 patients with active pulmonary TB and 16 healthy donors (HD) were performed. We found that proportion of IL-17-producing cells among lymphocyte was similar between TB patients and HD, whereas the proportions of γδ T cells in IL-17- producing cells (59.2%) and IL-17-producing cells in γδ T cells (19.4%) in peripheral blood were markedly increased in TB patients when compared to those in HD (43.9% and 7.7%, respectively). In addition, the proportions of IFN-γ-producing γδ T cells in TB patients were obviously lower than that in HD. Upon re-stimulated with M. tb heat-treated antigen (M. tb-HAg) in vitro, fewer IL-17-producing γδ T cells were generated from HD and TB patients, whereas IFN-γ-producing γδ T cells were increased in TB patients compared to that in HD. Our findings in TB patients and healthy human were consistent with other murine investigation that the IL-17- producing γδ T cells were main source of IL-17 in mouse model of BCG infection, suggesting that γδ T cells might be involved in the formation of tubercular granuloma in pulmonary TB patients, but need further identification. Cellular & Molecular Immunology. 2008;5(3):203-208.

  13. IL23R(Arg381Gln) functional polymorphism is associated with active pulmonary tuberculosis severity.

    Science.gov (United States)

    Ben-Selma, Walid; Boukadida, Jalel

    2012-08-01

    The purpose of our study was to investigate the association between a functional single nucleotide polymorphism (SNP) in the interleukin-23 receptor gene (IL23R; rs11209026, 1142 G(wild type) → A(reduced function), Arg381Gln) and disease severity outcome in pulmonary tuberculosis (TB) in the Tunisian population. SNP was investigated in a population of 168 patients with active pulmonary TB (cases were stratified into patients with minimal/moderate lung involvement, i.e., patients with minimal/moderate disease [Pmd], and patients with extensive lung involvement, i.e., patients with active disease [Pad]) and 150 healthy subjects. Genotype analyses were carried out using the PCR-restriction fragment length polymorphism method. We have found that the IL23R reduced-function allele 1142A and genotypes AA and AG were overrepresented, especially in the Pad subgroup compared with the control group (51% versus 18% [P = 10(-8)], 33% versus 5% [P = 10(-8)], and 36% versus 26% [P = 5 × 10(-3)], respectively). Additionally, comparison of the Pad and the Pmd groups showed that the A allele and AA genotype seemed to be associated with 2.79-fold (P = 4 × 10(-5)) and 7.74-fold (P = 10(-5)) increased risks of TB with minimal/moderate lung involvement, respectively. Our results demonstrate that the reduced-function polymorphism 1142G → A encoded by IL23R influences the outcome of disease severity of active pulmonary TB in Tunisian patients.

  14. [Hemophagocytic syndrome secondary to cavitary pulmonary tuberculosis].

    Science.gov (United States)

    Rakotoson, J L; Rakotonirainy, O H; Moroyandsa, F; Rakotoharivelo, H; Rakotomizao, J R; Andrianarisoa, A C F

    2012-01-01

    Hemophagocytic syndrome is due to the activation and nonmalignant proliferation of macrophages and T lymphocytes. The purpose of this report is to describe a 25-year-old man who presented with fever, coughing, and weight loss over the past month. Laboratory findings demonstrated pancytopenia, hyperferritinemia, and cytolysis. The myelogram showed a hemophagocytic syndrome, and tuberculosis bacilli were found in the sputum. Chest radiography and thoracic computed tomography depicted a cavitary lesion suggestive of pulmonary tuberculosis. Treatment of tuberculosis alone, without an immunosuppressant agent, was effective and led to improvement. In a country where tuberculosis is highly endemic, hemophagocytic syndrome should be considered in the differential diagnosis of patients with active tuberculosis complicated by pancytopenia.

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

    OpenAIRE

    Tshering Ongmu Bhutia; Luna Adhikari

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Uzum, Kazim; Karahan, Okkes I.; Dogan, Sukru; Coskun, Abdulhakim E-mail: coskuna@erciyes.edu.tr; Topcu, Faik

    2003-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  18. miRNA Signatures in Sera of Patients with Active Pulmonary Tuberculosis

    Science.gov (United States)

    Valente, Ilaria C.; Norbis, Luca; Sotgiu, Giovanni; Bosu, Roberta; Ambrosi, Alessandro; Codecasa, Luigi R.; Goletti, Delia; Matteelli, Alberto; Ntinginya, Elias N.; Aloi, Francesco; Heinrich, Norbert; Reither, Klaus; Cirillo, Daniela M.

    2013-01-01

    Several studies showed that assessing levels of specific circulating microRNAs (miRNAs) is a non-invasive, rapid, and accurate method for diagnosing diseases or detecting alterations in physiological conditions. We aimed to identify a serum miRNA signature to be used for the diagnosis of tuberculosis (TB). To account for variations due to the genetic makeup, we enrolled adults from two study settings in Europe and Africa. The following categories of subjects were considered: healthy (H), active pulmonary TB (PTB), active pulmonary TB, HIV co-infected (PTB/HIV), latent TB infection (LTBI), other pulmonary infections (OPI), and active extra-pulmonary TB (EPTB). Sera from 10 subjects of the same category were pooled and, after total RNA extraction, screened for miRNA levels by TaqMan low-density arrays. After identification of “relevant miRNAs”, we refined the serum miRNA signature discriminating between H and PTB on individual subjects. Signatures were analyzed for their diagnostic performances using a multivariate logistic model and a Relevance Vector Machine (RVM) model. A leave-one-out-cross-validation (LOOCV) approach was adopted for assessing how both models could perform in practice. The analysis on pooled specimens identified selected miRNAs as discriminatory for the categories analyzed. On individual serum samples, we showed that 15 miRNAs serve as signature for H and PTB categories with a diagnostic accuracy of 82% (CI 70.2–90.0), and 77% (CI 64.2–85.9) in a RVM and a logistic classification model, respectively. Considering the different ethnicity, by selecting the specific signature for the European group (10 miRNAs) the diagnostic accuracy increased up to 83% (CI 68.1–92.1), and 81% (65.0–90.3), respectively. The African-specific signature (12 miRNAs) increased the diagnostic accuracy up to 95% (CI 76.4–99.1), and 100% (83.9–100.0), respectively. Serum miRNA signatures represent an interesting source of biomarkers for TB disease with the

  19. miRNA signatures in sera of patients with active pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Paolo Miotto

    Full Text Available Several studies showed that assessing levels of specific circulating microRNAs (miRNAs is a non-invasive, rapid, and accurate method for diagnosing diseases or detecting alterations in physiological conditions. We aimed to identify a serum miRNA signature to be used for the diagnosis of tuberculosis (TB. To account for variations due to the genetic makeup, we enrolled adults from two study settings in Europe and Africa. The following categories of subjects were considered: healthy (H, active pulmonary TB (PTB, active pulmonary TB, HIV co-infected (PTB/HIV, latent TB infection (LTBI, other pulmonary infections (OPI, and active extra-pulmonary TB (EPTB. Sera from 10 subjects of the same category were pooled and, after total RNA extraction, screened for miRNA levels by TaqMan low-density arrays. After identification of "relevant miRNAs", we refined the serum miRNA signature discriminating between H and PTB on individual subjects. Signatures were analyzed for their diagnostic performances using a multivariate logistic model and a Relevance Vector Machine (RVM model. A leave-one-out-cross-validation (LOOCV approach was adopted for assessing how both models could perform in practice. The analysis on pooled specimens identified selected miRNAs as discriminatory for the categories analyzed. On individual serum samples, we showed that 15 miRNAs serve as signature for H and PTB categories with a diagnostic accuracy of 82% (CI 70.2-90.0, and 77% (CI 64.2-85.9 in a RVM and a logistic classification model, respectively. Considering the different ethnicity, by selecting the specific signature for the European group (10 miRNAs the diagnostic accuracy increased up to 83% (CI 68.1-92.1, and 81% (65.0-90.3, respectively. The African-specific signature (12 miRNAs increased the diagnostic accuracy up to 95% (CI 76.4-99.1, and 100% (83.9-100.0, respectively. Serum miRNA signatures represent an interesting source of biomarkers for TB disease with the potential to

  20. A cross sectional survey on the prevalence of active pulmonary tuberculosis in three ‘key’ elderly population

    Institute of Scientific and Technical Information of China (English)

    李曙光

    2014-01-01

    Objective To conduct a survey on the prevalence of active pulmonary tuberculosis among 65 year olds or above.Study subjects would include those with characteristics of TB suspicious symptoms,diabetes and close contacts.Methods Purpose-sampling method was applied to choose 3 counties in Shandong province as the study sites,relying on the local basic public health service,for those elderly under 65 years old or above.The

  1. Tomographic Aspects of Advanced Active Pulmonary Tuberculosis and Evaluation of Sequelae following Treatment

    Directory of Open Access Journals (Sweden)

    Rafael Barcelos Capone

    2017-01-01

    Full Text Available Objectives. To evaluate tomographic changes in pulmonary tuberculosis (TB, degree of agreement among three radiologists regarding tomographic diagnoses, and sequelae following treatment. Methods. Cross-sectional and descriptive study of 74 TB patients confirmed by sputum culture and chest computed tomography before (CT1 and 6 months after (CT2 drug therapy. Results were performed by three radiologists blinded to clinical and laboratory results. Results. Main findings in CT1 included nodules indicating the presence of a tree-in-bud pattern in 93% of cases, ill-defined nodules in 84% of cases, consolidation in 77% of cases, architectural distortion in 71% of cases, cavitary lesions in 62% of cases, and ground glass opacities in 37% of cases. Airway involvement, characterized by increased thickness and dilatation of the bronchial walls, occurred in 93% of cases. Pleural involvement occurred in 54%. There was an agreement on active TB among the three radiologists in 85% of cases. The results in CT2 indicated the presence of architectural distortion in 91% of cases and cylindrical bronchiectasis in 86%. Conclusions. The study established a tomographic pattern for diagnosis of active TB characterized by the presence of airway nodules, consolidation, architectural distortion, and cavitary lesions, and an almost complete degree of agreement (Kappa was observed among the radiologists (0.85. CT after treatment assists in defining the cure.

  2. Tc-99m Ciprofloxacin SPECT of Pulmonary Tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-06-15

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

  3. [Update on the radiological study of pulmonary tuberculosis].

    Science.gov (United States)

    Navarro Ballester, A; Marco Domenech, S F

    2015-01-01

    Tuberculosis has made a comeback in recent years. This upsurge has been attributed to factors such as increased immigration and the human immunodeficiency virus epidemic. Primary pulmonary tuberculosis manifests radiologically with parenchymal involvement, lymph node involvement, pleural effusion, and/or miliary disease. In post-primary tuberculosis, the earliest radiological sign is small nodules and branching centrilobular lesions that increase in size and coalesce to form ill-defined patchy consolidations; cavitations are very characteristic of active disease. The aim of this article is to describe the radiologic findings for pulmonary tuberculosis and its complications.

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

    Directory of Open Access Journals (Sweden)

    Alejandra Otazo M

    2012-12-01

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

  5. MCP-1 -2518 A/G functional polymorphism is associated with increased susceptibility to active pulmonary tuberculosis in Tunisian patients.

    Science.gov (United States)

    Ben-Selma, Walid; Harizi, Hedi; Boukadida, Jalel

    2011-11-01

    Monocyte chemoattractant protein-1 (MCP-1) plays crucial role in protective immunity against Mycobacterium tuberculosis (MT). In this study, we examined whether single nucleotide polymorphism (SNP) -2518 A/G (rs 1024611) of MCP-1 affect the susceptibility to active tuberculosis (TB) in Tunisian populations. Genomic DNA from patients with active TB (168 cases of pulmonary TB and 55 cases of extrapulmonary TB) and ethnically controls (150 cases) was genotyped for the MCP-1 -2518 A/G SNP by polymerase chain reaction fragment length polymorphism (PCR-RFLP). We observed that -2518 G allele and GG genotype (high MCP-1 producer) frequencies were significantly more elevated in active pulmonary TB group in comparison to control group [34 vs. 22%; P = 0.0007; 15 vs. 5%, P corrected for the number of genotypes (Pc) = 0.015; respectively]. Additionally, they were associated with increased risk development of this clinical form of TB [odds ratio (OR) = 1.83, 95% confidence intervals (CI) = 1.26-2.66; OR = 3.1, 95% CI = 1.28-7.76; respectively]. However, wild type allele -2518 A and AA genotype were over-represented in control group (78 and 62%) and seem to be protective factors against TB. Moreover, -2518 AA genotype was more frequent in control group and was associated with resistance against development of active pulmonary TB (OR = 0.56, 95% CI = 0.35-0.89, Pc = 0.03). Our findings confirm the key role of -2518 A/G SNP of MCP-1 and support its association with resistance/susceptibility to the development of active pulmonary TB in the Tunisian population.

  6. Rheumatoid arthritis increases the risk of nontuberculosis mycobacterial disease and active pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Jun-Jun Yeh

    Full Text Available BACKGROUND: Few studies have examined the association of rheumatoid arthritis (RA with nontuberculosis mycobacterium (NTM disease and pulmonary tuberculosis (PTB. METHODS: We identified 29 131 patients with RA from the catastrophic illness registry who were diagnosed from 1998-2008; 116 524 patients without RA from inpatient data files were randomly frequency matched according to sex, age, and index year and used as a comparison group. Both groups were followed-up until the end of 2010 to measure the incidence of NTM disease and active PTB. We analyzed the risk of NTM disease and active PTB using the Cox proportional hazards regression models, controlling for sex, age, and Charlson comorbidity index (CCI. RESULTS: The incidence of NTM disease was 4.22 times greater in the RA group than in the non-RA group (1.91 vs 0.45 per 10,000 person-years. The incidence of PTB was 2.99 times greater in the RA group than in the non-RA group (25.3 vs 8.46 per 10,000 person-years. After adjusting for age, sex, and CCI, the adjusted hazard ratios (HRs of NTM disease and active PTB for the RA group were 4.17 (95% CI = 2.61-6.65 and 2.87 (95% CI = 2.55-3.23, respectively, compared with the non-RA group. In the first 2 years of follow-up, the RA group yielded corresponding adjusted HRs of 4.98 and 3.39 compared with the non-RA group. The follow-up time-specific RA group to the non-RA group HR of both the NTM disease and active PTB varied. CONCLUSION: This study can serve as a reference for clinical physicians to increase awareness regarding the detection of NTM disease and active PTB in RA patients among the any stage of the clinical course even without CCI.

  7. Increased specific T cell cytokine responses in patients with active pulmonary tuberculosis from Central Africa.

    Science.gov (United States)

    Winkler, Stefan; Necek, Magdalena; Winkler, Heidi; Adegnika, Ayola A; Perkmann, Thomas; Ramharter, Michael; Kremsner, Peter G

    2005-07-01

    An understanding of T cell responses that are crucial for control of Mycobacterium tuberculosis (MTB) has major implications for the development of immune-based interventions. We studied the frequency of purified protein derivative (PPD)-specific CD3) cells expressing interleukin-2 (IL)-2, gamma interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha and IL-10 in HIV-negative pulmonary tuberculosis patients (TB, n=30) as well as in healthy individuals (controls, n=21) from Central Africa. Increased frequencies of PPD-stimulated CD3+ cells expressing IL-2, IFN-gamma, and TNF-alpha in TB were seen when compared with frequencies of controls. The presence of type 1 cytokine biased responses in TB patients was supported by a shift in the distribution pattern of cytokine expression from exclusively IL-2 or TNF-alpha expression seen in controls towards an increased frequency of IFN-gamma/IL-2 or IFN-gamma/TNF-alpha co-expression in TB. Higher levels of PPD-induced IFN-gamma in the supernatants from TB patients than from controls were found, which correlated with its intracellular expression. PPD was a weak inducer of IL-10 in T cells and insufficient in promoting cytokine production in TCRgammadelta+CD3+ cells. Non-specific stimulation with PMA and ionomycin revealed increased frequencies of CD4+ cells expressing IFN-gamma in controls, while expression of IL-2, IL-4, IL-10, IL-13, and TNF-alpha was not different. Non-specific cytokine responses of TCRgammadelta+CD3+ cells were similar in all groups. Pulmonary TB in Central Africa is associated with enhanced expression and secretion of specifically induced cytokines that are frequently implicated in host defense against MTB.

  8. Interferon gamma +874T/A polymorphism is associated with susceptibility to active pulmonary tuberculosis development in Tunisian patients.

    Science.gov (United States)

    Ben Selma, Walid; Harizi, Hedi; Bougmiza, Iheb; Hannachi, Naila; Ben Kahla, Imen; Zaieni, Radhia; Boukadida, Jalel

    2011-06-01

    Interferon gamma (IFN-γ) is a key cytokine involved mainly in the defense against intracellular pathogens such as Mycobacterium tuberculosis. Given its key role in the control of tuberculosis (TB), in the present article we have investigated a possible association between IFN-γ gene single-nucleotide polymorphism linked to high and low producer phenotypes (IFN-γ [+874T(high) → A(low)]) (rs2430561) and risk development of active TB in Tunisian patients. Genomic DNA samples were obtained from 223 patients with active TB (168 pulmonary and 55 extrapulmonary cases) and 150 healthy blood donors. Genotypes were analyzed using polymerase chain reaction-restriction fragment length polymorphism method. The +874 AA genotype (low IFN-γ producer) was significantly associated with increased risk of developing of active pulmonary TB (odds ratio [OR] = 2.18; 95% confidence intervals [CI], 1.33-3.57; P corrected for the number of genotypes [Pc] = 0.003). By contrast, the AT genotype was found to be significantly associated with resistance to pulmonary TB (OR = 0.46; 95% CI, 0.28-0.74; Pc = 0.0018) and extrapulmonary TB development (OR = 0.46; 95% CI, 0.23-0.91; Pc = 0.045). Collectively, our data showed that the IFN-γ +874T/A polymorphism is a determinant in the resistance or susceptibility to the development of active TB in the studied population.

  9. Increased levels of BAFF and APRIL related to human active pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Kai Liu

    Full Text Available BACKGROUND: Despite great efforts to improve diagnosis and treatment, tuberculosis (TB remains a major health problem worldwide, especially in developing countries. Lack of concrete immune markers is still the obstacle to properly evaluate active TB. Therefore, identification of more validated biomarkers and phenotypic signatures is imperative. In particular, T cell-related biomarkers are more significant. METHODOLOGY: To understand the nature of CD4(+ T cell-derived signatures involved in infection and disease development, we examined and analyzed whole genome expression profiles of purified CD4(+ T cells from healthy individuals (HD, two distinct populations with latent infection (with low or high IFN-γ levels, LTB(L/LTB(H and untreated TB patients. Following, we validated the expression profiles of genes in the peripheral CD4(+ T cells from each group and examined secretion levels of distinct cytokines in serum and pleural effusion. PRINCIPAL FINDINGS: Our bio-informatic analyses indicate that the two latent populations and clinical TB patients possess distinct CD4(+ T cell gene expression profiles. Furthermore, The mRNA and protein expression levels of B cell activating factor (BAFF, which belongs to the TNF family, and a proliferation-inducing ligand (APRIL were markedly up-regulated at the disease stage. In particular, the dramatic enhancement of BAFF and APRIL in the pleural effusion of patients with tuberculosis pleurisy suggests that these proteins may present disease status. In addition, we found that the BAFF/APRIL system was closely related to the Th1 immune response. Our study delineates previously unreported roles of BAFF and APRIL in the development of tuberculosis, and these findings have implications for the diagnosis of the disease. Our study also identifies a number of transcriptional signatures in CD4(+ T cells that have the potential to be utilized as diagnostic and prognostic tools to combat the tuberculosis epidemic.

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

    Directory of Open Access Journals (Sweden)

    Tshering Ongmu Bhutia

    2015-01-01

    Full Text Available Background: This study was carried with the main objectives: (1 to find out the occurrence of pulmonary mycoses in clinically suspected pulmonary tuberculosis cases at central referral hospital, Tadong, Sikkim. (2 To find out the various fungi causing pulmonary mycoses in clinically suspected pulmonary tuberculosis cases. Methods: 200 clinically suspected pulmonary tuberculosis cases who visited the department of microbiology for the diagnostic microscopic examination of sputum sample for acid fast bacilli were included in this cross sectional study, carried out under the department of microbiology, Sikkim Manipal institute of medical sciences, over one year. Smears of sputum samples were examined microscopically for acid fast bacilli and fungal elements. Sputum samples were also plated onto different fungal culture media. Results: Out of 200 patients, various types of pathogens were detected in 54 (27% patients. Fourteen (7% patients were positive only for AFB, while fungus as a primary etiological agent was detected in 16(8% patients. Fungus as a secondary etiological agent was detected in 4 (2% patients [AFB with fungus in 2 (1%, AFB with fungus and bacteria in 1 (0.5% and bacteria with fungus in 1 (0.5% patient]. Conclusion: Pulmonary mycosis can be a primary infection in non- tuberculosis cases or co-infection in pulmonary tuberculosis cases. Investigation for fungal cause in clinically suspected cases of pulmonary tuberculosis will prevent misdiagnosis and mistreatment of cases. [Int J Res Med Sci 2015; 3(1.000: 260-268

  11. PECULIARITIES OF THE FUNCTIONAL ACTIVITY OF BLOOD EOSINOPHIL GRANULOCYTES IN PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Yu. V. Kolobovnikova

    2014-01-01

    Full Text Available Eosinophils are polyfunctional leukocytes detected in excess in blood and in the focus of granulomatous inflammation in pulmonary TB.The research objective was to evaluate the adhesive properties as well as cytokine-secretory and antibacterial activity of blood eosinophils in pulmonary TB.The research has been conducted on eosinophils isolated from peripheral blood of 43 patients with freshly identified progressive destructive TB with and without eosinophilia. Using flow cytometry and ELISA, expression of CD9 and CD18 adhesion molecules on blood eosinophils has been studied along with the phagocyte and cytokine-secretory functions and activity of eosinophil granulocyte peroxidase.As a result of the research it has been established that in TB patients with eosinophilia the number of CD18-expressing eosinophils rises, whereas the amount of CD9+ remains within norm. Activation of the phagocyte function of blood eosinophil granulocytes is associated with the decrease in eosinophil peroxidase activity, while the increase in IL-5 and TNFα secretory reactivity is connected with oppositely directed changes in  IL-2 basal secretion by eosinophils in vitro (a fall in infiltrative TB and a rise in disseminated TB.

  12. DIFFERENCES BETWEEN PEDIATRIC PULMONARY AND EXTRA-PULMONARY TUBERCULOSIS: A WARNING SIGN FOR THE FUTURE

    Directory of Open Access Journals (Sweden)

    Ilker Devrim

    2014-08-01

    Full Text Available Introduction: Tuberculosis (TB remains a major global health problem affecting millions of people annually. Tuberculosis in children has unique features different from adults which makes the diagnosis to be more difficult. The spectrum of the symptoms of TB in children could vary from non-specific symptoms to severe clinical presentations.  In this study, we reviewed our experience at pediatric patients with active TB admitted in a tertiary hospital  and aimed to compare the epide­miological, clinical and microbiological features of  children with  the extra-pulmonary tuberculosis(EPTB and pulmonary tuberculosis(PTB. Material and methods: Patients under 14 years of age diagnosed with active TB in our unit between December 2008 and September 2013 were included in the study. Data including demographic characteristics, clinical history, microbiology, imaging studies, medications and outcomes of the patients were collected from medical records. Results: A total of 129 cases of active TB were identified.  Ninety-two (78.6% of the cases had Pulmonary Tuberculosis and 25 (21.4% of the cases had Extra-pulmonary tuberculosis. The most common signs and symptoms on admission were fever in 40 cases (34.2% and cough in 81 cases (69.2%. The number of patients without symptoms including fever, cough, malaise and weight loss were significantly higher in EXPTB (72.0% group when compared with patients in PTB group (13.0% (p 0.05. The detection rate of source in PTB group (42.4% was significantly higher than the rate in  EPTB group (20.0%( p=0.04. In the drug-resistant group, no source of infection could be established in 5 of 9 patients (55.5%. Conclusions: Extra-pulmonary tuberculosis diagnosis is more difficult than Pulmonary tuberculosis in children due to the various problems such as absence of associated pulmonary involvement,  lack of constitutional symptoms and negative tuberculosis exposure history compared to Pulmonary Tuberculosis. New

  13. The prevalence of pulmonary tuberculosis in Jeonbug Province

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, S. J.; Moon, M. C.; Song, H. Y.; Choi, K. C. [Jeonbug Natinal University College of Medicine, Jeonju (Korea, Republic of)

    1981-12-15

    A photofluorographic mass survey of P-A chest had been done to the 13136 residents (male 6264, female 6872) in Jeonbug province, Korea for about 2 years from May 5, to Dec.19, 1978 and from Mar. 5, to Dec. 22, 1979. The results are as follows: 1. The prevalence rate of all active pulmonary tuberculosis is 5.3%. 2. The prevalence rate of male(8.8%) is 4.2 times higher than that of female (2.1%). 3. The prevalence rates of all old age groups above fifty years are higher than that of remainder under fifty years of age. Of these, 61-70 years old age group is highest in prevalence rate. 4. According to extent of active pulmonary tuberculosis, 77.5% is minimal, 15.4% is moderately advanced, and 7.1% is far advanced. Inactive pulmonary tuberculosis are 39 cases (0.3% to objective population). 5. In the incidence of the involved side, right side is about 2 times higher than the left, and involvement of both sides is increased in moderately and far advance pulmonary tuberculosis. In all pulmonary tuberculosis, one or both upper lung fields are most commonly involved. The incidences of cavity in moderately and far advanced pulmonary tuberculosis show no significant difference. 6. The incidences of other intrathoracic lesions are as follows: suspected hypertensive heart disease 2.4%, dextrocardia with situs inversus 0.04%, pleural calcification 0.4%, pleural thickening 0.2%, pleural effusion 0.1%, pneumonia 0.02%, bronchiectasis 0.1%, lung abscess 0.02%, C.O.P.D. 0.2%, suspected lung tumor 0.06%, pneumothorax 0.0076%, and suspected mediastinal tumor 0.02%.

  14. STUDY OF PULMONARY FUNCTION IMPAIRMENT BY SPIROMETRY IN POST PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Sailaja

    2015-05-01

    Full Text Available Often pulmonary Tuberculosis patients declared cured will have residual respiratory disability due to impaired pulmonary function that will have impact on their daily activities . OBJECT IVES : To study pulmonary function impairment in treated pulmonary tuberculosis patients . D ESIGN : P rospective observational study - conducted from Jan 2014 to D ec 2014. METHODOLOG Y : Adult patients treated for pulmonary Tuberculosis under DOTS or Daily regimen and declared cured and presenting with dyspnea are studied . History regarding smoking , bronchial asthma , Interstial lung disease , occupational exposure are taken and if present are excluded from the study . History and clinical features suggestive of reactivation of Tuberculosis if present also excluded from the study . Simple spirometry done to all selected patients . Pre and post bronchodilator FEV 1 , FVC , FEV 1 /FVC recorded . RESULTS : 56 patients satisisfying the criteria are included in the study . In 62 . 5% Obstructive , 16 . 07% Restrictive and 21 . 42% Mixed abnormality detected . CONCLUSIONS : Obstructive , Restrictive and mixed type pattern are seen in treated pulmonary Tuberculosis patients but Obstructive patternof various degree is more common .

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

    Directory of Open Access Journals (Sweden)

    S. Buldeo

    2012-01-01

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

  16. Imagem em tuberculose pulmonar Pulmonary tuberculosis imaging

    Directory of Open Access Journals (Sweden)

    SIDNEY BOMBARDA

    2001-11-01

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

  17. [Tuberculous cheilitis revealing pulmonary tuberculosis].

    Science.gov (United States)

    Bricha, Myriem; Slimani, Hajar; Hammi, Sanae; Bourkadi, Jamal Eddine

    2016-01-01

    Tuberculosis of the oral cavity is rare. It is associated with clinical polymorphism and poses above all a diagnostic problem. We report the case of a 42-year-old male patient with tubercular cheilitis. This study aims to focus attention on tuberculosis that can be detected exceptionally in specific locations, such as the oral lip.

  18. Cavitary pulmonary tuberculosis HIV-related

    Energy Technology Data Exchange (ETDEWEB)

    Busi Rizzi, Elisa E-mail: radiologia@inmi.it; Schinina, Vincenzo; Palmieri, Fabrizio; Girardi, Enrico; Bibbolino, Corrado

    2004-11-01

    Introduction: It was usually assumed that pulmonary tuberculosis (TB) in HIV-seropositive patients represents reactivation TB, despite the radiographic appearance frequently consistent rather with a recent disease. Hence, these radiographic features were considered 'atypical'. We have hypothesised that the so called 'atypical' radiographic features could be due to a greater proportion of primary TB among these patients, representing the typical appearance of primary radiological pattern. Material and methods: We reviewed chest imaging of 219 HIV+ patients with microbiological proven pulmonary tuberculosis, who were assessed for the presence, number, distribution of cavitations and for associated pulmonary parenchymal abnormalities, adenopathies and pleural effusion, and were classified as a primary or post-primary pattern. Results: The patients with post-primary pattern were 50%, and the rate of cavitation was 63%, not wandering off the general population. Cavities still occurred with similar proportion in groups with CD4 <200 or >200 cells/mm{sup 3}. Conclusion: We suggest that HIV-related pulmonary tuberculosis is typical in its radiological appearances, consistent with those of the general population, and this could be confirmed by the most recent molecular epidemiological techniques that allow to definitely classify the tuberculosis episodes as either primary or post-primary disease.

  19. A CLINICAL STUDY OF PULMONARY TUBERCULOSIS AMONG DIABETES MELLITUS PATIENTS

    Directory of Open Access Journals (Sweden)

    Mojjada Dhanunjaya

    2015-09-01

    Full Text Available Of all the non - tuberculosis complications associated with disease, Diabetes Mellitus exerts, the most adverse influence on the course of pulmonary tuberculosis. The combined diagnosis was invariably fatal before Specific anti tuberculous and anti - diabetic drugs were available. As per new diabetes guidelines, every diabetic patient should be under gone screening for Pulmonary Tuberculosis. We conducted a clinical study of 60 Patients with Diabetes and Pulmonary Tuberculosis. For establishment of Diagnosis Ch est X – ray and Sputum for AFB were done for pulmonary tuberculosis and both blood & Urine Sugar were done for Diabetes Mellitus.

  20. SPECIFIC GYRB SEQUENCE OF MYCOBACTERIUM TUBERCULOSIS CLINICAL ISOLATED FROM SPUTUM OF PULMONARY TUBERCULOSIS PATIENTS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    N. M. Mertaniasih

    2014-12-01

    Full Text Available Background: Indonesia have many different geographic areas which could be various on the variant strains of Mycobacterium tuberculosis. The gyrB gene codes GyrB protein as sub unit compound of Gyrase enzyme that functioning in multiplication of bacteria. Detection of gyrB gene could be a marker of active multiplication of viable bacteria in the specimen from patients; and some of the DNA sequence regions were conserved and specific in the strain of Mycobacterium tuberculosis that would be a marker for identification. This research aims to analyze the sequence of gyrB gene of Mycobacterium tuberculosis clinical isolates from sputum of pulmonary TB patients in Indonesia, and determine the specific region. Method: Mycobacterium tuberculosis clinical isolates have been collected from sputum of the patients with pulmonary TB that live in some area in Indonesia. Isolation and identification of Mycobacterium tuberculosis clinical isolates using standard culture method; sequence analysis using PCR-direct sequencing of the part bases region of gyrB. Results: this study revealed that nucleotide sequence on a fragment 764 bases of gyrB gene Mycobacterium tuberculosis strains among clinical isolates almost identically to a wild type strain Mycobacterium tuberculosis H37Rv and subspecies member of Mycobacterium tuberculosis complex (MTBC, with a little difference of SNPs; there are many difference nucleotide sequence with MOTT and Gram positive or negative bacteria, except Corynebacterium diphtheriae identically with MTBC. Conclusion: the gyrB sequence in Mycobacterium tuberculosis strains among these clinical isolates from sputum of pulmonary TB patients in Indonesia have the conserved specific DNA region that almost identically with wild type strain H37Rv and MTBC.

  1. Pulmonary tuberculosis specificities in smokers

    Directory of Open Access Journals (Sweden)

    Rhanim Aziza

    2015-10-01

    Conclusion: Our study raised the harmful impact of smoking on the clinical and radiological presentation of tuberculosis, and late bacteriological negativity, therefore we need to integrate smoking control into the national TB control program.

  2. 78 FR 66744 - Draft Guidance for Industry on Pulmonary Tuberculosis: Developing Drugs for Treatment; Availability

    Science.gov (United States)

    2013-11-06

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Pulmonary Tuberculosis... industry entitled ``Pulmonary Tuberculosis: Developing Drugs for Treatment.'' The purpose of the draft... guidance for industry entitled ``Pulmonary Tuberculosis: Developing Drugs for Treatment.'' The purpose...

  3. Intrathoracic goitre associated with pulmonary tuberculosis.

    Science.gov (United States)

    Garg, Tinu; Gera, Kamal; Modi, Nikhil; Shah, Ashok

    2015-04-01

    Intrathoracic goitre is an uncommon condition which usually occurs in females in the fifth decade. It can cause compression of several mediastinal structures. A 42-year-old female with goitre since childhood was evaluated for dry cough, occasional wheezing and low grade fever. Imaging showed patchy airspace opacities with cavitation in left lung. Imaging of the neck revealed retrosternal extension of the goitre. Stains and cultures of bronchial aspirate were positive for Mycobacterium tuberculosis. A diagnosis of pulmonary tuberculosis with intrathoracic goitre was established, an unusual association.

  4. [Heterogeneity of pulmonary fibroblasts in tuberculosis].

    Science.gov (United States)

    Kogan, E A; Sekamova, S M; Bogadel'nikova, I V; Vitukhnovskaia, L A; Fipps, R; Perel'man, M I; Serov, V V

    1997-01-01

    Chronic inflammation and pneumofibrosis are the central events in tuberculosis morphogenesis. It was suggested that a certain type of fibroblasts may play a role in chronization of the inflammation and development of sclerosis in tuberculosis. Fibrous tissue from the foci of secondary tuberculosis (fibrous-cavernous tuberculosis and tuberculomas) of 35 patients were studied light- and electron-microscopically and immunohistochemically. (THY 1-)fibroblasts non-containing lipids and producing insulin-like growth factor 2 (ILGF 2), binding proteins 2 and 4 and epidermal growth factor receptors were found in the foci of secondary tuberculosis close to the granulomatous inflammation and in the new and scarrous fibrous connective tissue of the tuberculoma capsule and caverna walls. These fibroblasts are able for auto- and paracrine regulation of the proliferation of fibroblasts, epithelium and other cells in the inflammatory foci. (THY 1+) fibroblasts containing lipids were observed in the foci of old sclerotic changes among the rough collagen fibres. Thus, (THY 1-) fibroblasts probably play a key role in chronization of inflammation, proliferation and pretumorous dysplasia of pulmonary epithelium in secondary tuberculosis. (THY 1+) fibroblasts containing lipids may show more pronounced collagenesis and may persist under hypoxia condition in the collagenous scars for a long time.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  6. Reactivation of Pulmonary Tuberculosis following Treatment of Myelofibrosis with Ruxolitinib

    Directory of Open Access Journals (Sweden)

    Maheen Z. Abidi

    2016-01-01

    Full Text Available Ruxolitinib is widely in use for treatment of myeloproliferative disorders. It causes inhibition of the Janus kinase (JAK signal transducer and activation of transcription (STAT pathway, which plays a key role in the underlying pathophysiology of myeloproliferative diseases. We describe a case of reactivation pulmonary tuberculosis in a retired physician while on treatment with ruxolitinib. We also review the literature on opportunistic infections following use of ruxolitinib. Our case highlights the importance of screening for latent tuberculosis in patients from highly endemic areas prior to start of therapy with ruxolitinib.

  7. Mycobactericidal activity of sutezolid (PNU-100480 in sputum (EBA and blood (WBA of patients with pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Robert S Wallis

    Full Text Available RATIONALE: Sutezolid (PNU-100480 is a linezolid analog with superior bactericidal activity against Mycobacterium tuberculosis in the hollow fiber, whole blood and mouse models. Like linezolid, it is unaffected by mutations conferring resistance to standard TB drugs. This study of sutezolid is its first in tuberculosis patients. METHODS: Sputum smear positive tuberculosis patients were randomly assigned to sutezolid 600 mg BID (N = 25 or 1200 mg QD (N = 25, or standard 4-drug therapy (N = 9 for the first 14 days of treatment. Effects on mycobacterial burden in sputum (early bactericidal activity or EBA were monitored as colony counts on agar and time to positivity in automated liquid culture. Bactericidal activity was also measured in ex vivo whole blood cultures (whole blood bactericidal activity or WBA inoculated with M. tuberculosis H37Rv. RESULTS: All patients completed assigned treatments and began subsequent standard TB treatment according to protocol. The 90% confidence intervals (CI for bactericidal activity in sputum over the 14 day interval excluded zero for all treatments and both monitoring methods, as did those for cumulative WBA. There were no treatment-related serious adverse events, premature discontinuations, or dose reductions due to laboratory abnormalities. There was no effect on the QT interval. Seven sutezolid-treated patients (14% had transient, asymptomatic ALT elevations to 173±34 U/L on day 14 that subsequently normalized promptly; none met Hy's criteria for serious liver injury. CONCLUSIONS: The mycobactericidal activity of sutezolid 600 mg BID or 1200 mg QD was readily detected in sputum and blood. Both schedules were generally safe and well tolerated. Further studies of sutezolid in tuberculosis treatment are warranted. TRIAL REGISTRATION: ClinicalTrials.gov NCT01225640.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-01-01

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

  9. Rapid isolation and identification of Mycobacterium tuberculosis from pulmonary tuberculosis patients

    Institute of Scientific and Technical Information of China (English)

    Al-Sulami AA; Ali ZM; Al-Maleky DA

    2009-01-01

    Objective:The Study aimed to develop a rapid inexpensive and simple method for preliminary isolation and detection of M.tuberculosis from clinical specimens.Also to probe the impact of deteriorating health measures on the pulmonary tuberculosis control program in Basra city.Methods:A simple monophasic-diphasic setup (MDCS)was used for the isolation and preliminary identification of M.tuberculosis.This setup consists of a slanted Lowenstein-Jensen medium,the bottom of it is covered with 1 mL of tuberculosis broth thus establishing a diphasic solid liquid environment at the bottom of the screw capped test tube and above them a monophasic one.Results:During 7 months period from the beginning of December 2003 to the end of June 2004,1 295 cases were managed in Tuberculosis and Chest Diseases Clinic in Basra city.Only 348 cases were diagnosed as active pulmonary tuberculosis.They consist of 232 new cases and 116 previously registered ones.The MDCS method showed higher recovery of isolation rate of M.tuberculosis (92.3%)than Lowenstein-Jensen,and pyruvate methods with 78.1% and 51.9% respectively.Also this method revealed more rapid appearance of results of 12 days than Lowenstein-Jensen,and pyruvate media with 22 days and 23 days respectively by the traditional culturing methods.Concurrently the study revealed that drug resistance against one or more anti tu-berculosis drugs was 23.1% for new cases and 70.8% for the old ones.Multi drug resistance accounts for 20% of total isolates from old cases.This was based on using the critical concentration and 1% proportional procedures.Tuberculosis was more common among males than females with 69.4% and 30.6% respectively. A significant correlation (P <0.05)was found between the productive age group (25-54)and incidence of tu-berculosis.Tuberculosis was higher among married (83.8%)than unmarried peoples (22%).Children,hus-bands and wives showed higher infection rates than others indicating kinship influence.Failure of treatment

  10. The history of surgery for pulmonary tuberculosis.

    Science.gov (United States)

    Odell, John A

    2012-08-01

    Thoracic surgical procedures evolved from surgical management of tuberculosis; lung resections, muscle flaps, and thoracoscopy all began with efforts to control the disease. The discovery of antituberculosis drugs in 1944 to 1946 made sanatorium therapy and collapse therapy in all its forms obsolete and changed thoracic surgery dramatically. Currently, management of tuberculosis is primarily medical, and surgery has a minimal role. Today surgery is usually only performed in patients with tuberculosis when the diagnosis is necessary, who have complications or sequelae of the disease, or who have active disease resistant to therapy.

  11. Active Case Finding of Pulmonary Tuberculosis through Screening of Respiratory Symptomatics Using Sputum Microscopy: Is It Time to Change the Paradigm?

    Directory of Open Access Journals (Sweden)

    Eva Carolina del Portillo-Mustieles

    2013-01-01

    Full Text Available Background. One of the main strategies for the early detection of pulmonary tuberculosis (PTB is through the screening of individuals with symptoms compatible with PTB. Although this is programmatic strategy for active case finding, its yield is not well known. Objective. To determine the yield of pulmonary tuberculosis active case finding through the screening of respiratory symptomatic (RS patients at a general hospital. Methods. RS patients were defined as subjects complaining of cough and/or sputum for a period of 2 or more weeks. Outpatients and their companions were approached while they waited in the outpatient care areas of the hospital to detect RS. Two samples from different days or 2 samples taken 2 hours apart on the same day were collected. Results. 122 RS patients were identified. Fifty-seven patients (46.7% had at least one sputum sample analyzed. Three patients presented a positive smear and 2 were culture positive; neither had upper airway symptoms. None of the patients with productive cough and upper airway symptoms had a positive smear (. Only 19 (33.3% returned to the laboratory to retrieve their results. Conclusion. Current strategy to screen RS patients based only on clinical data has a low compliance. Specific strategies to increase compliance (removal of barriers, incentives, etc. should be implemented.

  12. CT imaging of coexisting pulmonary tuberculosis and lung cancer

    Institute of Scientific and Technical Information of China (English)

    吕岩

    2013-01-01

    Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer. Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination. All patients were divided into two groups,group

  13. Antigen induced production of υ-interferon ex vivo, in the peripheral blood of patients with active pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Z. M. Zagdyn

    2013-01-01

    Full Text Available Tuberculosis (TB is one of the most significant problems in the Russian Health Care. Russia remains on the list of the 22 countries with a high TB incidence and on the third place in the world with a high prevalence of Drug Resistant TB [1]. It is urgently needed to develop new TB diagnostic methods as well as effective measures of the specific TB prevention, including a development of the novel vaccines, so we have to know better about the most immunogenic antigens of Mycobacterium Tuberculosis. We studied the Interferon-Q production in the whole blood after stimulating immune response with different proteins of Mycobacterium Tuberculosis in patients with active TB. The study results permitted us to evaluate the immunogenicity of the previously known proteins (Ag85a и ESAT-6 in comparison to the recently identified ones (Rv2957, Rv2958c и Rv0447, analyzing simultaneously their relation to tuberculin, as well as to antigens of the different viruses (Human Immunodeficiency Virus, Cytomegalovirus, Epstein-Barr Virus, Influenza Virus. Protein Rv2958c, unlike protein ESAT-6, showed the high immunogenicity in comparison to tuberculin. The expressed immunogenicity of protein Rv2958c might be indicated a possible greatest specificity of immune response to this antigen in TB patients. Meanwhile, bacillary tuberculosis was strongly associated with low immune response to this protein. Also we were found statistical differences in immune responses of patients to the different Mycobacterium Tuberculosis antigens depending on the drug sensitivity. In addition it was interesting to know about a significantly low immune response of patients with Drug Resistant TB to protein pp65 CMV.

  14. Rifampicin-induced disseminated intravascular coagulation in pulmonary tuberculosis treatment

    Science.gov (United States)

    Chen, Guo; He, Jian-Qing

    2017-01-01

    Abstract Rationale: Disseminated intravascular coagulation (DIC) induced by daily rifampicin therapy is rare, especially the patient is absent of malignancy, severe infection, and prior exposure to rifampicin. Patient concerns: We report a case of DIC induced by daily rifampicin treatment for pulmonary tuberculosis. A 22-year-old, previously healthy man received an anti-tuberculosis therapy consisting of isoniazid, rifampicin, ethambutol, and pyrazinamide on the daily dose recommended by the World Health Organization tuberculosis guidelines after a diagnosis of pulmonary tuberculosis. Two weeks later, he was transferred to the West China Hospital with nasal hemorrhage for 1 week, hematochezia, hematuria, and petechiae for 5 days. Diagnoses: Laboratory data and symptoms on admission indicated DIC. Interventions: The anti-tuberculosis drugs were discontinued after admission and he was initiated with targeted treatment for DIC, omeprazole and polyene hosphatidylcholine infusion, as well as nutrition supportive treatment. Five days after admission, ethambutol, moxifloxacin, and amikacin were added to the patient without further active hemorrhage. Eight days after admission, the platelet count had risen gradually. Isoniazid was administered on 24 days after admission, while his liver function tests and platelet counts returned to normal. No recurrence of DIC occurred. The diagnosis of rifampicin-induced DIC was confirmed. Outcomes: The patient recovered and left hospital with isoniazid, ethambutol, levofloxacin, and streptomycin after 4 weeks of hospitalization. There was no recurrence of DIC or hemorrhage during the 8 months of follow-up. The literature review revealed that there were 10 other cases of rifampicin-induced DIC. Only 4 cases received rifampicin on a daily basis for pulmonary tuberculosis treatment and the others were on intermittent dosing schedule for pulmonary tuberculosis or leprosy treatment. Lessons: As a rare adverse effect, DIC induced by

  15. Radiological analysis of image on geriatric pulmonary tuberculosis

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

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

  16. Symptom screening rules to identify active pulmonary tuberculosis: Findings from the Zambian South African Tuberculosis and HIV/AIDS Reduction (ZAMSTAR) trial prevalence surveys

    Science.gov (United States)

    Claassens, M. M.; Floyd, S.; Ayles, H.; Beyers, N.

    2017-01-01

    Background High tuberculosis (TB) burden countries should consider systematic screening among adults in the general population. We identified symptom screening rules to be used in addition to cough ≥2 weeks, in a context where X-ray screening is not feasible, aiming to increase the sensitivity of screening while achieving a specificity of ≥85%. Methods We used 2010 Zambia South Africa Tuberculosis and HIV/AIDS Reduction (ZAMSTAR) survey data: a South African (SA) training dataset, a SA testing dataset for internal validation and a Zambian dataset for external validation. Regression analyses investigated relationships between symptoms or combinations of symptoms and active disease. Sensitivity and specificity were calculated for candidate rules. Results Among all participants, the sensitivity of using only cough ≥2 weeks as a screening rule was less than 25% in both SA and Zambia. The addition of any three of six TB symptoms (cough <2 weeks, night sweats, weight loss, fever, chest pain, shortness of breath), or 2 or more of cough <2 weeks, night sweats, and weight loss, increased the sensitivity to ~38%, while reducing specificity from ~95% to ~85% in SA and ~97% to ~92% in Zambia. Among HIV-negative adults, findings were similar in SA, whereas in Zambia the increase in sensitivity was relatively small (15% to 22%). Conclusion High TB burden countries should investigate cost-effective strategies for systematic screening: one such strategy could be to use our rule in addition to cough ≥2 weeks. PMID:28257424

  17. III 型活动性肺结核病人气道高反应性与肺功能康复关系研究%Study on relationship between broncho-hyperreactivity and pulmonary rehabilitation in patients with active pulmonary tuberculosis III

    Institute of Scientific and Technical Information of China (English)

    王永兴; 应延风

    2002-01-01

    Objective To investigate relationship between broncho-hyperreactivity (BHR) and pulmonary rehabilitation in patients with active pulmonary tuberculosis. Method Pulmonary function and histamine provocation tests were conducted to compare results in 103 cases. Results Positive rate for histamine provocation test was 13.59% . Compared with negative group, more patients in positive group developed cough and hemoptysis(P< 0.01).Incidence of BHR in patients with positive result for sputum examination for tubercle bacillus was higher than patients with negative results(P<0.01).Percentage of midexpiratory rate of flow(PMMF)in group with positive provocation test was strikingly lower than that in negative group. Conclusion BHR is closely related to stenosis of little airway in patients with pulmonary tuberculosis. Increased BHR affects pulmonary rehabilitation.

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

    Institute of Scientific and Technical Information of China (English)

    Cheng-Zhou Wu; Yan-Qiao Wu

    2016-01-01

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

  19. Keratinocyte growth factor administration attenuates murine pulmonary mycobacterium tuberculosis infection through granulocyte-macrophage colony-stimulating factor (GM-CSF)-dependent macrophage activation and phagolysosome fusion.

    Science.gov (United States)

    Pasula, Rajamouli; Azad, Abul K; Gardner, Jason C; Schlesinger, Larry S; McCormack, Francis X

    2015-03-13

    Augmentation of innate immune defenses is an appealing adjunctive strategy for treatment of pulmonary Mycobacterium tuberculosis infections, especially those caused by drug-resistant strains. The effect of intranasal administration of keratinocyte growth factor (KGF), an epithelial mitogen and differentiation factor, on M. tuberculosis infection in mice was tested in prophylaxis, treatment, and rescue scenarios. Infection of C57BL6 mice with M. tuberculosis resulted in inoculum size-dependent weight loss and mortality. A single dose of KGF given 1 day prior to infection with 10(5) M. tuberculosis bacilli prevented weight loss and enhanced pulmonary mycobacterial clearance (compared with saline-pretreated mice) for up to 28 days. Similar effects were seen when KGF was delivered intranasally every third day for 15 days, but weight loss and bacillary growth resumed when KGF was withdrawn. For mice with a well established M. tuberculosis infection, KGF given every 3 days beginning on day 15 postinoculation was associated with reversal of weight loss and an increase in M. tuberculosis clearance. In in vitro co-culture experiments, M. tuberculosis-infected macrophages exposed to conditioned medium from KGF-treated alveolar type II cell (MLE-15) monolayers exhibited enhanced GM-CSF-dependent killing through mechanisms that included promotion of phagolysosome fusion and induction of nitric oxide. Alveolar macrophages from KGF-treated mice also exhibited enhanced GM-CSF-dependent phagolysosomal fusion. These results provide evidence that administration of KGF promotes M. tuberculosis clearance through GM-CSF-dependent mechanisms and enhances host defense against M. tuberculosis infection.

  20. Spontaneous bronchoesophageal fistula in an adult – A possible delayed sequela of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Surendra Patel

    2015-01-01

    Full Text Available Spontaneous bronchoesophageal fistula in the adult is a rare clinical entity. Most bronchoesophageal fistulae are due to malignancy, prolonged endotracheal intubation or trauma. Granulomatous infections like tuberculosis, HIV and mediastinitis are rare causes of acquired bronchoesophageal fistula. We report a case of a 50 year old man, treated for pulmonary tuberculosis 15 years ago, who developed a spontaneous bronchoesophageal fistula between the mid-esophagus and right main stem bronchus, having no history of malignancy or trauma. Surgical closure of the fistula was done and post operative recovery was uneventful. In this case, the bronchoesophageal fistula probably developed as a delayed sequela of pulmonary tuberculosis as the patient had no active signs of pulmonary tuberculosis clinically or histopathologically.

  1. Monoarticular Poncet Disease after Pulmonary Tuberculosis: A Rare Case Report and Review of Literature

    Science.gov (United States)

    Garg, Paritosh; Gupta, Nikhil; Arora, Mohit

    2016-01-01

    Introduction: Tuberculosis is a major health problem worldwide, more so in Asian countries and especially India. Being a communicable disease, it can affect the lives of many people. Tuberculosis has varied manifestations and can affect almost every part of the human body. Pulmonary tuberculosis is the most common form. Poncet disease (tuberculous rheumatism) is a polyarticular arthritis that occurs during acute tuberculosis infection in which no mycobacterial involvement can be found or no other known cause of polyarthritis is detected. Case presentation: We describe an atypical presentation of active pulmonary tuberculosis with monoarticular Poncet disease of the right knee in a 24-year-old woman. Discussion: The diagnosis of Poncet disease is mainly clinical with exclusion of other causes. It generally presents as an acute or subacute form; however, chronic forms have been described in the literature. PMID:27455057

  2. Helminth infections coincident with active pulmonary tuberculosis inhibit mono- and multifunctional CD4+ and CD8+ T cell responses in a process dependent on IL-10.

    Directory of Open Access Journals (Sweden)

    Parakkal Jovvian George

    2014-09-01

    Full Text Available Tissue invasive helminth infections and tuberculosis (TB are co-endemic in many parts of the world and can trigger immune responses that might antagonize each other. We have previously shown that helminth infections modulate the Th1 and Th17 responses to mycobacterial-antigens in latent TB. To determine whether helminth infections modulate antigen-specific and non-specific immune responses in active pulmonary TB, we examined CD4(+ and CD8(+ T cell responses as well as the systemic (plasma cytokine levels in individuals with pulmonary TB with or without two distinct helminth infections-Wuchereria bancrofti and Strongyloides stercoralis infection. By analyzing the frequencies of Th1 and Th17 CD4(+ and CD8(+ T cells and their component subsets (including multifunctional cells, we report a significant diminution in the mycobacterial-specific frequencies of mono- and multi-functional CD4(+ Th1 and (to a lesser extent Th17 cells when concomitant filarial or Strongyloides infection occurs. The impairment in CD4(+ and CD8(+ T cell cytokine responses was antigen-specific as polyclonal activated T cell frequencies were equivalent irrespective of helminth infection status. This diminution in T cell responses was also reflected in diminished circulating levels of Th1 (IFN-γ, TNF-α and IL-2- and Th17 (IL-17A and IL-17F-associated cytokines. Finally, we demonstrate that for the filarial co-infections at least, this diminished frequency of multifunctional CD4(+ T cell responses was partially dependent on IL-10 as IL-10 blockade significantly increased the frequencies of CD4(+ Th1 cells. Thus, co-existent helminth infection is associated with an IL-10 mediated (for filarial infection profound inhibition of antigen-specific CD4(+ T cell responses as well as protective systemic cytokine responses in active pulmonary TB.

  3. Rapid Diagnosis of Active Tuberculosis by Lipoarabinomanna test

    Directory of Open Access Journals (Sweden)

    Urmila A.Sharma

    2000-04-01

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

  4. Lupus pleuritis: a relevant risk factor for pulmonary tuberculosis.

    Science.gov (United States)

    Pasoto, S G; Borba, E F; Bonfa, E; Shinjo, S K

    2010-12-01

    The objective of the study was to evaluate risk factors for pulmonary tuberculosis in systemic lupus erythematosus (SLE). Clinical/laboratorial features of 1283 SLE patients (ACR criteria) followed at the Lupus Clinic were obtained from the electronic register database from 2001 to 2009. Pulmonary tuberculosis was diagnosed in 20 patients (1.6%) (TB+ group). As control group (TB-), 40 patients without tuberculosis matched for age, gender, ethnicity, age at SLE diagnosis, and disease duration were arbitrarily selected. All 20 patients of the TB+ group presented confirmed pulmonary tuberculosis from 1 to 23 years after SLE diagnosis (7.6 ± 8.1 years). Frequencies of previous SLE involvements (cutaneous, articular, hematological, renal, pericarditis, pneumonitis, and central nervous system) were alike in TB+ and TB- groups (p > 0.05). In contrast, prior pleuritis was more frequent in the TB+ group (40% vs. 5%, p = 0.001). In fact, pulmonary tuberculosis was diagnosed in 8/10 patients with previous pleuritis. Immunosuppressive and corticosteroid therapies at the moment of tuberculosis diagnosis were also similar in both groups (p > 0.05). We have identified pleuritis as a relevant risk factor for pulmonary tuberculosis, suggesting that previous pleural injury is a critical part of the complex interplay between altered immune system, socio-economic conditions, and increased susceptibility to this mycobacterial infection.

  5. IMMUNOTHERAPY IN TREATMENT OF PULMONARY TUBERCULOSIS IN ADOLESCENTS

    Directory of Open Access Journals (Sweden)

    I. I. Lvova

    2014-01-01

    Full Text Available Comprehensive examination of 62 adolescents, hospitalized for pulmonary tuberculosis, established high spread of clinical and laboratory markers of secondary immune deficiency: chronic diseases of ear, throat and nose (59,6%, recurrent infection caused by the herpes simplex viruses (SPGV (55,8% ; serological SPGV activation (90,4% and cytomegalovirus infection (CMV (94,2%; absolute lymphopenia (53,8%, low level and lack of interferon-alpha (28,9% and interferongamma (76,9%. Validity, effectiveness and safety of modern technology immunization with interferon -α-2b (VIFERON® 3 million IU and 1 million IU suppositories in 1 month course in the complex treatment of pulmonary tuberculosis was proved with a random research by a «case-control» method. Significant positive clinical and laboratory dynamics was registered: increase in body weight in 84,6 % of adolescents; reduction in the frequency of arrhythmias; increase absolute lymphocyte count (46,1%, decrease in serological SPGV activation (30,8% and CMV infection (61,5% increase in the amount of interferon-alpha (61,5%, and interferon-gamma (61,5% and absence of intolerance and 3 times less undesirable effects of chemotherapy.

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

    Science.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

    吴静; 徐建; 张映铭; 王彩英

    2011-01-01

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

  8. Is tuberculosis a lymphatic disease with a pulmonary portal?

    Science.gov (United States)

    Behr, Marcel A; Waters, W Ray

    2014-03-01

    Tuberculosis most commonly presents as a pulmonary disease, in which infection, persistence, and induction of transmissible pathology all occur in the lungs. If viewed as a pulmonary disease, enlarged lymph nodes represent reactive adenitis, and extrapulmonary forms of tuberculosis (including lymphatic tuberculosis) are not transmissible, hence representing an evolutionary dead-end for the pathogen. In an alternative theory, Mycobacterium tuberculosis passes asymptomatically through the lungs and rapidly establishes a chronic lymphatic infection. After a period of weeks to decades secondary lung pathology develops, ultimately allowing transmission to occur. Evidence that supports this lymphatic model includes historical descriptions of human tuberculosis from the preantibiotic era, analogy with other mycobacterial infections, observations of tuberculosis in non-human hosts, and experimental models of tuberculosis disease. At a fundamental level, a lymphocentric model proposes that spread of organisms outside the lung parenchyma is essential to induce adaptive immunity, which is crucial for the generation of transmissible pathology. Furthermore, a lymphatic model could explain why the lesion associated with primary infection (Ghon focus) is anatomically separated from the most common site of reactivation disease (the apex). More practically, an alternative perspective that classes tuberculosis as a lymphatic disease might affect strategies for preclinical and clinical assessment of novel diagnostics, drugs, and vaccines.

  9. Sweet's syndrome: a very rare association with pulmonary tuberculosis.

    Science.gov (United States)

    Karmakar, Partha Sarathi; Sherpa, Pasang Lahmu; Ray, Achintya Narayan; Saha, Bikram Kr; Santra, Tuhin; Saha, Sanchita; Chakrabarti, Indranil

    2013-05-13

    Mycobacterium tuberculosis infection is a common infection in developing countries, including India. It can induce several cutaneous reactions such as erythema nodosum, and erythema induratum; however, association of tuberculosis with Sweet's syndrome (also known as acute febrile neutrophilic dermatosis) is extremely rare. Here we present an interesting case of sputum-positive pulmonary tuberculosis with Sweet's syndrome. A 55-year-old female who was receiving a regimen of four antitubercular drugs (isoniazid, rifampicin, pyrazinamide, ethambutol- HRZE) for six weeks for sputum-positive pulmonary tuberculosis developed new onset high-grade fever for 15 days along with multiple reddish brown plaques and nodules involving the face as well as all four limbs of the body. Histopathology of the skin lesion was suggestive of Sweet's syndrome. The patient responded well to immunosuppressive steroid therapy.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

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

    Directory of Open Access Journals (Sweden)

    Sevostyanova M.S.,

    2014-08-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sousa, Renato Telles de

    2010-06-01

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

  14. T Cell Functional Disturbances in Patients with Pulmonary Tuberculosis.

    Science.gov (United States)

    Ostanin, Alexander A.; Khonina, Nataliya A.; Norkin, Maxim N.; Leplina, Olga Yu.; Nikonov, Sergey D.; Ogirenko, Anatoly P.; Chernykh, Helen R.

    2000-04-01

    The investigations of 38 patients with pulmonary tuberculosis (PT) revealed combined T cell and monocyte functional disturbances. Indeed, the percentages of CD4(+) and CD8(+) T lymphocytes, proliferative response and IL-2 production, as well as the percentages of HLA DR(+) monocytes and IL-1beta production were significantly decreased in PT patients as compared with normal individuals. Herewith the absolute T lymphocyte number did not undergo the pronounced changes. The decrease of T cell proliferative response was not mediated through immunosuppressive action of monocytes or T lymphocytes since removing of "adherent" cells from patient's peripheral blood mononuclear cells (PBMC) or pretreatment of PBMC with indomethacin and cyclophosphan failed to recover mitogenic reactivity in vitro. The patient's sera also did not significantly influence on PBMC proliferation. The decrease of IL-2 production and the stimulation of T cell proliferative response via TcR-CD3 complex, i.e. through the classic pathway of activation, indicated the anergy of T lymphocyte in tuberculosis patients. Furthermore, T lymphocytes were characterized by enhanced apoptosis. It should be noted, that patient's sera (especially in the patients with an initially high apoptosis) promoted significant anti-apoptotic activity. It is likely that this mechanism may be an explanation, why absolute T lymphopenia is absent during tuberculosis infection. Our findings suggest, that T lymphocyte dysfunctions in patients with PT are caused by impairments of T cell activation process, which lead to predominance of "negative" response (induction anergy, apoptosis) and to a lesser degree connected with direct suppressive mechanisms mediated by monocytes, T lymphocytes or serum factors.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  16. Influence of Huangqi injection on the fibrosis indexes and cytokines of patients with pulmonary tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Jian-Dong Xi

    2016-01-01

    Objective:To observe the efficacy of huangqi injection for patients with pulmonary tuberculosis, and its influence on the fibrosis indexes and inflammation cytokines.Methods: A total of 120 cases of patients with pulmonary tuberculosis were randomly divided into control group and observation group, with 60 cases in each group. Patients in control group were adopted basic treatment, while those in observation group were treated with huangqi injection. Then the score of tuberculosis' activity, and the sputum negative conversion rate, absorption of pathological condition and void closure of two groups were compared. And the levels of Hyaluronic acid (HA), typeⅢ procollagen (PC-Ⅲ), matrix metalloproteinase 9 (MMP-9) and inflammatory cytokines interleukin-6 (IL-6), interleukin-8 (IL-8) both in bronchoalveolar lavage fluid and serum of the two groups were detected and compared respectively before and after treatment.Results:Two and six months after treatment, the score of tuberculosis' activity of observation group was significantly lower than that of control group, while the sputum negative conversion rate, absorption of pathological condition and the void closure were higher than those of control group; and the levels of HA, PC-Ⅲ, IL-8 and IL-6 of observation group in bronchoalveolar lavage fluid and serum were all significantly lower than those of control group, while the level of MMP-9 was higher than that of control group.Conclusion:Huangqi injection plays adjuvant efficacy for patients with pulmonary tuberculosis by regulating the expression of the fibrosis indexes and inflammatory cytokines.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  18. Biosecurity in pulmonary tuberculosis and nursing practice in a university hospital, RJ, BRAZIL.

    OpenAIRE

    Ramos, Ingrid; Residente de enfermagem pela Universidade federal do estado do rio de janeiro ( UNIRIO); Souza, Fabiana Barbosa Assumpção de; Professora adjunto da Universidade Federal do Estado do Rio de Janeiro ( UNIRIO); Oliveira, Alexandre Baroli; Doutorando em enfermagem pela UFRJ e enfermeiro do Instituto Nacional de Traumatologia e Ortopedia. ( M.S)

    2010-01-01

    The study aimed to use bio in nursing practice with clients in precautionary air for pulmonary tuberculosis (TB) in a University Hospital in Rio de Janeiro (RJ). OBJECTIVES: To describe the use of biosafety in nursing practice with clients holder of pulmonary tuberculosis; characterize the circumstances of use of biosecurity in nursing practice to patients in respiratory precautions for pulmonary tuberculosis. The theoretical addressed: etiology, transmission and pathogenesis of pulmonary tub...

  19. Spoligotype patterns of Mycobacterium tuberculosis isolated from extra pulmonary tuberculosis patients in Puducherry, India

    Directory of Open Access Journals (Sweden)

    G Kandhakumari

    2015-01-01

    Full Text Available Purpose: Genotyping studies like spoligotyping are valuable tools in understanding the genetic diversity and epidemiology of Mycobacterium tuberculosis. Though there are reports of spoligotyping of M. tuberculosis isolates from pulmonary specimens from different parts of India, spoligotyping of extra pulmonary tuberculosis isolates are very few. Puducherry has not yet recorded spoligopatterns of M. tuberculosis from either pulmonary or extra pulmonary (EPTB specimens. The aim of this study is to analyze the spoligotype patterns of EPTB strains circulating in Puducherry and neighboring districts of Tamil Nadu. Materials and Methods: During June 2011 to December 2013, 570 EPTB specimens were processed by culturing on to Lowenstein Jensen (LJ medium and automated Mycobacterium Growth Indicator Tube system (MGIT960. Identification of M. tuberculosis was carried out as per standard procedures, and MPT 64 antigen positivity in a commercial immunochromatography kit. Spoligotyping was carried out at National Institute of Research in Tuberculosis (ICMR, Chennai. Results: M. tuberculosis was isolated from 67 single EPTB specimens (11.8% like pus/cold abscess (34, TB spine (10, pleural fluid (10, urine (5, tissue bit (2, lymph nodes (2, ascitic fluid (2, synovial fluid (1 and endometrial curetting (1. Among 67 isolates with 41 spoligopatterns, EAI lineage with 28 isolates (41.8% predominated followed by 18 orphans (26.9%, 10 Beijing (14.9% and 8 U (11.9%. BOVIS1_BCG (ST482, T1-T2 (ST78 and H3 (ST50 were represented by one strain each (1.5%. C onclusions: Spoligotyping plays a significant role in the epidemiology of tuberculosis. Three spoligotypes, T1-T2 (ST78, EAI6 (ST292 and U (ST1429 are reported for the first time in India.

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

    Directory of Open Access Journals (Sweden)

    Ramakant Dixit

    2012-01-01

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

  1. Opportunistic microorganisms in patients undergoing antibiotic therapy for pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Silvia Maria Rodrigues Querido

    2011-12-01

    Full Text Available Antimicrobial therapy may cause changes in the resident oral microbiota, with the increase of opportunistic pathogens. The aim of this study was to compare the prevalence of Candida, Staphylococcus, Pseudomonas and Enterobacteriaceae in the oral cavity of fifty patients undergoing antibiotic therapy for pulmonary tuberculosis and systemically healthy controls. Oral rinsing and subgingival samples were obtained, plated in Sabouraud dextrose agar with chloramphenicol, mannitol agar and MacConkey agar, and incubated for 48 h at 37ºC. Candida spp. and coagulase-positive staphylococci were identified by phenotypic tests, C. dubliniensis, by multiplex PCR, and coagulase-negative staphylococci, Enterobacteriaceae and Pseudomonas spp., by the API systems. The number of Candida spp. was significantly higher in tuberculosis patients, and C. albicans was the most prevalent specie. No significant differences in the prevalence of other microorganisms were observed. In conclusion, the antimicrobial therapy for pulmonary tuberculosis induced significant increase only in the amounts of Candida spp.

  2. Prevalence of nutritional deficiency in patients with pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Silvana Gomes Nunes Piva

    2013-06-01

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

  3. Conformance contrast testing between rates of pulmonary tuberculosis in Ecuadorian border areas

    Directory of Open Access Journals (Sweden)

    Claudia Ortiz-Rico

    2015-11-01

    Full Text Available Objective. To estimate rates of cases of respiratory symptomatic subjects and the incidence rate of pulmonary tuberculosis in two border areas of Ecuador, and contrast them with official figures. Materials and methods. Cross-sectional survey in the southeastern (SEBA, and the Andean southern Ecuadorian border areas (ASBA, which were conducted, respectively, in 1 598 and 2 419 persons aged over 15 years recruited over periods of three weeks. In identified respiratory symptomatic cases, a sputum sample was taken for smear testing. The results (odds ratios and their respective 95% confidence intervals, were compared with local and national official figures using maximum likelihood contrasts. Results. The rates of respiratory symptomatic subjects (7.7% and 5.9% in the SEBA, and ASBA, respectively and of pulmonary tuberculosis (cumulative incidence rates of 125 and 140 per 100 000 inhabitants, in the same order were significantly greater than the official figures (of 0.98 and 0.99% for respiratory symptomatic subjects in the SEBA and ASBA, respectively; and of 38.23 per 100 000 inhabitants for pulmonary tuberculosis in Ecuador as a whole (p<0.001. Conclusion. It is necessary to reinforce both active case finding for respiratory symptomatic subject cases, and epidemiological surveillance of pulmonary tuberculosis in Ecuadorian border regions.

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

    Science.gov (United States)

    Yoneda, T

    1996-11-01

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

  5. Experience with pulmonary resection for extensively drug-resistant tuberculosis.

    Science.gov (United States)

    Shiraishi, Yuji; Katsuragi, Naoya; Kita, Hidefumi; Toishi, Masayuki; Onda, Takahito

    2008-12-01

    Extensively drug-resistant tuberculosis is becoming a global threat. It is a relatively new phenomenon, and its optimal management remains undetermined. We report our experience in using pulmonary resection for treating patients with this disease. Records were reviewed of 54 consecutive patients undergoing a pulmonary resection for multidrug-resistant tuberculosis at Fukujuji Hospital between 2000 and 2006. These patients were identified using the definition approved by the World Health Organization Global Task Force on extensively drug-resistant tuberculosis in October 2006. Five (9%) patients (3 men and 2 women) aged 31-60 years met the definition. None of the patients was HIV-positive. Although the best available multidrug regimens were initiated, no patient could achieve sputum conversion. Adjuvant resectional surgery was considered because the patients had localized disease. Procedures performed included pneumonectomy (2) and upper lobectomy (3). There was no operative mortality or morbidity. All patients attained sputum-negative status after the operation, and they were maintained on multidrug regimens for 12-25 months postoperatively. All patients remained free from disease at the time of follow-up. Pulmonary resection under cover of state-of-the-art chemotherapy is safe and effective for patients with localized extensively drug-resistant tuberculosis.

  6. Pulmonary tuberculosis and lung cancer: simultaneous and sequential occurrence

    Directory of Open Access Journals (Sweden)

    Denise Rossato Silva

    2013-06-01

    Full Text Available OBJECTIVE: Lung cancer (LC is the leading cause of cancer-related death and represents a major public health problem worldwide. Another major cause of morbidity and mortality, especially in developing countries, is tuberculosis. The simultaneous or sequential occurrence of pulmonary tuberculosis and LC in the same patient has been reported in various case series and case-control studies. The objective of this study was to describe the characteristics of patients developing tuberculosis and LC, either simultaneously or sequentially. METHODS: This was a cross-sectional study based on the review of medical charts. RESULTS: The study involved 24 patients diagnosed with tuberculosis and LC between 2009 and 2012. The diagnoses of tuberculosis and LC occurred simultaneously in 10 patients, whereas tuberculosis was diagnosed prior to LC in 14. The median time between the two diagnoses was 5 years (interquartile range: 1-30 years. Fourteen patients (58.3% were male, 20 (83.3% were White, and 22 (91.7% were smokers or former smokers. The most common histological type was adenocarcinoma, identified in 14 cases (58.3%, followed by epidermoid carcinoma, identified in 6 (25.0%. Seven patients (29.2% presented with distant metastases at diagnosis; of those 7 patients, 5 (71% were diagnosed with LC and tuberculosis simultaneously. CONCLUSIONS: In the present study, most of the patients with tuberculosis and LC were smokers or former smokers, and tuberculosis was diagnosed either before or simultaneously with LC. Non-small cell lung cancer, especially adenocarcinoma, was the most common histological type.

  7. [Alcohol sales and pulmonary tuberculosis mortality in the Republic of Belarus in 1981 to 2001].

    Science.gov (United States)

    Razvodovskiĭ, Iu E

    2006-01-01

    The fact that there is an association of alcohol abuse with pulmonary tuberculosis is well documented. The effect of alcohol sales per capita on tuberculosis mortality rates is considerably less known. The aim of the study was to evaluate the beverage-specific effect of alcohol on pulmonary tuberculosis mortality rates. Trends in pulmonary tuberculosis mortality rates in Belarus from 1981 to 2001 were analyzed in relation to those in the level of sales of various alcoholic beverages per capita, by applying the time series analysis. The analysis demonstrated a positive and statistically significant effect of changes in per capita alcohol sale levels on pulmonary tuberculosis mortality rates. It suggests that a 1% increase in alcohol sales per capita might cause 0.49 and 0.36% increases in pulmonary tuberculosis mortality rates in males and females, respectively. This study also indicates that tuberculosis prevention programs should place more emphasis on alcohol problems.

  8. Concomittant pulmonary tuberculosis and borderline leprosy with type-II lepra reaction in single patient.

    Science.gov (United States)

    Prasad, Rajendra; Verma, Sanjay Kumar; Singh, Rajni; Hosmane, Giridhar

    2010-01-01

    The concommitant occurrence of both tuberculosis and leprosy in a single individual are not an uncommon clinical condition but is being reported infrequently in literature. We report a case of leprosy, diagnosed previously and also diagnosed as pulmonary tuberculosis.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Singh T

    2005-01-01

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

  11. Co-existence of Pulmonary, Tonsillar and Laryngeal Tuberculosis

    Directory of Open Access Journals (Sweden)

    Erkan Ceylan

    2013-10-01

    Full Text Available    A 56-year old man applied to otorhinolaryngology clinic with sore throat, dysphagia. During direct examination, left palatine tonsil and tonsil plicas ulcerovegetative lesions were found. In the indirect laryngoscopy, in some regions of the larynx and epiglottis, ulcerovegetative lesions were observed too. Because of suspicion of laryngeal carcinoma and metastasis, punch biopsy of the left palatine tonsil was performed. Chest x-ray and computerized tomography of the thorax revealed two adjacent cavitations in the apicoposterior segment of the left upper lobe. In the histopathologic examination of biopsies, granulomatous structures that proved tuberculosis were observed. In the fiberoptic bronchoscopic analysis, endobronchial lesion was not detected. Acid-fast bacilli were determined in sputum and bronchial lavage in microscopy and culture. The case of this middle aged male patient with co-existence of tonsillar, laryngeal and pulmonary tuberculosis presents the clinical significance of upper airway tuberculosis in terms of its infectiousness and rare occurrence.

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

    Directory of Open Access Journals (Sweden)

    Munguia Guadalupe

    2010-05-01

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

  13. Pulmonary mucormycosis mimicking as pulmonary tuberculosis : A case report

    Directory of Open Access Journals (Sweden)

    Garg Rajiv

    2008-01-01

    Full Text Available Pulmonary Mucormycosis is an uncommon disease caused by fungi of class Zygomycetes. It occurs predminantly in an immunodeficient host most common risk factor being diabetes mellitus. The lesions are localized in the lungs or the mediastinum. We are reporting a case of 70 years old male, having cough, haemoptysis, fever and chest pain. He was on antituberculosis treatment (RHEZ for last 10 days and was later found to have Pulmonary Mucormycosis on further evaluation.

  14. Pulmonary mucormycosis mimicking as pulmonary tuberculosis: a case report.

    Science.gov (United States)

    Garg, Rajiv; Marak, Rungmei Sk; Verma, Sanjay Kumar; Singh, Jagdeep; Sanjay; Prasad, Rajendra

    2008-07-01

    Pulmonary Mucormycosis is an uncommon disease caused by fungi of class Zygomycetes. It occurs predminantly in an immunodeficient host most common risk factor being diabetes mellitus. The lesions are localized in the lungs or the mediastinum. We are reporting a case of 70 years old male, having cough, haemoptysis, fever and chest pain. He was on antituberculosis treatment (RHEZ) for last 10 days and was later found to have Pulmonary Mucormycosis on further evaluation.

  15. Clinical value of peripheral platelet count in assessing active pulmonary tuberculosis%血小板计数对判断肺结核病情的价值探讨

    Institute of Scientific and Technical Information of China (English)

    尹洪云; 冯永红; 邹丹凤; 肖和平

    2014-01-01

    目的:了解外周血小板计数增高对结核病患者病情的诊治价值。方法选择2012年1-6月住院初治肺结核进展期80例(进展期组)、治疗后好转期43例(好转期组)及同期健康体检者89名(对照组)。采用血常规细胞计数仪检测外周血白细胞、血小板计数,中性粒细胞比值;同日送检血红细胞沉降率(ESR)及 C反应蛋白(CRP)。SPSS13.0统计软件处理数据。结果进展期组 ESR及CRP分别明显高于好转期组(P=0.0065,P=0.0073);进展期组血小板计数高于正常参考值上限者占41.94%,均值亦明显高于好转组及对照者(分别为P=0.0014,P=0.0000);且血小板计数分别与 ESR及 CRP呈正相关。而白细胞计数及中性粒细胞比值与对照组比较差异无统计学意义(P>0.05)。结论结核病患者外周血血小板计数升高,对判断病情的活动性及治疗效果具有一定参考价值。%Objective To understand the role of increasing peripheral blood platelet count in the diagnosis and prognosis of patients with active pulmonary tuberculosis.Methods This analysis included 80 inpatients with active pulmonary tuberculosis evidenced by positive sputum smear,43 patients in recovery and 89 healthy controls during the period from January to June in 2012.Peripheral white blood cell,platelet count,and neutrophil percentage were assayed.Erythrocyte sedimentation rate (ESR)and serum C-reactive protein (CRP)were measured and compared.The data were analyzed by using SPSS 13.0 software.Results ESR and CRP values were significantly higher in the patients with active pulmonary tuberculosis than in the patients in recovery (P=0.006 5 and P=0.007 3,respectively).The peripheral blood platelet count exceeded normal range in 41.94% of the patients with active pulmonary tuberculosis,which was significantly higher than that in the patients in recovery (P=0.001 4)and controls (P=0.000 0).Platelet

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

    Directory of Open Access Journals (Sweden)

    Dongmei Shi

    2016-03-01

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

  17. 探讨C-反应蛋白对活动性肺结核的诊断价值分析%The Diagnostic Value of C-Reactive Protein in Active Pulmonary Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    林宏

    2013-01-01

    目的:探讨C-反应蛋白(CRP)判定肺结核病情活动的价值。方法:2011年-2012年本院住院收治的156例肺结核患者,将其分为活动组90例(菌阳者46例、菌阴者44例)和非活动组66例,分别检测其CRP,同时设正常对照组108例,为医院体检中心无结核病史的健康查体者。结果:156例患者CRP升高者142例,阳性率91.02%。活动组CRP明显高于非活动组和正常对照组,非活动组明显高于正常对照组;活动组中菌阳者CRP明显高于菌阴者,差异均有统计学意义(P<0.01)。结论:CRP在评论活动性肺结核中有重要的临床价值。%Objective:To evaluate the diagnostic value of CRP in the diagnosis of pulmonary tuberculosis.Method:One hundred and fifty-six patients with pulmonary tuberculosis in the years 2011-2012 in our hospital were divided into 90 cases of active group(46 cases of bacteria Yang, 44 cases of bacteria Yin)and 66 cases of non active group.The CRP was detected and 108 Healthy people as normal control group without a history of tuberculosis from hospital medical center were selected.Result:One hundred and fifty-six patients with CRP elevated in 142 cases,the positive rate was 91.02%.Activity of CRP was significantly higher than that in non active group and normal control group,non active group was significantly higher than that in normal control group;Bacteria Yang in CRP active group was obviously higher than that of bacteria Yin,the differences were statistically significant (P<0.01).Conclusion:CRP in comment active tuberculosis has important clinical value.

  18. CT findings of pulmonary tuberculosis and tuberculous pleurisy in diabetes mellitus patients

    Science.gov (United States)

    Kim, Jihyun; Lee, In Jae; Kim, Joo-Hee

    2017-01-01

    PURPOSE We aimed to assess computed tomography (CT) findings of pulmonary tuberculosis (TB) and TB pleurisy in diabetes mellitus (DM) patients and to evaluate the effect of duration of DM on radiologic findings of pulmonary TB and TB pleurisy. METHODS Ninety-three consecutive patients diagnosed as active pulmonary TB with underlying DM were enrolled in our study. As a control group, 100 pulmonary TB patients without DM were randomly selected. TB patients with DM were subdivided into two subgroups depending on diabetes duration of ≥10 years or <10 years. Medical records and CT scans of the patients were retrospectively reviewed and compared. RESULTS Bilateral pulmonary involvement (odds ratio [OR]=2.39, P = 0.003), involvement of all lobes (OR=2.79, P = 0.013), and lymph node enlargement (OR=1.98, P = 0.022) were significantly more frequent CT findings among TB patients with DM compared with the controls. There were no statistically significant differences in CT findings of pulmonary TB depending on the duration of DM. CONCLUSION Bilateral pulmonary involvement, involvement of all lobes, and lymph node enlargement are significantly more common CT findings in TB patients with underlying DM than in patients without DM. Familiarity with the CT findings may be helpful to suggest prompt diagnosis of pulmonary TB in DM patients. PMID:28185999

  19. 积极早期胰岛素治疗肺结核合并糖尿病临床效果研究%Clinical Effect of Active Early Insulin Treatment for Pulmonary Tuberculosis Complicated With Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    温乐梅

    2015-01-01

    Objective To explore positive ways of early insulin treatment for pulmonary tuberculosis clinical results. Methods 100 cases of pulmonary tuberculosis complicated with diabetes were selected from May 2012 to May 2014 in our hospital. 50 cases were treated with hypoglycemic drugs and insulin respectively.ResultsTB observation group were signiifcantly better than the control group, and the level of glycemic control was signiifcantly better than the control group (P<0.05).Conclusion For the implementation of active tuberculosis in patients with diabetes early insulin treatment can achieve more signiifcant therapeutic effect,worthy of clinical application.%目的:探讨应用积极早期胰岛素方式对肺结核合并糖尿病进行治疗的临床效果。方法选择2012年5月~2014年5月在我院接受治疗的100例肺结核合并糖尿病患者随机平分为观察组、对照组各50例,分别给予降糖药物、胰岛素进行治疗。结果观察组抗结核疗效优于对照组,且血糖控制水平也优于对照组(P<0.05)。结论对肺结核合并糖尿病患者实施积极早期胰岛素治疗可取得更加显著的治疗效果。

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

    OpenAIRE

    Guadalupe Delgado-Sánchez; Lourdes García-García; Martín Castellanos-Joya; Pablo Cruz-Hervert; Leticia Ferreyra-Reyes; Elizabeth Ferreira-Guerrero; Andrés Hernández; Victor Manuel Ortega-Baeza; Rogelio Montero-Campos; José Antonio Sulca; Ma de Lourdes Martínez-Olivares; Norma Mongua-Rodríguez; Renata Baez-Saldaña; Jesús Felipe González-Roldán; Hugo López-Gatell

    2015-01-01

    Background Tuberculosis (TB) remains a public health problem in Mexico while the incidence of diabetes mellitus type 2 (DM) has increased rapidly in recent years. Objective To describe the trends of incidence rates of pulmonary TB associated with DM and not associated with DM and to compare the results of treatment outcomes in patients with and without DM. Materials and Methods We analysed the National Tuberculosis Registry from 2000 to 2012 including patients with pulmonary TB among individu...

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

    OpenAIRE

    Pardeshi, Geeta S

    2008-01-01

    Aims: To describe the number, types and reasons of consultations amongst patients of pulmonary tuberculosis from an urban area. Settings and Design Cross sectional study was conducted amongst new patients of pulmonary tuberculosis initiated on DOTS at District Tuberculosis Centre (DTC), Yavatmal from January to June 2006. Material and Methods: The data regarding consultations were collected along a time line. The reasons for consultations were studied by in-depth interviews. Statistical analy...

  2. Drug susceptibility patterns of the Mycobacterium tuberculosis isolated from previously treated and new cases of pulmonary tuberculosis at German-Nepal tuberculosis project laboratory, Kathmandu, Nepal

    Directory of Open Access Journals (Sweden)

    Gobinda Thapa

    2016-08-01

    Full Text Available Abstract Background Multidrug resistant tuberculosis (MDR-TB is a serious public health problem in Nepal. It is a major obstacle for the control of the tuberculosis. The main objectives of this study were to determine the prevalence of the multidrug resistant pulmonary tuberculosis and to evaluate the drug susceptibility patterns of Mycobacterium tuberculosis isolated from previously treated and newly diagnosed cases of pulmonary tuberculosis. Methods A cross-sectional study was conducted from March 2013 to August 2013 at German-Nepal tuberculosis project (GENETUP laboratory, Kathmandu, Nepal. For this the sputum samples from total of 153 (49 new and 104 previously treated suspected pulmonary tuberculosis patients were used. The diagnosis of the tuberculosis was performed by using fluorescent microscopy and culture, while the drug susceptibility testing of Mycobacterium tuberculosis was performed by proportion method. Lowenstein-Jensen (L-J medium was used for the culture of Mycobacterium tuberculosis and the colonies grown were identified on the basis of the colony morphology, pigment production and biochemical characteristics. Results The prevalence of MDR-TB among all the cases of culture positive pulmonary tuberculosis was 15.6 %. The rate of MDR-TB among previously treated culture positive tuberculosis patients was 19.4 % and that among newly diagnosed culture positive pulmonary tuberculosis cases was 7.1 %. The highest rate of resistance of Mycobacterium tuberculosis, was toward streptomycin (24.4 % followed by isoniazid (23 %, rifampicin (17.8 % and ethambutol (15.6 %. Among the total of MDR-TB cases among previously treated patients, highest percentage of the cases were relapse (61.1 % followed by chronic (16.7 %. Conclusions The high prevalence of DR/MDR-TB in our study reflects poor implementation of tuberculosis control program. On the basis of the drug susceptibility patterns of M. tuberculosis we found in our study, we

  3. Pulmonary impairment after tuberculosis in a South African population

    Directory of Open Access Journals (Sweden)

    Gibwa Cole

    2016-02-01

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

  4. γ-干扰素释放试验对活动性肺结核的诊断价值%Clinical value of interferon-gamma release assay in the diagnosis of active pulmonary tuberculosis

    Institute of Scientific and Technical Information of China (English)

    任斐; 岳英; 苗风济; 孙晓方; 严文; 苟超伦

    2015-01-01

    目的:评价γ-干扰素释放试验( interferon-gamma release assay,IGRA, T-SPOT. TB)对活动性肺结核的诊断价值。方法选取活动性肺结核组(观察组)120例和非结核病组(对照组)84例共计204例,两组患者均行结核菌素试验( tuberculin skin test,TST),血清结核抗体检测( TB-Ab),T-SPOT. TB检测,比较三种方法对活动性肺结核诊断的敏感度、特异度、阳性预测值、阴性预测值。结果外周血 T-SPOT. TB 诊断活动性肺结核的敏感度为90.0%,明显高于 TST (50.0%)和 TB-Ab (55.8%)(P0.05);T-SPOT. TB诊断活动性肺结核的阳性预测值明显高于TST(81.2% vs 67.4%,P0.05);T-SPOT. TB诊断活动性肺结核的阴性预测值为83.0%,明显高于TST(47.8%)和TB-Ab(51.4%)(P0. 05). The positive prediction value of T-SPOT. TB in the diagnosis of active pulmonary tuberculosis was higher than that of TST (81. 2% vs 67. 4%,P 0. 05). The negative prediction value of T-SPOT. TB for non-active pulmonary tuberculosis was 83. 0%, significantly higher than that of TST(47. 8%)and TB-Ab(51. 4%)(P<0. 05). Conclusion Peripheral blood T-SPOT. TB is very sensitive and specific, and the negative prediction value is significantly better than TST and TB-Ab. T-SPOT. TB has a good application value in diagnosis and differenti-al diagnosis of active pulmonary tuberculosis.

  5. [The chest CT findings and pathologic findings of pulmonary tuberculosis].

    Science.gov (United States)

    Ogata, Hideo

    2009-08-01

    The past research of the radiologic manifestations of pulmonary tuberculosis in Japan was based on morphological pathology of the untreated patient autopsy. I would like to show the chest CT scan of tuberculosis diseases with caseous granuloma at its exudative reaction, proliferative reaction, productive reaction, cirrhotic reaction until self cure. This progress reflects the normal cell mediated immunological responses. Also I would like to show the cavitation of granuloma, which results from liquefaction of caseous materials during the course and results in the formation of the source of infection. And finally I would like to show the morphological differences of acinous lesion, acino-nodular lesion and caseous lobular pneumonia. These differences reflect the amount of bacilli disseminated in the peripheral parts under the lobules. In this study, I do not show old age cases and HIV positive cases, who do not form typical granuloma due to the decreased cell mediated immnunity and whose X ray findings are atypical.

  6. Factors influencing response to treatment of pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Hiyama J

    2000-08-01

    Full Text Available We analyzed 150 patients with pulmonary tuberculosis from 1990 to 1996 (i to evaluate the frequency of drug resistance, (ii to elucidate factors influencing the response to chemotherapy, and (iii to attempt to improve the therapeutic approach. Multidrug-resistant tuberculosis strains were not found. By univariate analysis, there were 8 factors associated with an increased sputum conversion time: male gender, prior treatment, complications, progressive chest radiographic findings, a high Ziehl-Neelsen stain score, lymphocytopenia, a high erythrocyte sedimentation rate (ESR, and hypoproteinemia. Complications, prior treatment, a high Ziehl-Neelsen stain score, and a high ESR were independent predictive factors in a Cox proportional hazard model. Recursive partitioning and amalgamation (RPA defined 3 subgroups that responded to treatment. In order to reduce the time to sputum conversion, poor responders according to the RPA should be treated with a 4-drug regimen containing pyrazinamide.

  7. Chronic pneumonia due to Klebsiella oxytoca mimicking pulmonary tuberculosis.

    Science.gov (United States)

    Gera, Kamal; Roshan, Rahul; Varma-Basil, Mandira; Shah, Ashok

    2015-01-01

    Klebsiella species infrequently cause acute community acquired pneumonia (CAP). The chronic form of the disease caused by K. pneumoniae (Friedlander's bacillus) was occasionally seen in the pre-antibiotic era. K. oxytoca is a singularly uncommon cause of CAP. The chronic form of the disease caused by K. oxytoca has been documented only once before. A 50-year-old immunocompetent male smoker presented with haemoptysis for 12 months. Imaging demonstrated a cavitary lesion in the right upper lobe with emphysematous changes. Sputum stains and cultures for Mycobacterium tuberculosis were negative. However, three sputum samples for aerobic culture as well as bronchial aspirate cultured pure growth of K. oxytoca. A diagnosis of chronic pneumonia due to K. oxytoca was established and with appropriate therapy, the patient was largely asymptomatic. The remarkable clinical and radiological similarity to pulmonary tuberculosis can result in patients with chronic Klebsiella pneumonia erroneously receiving anti-tuberculous therapy.

  8. CT在肺结核疗效判断与随访观察中的应用评价%Evaluation of values of CT in judging clinical changes and follow-up in active pulmonary tuberculosis SONG

    Institute of Scientific and Technical Information of China (English)

    宋其生; 路希伟; 王镇山; 张国庆

    2008-01-01

    目的 探讨活动性肺结核治愈后肺部病变CT表现的演变规律,评价CT在肺结核临床转归判断中的价值.方法 观察60例获得细菌学治愈的涂阳肺结核患者治疗前、治疗后和随访6个月时的CT征象变化;使用呼气末CT扫描,观察小气道阻塞与空气潴留征象,并探讨空气潴留体积与肺功能参数的相关性.结果 在治疗前、治疗疗程结束和6个月随访3个阶段,肺结核活动性CT征象的检出率分别为95.0%、31.7%和3.3%.在停药随访期内仍有39例(65.0%)肺内残留病变进一步缩小和吸收.小气道病变在治疗结束后仍持续存在,气体潴留体积与肺功能指标MMEF、FEF25%、FEF50%相关(P<0.05).结论 肺结核病变的CT影像转归滞后于细菌学转归;单凭CT征象对疗程结束时肺结核活动性进行判定存在限度;CT对肺结核细菌学治愈后的继发小气道改变有较高的诊断价值.%Objective To observe evolving rules of pulmonary pathological changes manifested by CT of active tuberculosis patients after they have been cured.To evaluate values of CT in judging clinical changes.Methods Sixty smear-positive tuberculosis patients,who had been bacteriologically cured,were collected.CT sign-changes of pre-,post-treatment and 6-month follow-up period of patients were observed.Small airways obstruction and air-trapping sign were observed by post-expiratory CT scans.Correlation between volume of air-trapping and pulmonary function tests was studied.Results During stages of pre-,post-treatment and 6-month follow-up period,checking rates of CT images of active pulmonary tuberculosis were 95.0%,31.7% and 3.3%,respectively.During follow-up period without medicine,there were still 39 patients(65.0%),whose residual lesions had been reduced and absorbed.Small airway diseases still existed after treatment.FEF25%,FEF50% and MMEF were significantly correlated in volume of air-trapping and pulmonary function indexes(P<0.05).Conclusions CT

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

    Directory of Open Access Journals (Sweden)

    Lalit Singh

    2015-01-01

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

  10. Population Structure among Mycobacterium tuberculosis Isolates from Pulmonary Tuberculosis Patients in Colombia

    Science.gov (United States)

    Realpe, Teresa; Correa, Nidia; Rozo, Juan Carlos; Ferro, Beatriz Elena; Gomez, Verónica; Zapata, Elsa; Ribon, Wellman; Puerto, Gloria; Castro, Claudia; Nieto, Luisa María; Diaz, Maria Lilia; Rivera, Oriana; Couvin, David; Rastogi, Nalin; Arbelaez, Maria Patricia; Robledo, Jaime

    2014-01-01

    Background Phylogeographic composition of M. tuberculosis populations reveals associations between lineages and human populations that might have implications for the development of strategies to control the disease. In Latin America, lineage 4 or the Euro-American, is predominant with considerable variations among and within countries. In Colombia, although few studies from specific localities have revealed differences in M. tuberculosis populations, there are still areas of the country where this information is lacking, as is a comparison of Colombian isolates with those from the rest of the world. Principal Findings A total of 414 M. tuberculosis isolates from adult pulmonary tuberculosis cases from three Colombian states were studied. Isolates were genotyped using IS6110-restriction fragment length polymorphism (RFLP), spoligotyping, and 24-locus Mycobacterial interspersed repetitive units variable number tandem repeats (MIRU-VNTRs). SIT42 (LAM9) and SIT62 (H1) represented 53.3% of isolates, followed by 8.21% SIT50 (H3), 5.07% SIT53 (T1), and 3.14% SIT727 (H1). Composite spoligotyping and 24-locus MIRU- VNTR minimum spanning tree analysis suggest a recent expansion of SIT42 and SIT62 evolved originally from SIT53 (T1). The proportion of Haarlem sublineage (44.3%) was significantly higher than that in neighboring countries. Associations were found between M. tuberculosis MDR and SIT45 (H1), as well as HIV-positive serology with SIT727 (H1) and SIT53 (T1). Conclusions This study showed the population structure of M. tuberculosis in several regions from Colombia with a dominance of the LAM and Haarlem sublineages, particularly in two major urban settings (Medellín and Cali). Dominant spoligotypes were LAM9 (SIT 42) and Haarlem (SIT62). The proportion of the Haarlem sublineage was higher in Colombia compared to that in neighboring countries, suggesting particular conditions of co-evolution with the corresponding human population that favor the success of this

  11. Case-finding for pulmonary tuberculosis in Penang.

    Science.gov (United States)

    Hooi, L N

    1994-09-01

    The process of case-finding was studied in 100 consecutive patients with pulmonary tuberculosis treated by the Chest Clinic, Penang Hospital. The median time from the onset of the illness until the initial medical consultation was two weeks (patient's delay). This delay was longer in males, patients with lower than secondary education and drug abusers. Only 47% of patients were put on treatment with a correct diagnosis within one month of the first consultation (doctor's delay). Almost all patients had at least one symptom suggestive of tuberculosis at presentation and the mean number of consultations before diagnosis was three. Patients who first visited government medical facilities had shorter doctor's delay than those who first saw private practitioners, and patients who first consulted a private practitioner were the least likely to be appropriately investigated by sputum examination and chest radiography. The median total delay was three months and at the time of diagnosis, 95% of patients had moderate or far advanced disease radiologically. In order to shorten doctor's delay, all medical practitioners, especially those in the private sector, should be made aware of the importance of early diagnosis and the proper management of tuberculosis. Health education campaigns for the public should also be undertaken to shorten patient's delay.

  12. The analysis of lower respiratory tract infection pathogens in active pulmonary tuberculosis group%活动性肺结核合并下呼吸道感染的致病菌群分析

    Institute of Scientific and Technical Information of China (English)

    苗小艳; 刘薇

    2012-01-01

    目的 通过对活动性肺结核合并呼吸道感染的住院患者痰样检测观察,探讨肺结核住院患者下呼吸道致病菌种的分布及药物敏感情况.方法 选取大连市结核病医院1999年1月至2002年1月间住院的活动性肺结核同时合并下呼吸道感染患者164例,对患者晨起漱口后咯出气管深部痰液,置于无菌器皿内及时送检.接种于血平板和伊红美兰平板内24 h后观察,然后按细菌学特征鉴定,及进行抗菌药物体外药敏试验并列表分析.结果 本组肺结核住院患者以Gˉ菌引起的下呼吸道感染为主,占71.8%,真菌感染占28.7%,厌氧菌感染占4.6%,G+球菌占3.8%.单纯感染者59例,占36.0%;伴两种(或两种以上)细菌生长属混合感染105例,占64.0%.结论 肺结核住院患者下呼吸道致病菌种以Gˉ菌为主,真菌感染次之,感染者多为老年复治患者.分析反复发病原因,既往应用多种抗痨药物及抗生素,造成菌群失调导致二重感染.绝大多数肺结核患者营养状况差,住院时间长,极易造成院内感染.菌株检出率相对偏高,且混合感染多.%Objective To investigate the distribution and drug sensitivity of the pathogens in inpatients with active pulmonary tuberculosis combined with lower respiratory tract infection. Methods 164 cases of hospitalized active pulmonary tuberculosis patients with lower respiratory tract infection from January 1999 to January 2002 were collected. Patients' morning sputa in deep trachea were sampled, inoculated on blood agar and eosin methylene blue tablet, and observed after 24 hours. Bacteria identification and drug susceptibility test were performed. Results The main pathogens that caused lower respiratory tract infection of inpatients with tuberculosis were G- bacteria, accounting for 71. 8%; The other pathogens were fungi (28. 7%), anaerobic bacteria (4. 6%), and G+ cocci (3. 8%). There were 59 cases of simple infection (36. 0%) and 105 cases

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

    Directory of Open Access Journals (Sweden)

    Shilpa Bawankule

    2010-07-01

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

  14. Clinical Value of Mycobacterium Tuberculosis in Sputum of Patients With Pulmonary Tuberculosis%肺结核患者痰中结核分枝杆菌检验的临床价值

    Institute of Scientific and Technical Information of China (English)

    郭春梅; 李玉梅; 刘佃香

    2016-01-01

    ObjectiveThis study was to investigate the clinical value of mycobacterium tuberculosis in sputum of patients with pulmonary tuberculosis.Methods In our hospital,125 cases of active pulmonary tuberculosis and 25 cases of non active pulmonary tuberculosis patients as the research object.Results Active pulmonary tuberculosis culture positive rate(63.12%)was higher than non active pulmonary tuberculosis(χ2=4.208 5,P<0.001). Conclusion The culture of mycobacterium tuberculosis can improve the positive detection rate of Mycobacterium tuberculosis,and it is of great significance in the early detection and treatment of tuberculosis.%目的:本研究探讨肺结核患者痰中结核分歧杆菌检验的临床价值。方法以我院的125例活动性肺结核和25例非活动性肺结核患者为研究对象。结果活动性肺结核培养的阳性率(63.12%)高于非活动性肺结核(χ2=4.2085,P<0.001)。结论结核分歧杆菌培养有利于提高结核分歧杆菌的阳性检出率,在结核病变早期检出、治疗有着重要的意义。

  15. Epidemiology of extra pulmonary tuberculosis in Eastern Sudan

    Institute of Scientific and Technical Information of China (English)

    Taj; Eldin; Mohammedein; Abdallah; Fatah; Elrahman; Mohmmed; Toum; Osman; Habeeb; Bashir; Tajedin; Ibrahim; mansoor; Mona; Mamoun; Yuosif; Mustafa; Awad-Elseed; Elkhawad; Idris; Osman; Okud; Abbashar; Osman; Mohammed; Abdel; Aziem; Abdalla; Ali

    2015-01-01

    Objective: To investigate the epidemiological factors associated with extra pulmonary tuberculosis(EPTB) in Kassala, Eastern Sudan.Methods: Patients infected with TB(pulmonary and extra-pulmonary) documented at the hospital were interviewed with a structured questionnaire used to gather socio-demographic information. The diagnosis of EPTB cases was based on presence of tuberculous granulomas in the histological samples, positive PCR to DNA of mycobacterium tuberculosis, radiological i ndings and l uid analysis suggestive of EPTB and clinical diagnosis with adequate response to anti-tuberculous therapy.Results: A total of 985 patients with TB were enrolled in the study, including 761(77.3%) with PTB and 224(22.7%) with EPTB. The mean age(SD) of patients with PTB and EPTB was 33.2(15.4) and 34.7(14.6) years respectively. The prevalence of EPTB was at(22.7%), with TB lymphadenitis 79(35.3%), marking the frequent form of EPTB followed by peritoneal TB 27(12.05%). While residence and occupation were not associated with EPTB, those with lower level of education(OR = 0.3; coni dence intervals(CI) = 0.2-0.5; P < 0.001), female(OR = 8.7, CI = 4.9-15.1, P < 0.001), non vaccination(OR=70.3, CI = 34.2-144.3, P < 0.001), and non smoker(OR = 0.1; CI = 0.06-0.20; P < 0.001), were associated with high prevalence of EPTB. Conclusions: Around one quarter of patients with TB in this study were more likely to have EPTB. Therefore, ef ective strategic plans regarding diagnostic procedures and control measures are needed to reduce the burden of the disease in Sudan.

  16. Pattern recognition in pulmonary tuberculosis defined by high content peptide microarray chip analysis representing 61 proteins from M. tuberculosis.

    Directory of Open Access Journals (Sweden)

    Simani Gaseitsiwe

    Full Text Available BACKGROUND: Serum antibody-based target identification has been used to identify tumor-associated antigens (TAAs for development of anti-cancer vaccines. A similar approach can be helpful to identify biologically relevant and clinically meaningful targets in M. tuberculosis (MTB infection for diagnosis or TB vaccine development in clinically well defined populations. METHOD: We constructed a high-content peptide microarray with 61 M. tuberculosis proteins as linear 15 aa peptide stretches with 12 aa overlaps resulting in 7446 individual peptide epitopes. Antibody profiling was carried with serum from 34 individuals with active pulmonary TB and 35 healthy individuals in order to obtain an unbiased view of the MTB epitope pattern recognition pattern. Quality data extraction was performed, data sets were analyzed for significant differences and patterns predictive of TB+/-. FINDINGS: Three distinct patterns of IgG reactivity were identified: 89/7446 peptides were differentially recognized (in 34/34 TB+ patients and in 35/35 healthy individuals and are highly predictive of the division into TB+ and TB-, other targets were exclusively recognized in all patients with TB (e.g. sigmaF but not in any of the healthy individuals, and a third peptide set was recognized exclusively in healthy individuals (35/35 but no in TB+ patients. The segregation between TB+ and TB- does not cluster into specific recognition of distinct MTB proteins, but into specific peptide epitope 'hotspots' at different locations within the same protein. Antigen recognition pattern profiles in serum from TB+ patients from Armenia vs. patients recruited in Sweden showed that IgG-defined MTB epitopes are very similar in individuals with different genetic background. CONCLUSIONS: A uniform target MTB IgG-epitope recognition pattern exists in pulmonary tuberculosis. Unbiased, high-content peptide microarray chip-based testing of clinically well-defined populations allows to visualize

  17. Evaluation of the Mean Cost and Activity Based Cost in the Diagnosis of Pulmonary Tuberculosis in the Laboratory Routine of a High-Complexity Hospital in Brazil

    Science.gov (United States)

    de Almeida, Isabela N.; de Assis Figueredo, Lida J.; Soares, Valéria M.; Vater, Maria C.; Alves, Suely; da Silva Carvalho, Wânia; Kritski, Afrânio L.; de Miranda, Silvana S.

    2017-01-01

    At a global level, with the increase in healthcare costs, there is a need to assess the economic impact of the incorporation of new technologies in different health disorders in different countries. There is scarce information regarding costs incurred with the use of current or new diagnostic tests for tuberculosis or from the vantage point of their incorporation within the healthcare systems of high-burden countries. The present study aimed to assess the mean cost and the activity based cost of the laboratory diagnosis for tuberculosis by means of conventional techniques and from the Detect TB®LabTest molecular test kit in a general high-complexity hospital of the public health system in Brazil. Cost analysis was performed by means of primary data, collected in the Mycobacteria and Molecular Biology Laboratory in 2013. The mean cost and activity based cost were, respectively, U$10.06/U$5.61 for centrifuged bacilloscopy by Ziehl Neelsen (ZN) and Auramine (AU); U$7.42/U$4.15 for direct bacilloscopy by ZN; U$27.38/U$16.50 for culture in a Loweinstein-Jensen solid medium; and U$115.74/U$73.46 for the Detect TB®LabTest Kit. The calculation of the ABC should be used in making decisions by administrators to be the best method of assessing the costs of conventional techniques and molecular method for providing the real value of the tests. So it is need to calculate the ABC, and not of the mean cost, in various scenarios before incorporating new technologies in health institutions. PMID:28261194

  18. Type 2 diabetes mellitus coincident with pulmonary or latent tuberculosis results in modulation of adipocytokines.

    Science.gov (United States)

    Pavan Kumar, Nathella; Nair, Dina; Banurekha, V V; Dolla, Chandrakumar; Kumaran, Paul; Sridhar, Rathinam; Babu, Subash

    2016-03-01

    Type 2 diabetes mellitus (T2DM) is recognized as major risk factor for the progress of active pulmonary tuberculosis (PTB), although the mechanistic link between diabetes and tuberculosis remains poorly characterized. Moreover, the influence of poorly controlled diabetes on the baseline levels of adipocytokines in the context of tuberculosis has not been explored in detail. To characterize the influence of coexistent DM on adipocytokine levels in pulmonary or latent TB (LTB), we examined circulating levels of adipocytokines in the plasma of individuals with PTB-DM or LTB-DM and compared them with those without DM (PTB or LTB). PTB-DM or LTB-DM is characterized by diminished circulating levels of adiponectin and adipsin and/or heightened circulating levels of leptin, visfatin and PAI-1. In addition, adiponectin and adipsin exhibit a significant negative correlation, whereas leptin, visfatin and PAI-1 display a significant positive correlation with HbA1C levels and random blood glucose levels. Therefore, our data reveal that PTB-DM or LTB-DM is characterized by alterations in the systemic levels of adipocytokines, indicating that altered adipose tissue inflammation underlying Type 2 diabetes potentially contributes to pathogenesis of TB disease.

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

    Science.gov (United States)

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

    2009-10-01

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

  20. Wegener′s granulomatosis disease mimicking pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Naveen Pandhi

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Nazan Dalgic

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Alessandro Perazzo

    2014-03-01

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

  4. Pulmonary involvement in patients presenting with extra-pulmonary tuberculosis: thinking beyond a normal chest x-ray

    Directory of Open Access Journals (Sweden)

    Herath S

    2014-03-01

    Full Text Available INTRODUCTION: Recognition of pulmonary involvement in extra-pulmonary tuberculosis (TB may be an important public health issue, as smear-negative pulmonary TB is responsible for about 17% of new infections. Pulmonary TB can be present despite a normal chest x-ray (CXR, even in human immunodeficiency virus (HIV–negative patients. In this retrospective clinical audit, we reviewed a case series of HIV-negative patients with extra-pulmonary tuberculosis to identify the proportion with concurrent pulmonary TB despite an unremarkable CXR. METHODS: Clinical notes, microbiology results and CXR reports were reviewed from consecutive patients treated at Auckland City Hospital for extra-pulmonary TB from January 2007 to July 2010. RESULTS: Of the sample of 103 patients with extra-pulmonary TB, the majority of patients were born in an Asian country (n=70; 68%. The commonest presentation of extra-pulmonary TB was lymphadenopathy (n=51; 50%, followed by pleural (n=24; 23% and bone (n=6; 6% disease. Extra-pulmonary TB was diagnosed by biopsy or excision of the extra-pulmonary site in the majority (n=74; 72%, and by sputum testing alone in 26 (25%. The majority had CXR abnormalities (n=76; 74%. In the group with a normal CXR (n=27, 55% (n=15 had sputum cultures performed. In total, 18% (n=5 of patients with extra-pulmonary TB and a normal CXR had pulmonary TB, of whom two were smear positive. DISCUSSION: In patients with extra-pulmonary TB, sputum testing should be considered to detect concurrent pulmonary TB even if a CXR is normal, especially in immunosuppressed or symptomatic patients. This may aid diagnosis and determine infectivity and consequent public health action.

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

    Directory of Open Access Journals (Sweden)

    Dan-Dan Xu

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

  6. Seasonality in pulmonary tuberculosis among migrant workers entering Kuwait

    Directory of Open Access Journals (Sweden)

    Mohammad Hameed GHH

    2008-01-01

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

  7. Channa striatus capsules induces cytokine conversion in pulmonary tuberculosis patients

    Directory of Open Access Journals (Sweden)

    Novita Paliliewu

    2013-06-01

    Full Text Available Objective: This study aimed to investigate whether Channa striatus capsule induces sputum and cytokine conversion in pulmonary tuberculosis (TB patients. Methods: Randomized, placebo-controlled, double-blind pilot study was conducted to pulmonary TB patients who admitted to Department of Internal Medicine, Faculty of Medicine, University of Sam Ratulangi, Manado, North Sulawesi, Indonesia. A total of 36 pulmonary TB patients were randomly divided into two equal groups (n = 18 including one group received standart antituberculosis drugs plus Channa striatus capsule and another group received standart antituberculosis drugs plus placebo. Channa striatus capsule was given at a dose of 2 g each time, 3 times per day, for 12 weeks. The levels of tumor necrosis factor (TNF-α, interferon (IFN-γ, and interleukin (IL-10 were analyses using enzyme linked immunosorbent assay (ELISA method. Results: The rate of positive sputum smear decline was more pronounced in the Channa striatus group but did not reach statistically different value between groups. The levels of TNF-α, IFN-γ, and IL-10 were not significantly different in Channa striatus group compared to placebo group at baseline (week 0. But at week 12, the supplementation of Channa striatus capsule significantly decreased TNF-α, IFN-γ, and IL-10 levels compared to baseline. In placebo groups, there were no significant differences for IL-10 levels at week 12, but the levels of TNF-α and IFN-γ significantly decreased. Conclusion: Adjunctive supplementation of Channa striatus capsules accelerated the beneficial therapeutic effect of TB chemotherapy by improving cytokine response. [J Exp Integr Med 2013; 3(3.000: 237-242

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

    Energy Technology Data Exchange (ETDEWEB)

    Soussan, Michael, E-mail: michael.soussan@avc.aphp.fr [Université Paris 13, Faculté de médecine SMBH, Department of Nuclear Medicine, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Brillet, Pierre-Yves [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Mekinian, Arsène [Université Paris 13, Faculté de médecine SMBH, Department of Internal Medicine, Hôpital Jean Verdier, Bondy (France); Khafagy, Abrahim [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Nicolas, Patrick [Université Paris 13, Faculté de médecine SMBH, Department of Pharmacology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Vessieres, Annie [Université Paris 13, Faculté de médecine SMBH, Department of Bacteriology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France); Brauner, Michel [Université Paris 13, Faculté de médecine SMBH, Department of Radiology, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny (France)

    2012-10-15

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

  9. THE VALIDITY OF MYCOBACTERIUM TUBERCULOSIS ANTIGENS COCKTAIL: ESAT-6, CFP-10 AND MPT64 IN SPUTUM AND CEREBROSPINAL FLUID FOR PULMONARY TUBERCULOSIS AND TUBERCULOUS MENINGITIS DIAGNOSIS

    OpenAIRE

    Dewi Kartika Turbawaty; Nenny Gustiani; Livia Noviani; Ida Parwati

    2015-01-01

    Objective: To determine the validity of tuberculosis (TB) antigen cocktail (ESAT-6, CFP-10 and MPT64) for pulmonary tuberculosis and TB meningitis diagnosis. Methods: This is a descriptive observational study design. The study was conducted at the Clinical Pathology Laboratory of Dr. Hasan Sadikin General Hospital during September 2012 until March 2013 for the pulmonary tuberculosis study and from January 2014 to May 2014 for the TB meningitis study. The TB antigen cocktail rapid imm...

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

    Directory of Open Access Journals (Sweden)

    Adriana Antônia da Cruz Furini

    2013-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Alonso Soto

    2013-08-01

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

  12. Central Nervous System Tuberculosis

    OpenAIRE

    Bano, Shahina; Chaudhary, Vikas; Yadav, Sachchidanand

    2012-01-01

    Central nervous system tuberculosis is a rare presentation of active tuberculosis and accounts for about 1% of cases (1). The three clinical categories include meningitis, intracranial tuberculomas, and spinal tuberculous arachnoiditis. We report a case of a young man who presented with active pulmonary tuberculosis in addition to tuberculous meningitis and the presence of numerous intracranial tuberculomas.

  13. Reactivation of pulmonary tuberculosis following local radiation therapy of prostate cancer.

    Science.gov (United States)

    Thomas, Persis; Foley, Raymond; Kosowicz, Lynn

    2014-02-01

    In this report, we describe the case of an 81-year-old male with reactivation tuberculosis following local radiation therapy for prostate cancer. The patient was asymptomatic except for an unintentional 20-pound weight loss and was incidentally found to have a pulmonary infiltrate in the right upper lobe on imaging for shoulder pain. The medical history was not able for recently treated prostate cancer. After further investigation, the patient was determined to have Mycobacterium tuberculosis infection. It is important to have a high level of suspicion for reactivation tuberculosis in patients with a pulmonary infiltrate following radiation therapy due to the impact of radiation on the host's immune system. We will review the literature on reactivation tuberculosis following radiation therapy and explore the mechanism of immunosuppression in this process. To our knowledge, this is the first reported case of tuberculosis reactivation following local radiation therapy for prostate cancer.

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

    Directory of Open Access Journals (Sweden)

    Qi Yuhua

    2012-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Roya Alavi-Naini

    2009-09-01

    Full Text Available

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

  16. Diagnosing sputum/smear-negative pulmonary tuberculosis: Does fibre-optic bronchoscopy play a significant role?

    Directory of Open Access Journals (Sweden)

    Bachh Arshad

    2010-01-01

    Full Text Available Background : Diagnosis of sputum/smear-negative pulmonary tuberculosis patients can be both challenging and time consuming with many patients being put on empirical anti-tubercular treatment. Fibreoptic bronchoscopy may provide a confirmative and early diagnosis in such patients. Aims: To assess the role of fibreoptic bronchoscopy in the diagnosis of sputum /smear-negative pulmonary tuberculosis. Materials and Methods: The study was conducted on 75 suspected sputum / smear-negative pulmonary tuberculosis cases attending Pulmonary Medicine Department of Mamata Medical College and Hospital, Khammam, AP. Fibreoptic bronchoscopy was performed; culture of sputum and bronchial washings for Mycobacterium tuberculosis was done by BACTEC method. Results: A final diagnosis of sputum /smear-negative pulmonary tuberculosis was made in 60 patients. Bronchial washings smear for acid-fast bacilli (AFB was positive in 21 patients while culture of bronchial washings was positive in 39 patients. In 29 patients, smear or culture of bronchial washing alone contributed to the final diagnosis. Total yield of bronchoscopy in diagnosis of sputum smear negative pulmonary tuberculosis was 83.33% (50/60; bronchoscopy was the only diagnostic method in 66% cases (40/60 with bronchial washings being the only diagnostic method in 48.33%. Bronchial washings smear for AFB and histopathological evidence of caseating granuloma made immediate diagnosis possible in 48.33% (29/60 patients. Conclusion: Our study suggests that fibreoptic bronchoscopy can provide excellent material for diagnosis of suspected cases of Pulmonary Tuberculosis in whom smears of expectorated sputum do not reveal mycobacteria.

  17. Strain Diversity of Mycobacterium tuberculosis Isolates from Pulmonary Tuberculosis Patients in Afar Pastoral Region of Ethiopia

    Directory of Open Access Journals (Sweden)

    Mulugeta Belay

    2014-01-01

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

  18. Evaluation of blood PCR in the diagnosis of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Aliakbar Heydari

    2012-05-01

    Full Text Available Background and Aim: Culture and specific staining (including Zeil-Nelson and fluorescent methods are standard measures for the diagnosis of tuberculosis (TB.Because these methods are time-consuming and, sometimes, due to their low accuracy faster and more accurate methods are necessitated. Methods, which can substitute invasive procedures, when obtaining smear samples and culture is not possible and in addition to being simple and fast, they have an acceptable diagnostic accuracy. The aim of the present study was to verify the diagnostic value of blood PCR in pulmonary TB. Materials and Methods: This case-control study included 64 proven pulmonary TB cases (according to The National TB Protocol and 28 subjects who were completely healthy. 4.5ml of blood was derived from each participant and then mixed with 0.5ml EDTA. Finally, DNA extraction and PCR testing using SI 6110 primers was performed for all blood samples. Results: Mean age of the cases and controls was 49.8±18.6 and 48.2±18.5, respectively. 49.2% of the cases and 25% of controls were male. Blood PCR in 23 patients with TB was positive, but none of the controls had a positive PCR (thus, sensitivity of 35.7% and specificity of 100%. Conclusion: With regard to specificity of 100% in PCR method (despite its low sensitivity, in conditions where there is no access to an appropriate specimen, a positive blood PCR can obviate invasive procedures and rapid and definitive diagnosis of the disorder and timely treatment of the patient, his life is saved.

  19. Is there a rationale for pulmonary rehabilitation following successful chemotherapy for tuberculosis?

    Directory of Open Access Journals (Sweden)

    Marcela Muñoz-Torrico

    Full Text Available ABSTRACT The role of tuberculosis as a public health care priority and the availability of diagnostic tools to evaluate functional status (spirometry, plethysmography, and DLCO determination, arterial blood gases, capacity to perform exercise, lesions (chest X-ray and CT, and quality of life justify the effort to consider what needs to be done when patients have completed their treatment. To our knowledge, no review has ever evaluated this topic in a comprehensive manner. Our objective was to review the available evidence on this topic and draw conclusions regarding the future role of the "post-tuberculosis treatment" phase, which will potentially affect several million cases every year. We carried out a non-systematic literature review based on a PubMed search using specific keywords (various combinations of the terms "tuberculosis", "rehabilitation", "multidrug-resistant tuberculosis", "pulmonary disease", "obstructive lung disease", and "lung volume measurements". The reference lists of the most important studies were retrieved in order to improve the sensitivity of the search. Manuscripts written in English, Spanish, and Russian were selected. The main areas of interest were tuberculosis sequelae following tuberculosis diagnosis and treatment; "destroyed lung"; functional evaluation of sequelae; pulmonary rehabilitation interventions (physiotherapy, long-term oxygen therapy, and ventilation; and multidrug-resistant tuberculosis.The evidence found suggests that tuberculosis is definitively responsible for functional sequelae, primarily causing an obstructive pattern on spirometry (but also restrictive and mixed patterns, and that there is a rationale for pulmonary rehabilitation. We also provide a list of variables that should be discussed in future studies on pulmonary rehabilitation in patients with post-tuberculosis sequelae.

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

    Directory of Open Access Journals (Sweden)

    Zhang Tian-Hua

    2010-06-01

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

  1. 初治活动性继发性肺结核的HRCT影像研究%The high-resolution CT imaging of active secondary pulmonary tuberculosis in the primary therapy

    Institute of Scientific and Technical Information of China (English)

    吕岩; 李成海; 谢汝明; 王岳; 周震; 宁锋钢; 周新华; 贺伟

    2015-01-01

    Objective To study the high-resolution CT imaging feature of active secondary pulmonary tuberculosis in the primary therapy.Methods High-resolution CT imaging of 323 cases with active secondary pulmonary tuberculosis in the primary therapy in Beijing Chest Hospital, Capital Medical University were collected, and the lesion distribution and morphological characteristics were observed, respectively. The imaging of high-resolution CT in pulmonary tuberculosis of negative and positive sputum for tuberculous bacterium were compared, the difference of count data in two groups were analyzed by Chi-square test and Logistic regression.Results Among the 323 cases, the lesions of 86 (26.6%) case located in single lung lobe, the lesions of 237 (73.4%) case located in more lung lobe and more segment, mostly in S1, S2 and S6. High-resolution CT manifestation: centrilobular nodles, there were alveolar nodules in 282 case and "tree-in-bud" sign in 193 case, 45 cases with "reversed halo sign" among them, reversed halos with nodular walls and nodules inside the halos were observed. There were 293 (90.7%) lobular and subsegmental consolidation, 115 (35.6%) segmental comsolidation, 22 (6.8%) lobe consolidation , of which, the CT ifndings showed small patchy low-density areas in the lesions, and with bronchiectasis and cavity in part lesions. There were 37 spherical or mass lesions, > 3 cm, the contrast-enhanced CT scanning showed that ring enhancement and uneven enhancement appeared small patchy low-density areas and boundaries were vague. There were 123 interstitial abnormalities, intralobular, include intralobular reticular reticulation with 105 (85.4%) cases, thickened interlobular septum with 35 (28.5%) cases, thickened peribroncho-vascular interstitium with 86 (69.9%) cases, thickening of the airway wall in telecentric end with 78 (90.7%) cases. Lung parenchyma and interstitial lesions: 131 (40.6%) cases with ground-glass opacity. Along with the sign: 112 (34.7%) cases with

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

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seo In; Seon, Hyun Ju; Kim, Yun Hyeon [Dept. of Radiology, Chunnam National University Hospital, Gwangju (Korea, Republic of); Choi, Sung [Dept. of Radiology, Chunnam National University Hwasun Hospital, Hwasun(Korea, Republic of)

    2011-12-15

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

  3. Assessment of Cardiovascular Fitness of Patients with Pulmonary Tuberculosis Using Six Minute Walk Test

    Directory of Open Access Journals (Sweden)

    Taofeek Oluwole Awotidebe

    2010-04-01

    Full Text Available AIM: Patients with pulmonary tuberculosis (TB tends to have limited exercise tolerance and a significant disability affecting their activities of daily living. The importance of exercise in the management of these patients has not been well investigated. This study was designed to assess the cardiovascular fitness of patients with pulmonary TB using the six-minute walk test (6-MWT. METHOD: Sixty five consented patients with Pulmonary TB were consecutively recruited into the study. The patients performed 6-MWT over a 30 meter course on a level walkway at a speed as fast as they could. Data were obtained on participants’ physical characteristics, pre and post exercise blood pressure and heart rate, and maximum oxygen consumption. Data were analyzed using descriptive statistics of mean and standard deviation and paired t-test. RESULTS: The post walk test cardiovascular parameters were significantly higher than the resting cardiovascular parameters. The mean VO2 max and MET of the participants were 11.7±0.97 (ml O2kg -1min-1 and 3.35±0.28 (mL/Kg respectively. The means 6-MWT distance for male and female participants were 502.0±43.0m 481.7±68.3m respectively. CONCLUSION: The result implies that the 6-MWT is capable of evoking a significant cardiovascular change among patients with pulmonary TB. The 6-MWT may be useful in the assessment of functional capacity of patients with pulmonary TB. [TAF Prev Med Bull 2010; 9(2.000: 99-106

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

    Directory of Open Access Journals (Sweden)

    Mani Harika eVemula

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    José Danilo Pacheco González

    2010-12-01

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

  6. Association of Pulmonary Tuberculosis and HIV in the Mexican Institute of Social Security, 2006-2014

    Science.gov (United States)

    Padilla-Velázquez, Rosario; Valle-Alvarado, Gabriel; Arriaga-Nieto, Lumumba; Rojas-Mendoza, Teresita; Rosado-Quiab, Ulises; Grajales-Muñiz, Concepción

    2016-01-01

    Background Tuberculosis and HIV remain a public health problem in developed countries. The objective of this study was to analyze the incidence trends of pulmonary TB and HIV comorbidity and treatment outcomes according to HIV during the period 2006 to 2014 in the Mexican Institute of Social Security. Methods Analyzed data from this registry including pulmonary tuberculosis patients aged 15 years and older who had been diagnosed during the years 2006 to 2014 in the Mexican Institute of Social Security. The outcomes that we use were incidents rate, failure to treatment and death. Regression models were used to quantify associations between pulmonary tuberculosis and HIV mortality. Results During the study period, 31,352 patients were registered with pulmonary tuberculosis. The incidence rate observed during 2014 was 11.6 case of PTB per 100,000. The incidence rate for PTB and HIV was 0.345 per 100,000. The PTB incidence rate decreased by 0.07%, differences found in the PTB incidence rate by sex since in women decreased by 5.52% and in man increase by 3.62%. The pulmonary TB with HIV incidence rate decreased by 16.3% during the study period (In women increase 4.81% and in man decrease 21.6%). Analysis of PTB associated with HIV by age groups revealed that the highest incidence rates were observed for the 30 to 44 years old group. Meanwhile, the highest incidence rates of PTB without HIV occurred among the 60 and more years old individuals. We did not find statistically significant differences between treatment failure and PTB patients with HIV and without HIV. The treatment failure was associated with sex and the region of the patient. We found a strong association between HIV and the probability of dying during treatment. Our data suggested that patients suffering from both conditions (PTB and HIV) have no difference in the probability of failure of treatment contrary to other reports. Hypotheses to this is adherence to tuberculosis treatment with people living with

  7. Comparison of bronchial brushing and sputum in detection of pediatric pulmonary tuberculosis.

    Science.gov (United States)

    Chen, Qiao-Pei; Ren, Shi-Feng; Wang, Xin-Feng; Wang, Mao-Shui

    2016-01-27

    The retrospective study aimed to evaluate the diagnostic value of bronchial brushing and sputum using acid fast bacilli smear, mycobacterial culture and real-time PCR in detection of pediatric pulmonary tuberculosis, sensitivity and specificity of bronchial brushing and sputum examined by the three methods were calculated and compared to each other. Data showed there were no significant difference in sensitivity between bronchial brushing and matched sputum using each method. But the specificity of real-time PCR on bronchial brushing was lower than on sputum. Compared with bronchial brushing, sputum was better specimen in detection of pediatric pulmonary tuberculosis.

  8. Pulmonary tuberculosis and lepromatous leprosy co-infection in a single individual: A Case report

    Directory of Open Access Journals (Sweden)

    Satyadeo Choubey

    2014-01-01

    Full Text Available The concomitant occurrence of the two oldest mycobacterial diseases that is tuberculosis and leprosy in a single individual is not rare but has been infrequently reported. Herein, we report a case of 34-year-old laborer who concomitantly presented with both sputum positive pulmonary tuberculosis and lepromatous leprosy. The diagnosis of the two diseases was made simultaneously, which is again infrequent in literature. The treatment of leprosy warrants screening of individual for tuberculosis because multi-drug therapy for leprosy may lead to acquired drug resistance for rifampicin, which is a mainstem of anti-tubercular therapy.

  9. A Histomorphological Pattern Analysis of Pulmonary Tuberculosis in Lung Autopsy and Surgically Resected Specimens

    Directory of Open Access Journals (Sweden)

    Mamta Gupta

    2016-01-01

    Full Text Available Background. Tuberculosis (TB is a major cause of morbidity and mortality globally. Many cases are diagnosed on autopsy and a subset of patients may require surgical intervention either due to the complication or sequelae of TB. Materials and Methods. 40 cases of resected lung specimens following surgery or autopsy in which a diagnosis of pulmonary tuberculosis was made were included. Histopathological pattern analysis of pulmonary tuberculosis along with associated nonneoplastic changes and identification of Mycobacterium tuberculosis bacilli was done. Results. The mean age of diagnosis was 41 years with male predominance (92.5%. Tuberculosis was suspected in only 12.1% of cases before death. Seven cases were operated upon due to associated complications or suspicion of malignancy. Tubercular consolidation was the most frequent pattern followed by miliary tuberculosis. The presence of necrotizing granulomas was seen in 33 cases (82.5%. Acid fast bacilli were seen in 57.5% cases on Ziehl-Neelsen stain. Conclusion. Histopathology remains one of the most important methods for diagnosing tuberculosis, especially in TB prevalent areas. It should be considered in the differential diagnosis of all respiratory diseases because of its varied clinical presentations and manifestations.

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

    Directory of Open Access Journals (Sweden)

    Velat Şen

    2014-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Guadalupe Delgado-Sánchez

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

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

    Science.gov (United States)

    Delgado-Sánchez, Guadalupe; García-García, Lourdes; Castellanos-Joya, Martín; Cruz-Hervert, Pablo; Ferreyra-Reyes, Leticia; Ferreira-Guerrero, Elizabeth; Hernández, Andrés; Ortega-Baeza, Victor Manuel; Montero-Campos, Rogelio; Sulca, José Antonio; Martínez-Olivares, Ma. de Lourdes; Mongua-Rodríguez, Norma; Baez-Saldaña, Renata; González-Roldán, Jesús Felipe; López-Gatell, Hugo; Ponce-de-León, Alfredo; Sifuentes-Osornio, José; Jiménez-Corona, María Eugenia

    2015-01-01

    Background Tuberculosis (TB) remains a public health problem in Mexico while the incidence of diabetes mellitus type 2 (DM) has increased rapidly in recent years. Objective To describe the trends of incidence rates of pulmonary TB associated with DM and not associated with DM and to compare the results of treatment outcomes in patients with and without DM. Materials and Methods We analysed the National Tuberculosis Registry from 2000 to 2012 including patients with pulmonary TB among individuals older than 20 years of age. The association between DM and treatment failure was analysed using logistic regression, accounting for clustering due to regional distribution. Results In Mexico from 2000 to 2012, the incidence rates of pulmonary TB associated to DM increased by 82.64%, (p <0.001) in contrast to rates of pulmonary TB rate without DM, which decreased by 26.77%, (p <0.001). Patients with a prior diagnosis of DM had a greater likelihood of failing treatment (adjusted odds ratio, 1.34 (1.11–1.61) p <0.002) compared with patients who did not have DM. There was statistical evidence of interaction between DM and sex. The odds of treatment failure were increased in both sexes. Conclusion Our data suggest that the growing DM epidemic has an impact on the rates of pulmonary TB. In addition, patients who suffer from both diseases have a greater probability of treatment failure. PMID:26075393

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

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

    Science.gov (United States)

    Ordonez, Alvaro A; Tasneen, Rokeya; Pokkali, Supriya; Xu, Ziyue; Converse, Paul J; Klunk, Mariah H; Mollura, Daniel J; Nuermberger, Eric L; Jain, Sanjay K

    2016-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Alvaro A. Ordonez

    2016-07-01

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

  16. Concomitant pulmonary tuberculosis in hospitalized healthcare-associated pneumonia in a tuberculosis endemic area: a multi-center retrospective study.

    Directory of Open Access Journals (Sweden)

    Jia-Yih Feng

    Full Text Available BACKGROUND: In tuberculosis (TB endemic areas, Mycobacterium tuberculosis is an important but easily misdiagnosed pathogen in community-acquired pneumonia (CAP. However, the occurrence of concomitant pulmonary tuberculosis (PTB in hospitalized healthcare-associated pneumonia (HCAP has never been investigated. METHODS AND FINDINGS: Seven hundred and one hospitalized HCAP and 934 hospitalized CAP patients from six medical centers in Taiwan were included in this nationwide retrospective study. Concomitant PTB was defined as active PTB diagnosed within 60 days of admission due to HCAP or CAP. The predictors for concomitant PTB and the impact of PTB on the outcomes of pneumonia were investigated. Among the enrolled subjects, 21/701 (3% of the HCAP patients and 25/934 (2.7% of the CAP patients were documented to have concomitant PTB. In multivariate analysis, a history of previous anti-TB treatment (OR = 5.84, 95% CI: 2.29-20.37 in HCAP; OR = 3.33, 95% CI: 1.09-10.22 in CAP and escalated pneumonia severity index (PSI scores (OR = 1.014, 95% CI: 1.002-1.026, in HCAP; OR = 1.013, 95% CI: 1.001-1.026, in CAP were independent predictors for concomitant PTB in both CAP and HCAP patients. Regarding treatment outcomes, HCAP patients with concomitant PTB were associated with more acute respiratory failure within 48 hours of admission (47.6% vs. 22.6%, p = 0.008, higher intensive care unit admission rate (61.9% vs. 35.7%, p = 0.014, longer hospitalization (39.6±34.1 vs. 23.7±27 days, p = 0.009, and higher in-hospital mortality (47.6% vs. 26.3%, p = 0.03 than those without concomitant PTB. Exposure to certain groups of antibiotics for the treatment of pneumonia was not associated with the occurrence of concomitant PTB. CONCLUSIONS: In HCAP patients, the occurrence of concomitant PTB is comparable with that in CAP patients and associated with higher PSI scores, more acute respiratory failure, and higher in-hospital mortality.

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

    Science.gov (United States)

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

    2012-01-01

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

  18. Capreomycin-induced optic neuritis in a case of multidrug resistant pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Magazine Rahul

    2010-01-01

    Full Text Available A patient of multidrug-resistant pulmonary tuberculosis was prescribed an anti-tubercular regimen containing capreomycin. Patient developed optic neuritis 3 months after starting treatment. Investigations did not reveal any specific cause for this ocular condition and on discontinuing capreomycin his vision recovered. We conclude that capreomycin is the cause of reversible optic neuritis in our case.

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

    Science.gov (United States)

    Aggarwal, Deepak; Chander, Jagdish; Janmeja, Ashok K; Katyal, Rahul

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Deepak Aggarwal

    2015-01-01

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

  1. Induced Sputum for the Diagnosis of Pulmonary Tuberculosis: Is It Useful in Clinical Practice?

    Directory of Open Access Journals (Sweden)

    S-R Olsen

    2010-01-01

    Full Text Available BACKGROUND: Diagnosing pulmonary tuberculosis (PTB is challenging in patients who are unable to spontaneously expectorate. Published evidence suggests that induced sputum (IS is the least invasive and most cost-effective method of diagnosis, and should be used before fibre-optic bronchoscopy (FOB.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  3. Pulmonary tuberculosis: virulence of Mycobacterium africanum and relevance in HIV co-infection.

    Science.gov (United States)

    Meyer, Christian G; Scarisbrick, Genevieve; Niemann, Stefan; Browne, Edmund N L; Chinbuah, Margaret Amanua; Gyapong, John; Osei, Ivy; Owusu-Dabo, Ellis; Kubica, Tanja; Rüsch-Gerdes, Sabine; Thye, Thorsten; Horstmann, Rolf D

    2008-09-01

    Although Mycobacterium africanum is being isolated in a significant proportion of cases of pulmonary tuberculosis in West Africa, its pathogenic potential remains a matter of discussion. Recent reports leave the question of whether M. africanum causes more severe pathology than M. tuberculosis or resembles opportunistic pathogens and might gain importance in the course of the HIV pandemic. Patients with pulmonary tuberculosis associated with M. africanum (n=556) and M. tuberculosis (n=1350) were studied in Ghana, West Africa, and compared regarding self-reported signs and symptoms, chest radiography, HIV status, mycobacterial drug resistance and mycobacterial clustering as determined by spoligotyping and IS6110 fingerprints. The rate of M. africanum infections was similar in HIV-positive (27%) and HIV-negative (30%) patients. M. africanum clustered less than M. tuberculosis (21% vs 79%; OR, 0.38; 95% CI, 0.3-0.5; pHIV-negative patients only. No difference in virulence, as assessed by the severity of radiological presentation, was found when the two M. africanum subtypes West African 1 and West African 2 were compared. In the population studied, M. africanum closely resembled M. tuberculosis in pathology and cannot be considered an opportunistic pathogen.

  4. COLD AGGLUTININ INDUCED HEMOLYTIC ANEMIA IN A PATIENT WITH PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Lohmror Anurag, Choudhary Richa

    2015-11-01

    Full Text Available Autoimmune hemolytic anemias (AIHA are an uncommon group of disorders characterized by red cell destruction due to autoantibodies. Though usually idiopathic, AIHA is commonly associated with lymphoproliferative disorders, infections, autoimmune disease, and some drugs. This report describes a case of 25 year old female presenting history of fever associated with cough and fatigue. There was a past history of receiving blood transfusion on four occasions. The HRCT thorax demonstrated fine nodular densities in right upper lobe, suggestive of tuberculosis. Abdominal ultrasonography revealed mild splenomegaly. A bone marrow biopsy performed on the patient revealed erythroid hyperplasia. There was no evidence of any malignancy. Diagnosis of cold autoantibody hemolytic anemia complicated by pulmonary tuberculosis was made. The patient was managed with blood transfusions and treated with anti-tubercular agents. The occurrence of AIHA in pulmonary tuberculosis is rare.

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

    DEFF Research Database (Denmark)

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

    1999-01-01

    ESAT-6 (for 6-kDa early secreted antigenic target) is a secreted antigen found almost exclusively in organisms of the Mycobacterium tuberculosis complex. We compared in vitro gamma interferon (IFN-gamma) responses by peripheral blood mononuclear cells to this antigen in patients with pulmonary...... disease due to either Mycobacterium avium complex (MAC) or Mycobacterium tuberculosis with those in healthy, skin test-negative, control subjects. Significant IFN-gamma responses to ESAT-6 were detected in 16 (59%) of 27 M. tuberculosis pulmonary disease patients, 0 (0%) of 8 MAC disease patients, and 0...... (0%) of 8 controls. Significant IFN-gamma responses to M. tuberculosis purified protein derivative were detected in 23 (85%) of 27 M. tuberculosis disease patients, 2 (25%) of 8 MAC disease patients, and 5 (63%) of 8 healthy controls. M. avium sensitin was recognized in 24 (89%) of 27 M. tuberculosis...

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

    Directory of Open Access Journals (Sweden)

    Heldal Einar

    2005-02-01

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

  7. Sputum Conversion Among Patients With Smear Positive Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Soudbakhsh A R

    2003-06-01

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

  8. High isoniazid resistance rates in rifampicin susceptible Mycobacterium tuberculosis pulmonary isolates from Pakistan.

    Directory of Open Access Journals (Sweden)

    Naima Fasih

    Full Text Available BACKGROUND: Rapid new diagnostic methods (including Xpert MTB/RIF assay use rifampicin resistance as a surrogate marker for multidrug resistant tuberculosis. Patients infected with rifampicin susceptible strains are prescribed first line anti-tuberculosis therapy. The roll out of such methods raises a concern that strains with resistance to other first line anti-tuberculosis drugs including isoniazid will be missed and inappropriate treatment given. To evaluate implications of using such methods review of resistance data from high burden settings such as ours is essential. OBJECTIVE: To determine resistance to first line anti-tuberculosis drugs amongst rifampicin susceptible pulmonary Mycobacterium tuberculosis (MTB isolates from Pakistan. MATERIALS AND METHODS: Data of pulmonary Mycobacterium tuberculosis strains isolated in Aga Khan University Hospital (AKUH laboratory (2009-2011 was retrospectively analyzed. Antimicrobial susceptibility profile of rifampicin susceptible isolates was evaluated for resistance to isoniazid, pyrazinamide, ethambutol, and streptomycin. RESULTS: Pulmonary specimens submitted to AKUH from 2009 to 2011 yielded 7738 strains of Mycobacterium tuberculosis. These included 54% (n 4183 rifampicin susceptible and 46% (n: 3555 rifampicin resistant strains. Analysis of rifampicin susceptible strains showed resistance to at least one of the first line drugs in 27% (n:1133 of isolates. Overall isoniazid resistance was 15.5% (n: 649, with an isoniazid mono-resistance rate of 4% (n: 174. Combined resistance to isoniazid, pyrazinamide, and ethambutol was noted in 1% (n: 40, while resistance to isoniazid, pyrazinamide, ethambutol, and streptomycin was observed in 1.7% (n: 70 of strains. CONCLUSIONS: Our data suggests that techniques (including Xpert MTB/RIF assay relying on rifampicin susceptibility as an indicator for initiating first line therapy will not detect patients infected with MTB strains resistant to other first line

  9. A description of patients with recurrence of Pulmonary Tuberculosis in a Tuberculosis Hospital, Ermelo

    Directory of Open Access Journals (Sweden)

    Ubon S. Akpabio

    2011-02-01

    Full Text Available Background: Retreatment TB (tuberculosis is a serious category of pulmonary TB with a treatment outcome that could include MDR-TB (multidrug resistant TB. In the Msukaligwa municipality of Mpumalanga Province, South Africa, the burden of TB is high with poor treatment outcome indicators, thus creating some preconditions for retreatment TB. Knowledge of the characteristics of the patients and related health system factors would help in designing interventions to improve the care for patients, the adherence to medication and the prevention of retreatment TB. Aim of the study: The aim was to describe the occurrence, characteristics and management outcome of retreatment pulmonary tuberculosis in patients in a TB hospital in Ermelo.Objectives: The specific objectives were to describe the socio-demographic, behavioural and clinical factors related to recurrence of TB in patients; to determine the contribution of defaulting treatment to recurrence of TB in the study population; to identify the prevalence of resistance to TB medication amongst patients with retreatment TB; and to identify treatment outcomes in patients who have been followed up for the duration of retreatment TB.This study was set in the 58-bed TB hospital in Ermelo.The study design was cross-sectional and descriptive, and the study population comprised of patients admitted with TB at the Ermelo TB hospital between 01 January 2005 and 31 December 2007. Data were collected from the patients’ medical records and the TB registers by using a predesigned form. Data were analysed with Microsoft Excel Spreadsheet at the Centre for Statistical Consultation at the University of Stellenbosch.Results: All of the 388 patient records with retreatment TB, which formed 19.6% of TB patients admitted between 2005 and 2007, were reviewed. This comprised 66% male patients with a mean age of 41.4, and 34% female patients with a mean age of 35.3. They were mostly unemployed, and 93% had a primary

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

    Science.gov (United States)

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

    2013-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Michael Eisenhut

    2016-01-01

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

  12. Differential X-ray diagnosis of disseminated pulmonary tuberculosis and certain collagenoses

    Energy Technology Data Exchange (ETDEWEB)

    Sokolov, V.A. (Sverdlovskij Meditsinskij Inst. (USSR))

    X-ray picture has been analysed in patients of 2 groups. The 1st group included 120 patients with disseminated tuberculosis, the 2 nd one 56 patients with systemic diseases (lupus erythematosus and scleroderma). The disease initial diagnosis was erroneous in 8 cases (4.5%), i.e. in 5 patients tuberculosis was unrecognized, and in 3 the systemic disease. It is marked, that x-ray pulmonary alterations bore interstitial character in collagenoses, and focal in tuberculosis. Predominant apical posterior lung segment lesion was detected in 95% of cases in tuberculosis, while caverns were diagnosed in 65.8%. Besides, radiographic features of the gastrointestinal tract, the skeleton, and the heart damage were established in 82.9% of systemic scleroderma patients.

  13. Deregulated tyrosine-phenylalanine metabolism in pulmonary tuberculosis patients.

    Science.gov (United States)

    Das, Mrinal Kumar; Bishwal, Subasa Chandra; Das, Aleena; Dabral, Deepti; Badireddy, Vinod Kumar; Pandit, Bhaswati; Varghese, George M; Nanda, Ranjan Kumar

    2015-04-01

    Metabolic profiling of biofluids from tuberculosis (TB) patients would help us in understanding the disease pathophysiology and may also be useful for the development of novel diagnostics and host-directed therapy. In this pilot study we have compared the urine metabolic profiles of two groups of subjects having similar TB symptoms and categorized as active TB (ATB, n = 21) and non-TB (NTB, n = 21) based on GeneXpert test results. Silylation, gas chromatography mass spectrometry, and standard chemometric methods were employed to identify the important molecules and deregulated metabolic pathways. Eleven active TB patients were followed up on longitudinally for comparative urine metabolic profiling with healthy controls (n = 11). A set of 42 features qualified to have a variable importance parameter score of > 1.5 of a partial least-squares discriminate analysis model and fold change of > 1.5 at p value phenylalanine metabolic pathway. In the longitudinal study we observed a treatment-dependent trend in the urine metabolome of follow-up samples, and subjects declared as clinically cured showed similar metabolic profile as those of asymptomatic healthy subjects. The deregulated tyrosine-phenylalanine axis reveals a potential target for diagnostics and intervention in TB.

  14. -592 and -1082 interleukin-10 polymorphisms in pulmonary tuberculosis with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  15. Coexistence of pulmonary tuberculosis and sarcoidosis: a diagnostic dilemma.

    Science.gov (United States)

    Mandal, Sanjay Kumar; Ghosh, Sudip; Mondal, Soumya Sarathi; Chatterjee, Sumanta

    2014-12-19

    Tuberculosis and sarcoidosis are multisystem diseases having different aetiology and management; however, they have similar clinical and histological characteristics. Very rarely they may coexist. We report a rare case of a 38-year-old woman who presented with chronic cough, low-grade fever and respiratory distress that was initially diagnosed as miliary tuberculosis. Diagnosis was supported by positive mycobacterial culture and initially responded to antitubercular treatment, but later recurrences led to further investigations and the diagnosis of coexisting sarcoidosis.

  16. Simultaneous occurrence of pulmonary tuberculosis and carcinomatous lymphangitis Ocorrência simultânea de tuberculose pulmonar e linfangite carcinomatosa

    Directory of Open Access Journals (Sweden)

    Felipe Francisco Tuon

    2007-02-01

    Full Text Available Tuberculosis is an important cause of mortality due to its high prevalence, considering that one third of the world’s population is infected with the tuberculosis bacillus. We report the first case of carcinomatous lymphangitis associated with active pulmonary tuberculosis. Carcinomatous lymphangitis is a rare event that may be confounded with tuberculosis because of its radiographic and clinical characteristics.Tuberculose é uma causa importante de mortalidade devido a sua alta prevalência, uma vez que um terço da população mundial encontra-se infectada com o bacilo da tuberculose. Nós relatamos o primeiro caso de linfangite carcinomatosa associada à tuberculose pulmonar ativa. A linfangite carcinomatosa é um evento raro que pode ser confundida com tuberculose pelos aspectos clínicos e radiológicos.

  17. Tuberculosis and pulmonary candidiasis co-infection present in a previously healthy patient

    Science.gov (United States)

    Jiménez Borré, Gustavo; Gómez Camargo, Doris; Chalavé Jiménez, Neylor; Bellido Rodríguez, Javier; Cuadrado Cano, Bernarda; Navarro Gómez, Shirley

    2016-01-01

    Background: The coexistance among fungal pathogens and tuberculosis pulmonary is a clinical condition that generally occurs in immunosuppressive patients, however, immunocompetent patients may have this condition less frequently. Objective: We report the case of an immunocompetent patient diagnosed with coinfection Mycobacterium tuberculosis and Candida albicans. Case Description: A female patient, who is a 22-years old, with fever and a new onset of hemoptysis. Clinical findings and diagnosis: Diminished vesicular breath sounds in the apical region and basal crackling rales in the left lung base were found in the physical examination. Microbiological tests include: chest radiography and CAT scan pictograms in high resolution, Ziehl-Neelsen stain, growth medium for fungus and mycobacteria through Sabouraudís agar method with D-glucose. Medical examinations showed Candida albicans fungus and Mycobacterium tuberculosis present in the patient. Treatment and Outcome: Patient was treated with anti-tuberculosis and anti-fungal medications, which produced good responses. Clinical relevance: Pulmonary tuberculosis and fungal co-infection are not common in immunocompetent patients. However, we can suspect that there is a presence of these diseases by detecting new onset of hemoptysis in patients. PMID:27546933

  18. Relationship between human LTA4H polymorphisms and extra-pulmonary tuberculosis in an ethnic Han Chinese population in Eastern China.

    Science.gov (United States)

    Yang, Jinghui; Chen, Jin; Yue, Jun; Liu, Lirong; Han, Min; Wang, Hongxiu

    2014-12-01

    Two single nucleotide polymorphisms in Leukotriene A4 hydrolase (LTA4H) gene were reported to be associated with protection from pulmonary tuberculosis in Vietnamese population. But these associations were not found in the Russians. To investigate the association of LTA4H polymorphisms with tuberculosis in a Han Chinese population in Eastern China, we genotyped 5 SNPs of LTA4H gene in 743 of pulmonary tuberculosis patients, 372 of extra-pulmonary tuberculosis patients and 888 of healthy controls individuals. The CC and TT homozygotes of rs1978331 and rs2540474 were identified to have higher rates (P tuberculosis (OR = 1.412; 95% CI = 1.104-1.804 and(OR = 1.380; 95% CI = 1.080-1.764). However, no significant association was found between any of the SNPs and pulmonary tuberculosis. In the extra-pulmonary tuberculosis subgroups. LTA4H gene were significantly associated with tuberculous meningitis, lymph node tuberculosis, bone tuberculosis and other extra-pulmonary tuberculosis except for pleural tuberculosis. The present findings suggest that polymorphisms in the LTA4H gene may affect susceptibility to extra-pulmonary tuberculosis and change the risk of developing the disease in the Han nationality in the East China.

  19. Platelet–lymphocyte ratios: a potential marker for pulmonary tuberculosis diagnosis in COPD patients

    Directory of Open Access Journals (Sweden)

    Chen G

    2016-11-01

    Full Text Available Guozhong Chen, Chunling Wu, Zhiying Luo, Yiming Teng, Suping Mao Department of Respiratory Medicine, Yiwu Central Hospital, Yiwu, Zhejiang Province, People’s Republic of China Background: In recent decades, morbidity and mortality have been found to be significantly increased in patients with chronic obstructive pulmonary disease (COPD complicated with pulmonary tuberculosis (PTB. Platelet–lymphocyte ratio (PLR is an indicator for inflammatory diseases. This study aims to investigate whether PLR could act as a potential marker for patients with COPD complicated with PTB.Methods: In this retrospective study, laboratory characteristics of 87 COPD patients complicated with PTB (determined by Mycobacterium tuberculosis positive culture from sputum or bronchial lavage fluid and 83 COPD patients (as the control group, determined by M. tuberculosis culture negativity from sputum or bronchial lavage fluid were investigated. Data obtained on the day of admission were analyzed.Results: PLR >216.82 was identified as the optimal cutoff value for discriminating COPD patients with PTB (sensitivity 92.4%, specificity 84.5%, positive-predictive value 91.6%, negative-predictive value 86.2%, and area under the curve [AUC] was 0.87 from patients with COPD alone. The AUC of PLR was significantly greater than that of neutrophil–lymphocyte count ratio (AUC, 0.74; 95% confidence interval, 0.67–0.81; P<0.01.Conclusion: PLR could be developed as a valuable maker for identifying tuberculosis infection in COPD patients. Keywords: platelet to lymphocyte ratio, pulmonary tuberculosis, chronic obstructive pulmonary disease

  20. Adenosine deaminase in CSF and pleural fluid for diagnosis of tubercular meningitis and pulmonary tuberculosis.

    Science.gov (United States)

    Nepal, A K; Gyawali, N; Poudel, B; Mahato, R V; Lamsal, M; Gurung, R; Baral, N; Majhi, S

    2012-12-01

    Tuberculosis (TB) is one of the most common infectious diseases in developing countries including Nepal. Delay in diagnosis and treatment of tuberculosis results in poor prognosis of the disease. This study was conducted to estimate diagnostic cut off values of Adenosine Deaminase (ADA) in cerebrospinal fluid (CSF) and pleural fluid and to evaluate the sensitivity, specificity, positive and negative predictive values ofADA in pleural fluid and CSF from patients with tuberculous and non-tuberculous disease. A total of 98 body fluid (CSF: 24, Pleural fluid: 74) specimens were received for the estimation of ADA. ADA activity was measured at 37 degrees C by spectrophotometric method of Guisti and Galanti, 1984 at 625nm wavelength. Among the patients enrolled for the study subjects for which CSF were received (n = 24) included 8 tuberculous meningitis (TBM), and 16 non-tubercular meningitis (NTM). Pleural fluid samples (n = 74) were received from 19 pulmonary TB with pleural effusion, 17 PTB without pleural effusion and 37 of non-tuberculous disease patients. CSF ADA activity were (11. 1 +/- 2.03 IU/L) and (5.3 +/- +1.89 IU/L) (p <00001) in TM and non-NTM groups and Pleural fluid ADA activity were (10 +/- 22.18 IU/L) and (23.79 +/- 11.62 IU/L) (p < 0.001) in PTB and non-TB groups respectively. ADA test in body fluids, which is simple, cost-effective and sensitive, specific for the tubercular disease is recommended to perform before forwarding the cumbersome and expensive procedures like culture and PCR for TB diagnosis.

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

    Directory of Open Access Journals (Sweden)

    Vaid Mudit

    2006-01-01

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

  2. The Purinergic P2X7 Receptor Is Not Required for Control of Pulmonary Mycobacterium tuberculosis Infection

    OpenAIRE

    Myers, Amy J.; Eilertson, Brandon; Fulton, Scott A; JoAnne L Flynn; Canaday, David H.

    2005-01-01

    The importance in vivo of P2X7 receptors in control of virulent Mycobacterium tuberculosis was examined in a low-dose aerosol infection mouse model. P2X7−/− mice controlled infection in lungs as well as wild-type mice, suggesting that the P2X7 receptor is not required for control of pulmonary M. tuberculosis infection.

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

    Directory of Open Access Journals (Sweden)

    Pratibha Dube

    2016-01-01

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

  4. [Immunomodulator Intensification of Etioropic Therapy in Patients with Advanced Pulmonary Tuberculosis].

    Science.gov (United States)

    Kolomiets, V M; Abramov, A V; Rachina, N V; Rubleva, N V

    2015-01-01

    The study was aimed at possible increase of the therapy efficacy in patients with advanced tuberculosis by including immunomodulators to the treatment schemes. The data concerning 6034 patients with advanced tuberculosis, mainly fibrocavernous tuberculosis of the lungs, were analysed. Four groups of the patients were randomized. In group 1 the management of the patients included etiotropic therapy and some treatment and rehabilitation measures with the use of Cycloferon. The group 2 patients in addition to the etiotropic therapy and some treatment and rehabilitation measures were given Omega-3. In group 3 the management included the etiotropic therapy and some treatment and rehabilitation measures. In group 4 the etioropic therapy was used alone. The analysis showed that 3419 patients had primary pulmonary tuberculosis, 340 patients had relapsing tuberculosis and 2275 patients had long-term process. The etiotropic therapy efficacy was estimated after an intensive phase of not more than 3 months. In the cases with Mycobacterium tuberculosis drug resistance and some other unfavourable factors it was estimated after a 5-month intensive phase. The results confirmed that inclusion of immunomodulators to the treatment schemes allowed to increase the therapy efficacy and the patients' adherence to the treatment, as well as to shorten the period of the bacteria carriage. Thus, the use of Cycloferon in the schemes of the treatment of the patients with fibrocavernous pulmonary tuberculosis allowed to shorten the period of the pathogen carriage (as well as the drug resistant forms) in 94.1 ± 3.33% of the patients in spite of concomitant diseases. The effect of Cycloferon in such cases was likely due to both its direct immunoprotective action and the improvement of the general state of the patients and their higher adherence to the treatment.

  5. Frequency of hypovitaminosis D and its associated risk factors in newly diagnosed pulmonary tuberculosis patients

    Science.gov (United States)

    Azam, Fahad; Shaheen, Abida; Arshad, Rabia

    2016-01-01

    Objective: To find out the frequency of hypovitaminosis D and its associated risk factors in newly diagnosed pulmonary tuberculosis patients prior to administration of standard anti tuberculosis therapy. Methods: This cross-sectional study was carried out in Ojha Institute of Chest Diseases-DUHS. After approval from BASR and following written informed consent eighty newly diagnosed, as per WHO criteria, tuberculosis patients were enrolled. Prior to the initiation of anti tuberculosis therapy, the serum vitamin D level was determined by 25-OH Vitamin D kit using the chemiluminescent immunoassay (CLIA) method. A cut off value of >30 ng/mL of serum vitamin D was taken as normal whereas a range between 10-30 ng/mL and <10 ng/mL were considered insufficient and deficient respectively. Frequency of socio-demographic associated risk factors of hypovitaminosis D was also determined. Results: Out of eighty newly diagnosed tuberculosis patients 33 (41.25%) were males and 47(58.75%) were females with their ages ranging from 18-50 years. 54 patients (26 male and 28 female patients) were smokers. BMI of all the patients was found to be less than the normal ranges. Hypovitaminosis was present in all the cases. Vitamin D insufficiency was found in 49 participants (20 male and 29 female) whereas 31 patients (13 male and 18 female) were found to be vitamin D deficient. Conclusion: Prevalence of serum vitamin D level derangement is very high in newly diagnosed patients with pulmonary tuberculosis in our local setting which necessitates administration of adjuvant vitamin D along with standard anti tuberculosis therapy. PMID:27182266

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

    DEFF Research Database (Denmark)

    Wang, Qiuzhen; Ma, Aiguo; Bygbjerg, Ib Christian;

    2013-01-01

    deficiencies, such as retinol and vitamin D, which are especially important to immunity of the body and may influence pancreas β-cell function. However, the effects of retinol and vitamin D supplementation in active TB patients with diabetes on treatment outcomes, immune and nutrition state are still uncertain...

  7. EVALUATION OF SEROLOGICAL AND MOLECULAR METHODS OVE R CONVENTIONAL METHODS IN DIAGNOSIS OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Deepika

    2012-10-01

    Full Text Available BACKGROUND : Despite advances in field of microbiology, diagn osis of Tuberculosis remains a challenge. Diagnosis of Extrapulmonary tuberculosis is more problematic due to low bacillary load in the specimen and difficulty in obtaining the specimen from the site of lesion in many cases. PCR and its modifications are a boon in diag nosis of tuberculosis in such cases. But serological methods like ELISA are still the first choice of small laboratories in India. AIM : Comparative evaluation of serological and molecular methods over conventional methods in diagnosis of extrapulmonary and pulmonary tuberculos is. METHODS : 170 different clinical specimens suspected of tuberculosis, (100 pulmonary an d 70 Extrapulmonary were examined by PCR using MPB 64 primer, culture and microscopy. A ll specimens were processed using USP methodology for inhibitors free PCR. TB Ig G, Ig M and Ig A was determined using PATHOZYME MYCO Kit. Response to ATT on clinical follow up was c onsidered as gold standard. RESULTS: Total pulmonary specimens found positive by any of the four tests was 87 (out of 100 while that for extrapulmonary samples was 63(out of 70 . F or Pulmonary Specimens the diagnostic accuracy of microscopy was 88.3%,for culture 88.3%,f or ELISA 67.4% and for PCR 94.1%.For extrapulmonary samples the diagnostic accuracy of microscopy was 30.1%,for culture 49.2%,for ELISA 44.4% and for PCR 87.3%. CONCLUSION: As diagnosis by microscopy and culture are sensitive and specific, for pulmonary spec imens, PCR should be kept reserved for clinically probable cases found negative by conventi onal tests. For Extrapulmonary specimens PCR can be used as an effective screening tool as c onventional methods are mostly negative. ELISA was found to have no role in diagnosis of pul monary TB. For Extrapulmonary TB ELISA can be used as an adjunct tool but results should b e interpreted with utmost caution after full evaluation of the patient both clinically and radiol

  8. USING KRIGING FOR STATISTICAL DISEASE MAPPING OF PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    M MOHAMMAD ZADE

    2003-06-01

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

  9. Diabetes is a risk factor for pulmonary tuberculosis

    DEFF Research Database (Denmark)

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

    2011-01-01

    Background Diabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB) is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent. Methods A case-control study was conducted in an urban...

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

    Directory of Open Access Journals (Sweden)

    Richa Kumari

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

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

    Directory of Open Access Journals (Sweden)

    Korpusenko I.V.

    2015-06-01

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

  12. A case of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection.

    Science.gov (United States)

    Das, Joyutpal; Layton, Benjamin; Lamb, Harriet; Sinnott, Nicola; Leahy, Bernard C

    2015-11-01

    Serratia marcescens is a saprophytic gram-negative bacillus capable of causing a wide range of infections. A 57-year-old female was admitted to our hospital for four weeks with community acquired pneumonia. A chest x-ray, six weeks after discharge, demonstrated multiple, bilateral 'cannon ball'-like opacities and mediastinal lymphadenopathy which were highly suspicious of disseminated malignancy or tuberculosis. The only symptom that this patient had was a productive cough. She had multiple commodities, but no specific immunodeficiency disorder. Interestingly, her sputum and bronchial washing samples grew S. marcescens. The computed tomography-guided lung biopsy demonstrated necrotic granulomatous changes. There was no pathological evidence of tuberculosis or fungal infection, malignancy or vasculitis. There are only a handful of reported cases of Serratia granulomas. Thus, we are reporting a rare instance of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection.

  13. B cells moderate inflammatory progression and enhance bacterial containment upon pulmonary challenge with Mycobacterium tuberculosis.

    Science.gov (United States)

    Maglione, Paul J; Xu, Jiayong; Chan, John

    2007-06-01

    Though much is known about the function of T lymphocytes in the adaptive immune response against Mycobacterium tuberculosis, comparably little is understood regarding the corresponding role of B lymphocytes. Indicating B cells as components of lymphoid neogenesis during pulmonary tuberculosis, we have identified ectopic germinal centers (GCs) in the lungs of infected mice. B cells in these pulmonary lymphoid aggregates express peanut agglutinin and GL7, two markers of GC B cells, as well as CXCR5, and migrate in response to the lymphoid-associated chemokine CXCL13 ex vivo. CXCL13 is negatively regulated by the presence of B cells, as its production is elevated in lungs of B cell-deficient (B cell(-/-)) mice. Upon aerosol with 100 CFU of M. tuberculosis Erdman, B cell(-/-) mice have exacerbated immunopathology corresponding with elevated pulmonary recruitment of neutrophils. Infected B cell(-/-) mice show increased production of IL-10 in the lungs, whereas IFN-gamma, TNF-alpha, and IL-10R remain unchanged from wild type. B cell(-/-) mice have enhanced susceptibility to infection when aerogenically challenged with 300 CFU of M. tuberculosis corresponding with elevated bacterial burden in the lungs but not in the spleen or liver. Adoptive transfer of B cells complements the phenotypes of B cell(-/-) mice, confirming a role for B cells in both modulation of the host response and optimal containment of the tubercle bacillus. As components of ectopic GCs, moderators of inflammatory progression, and enhancers of local immunity against bacterial challenge, B cells may have a greater role in the host defense against M. tuberculosis than previously thought.

  14. Peripheral T cell cytokine responses for diagnosis of active tuberculosis.

    Directory of Open Access Journals (Sweden)

    Johannes Nemeth

    Full Text Available BACKGROUND: A test for diagnosis of active Tuberculosis (TB from peripheral blood could tremendously improve clinical management of patients. METHODS: Of 178 prospectively enrolled patients with possible TB, 60 patients were diagnosed with pulmonary and 27 patients with extrapulmonary TB. The frequencies of Mycobacterium tuberculosis (MTB specific CD4(+ T cells and CD8(+ T cells producing cytokines were assessed using overnight stimulation with purified protein derivate (PPD or early secretory antigenic target (ESAT-6, respectively. RESULTS: Among patients with active TB, an increased type 1 cytokine profile consisting of mainly CD4(+ T cell derived interferon (IFN-γ was detectable. Despite contributing to the cytokine profile as a whole, the independent diagnostic performance of one cytokine producing T cells as well as polyfunctional T cells was poor. IFN-γ/Interleukin(IL-2 cytokine ratios discriminated best between active TB and other diseases. CONCLUSION: T cells producing one cytokine and polyfunctional T cells have a limited role in diagnosis of active TB. The significant shift from a "memory type" to an "effector type" cytokine profile may be useful for further development of a rapid immune-diagnostic tool for active TB.

  15. Glucose Metabolism Disorder Is Associated with Pulmonary Tuberculosis in Individuals with Respiratory Symptoms from Brazil

    Science.gov (United States)

    Castro, Simone; Cafezeiro, Aparecida S.; Daltro, Carla; Netto, Eduardo M.; Kornfeld, Hardy; Andrade, Bruno B.

    2016-01-01

    Background Diabetes mellitus (DM) has been associated with increased risk for pulmonary tuberculosis (PTB) in endemic settings but it is unknown whether PTB risk is also increased by pre-DM. Here, we prospectively examined the association between glucose metabolism disorder (GMD) and PTB in patients with respiratory symptoms at a tuberculosis primary care reference center in Brazil. Methods Oral glucose tolerance test was performed and levels of fasting plasma glucose and glycohemoglobin (HbA1c) were measured in a cohort of 892 individuals presenting with respiratory symptoms of more than two weeks duration. Patients were also tested for PTB with sputum cultures. Prevalence of pre-DM and DM (based on HbA1c) was estimated and tested for association with incident PTB. Other TB risk factors including smoking history were analyzed. Results The majority of the study population (63.1%) exhibited GMD based on HbA1c ≥5.7%. Patients with GMD had higher prevalence of PTB compared to normoglycemic patients. Individuals with DM exhibited increased frequency of TB-related symptoms and detection of acid-fast bacilli in sputum smears. Among patients with previous DM diagnosis, sustained hyperglycemia (HbA1c ≥7.0%) was associated with increased TB prevalence. Smoking history alone was not significantly associated with TB in our study population but the combination of smoking and HbA1c ≥7.0% was associated with 6 times higher odds for PTB. Conclusions Sustained hyperglycemia and pre-DM are independently associated with active PTB. This evidence raises the question whether improving glycemic control in diabetic TB patients would reduce the risk of TB transmission and simultaneously reduce the clinical burden of disease. A better understanding of mechanisms underlying these associations, especially those suggesting that pre-DM may be a factor driving susceptibility to TB is warranted. PMID:27078026

  16. The Investigation of Close-Contacts in Soldier Patients with Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Mustafa Harun Ugan

    2008-06-01

    Full Text Available BACKGROUND: The aim of this study is to estimate the average numbers of close contacts of soldiers patients with tuberculosis (TB, who admitted to Chest Diseases Hospital, in their troops, and to reveal active patients and the cases who needs for chemoprophylaxis, and to evaluate the treatment results. METHODS: This study was done in Pulmonary Division of GATA Haydarpasa Training Hospital between 1st of January 2005 and 31st of March 2006. Persons who worked with soldier patients bacteriologially diagnosed with TB in our hospital, in closed areas, and/or sleeping in the same dormitory were accepted as close contacts. Contacts were performed tuberculin skin test (TST, and taken their chest roentgenogram at 0, 3rd, and 6th months. More than 10 mm indurations in cases with no BCG and 15 mm indurations in cases with BCG were accepted as positive TCT. Close contacts that had positive TST or more than 6 mm increase in their controls were given the chemoprophylaxis with isoniasid for six months. Ninety-two smear positive patients with PTB were enrolled into the study. RESULTS: The mean age was 21.6±2.3 years. Of the 4501 close contacts, 89% were screened during the first period and the control rates at 3rd and 6th months decreased to 58% and 42%, respectively. 11 new tuberculosis cases were found by screening of close contacts (with an incidence of 244/100.000. TST positivity or conversion was shown in 420 contacts, and were given chemoprophylaxis. Of 165 (39.2% were completed six month therapy. COCLUSION: In our study, although the number of close contacts per patients was significantly higher, the incidence of patients in close contacts was low. [TAF Prev Med Bull. 2008; 7(3: 199-204

  17. Interação de fatores riscos em tuberculose Interaction of factors on pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Antônio Ruffino-Netto

    1979-06-01

    Full Text Available Estudou-se o possível sinergismo dos fatores alcoolismo e tabagismo na tuberculose pulmonar, a partir de dados de um estudo caso-controle onde 854 pessoas foram entrevistadas (sendo 427 casos-pacientes portadores de tuberculose pulmonar e 427 controles e questionadas quanto ao hábito de ingestão alcoólica e o de fumar em períodos precedendo ao diagnóstico da doença. Concluiu-se que existe pequena interação destes fatores na tuberculose pulmonar; o hábito de fumar estaria relacionado com a doença tuberculose através de sua associação com a ingestão de bebidas alcoólicas.A case-control study was made of the possible synergetic effect of smoking and alcohol drinking on pulmonary tuberculosis. Analysis of the results of 854 interviews showed that there is little interactive effect in the multiplicative sense (synergism between these factors and pulmonary tuberculosis. It is suggested that the habit of smoking may be related to pulmonary tuberculosis only through its association with that of alcohol drinking.

  18. STUDY OF ATD ANGLE, FINGER RIDGE COUNT IN PULMONARY TUBERCULOSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    Jagdish S. Chaudhari

    2015-12-01

    Full Text Available Objective: To determine whether the Dermatoglyphics parameters in Pulmonary tuberculosis patients (sputum smear positive cases and normal healthy controls were differ or not. Materials and Methods: In present study 100 cases (77 males and 23 females of Pulmonary tuberculosis (sputum smear positive in the age group of 18 to 70 were collected and studied for Dermatoglyphics parameters such as ‘ATD’ angle, total and absolute finger ridge counts. These parameters of cases were compared to those of 100 unrelated healthy subjects (controls and analyzed for statistical significance. Results and conclusion: In present study we observed decrease ‘ATD’ angle in both hands of male and female cases as compared to controls that difference was statistically highly significant. There were no statistically significant difference observed in total finger ridge count (TFRC and absolute finger ridge count (AFRC of cases compared to controls. Dermatoglyphics can be used for screening tool for Pulmonary tuberculosis contacts for genetic susceptibility to disease as a cost effective, noninvasive harmless technique.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-02-01

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

  20. Progression of chronic pulmonary tuberculosis in mice intravenously infected with ethambutol resistant Mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    Srivastava S

    2008-01-01

    Full Text Available Purpose: Ethambutol (EMB is an important first line drug, however little information on its molecular mechanism of resistance and pathogenicity of resistant isolates is available. Present work was designed to study virulence of the EMB resistant M. tuberculosis strains and the host responses in-vivo on infection of EMB resistant M. tuberculosis using Balb/c mouse model of infection. Methods: Three groups of Balb/c mice (female, age 4-6 wk; 21 mice in each group were infected intravenously with 106 CFU of M. tuberculosis H37Rv and two EMB resistant clinical isolates. Age and sex matched control animals were mock inoculated with Middlebrook 7H9 broth alone. At 10, 20, 30, 40, 50, 60, and 70 days post-infection three animals from each group were sacrificed by cervical dislocation and lung tissue was collected for further analysis. Results: Infection with EMB resistant M. tuberculosis led to progressive and chronic disease with significantly high bacillary load (p=0.02. Massive infiltration and exacerbated lung pathology with increased expression of IFN-γ and TNF-α was observed in lungs of mice infected with EMB resistant strains. The present study suggests that infection with EMB resistant M. tuberculosis leads to chronic infection with subsequent loss of lung function, bacterial persistence with elevated expression of TNF-α resulting in increased lung pathology. Conclusion: These findings highlight that EMB resistant M. tuberculosis regulates host immune response differentially and its pathogenicity is different from drug sensitive strains of M. tuberculosis.

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

    Directory of Open Access Journals (Sweden)

    Gessessew Amanuel

    2009-02-01

    Full Text Available Abstract Background Delays seeking care increase transmission of pulmonary tuberculosis and hence the burden of tuberculosis, which remains high in developing countries. This study investigates patterns of health seeking behavior and determines risk factors for delayed patient consultation at public health facilities in 10 districts of Ethiopia. Methods New pulmonary TB patients ≥ 15 years old were recruited at 18 diagnostic centres. Patients were asked about their health care seeking behaviour and the time from onset of symptoms to first consultation at a public health facility. First consultation at a public health facility 30 days or longer after onset of symptoms was regarded as prolonged patient delay. Results Interviews were held with 924 pulmonary patients. Of these, 537 (58% were smear positive and 387 (42% were smear negative; 413 (45% were female; 451 (49% were rural residents; and the median age was 34 years. Prior to their first consultation at a public health facility, patients received treatment from a variety of informal sources: the Orthodox Church, where they were treated with holy water (24%; private practitioners (13%; rural drug vendors (7%; and traditional healers (3%. The overall median patient delay was 30 days (mean = 60 days. Fifty three percent [95% Confidence Intervals (CI (50%, 56%] of patients had delayed their first consultation for ≥ 30 days. Patient delay for women was 54%; 95% CI (54%, 58% and men 51%; 95% CI (47%, 55%. The delay was higher for patients who used informal treatment (median 31 days than those who did not (15 days. Prolonged patient delay (≥ 30 days was significantly associated with both patient-related and treatment-related factors. Significant patient-related factors were smear positive pulmonary disease [Adjusted Odds Ratio (AOR 1.4; 95% CI (1.1 to 1.9], rural residence [AOR 1.4; 95% CI (1.1 to 1.9], illiteracy [AOR 1.7; 95% CI (1.2 to 2.4], and lack of awareness/misperceptions of causes of

  2. Progressive Primary Pulmonary Tuberculosis Presenting as the Sudden Unexpected Death in Infancy: A Case Report

    Science.gov (United States)

    Dempers, Johan; Sens, Mary Ann; Wadee, Shabbir Ahmed; Kinney, Hannah C.; Odendaal, Hein J.; Wright, Colleen A.

    2010-01-01

    The classification of an unexpected infant death as the sudden infant death syndrome (SIDS) depends upon a complete autopsy and death scene investigation to exclude known causes of death. Here we report the death of a four-month-old infant in a tuberculosis endemic area that presented as a sudden unexpected death in infancy (SUDI) with no apparent explanation based on the death scene characteristics. The autopsy, however, revealed progressive primary pulmonary tuberculosis with intrathoracic adenopathy, compression of the tracheobronchial tree and miliary lesions in the liver. This case underscores the clinical difficulties in the diagnosis of infantile tuberculosis, as well as the possibility of sudden death as part of its protean manifestations. The pathology and clinical progression of tuberculosis in infants differs from older children and adults due to the immature immune response in infants. This case dramatically highlights the need for complete autopsies in all sudden and unexpected infant deaths, as well as the public health issues in a sentinel infant tuberculosis diagnosis. PMID:20705406

  3. Fatal Hemoptysis due to Chronic Cavitary Pulmonary Aspergillosis Complicated by Nontuberculous Mycobacterial Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ioannis Kokkonouzis

    2011-01-01

    Full Text Available A 51-year-old man, with a history of severe COPD and bilateral pneumothorax, who was under treatment for pulmonary tuberculosis due to mycobacterium avium, was admitted due to high-grade fever, weight loss, cough, and production of purulent sputum, for almost one month without any special improvement despite adequate antibiotics treatment in outpatient setting. A CT scan revealed multiple consolidations, fibrosis, scaring, and cavitary lesions in both upper lobes with newly shadows which were fungus balls inside them. Aspergillus flavius was isolated in three sputum samples, a diagnosis of chronic cavitary pulmonary aspergillosis was made, and treatment with intravenous amphotericin B was started. An initially clinical improvement was noted, and a first episode of minor hemoptysis was treated with conservative measures. Unfortunately a second major episode of hemoptysis occurred and he died almost immediately. Aspergilloma is defined as the presence of a fungus ball inside a preexisting pulmonary cavity or dilated airway and is one of the clinical conditions associated with the clinical spectrum of pulmonary colonization. Tuberculosis is the most common underling disease. Hemoptysis is the most common symptom. Antifungal antibiotics, surgical interventions, bronchial arteries embolization, and intracavity infusion of antibiotics have been proposed without always adequate sufficiency.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  5. [Multiple pulmonary nodules and posterior uveitis as unusual manifestation of pulmonary tuberculosis].

    Science.gov (United States)

    Ibarburen González-Arenas, C; Zapatero Gaviria, A; Gómez Santos, D; García-Castaño, B; Tomás Ros, M; Merino Morales, F

    1990-12-01

    Pulmonar tuberculosis still being one of the diseases more frequent in our area, this producing different clinical and radiological presentation. A case with posterior uveitis and bilateral lungs nodules which required a thoracotomy to perform a diagnosis, is presented.

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

    Science.gov (United States)

    Conde, Marcus B.; Mello, Fernanda C. Q.; Duarte, Rafael Silva; Cavalcante, Solange C.; Rolla, Valeria; Dalcolmo, Margareth; Loredo, Carla; Durovni, Betina; Armstrong, Derek T.; Efron, Anne; Barnes, Grace L.; Marzinke, Mark A.; Savic, Radojka M.; Dooley, Kelly E.; Cohn, Silvia; Moulton, Lawrence H.; Chaisson, Richard E.; Dorman, Susan E.

    2016-01-01

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

  7. A genome wide association study of pulmonary tuberculosis susceptibility in Indonesians

    Directory of Open Access Journals (Sweden)

    Png Eileen

    2012-01-01

    Full Text Available Abstract Background There is reason to expect strong genetic influences on the risk of developing active pulmonary tuberculosis (TB among latently infected individuals. Many of the genome wide linkage and association studies (GWAS to date have been conducted on African populations. In order to identify additional targets in genetically dissimilar populations, and to enhance our understanding of this disease, we performed a multi-stage GWAS in a Southeast Asian cohort from Indonesia. Methods In stage 1, we used the Affymetrix 100 K SNP GeneChip marker set to genotype 259 Indonesian samples. After quality control filtering, 108 cases and 115 controls were analyzed for association of 95,207 SNPs. In stage 2, we attempted validation of 2,453 SNPs with promising associations from the first stage, in 1,189 individuals from the same Indonesian cohort, and finally in stage 3 we selected 251 SNPs from this stage to test TB association in an independent Caucasian cohort (n = 3,760 from Russia. Results Our study suggests evidence of association (P = 0.0004-0.0067 for 8 independent loci (nominal significance P JAG1, DYNLRB2, EBF1, TMEFF2, CCL17, HAUS6, PENK and TXNDC4. Conclusions Mechanisms of immune defense suggested by some of the identified genes exhibit biological plausibility and may suggest novel pathways involved in the host containment of infection with TB.

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

    Directory of Open Access Journals (Sweden)

    Etienne Mokondjimobe

    2012-01-01

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

  9. Knowledge and practice regarding pulmonary tuberculosis among private practitioners

    Directory of Open Access Journals (Sweden)

    M Basu

    2013-12-01

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

  10. Evaluation and Comparison of Body Mass Index and Albumin Level in Patients with Active Tuberculosis and Latent Tuberculosis Infection

    Directory of Open Access Journals (Sweden)

    Fatemeh Heidarnezhad

    2016-06-01

    Full Text Available Introduction: Limited data are available on the relationship between nutritional status and tuberculosis. The aim of this study was to evaluate and compare the body mass index (BMI and serum albumin level in patients with active tuberculosis (ATB and latent tuberculosis (LTB. Materials and Methods: A cross-sectional study was conducted on 17 patients newly diagnosed with pulmonary TB  who were referred in Iran, during September 2011 to March 2012 and 17 latent tuberculosis infection individuals. Standard method was performed to collect an early morning fasting blood sample for albumin (by the bromocresolgreen method. Also (BMI was calculated as body weight divided by height squared (kg/m2. Results: One-sample Kolmogorov-Smirnov test was used to check normal distribution data The mean ± Standard deviation(SD for albumin in the patients and controls were 3.62±0/56 and 4.68±0.25, respectively. BMI in the patients and controls were 19.46±2.79 and  25.4±3.46, respectively. The serum albumin level was significantly lower in the patient group, compared to the control group (P

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

    Science.gov (United States)

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

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Xin-Xu Li

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Balwani Manish R

    2015-04-01

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

  14. Mycobacterium tuberculosis strains exhibit differential and strain-specific molecular signatures in pulmonary epithelial cells.

    Science.gov (United States)

    Mvubu, Nontobeko Eunice; Pillay, Balakrishna; Gamieldien, Junaid; Bishai, William; Pillay, Manormoney

    2016-12-01

    Although pulmonary epithelial cells are integral to innate and adaptive immune responses during Mycobacterium tuberculosis infection, global transcriptomic changes in these cells remain largely unknown. Changes in gene expression induced in pulmonary epithelial cells infected with M. tuberculosis F15/LAM4/KZN, F11, F28, Beijing and Unique genotypes were investigated by RNA sequencing (RNA-Seq). The Illumina HiSeq 2000 platform generated 50 bp reads that were mapped to the human genome (Hg19) using Tophat (2.0.10). Differential gene expression induced by the different strains in infected relative to the uninfected cells was quantified and compared using Cufflinks (2.1.0) and MeV (4.0.9), respectively. Gene expression varied among the strains with the total number of genes as follows: F15/LAM4/KZN (1187), Beijing (1252), F11 (1639), F28 (870), Unique (886) and H37Rv (1179). A subset of 292 genes was commonly induced by all strains, where 52 genes were down-regulated while 240 genes were up-regulated. Differentially expressed genes were compared among the strains and the number of induced strain-specific gene signatures were as follows: F15/LAM4/KZN (138), Beijing (52), F11 (255), F28 (55), Unique (186) and H37Rv (125). Strain-specific molecular gene signatures associated with functional pathways were observed only for the Unique and H37Rv strains while certain biological functions may be associated with other strain signatures. This study demonstrated that strains of M. tuberculosis induce differential gene expression and strain-specific molecular signatures in pulmonary epithelial cells. Specific signatures induced by clinical strains of M. tuberculosis can be further explored for novel host-associated biomarkers and adjunctive immunotherapies.

  15. Serum PCT and its Relation to Body Weight Gain in Pulmonary Tuberculosis.

    Science.gov (United States)

    Rohini, K; Bhat, Surekha; Srikumar, P S; Mahesh Kumar, A

    2015-07-01

    The present study was aimed at assessing alterations in serum PCT in terms of its relation to body weight gain in pulmonary tuberculosis (PTB) patients undergoing treatment. Among patients (25-75 years) diagnosed with pulmonary tuberculosis, those that were new smear positive, showed sputum conversion at the end of 2 months and were declared clinically cured at the end of 6 months, were included in the study (n = 40). Serum procalcitonin was determined by BRAHMS PCT-Q kit. Patients were divided into two study groups-Group 1 (n = 21; serum PCT > 2 ng/ml at diagnosis), Group 2 (n = 19; serum PCT > 10 ng/ml at diagnosis). Body weights of all patients were obtained at three different time points, PTB-0 (at diagnosis), PTB-2 (after 2 months of intensive treatment) and PTB-6 (after 6 months of treatment). In both groups, mean body weights at PTB-2 and PTB-6 were significantly higher than those at PTB-0 and at PTB-6 were significantly higher than those at PTB-2. However, percentage body weight gain following 2 months of intensive treatment was higher in group 1 (4.05 % gain, p < 0.01) than in group 2 (2.75 % body weight gain, p < 0.05). Thus, the percentage gain in group 1 was tending more towards the desirable minimum gain of 5 % during intensive phase. Increase in serum PCT levels in pulmonary tuberculosis is inversely associated with body weight gain during treatment. Thus, PCT could play a role in regulation of body weight gain in anorectic conditions like tuberculosis.

  16. Isoniazid Mono-Resistant Tuberculosis: Impact on Treatment Outcome and Survival of Pulmonary Tuberculosis Patients in Southern Mexico 1995-2010

    OpenAIRE

    Báez-Saldaña, Renata; Delgado-Sánchez, Guadalupe; García-García, Lourdes; Cruz-Hervert, Luis Pablo; Montesinos-Castillo, Marlene; Ferreyra-Reyes, Leticia; Bobadilla-del-Valle, Miriam; Canizales-Quintero, Sergio; Ferreira-Guerrero, Elizabeth; Téllez-Vázquez, Norma; Montero-Campos, Rogelio; Yanes-Lane, Mercedes; Mongua-Rodriguez, Norma; Martínez-Gamboa, Rosa Areli; Sifuentes-Osornio, José

    2016-01-01

    Background Isoniazid mono-resistance (IMR) is the most common form of mono-resistance; its world prevalence is estimated to range between 0.0 to 9.5% globally. There is no consensus on how these patients should be treated. Objective To describe the impact of IMR tuberculosis (TB) on treatment outcome and survival among pulmonary TB patients treated under programmatic conditions in Orizaba, Veracruz, Mexico. Materials and Methods We conducted a prospective cohort study of pulmonary TB patients...

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

    Directory of Open Access Journals (Sweden)

    J.-Gonzalo Ocejo-Vinyals

    2012-01-01

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

  18. Molecular detection of multidrug-resistant tuberculosis among smear-positive pulmonary tuberculosis patients in Jigjiga town, Ethiopia

    Science.gov (United States)

    Brhane, Mussie; Kebede, Ameha; Petros, Yohannes

    2017-01-01

    Background Molecular methods that target drug resistance mutations are suitable approaches for rapid drug susceptibility testing to detect multidrug-resistant tuberculosis (MDR-TB). The aim of the study was to determine MDR-TB cases and to analyze the frequency of gene mutations associated with rifampicin (RIF) and/or isoniazid (INH) resistance of Mycobacterium tuberculosis among smear-positive pulmonary tuberculosis patients. Methods Institution-based cross-sectional study design was employed. Sputum specimens were collected, and using a pretested questionnaire, data for associated risk factors for drug resistance were collected from 105 consecutive smear-positive pulmonary tuberculosis patients in Karamara General Hospital. Specimens were transported to Harar Health Research and Regional Laboratory, Harar, where molecular drug susceptibility testing was performed using GenoType® MTBDRplus assay. Results Of the total 105 sputum specimens, 98 (93.3%) gave interpretable results, in which 67 (68.4%) were new cases and 31 (31.6%) were previously treated cases. Of these, 80 (81.6%) were sensitive to both drugs and 18 (18.4%) were resistant to RIF and/or INH. The prevalences of MDR-TB in total cases, new, and previously treated cases were 10 (10.2%), 3 (4.5%), and 7 (22.6%), respectively. Among the ten total RIF-resistant specimens, eight (80%) had resulted because of absence of rpoB WT8 and presence of MUT3 and in all specimens, the amino acids changed were Ser531Lue. Of the 18 total INH-resistant specimens, 15 (83.3%) had mutations in the katG gene (katG MUT1, Ser315Thr1), indicating high-level resistance, while 3 (14.7%) had mutations in the inhA promoter gene (Cys15Thr), indicating low-level resistance. Conclusion Among the mutations associated with resistance to RIF and INH, the majority were in codon 531 of the rpoB gene and codon 315 of the katG gene. Relatively high prevalence of MDR-TB was observed in the study.

  19. Evaluation of voice disorders in patients with active laryngeal tuberculosis.

    Directory of Open Access Journals (Sweden)

    Marcia Mendonça Lucena

    Full Text Available Laryngeal tuberculosis (LTB is the most frequent larynx granulomatous disease. In general there is lung involvement, but in an important proportion of cases you can find LTB without pulmonary disease. The lesions observed in LTB, such as ulceration and fibrosis, can interfere in the process of voice production. The involvement of the mucous lining of the vocal folds can change their flexibility and, consequently, change voice quality, and the main symptom is dysphonia present in almost 90% of cases.To describe the anatomical characteristics and voice quality in LTB patients.A descriptive cross-sectional study was conducted with 24 patients.The most frequently affected sites were vocal folds in 87.5% patients, vestibular folds in 66.7%, epiglottis in 41.7%, arytenoid in 50%, aryepiglottic folds in 33.3%, and interarytenoid region in 33.3% patients. We found 95.8% cases of dysphonia. The voice acoustic analysis showed 58.3% cases of Jitter alterations, 83.3% of Shimmer and 70.8% of GNE.Voice disorders found in active laryngeal tuberculosis are similar to those reported after clinical healing of the disease, suggesting that sequelae and vocal adjustments may install during the active phase of the disease, negatively impacting the process of vocal quality reestablishment.

  20. [Pulmonary actinomycosis and tuberculosis. A comorbidity pediatric case].

    Science.gov (United States)

    Bisero, Elsa D; Luque, Graciela F; Rizzo, Cristina N; Zapata, Alejandra E; Cuello, María S

    2016-08-01

    La actinomicosis es una infección supurativa crónica, producida por bacterias Gram-positivas anaeróbicas o especies Actinomyces microaerófilas. Es rara en niños y adolescentes; es más común en inmunodeprimidos. El Mycobacterium tuberculosis colabora en el desarrollo de la enfermedad. La afectación pulmonar aparece como un cuadro de condensación crónica que no mejora con el tratamiento antibiótico convencional. Las complicaciones clásicas de afectación de la pared torácica con fistulización y supuración en «granulo de azufre» son descritas con menor frecuencia en la actualidad. El diagnóstico es un verdadero desafío y se establece mediante el aislamiento de las especies de Actinomyces. El tratamiento de elección para todas las formas clínicas de la enfermedad es el uso prolongado de antibióticos. Objetivo. Presentar un caso pediátrico de comorbilidad entre tuberculosis y actinomicosis. Resaltar la importancia de la sospecha diagnóstica de actinomicosis frente a todo proceso supurado crónico.

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

    Directory of Open Access Journals (Sweden)

    Geeta S. Pardeshi

    2008-11-01

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

  2. Clinical features of 203 infants with pulmonary tuberculosis%婴儿肺结核203例临床特征分析

    Institute of Scientific and Technical Information of China (English)

    龚春竹; 朱朝敏

    2014-01-01

    Objectives To summarize the clinical features and relevant factors of 203 cases with infantile pulmonary tuberculosis. Methods Clinical data of 203 infantile with pulmonary tuberculosis were retrospectively reviewed. Results Among 203 infants, 127 (62.6%) were from country, 76 (37.4%) from city;64.5%of city infants have received BCG vaccination, which is higher than 46.5%in country infants;78 cases (38.4%) have clear evidence for active tuberculosis exposure, 26 cases (12.8%) have suspicious tuberculosis exposure;175 cases (86.2%) have fever, 165 cases (81.3%) have respiratory symptoms, 107 cases (52.7%) have pulmonary signs, 80 cases (39.4%) have hepatosplenomegaly;Etiology was conifrmed in 91 cases (44.8%);54.7%of patients were found with concurrent extrapulmonary tuberculosis, and the most commonly seen was formis tuberculous meningitis. In this study, the misdiagnosis rate is 39.9%, and 84.0%patients were often misdiagnosed as bronchial pneumonia;Vaccinated BCG rate is lower in infants with severe tuberculosis (44.83%) than that of infants with mild tuberculosis (74.14%). Conclusions Infantile pulmonary tuberculosis is featured with acute onset, severe clinical performance and easily complicated with extrapulmonary tuberculosis, atypical clinical performance, and high misdiagnosed rate which needs early detection and diagnosis. Unvaccinated BCG and active tuberculosis exposure were important clues for the diagnosis of infantile pulmonary tuberculosis.%目的:总结分析婴儿肺结核的临床特点及相关因素。方法回顾性分析2001年至2011年收治的203例婴儿肺结核的临床资料。结果203例住院肺结核患儿中,来自农村127例(62.56%),城市76例(37.44%);城市患儿BCG接种率(64.47%)高于农村(46.46%),差异有统计学意义(P<0.05)。有明确活动性肺结核接触史78例(38.42%),可疑结核接触史26例(12.81%);临床表现发热175例(86.21%),呼吸道症状165例(81.28%),有肺部体征107例(52

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

    Directory of Open Access Journals (Sweden)

    Antonio Flavio Ferraz

    2014-03-01

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

  4. Molecular diversity of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in Mozambique

    Directory of Open Access Journals (Sweden)

    Hill Véronique

    2010-07-01

    Full Text Available Abstract Background Mozambique is one of the countries with the highest burden of tuberculosis (TB in Sub-Saharan Africa, and information on the predominant genotypes of Mycobacterium tuberculosis circulating in the country are important to better understand the epidemic. This study determined the predominant strain lineages that cause TB in Mozambique. Results A total of 445 M. tuberculosis isolates from seven different provinces of Mozambique were characterized by spoligotyping and resulting profiles were compared with the international spoligotyping database SITVIT2. The four most predominant lineages observed were: the Latin-American Mediterranean (LAM, n = 165 or 37%; the East African-Indian (EAI, n = 132 or 29.7%; an evolutionary recent but yet ill-defined T clade, (n = 52 or 11.6%; and the globally-emerging Beijing clone, (n = 31 or 7%. A high spoligotype diversity was found for the EAI, LAM and T lineages. Conclusions The TB epidemic in Mozambique is caused by a wide diversity of spoligotypes with predominance of LAM, EAI, T and Beijing lineages.

  5. Molecular analysis of Rv0679c and Rv0180c genes of Mycobacterium tuberculosis from clinical isolates of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    L Rupa

    2016-01-01

    Full Text Available Context: Two novel proteins/genes Rv0679c and Rv0180c of Mycobacterium tuberculosis (MTB H37Rv were classified as a hypothetical membrane and transmembrane proteins which might have a role in the invasion. Molecular analysis of these genes in human clinical isolates of pulmonary tuberculosis (PTB patients was not well characterised. Aims: To assess the molecular diversity of Rv0679c and Rv0180c genes of MTB from clinical isolates of PTB patients. Settings and Design: DNA from 97 clinical isolates was extracted and subjected to amplification using selective primers by polymerase chain reaction (PCR. The PCR product obtained was sequenced commercially. Patients and Methods: Clinical isolates obtained from tuberculosis patients were investigated for polymorphisms in the Rv0679c and Rv0180c genes by PCR and DNA sequencing. Genomic DNA isolated by cetyltrimethylammonium bromide method was used for amplification of genes. Results: Rv0679c gene was highly conserved in 61 out of 65 clinical isolates assessed for sequence homology with wild-type H37Rv gene and was identical using ClustalW. Fifty-five out of 78 (70.5% clinical isolates assessed for Rv0180c were positive for single nucleotide polymorphism (SNP at 258th position where the nucleotide G was replaced with T (G to T. In clinical isolates of untreated cases, the frequency was 54.5% for SNP at 258th position which is low compared to cases undergoing treatment where the frequency was 73.1%. Conclusions: Molecular analysis of Rv0180c in clinical isolates of PTB assessed in this study was the first report, where an SNP at 258th position G to T was identified within the gene. Rv0679c gene was highly conserved (94%, within Indian clinical isolates as compared to reports from other nations.

  6. Effect of anti-tuberculosis therapy on liver function of pulmonary tuberculosis patients infected with hepatitis B virus

    Institute of Scientific and Technical Information of China (English)

    Lei Pan; Zhan-Sheng Jia; Lin Chen; En-Qing Fu; Guang-Yu Li

    2005-01-01

    AIM: To observe the effect of anti-tuberculosis therapy on liver function of pulmonary tuberculosis patients with hepatitis B virus (HBV) infection, and to compare the differences of liver function by two treatments of antituberculosis.METHODS: Forty-seven TB patients with HBV infection and 170 TB patients without HBV infection were divided into HPBE(S) and HLAMKO treatment groups. Liver function tests before and after the treatments were performed once in 2 wk or monthly, and their clinical manifestations were recorded.RESULTS: The rate of hepatotoxicity occurred in 26 (59%)TB patients with HBV during anti-TB treatment, higher than that in 40 (24%) TB patients without HBV. Hepatotoxicity occurred in 66 out of 217 patients, and the incidence of liver dysfunction was 46.1% in HPBE(S) group, significantly higher than that in HLAMKO group (12.7%) (P<0.01).CONCLUSION: TB patients with HBV should choose HLAMKO treatment because of fewer hepatotoxicity.

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

    Directory of Open Access Journals (Sweden)

    Cleoni Alves Mendes de Lima

    2013-06-01

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

  8. Plasma drug activity assay for treatment optimization in tuberculosis patients.

    Science.gov (United States)

    Heysell, Scott K; Mtabho, Charles; Mpagama, Stellah; Mwaigwisya, Solomon; Pholwat, Suporn; Ndusilo, Norah; Gratz, Jean; Aarnoutse, Rob E; Kibiki, Gibson S; Houpt, Eric R

    2011-12-01

    Low antituberculosis (TB) drug levels are common, but their clinical significance remains unclear, and methods of measurement are resource intensive. Subjects initiating treatment for sputum smear-positive pulmonary TB were enrolled from Kibong'oto National TB Hospital, Tanzania, and levels of isoniazid, rifampin, ethambutol, and pyrazinamide were measured at the time of typical peak plasma concentration (C(2 h)). To evaluate the significance of the effect of observed drug levels on Mycobacterium tuberculosis growth, a plasma TB drug activity (TDA) assay was developed using the Bactec MGIT system. Time to detection of plasma-cocultured M. tuberculosis versus time to detection of control growth was defined as a TDA ratio. TDA assays were later performed using the subject's own M. tuberculosis isolate and C(2 h) plasma from the Tanzanian cohort and compared to drug levels and clinical outcomes. Sixteen subjects with a mean age of 37.8 years ± 10.7 were enrolled. Fourteen (88%) had C(2 h) rifampin levels and 11 (69%) had isoniazid levels below 90% of the lower limit of the expected range. Plasma spiked with various concentrations of antituberculosis medications found TDA assay results to be unaffected by ethambutol or pyrazinamide. Yet with a range of isoniazid and rifampin concentrations, TDA exhibited a statistically significant correlation with drug level and drug MIC, and a TDA of ~1.0 indicated the presence of multidrug-resistant TB. In Tanzania, low (≤ 2.0) TDA was significantly associated with both lower isoniazid and rifampin C(2 h) levels, and very low (≤ 1.5) TDA corresponded to a trend toward lack of cure. Study of TDA compared to additional clinical outcomes and as a therapeutic management tool is warranted.

  9. Pulmonary tuberculosis in Asian elephants (Elephas maximus): histologic lesions with correlation to local immune responses.

    Science.gov (United States)

    Landolfi, J A; Terio, K A; Miller, M; Junecko, B F; Reinhart, T

    2015-05-01

    Although Mycobacterium tuberculosis infection is an important health concern for Asian elephants (Elephas maximus), no studies have evaluated the associated local immune responses or histologic lesions. In primates including humans, latent tuberculosis is distinguished by well-organized granulomas with TH1 cytokine expression, whereas active disease is characterized by poorly organized inflammation and local imbalance in TH1/TH2 cytokines. This study examined archival, formalin-fixed, paraffin-embedded lung samples from 5 tuberculosis-negative and 9 tuberculosis-positive Asian elephants. Lesions were assessed by light microscopy, and lymphoid infiltrates were characterized by CD3 and CD20 immunolabeling. Expression of TH1 (interferon [IFN]-γ, tumor necrosis factor [TNF]-α) and TH2 (interleukin [IL]-4, IL-10, transforming growth factor [TGF]-β) cytokines was determined using in situ hybridization. In 6 of 9 samples, inflammation was similar to the pattern of primate active disease with low to moderate numbers of lymphocytes, most of which were CD20 positive. In 1 sample, inflammation was most similar to latent tuberculosis in primates with numerous CD3-positive lymphocytes. Expression of IFN-γ was detected in 3 of 8 tuberculosis-positive samples. Expression of TNF-α was detected in 3 of 8 positive samples, including the one with latent morphology. Low-level expression of IL-4 was present in 4 of 8 positive samples. Only single positive samples displayed expression of IL-10 and TGF-β. Tuberculosis-negative samples generally lacked cytokine expression. Results showed heterogeneity in lesions of elephant tuberculosis similar to those of latent and active disease in primates, with variable expression of both TH1 and TH2 cytokines.

  10. Evidence from Chile that arsenic in drinking water may increase mortality from pulmonary tuberculosis.

    Science.gov (United States)

    Smith, Allan H; Marshall, Guillermo; Yuan, Yan; Liaw, Jane; Ferreccio, Catterina; Steinmaus, Craig

    2011-02-15

    Arsenic in drinking water causes increased mortality from several cancers, ischemic heart disease, bronchiectasis, and other diseases. This paper presents the first evidence relating arsenic exposure to pulmonary tuberculosis, by estimating mortality rate ratios for Region II of Chile compared with Region V for the years 1958-2000. The authors compared mortality rate ratios with time patterns of arsenic exposure, which increased abruptly in 1958 in Region II and then declined starting in 1971. Tuberculosis mortality rate ratios in men started increasing in 1968, 10 years after high arsenic exposure commenced. The peak male 5-year mortality rate ratio occurred during 1982-1986 (rate ratio = 2.1, 95% confidence interval: 1.7, 2.6; P cause of chronic lung disease. Finding weaker associations in women is unsurprising, because this is true of most arsenic-caused health effects. Confirmatory evidence is needed from other arsenic-exposed populations.

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

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sang Chul; Kim, Yong Ju; Park, Joong Wha; Lee Myeong Sub; Kim Dong Jin; Hong In Soo [Yonsei Univ. College of Medicine, Wonju (Korea, Republic of)

    2001-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jun Cheng

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

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

    Science.gov (United States)

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

    2016-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Busi Rizzi, E. E-mail: radiologia@inmi.it; Schinina, V.; Palmieri, F.; Girardi, E.; Bibbolino, C

    2003-06-01

    AIM: To evaluate whether highly active antiretroviral therapy (HAART) modifies radiographic appearances of pulmonary tuberculosis (TB), in terms of patterns and their relative frequencies, among patients with human immunodeficiency virus (HIV) infection. MATERIALS AND METHODS: Chest radiographs were obtained in 209 HIV-infected patients with culture confirmed pulmonary TB. Computed tomography (CT) images were also reviewed for 42 patients whose chest radiographs were normal or showed questionable abnormalities. Imaging was evaluated for the presence and distribution of consolidation, cavitation, interstitial changes, pleural disease, adenopathy, and were classified as a primary or post-primary pattern. RESULTS: A post-primary pattern was more frequent after 1996 when HAART came into clinical use. Forty-four percent (77/176) of patients not on HAART had a post-primary pattern in comparison with 82% (27/33) of patients receiving HAART (p<0.001). A primary pattern was significantly more frequent (p<0.001), in patients with more severe immunosuppression (CD4 lymphocyte less than 200/mm{sup 3}). CONCLUSION: HIV patients receiving HAART with pulmonary TB, had a post-primary pattern more frequently than those not receiving this treatment. This observation is consistent with the partial restoration of cell-mediated immunity that can be induced by HAART.

  15. Utility of line probe assay for the early detection of multidrug-resistant pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    K Madhuri

    2015-01-01

    Full Text Available Background: Despite endorsement of the line probe assay (LPA for the diagnosis of drug-resistant pulmonary tuberculosis patients, there is limited data available on the performance of LPAs in India, especially from high burden states like Maharashtra, for the early diagnosis and detection of drug resistance, in order to initiate timely and appropriate treatment. Objective: To evaluate the utility of the line probe assay (LPA for the early diagnosis of drug-resistant pulmonary tuberculosis as compared to the ′Gold standard′ 1% proportion method (PM. Materials and Methods: A total of 687 patients suspected of pulmonary tuberculosis were screened. One hundred samples (95 sputum and 5 BAL, positive for Acid Fast Bacilli (AFB by Ziehl Neelson (ZN smears, were included in the study. Digested and decontaminated specimens were subjected directly to the LPA (Genotype MTBDR@ plus assay and were processed in parallel using the conventional culture on the Lowenstein-Jensen (LJ medium followed by drug susceptibility testing (DST using the PM. Results: All the 100 samples gave interpretable results on LPA with a turnaround time of 24-48 hours as opposed to six to eight weeks taken by the 1% proportion method. Sensitivity for the detection of rifampicin, isoniazid, and multidrug resistance (MDR was 98.1, 92.1, and 95%, respectively, with a specificity of 97.8% for rifampicin and 98.33% for MDR detection. It also had the additional advantage of allowing a study of mutation patterns. Conclusions: High performance characteristics and a short turnaround time makes LPA an excellent diagnostic tool, for an early and accurate diagnosis, in a high MDR- TB-prevalent region, as reflected from our data.

  16. Experience of active tuberculosis case finding in nearly 5 million households in India

    Science.gov (United States)

    Satyanarayana, S.; Chadha, S. S.; Das, A.; Thapa, B.; Mohanty, S.; Pandurangan, S.; Babu, E. R.; Tonsing, J.; Sachdeva, K. S.

    2016-01-01

    In India, to increase tuberculosis (TB) case detection under the National Tuberculosis Programme, active case finding (ACF) was implemented by the Global Fund-supported Project Axshya, among high-risk groups in 300 districts. Between April 2013 and December 2014, 4.9 million households covering ~20 million people were visited. Of 350 047 presumptive pulmonary TB cases (cough of ⩾2 weeks) identified, 187 586 (54%) underwent sputum smear examination and 14 447 (8%) were found to be smear-positive. ACF resulted in the detection of a large number of persons with presumptive pulmonary TB and smear-positive TB. Ensuring sputum examination of all those with presumptive TB was a major challenge. PMID:27051605

  17. The Effect of Low CD4+ Lymphocyte Count on the Radiographic Patterns of HIV Patients with Pulmonary Tuberculosis among Nigerians.

    Science.gov (United States)

    Affusim, Christopher; Abah, Vivien; Kesieme, Emeka B; Anyanwu, Kester; Salami, Taofik A T; Eifediyi, Reuben

    2013-01-01

    Objective. To assess the radiographic features in patients with Human Immunodeficiency Virus (HIV) complicated by pulmonary tuberculosis (PTB), and the association with CD4 lymphocyte count and sputum smear. Method. A prospective study was carried out on 89 HIV positive patients with PTB. The demographics, smoking history, sputum smear result, chest radiographic findings and CD4 lymphocyte count were documented. Results. Out of the 89 patients recruited in the study, 41 were males and 48 were females. Eighteen (18) patients had typical radiographic features, 60 patients had atypical radiographic features while only 11 of them had normal radiographic films. Sixty eight (68) patients had CD4 count HIV) complicated by pulmonary tuberculosis.

  18. Development of a simple reliable radiographic scoring system to aid the diagnosis of pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Lancelot M Pinto

    Full Text Available RATIONALE: Chest radiography is sometimes the only method available for investigating patients with possible pulmonary tuberculosis (PTB with negative sputum smears. However, interpretation of chest radiographs in this context lacks specificity for PTB, is subjective and is neither standardized nor reproducible. Efforts to improve the interpretation of chest radiography are warranted. OBJECTIVES: To develop a scoring system to aid the diagnosis of PTB, using features recorded with the Chest Radiograph Reading and Recording System (CRRS. METHODS: Chest radiographs of outpatients with possible PTB, recruited over 3 years at clinics in South Africa were read by two independent readers using the CRRS method. Multivariate analysis was used to identify features significantly associated with culture-positive PTB. These were weighted and used to generate a score. RESULTS: 473 patients were included in the analysis. Large upper lobe opacities, cavities, unilateral pleural effusion and adenopathy were significantly associated with PTB, had high inter-reader reliability, and received 2, 2, 1 and 2 points, respectively in the final score. Using a cut-off of 2, scores below this threshold had a high negative predictive value (91.5%, 95%CI 87.1,94.7, but low positive predictive value (49.4%, 95%CI 42.9,55.9. Among the 382 TB suspects with negative sputum smears, 229 patients had scores <2; the score correctly ruled out active PTB in 214 of these patients (NPV 93.4%; 95%CI 89.4,96.3. The score had a suboptimal negative predictive value in HIV-infected patients (NPV 86.4, 95% CI 75,94. CONCLUSIONS: The proposed scoring system is simple, and reliably ruled out active PTB in smear-negative HIV-uninfected patients, thus potentially reducing the need for further tests in high burden settings. Validation studies are now required.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

  20. Mapping the epidemiology and trends of extra-pulmonary tuberculosis in Saudi Arabia.

    Science.gov (United States)

    Varghese, Bright; Al-Hajoj, Sahal

    2015-12-01

    An extra-pulmonary tuberculosis (EPTB) infection rate of 30% in Saudi Arabia remains above the global rate. A variable rate of infection in each province has been reported and the involvement of most organs has been cited. Nationwide collective data on the current trends of infection are scarce and the factors behind the increased rate of EPTB are perplexing. This review endeavors to shed light into the epidemiology of EPTB, various types of infections sites, geographical differences in the infection rate, known risk factors, and challenges in the diagnosis and management of EPTB in Saudi Arabia.

  1. [PECULIARITES OF SIMULTANT INTERVENTIONS FOR SOME TYPES OF CHRONIC PHTHISIC PLEURITIS, COEXISTENT WITH PULMONARY TUBERCULOSIS].

    Science.gov (United States)

    Duzhiy, I D; Grehsko, I Ya; Kravets, O V; Oleshchenko, G P; Glazunova, N I

    2016-01-01

    In coincidence of chronic phthisic pleuritis in a rigid stage with pulmonary tuberculosis operative intervention is indicated of a pleuropulmonectomy type, what is a complex situation for performance and preservation of the patient's functional state. Pleuropulmonectomy in some patients is complicated by empyema and pathological processes in bronchi. Possibilities of operative interventions application, alternative to pleuropulmonectomy, were studied. Of 48 patients, to whom pleuropulmonectomy is indicated in accordance to data of clinic-roentgenological investigations, in 7--simultant operative treatment were conducted with positive results.

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

    Directory of Open Access Journals (Sweden)

    Kalmykova Y.S.

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Ana Lucia Roscani Calusni

    2003-07-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  5. Pulmonary tuberculosis - An emerging risk factor for venous thromboembolism: A case series and review of literature

    Directory of Open Access Journals (Sweden)

    Amitesh Gupta

    2017-01-01

    Full Text Available One-third of patients with symptomatic venous thromboembolism (VTE manifest pulmonary embolism, whereas two-thirds manifest deep vein thrombosis (DVT. Overall, 25%–50% of patients with first-time VTE have an idiopathic condition, without a readily identifiable risk factor, and its association with tuberculosis (TB is a rare occurrence. Deep venous thrombosis has been associated with 1.5%–3.4% cases of TB. Early initiation of anti-TB treatment along with anticoagulant therapy decreases the overall morbidity and mortality associated with the disease. We report three cases of DVT associated with pulmonary TB who were diagnosed due to high index of suspicion as the risk factors for the development of DVT were present in these cases.

  6. Pulmonary tuberculosis - An emerging risk factor for venous thromboembolism: A case series and review of literature

    Science.gov (United States)

    Gupta, Amitesh; Mrigpuri, Parul; Faye, Abhishek; Bandyopadhyay, Debdutta; Singla, Rupak

    2017-01-01

    One-third of patients with symptomatic venous thromboembolism (VTE) manifest pulmonary embolism, whereas two-thirds manifest deep vein thrombosis (DVT). Overall, 25%–50% of patients with first-time VTE have an idiopathic condition, without a readily identifiable risk factor, and its association with tuberculosis (TB) is a rare occurrence. Deep venous thrombosis has been associated with 1.5%–3.4% cases of TB. Early initiation of anti-TB treatment along with anticoagulant therapy decreases the overall morbidity and mortality associated with the disease. We report three cases of DVT associated with pulmonary TB who were diagnosed due to high index of suspicion as the risk factors for the development of DVT were present in these cases. PMID:28144063

  7. A case of Bochdalek hernia in adult misdiagnosed as pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Pradosh Kumar Sarangi

    2017-01-01

    Full Text Available Bochdalek hernias are congenital defects resulting from the failure of posterolateral diaphragmatic foramina to fuse in utero. Usually it manifests in the neonatal period and occasionally in childhood. Symptomatic Bochdalek hernias in adults are infrequent and may lead to gastrointestinal dysfunction or severe pulmonary disease. Patients are initially investigated and treated for other diseases, therefore diagnosis is purely incidental. Herein, we are reporting a case of symptomatic Bochdalek hernia in an 18-year-old female misdiagnosed as pulmonary tuberculosis and treated accordingly, but with no improvement. This case illustrates importance of high index of clinical suspicion and role of computed tomography in avoiding misdiagnosis and occurrence of serious complication if not treated early. [J Med Allied Sci 2017; 7(1.000: 59-63

  8. STUDY OF EFFECT OF IMMUNOMODULATOR IN TREATMENT OF CATEGORY - I SPUTUM POSITIVE PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Rabindra Kumar

    2015-10-01

    Full Text Available BACKGROUND : Tuberculosis is amongst one of the major public health problems in the developing countries of the world today . Modern Chemotherapy kills most of the bacilli within days. WHO initiated DOTS for treating TB but still success rate of treatment is less. Immune response in most of the tuberculosis patients is inappropriate because of gross tissue destruction and progre ssion of the disease. The nature of an effective immune response to TB is incompletely understood but the most effective vaccination strategies is to stimulate T - cell responses, both CD4 and CD8, to produce Th - 1 associated cytokines. So rationale for TB i mmunotherapy is to replace immunopathology with protective antibacterial immunity. Mycobacter i um w. have such immunogenic properties, so it was used in clinical trial as an injectable immunomodulator adjuvant to treatment of sputum positive new Pulmonary T B cases taking Cat - 1 therapy. AIMS AND OBJECTIVES: To study the effect of Immunomodulator used as an adjuvant to treatment of newly diagnosed sputum positive cases of Pulmonary Tuberculosis taking Cat - I Therapy under RNTCP. MATERIAL AND METHODS : Patients w ere selected from OPD and IPD of TB & Chest Department V.S.S. Medical College Burla. It was a Double blind randomized placebo contolled study done during Jan. 2004 to Jan. 2006. Study was conducted in30 newly diagnosed cases of Pulmonary Tuberculosis of wh ich 17 were in group A and 13 were in group B after taking informed consent. The study subjects were randomly assigned to one of the two groups (A&B.Group A was treated with Cat - I and injectable Immunomodulator and Group B received Cat - I with placebo. Ana lysis of sputum status was done at 15, 30, 45 and 60 days. Sputum conversion, side effects, weight gain and relief of symptoms between both the groups were analysed. RESULTS: The majority of patients of new sputum positive pulmonary tuberculosis were found in between the age group of 21 – 40

  9. [Bronchopleurocutaneous Fistula: A Rare Complication of Pulmonary Tuberculosis].

    Science.gov (United States)

    Montez, Ana Sofia José; Coutinho, Daniel; Velez, Jorge; Freitas, Filomena; Oliveira, Célia

    2015-01-01

    Introdução: A tuberculose pulmonar pode cursar com diversas complicações. As fístulas bronco-pleuro-cutâneas consistem em comunicações anormais entre o brônquio, o espaço pleural e a pele.Caso Clínico: Apresentamos o caso de um homem, 47 anos, esquizofrénico, enviado ao Serviço de Urgência por toracalgia esquerda, tosse produtiva e emagrecimento. Apresentava-se caquético, sendo evidente um orifício cutâneo torácico latero-anterior esquerdo com drenagem purulenta, na qual o exame direto revelou bacilos ácido-álcool resistentes. A radiografia torácica evidenciava infiltrado heterogéneo bilateral. Foi internado com o diagnóstico de tuberculose pulmonar fistulizada. Na expetoração, a pesquisa de bacilos ácido-álcool resistentes foi igualmente positiva, sendo evidenciado Mycobacterium tuberculosis por reação de polimerase em cadeia e exame cultural. Iniciou terapêutica antituberculosa quádrupla apresentando evolução clínica favorável.Conclusões: A formação de fístulas bronco-pleuro-cutâneas é atualmente e em países desenvolvidos, uma complicação rara de tuberculose pulmonar. Assim, apesar da tuberculose ser frequente em Portugal, a raridade deste tipo de complicações torna pertinente a apresentação deste caso clínico.

  10. M. tuberculosis induces potent activation of IDO-1, but this is not essential for the immunological control of infection.

    Directory of Open Access Journals (Sweden)

    Antje Blumenthal

    Full Text Available Indoleamine 2,3-dioxygenesae-1 (IDO-1 catalyses the initial, rate-limiting step in tryptophan metabolism, thereby regulating tryptophan availability and the formation of downstream metabolites, including picolinic and quinolinic acid. We found that Mycobacterium tuberculosis infection induced marked upregulation of IDO-1 expression in both human and murine macrophages in vitro and in the lungs of mice following aerosol challenge with M. tuberculosis. The absence of IDO-1 in dendritic cells enhanced the activation of mycobacteria-specific T cells in vitro. Interestingly, IDO-1-deficiency during M. tuberculosis infection in mice was not associated with altered mycobacteria-specific T cell responses in vivo. The bacterial burden of infected organs, pulmonary inflammatory responses, and survival were also comparable in M. tuberculosis-infected IDO-1 deficient and wild type animals. Tryptophan is metabolised into either picolinic acid or quinolinic acid, but only picolinic acid inhibited the growth of M. tuberculosis in vitro. By contrast macrophages infected with pathogenic mycobacteria, produced quinolinic, rather than picolinic acid, which did not reduce M. tuberculosis growth in vitro. Therefore, although M. tuberculosis induces robust expression of IDO-1 and activation of tryptophan metabolism, IDO-1-deficiency fails to impact on the immune control and the outcome of the infection in the mouse model of tuberculosis.

  11. A STUDY TO EVALUATE PATTERN OF RIFAMPICIN RESISTANCE IN CASES OF SPUTUM POSITIVE PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Joydeep

    2015-04-01

    Full Text Available AIMS: The emergence of drug resistance and development of multidrug resistant tuberculosis (MDR TB has become a new but significant obstacle for TB control. As Rifampicin resistance is an important indicator for drug resistant TB , rapid diagnosis of tuberculosis and detection of Rifampicin (RIF resistance are essential for knowing the magnitude of problem & early management of drug resistance TB. The aim of this study is to determine the pattern of rifampicin resistance in the sputum positive MDR TB suspects by using GeneXpert MTB/RIF and thus to focus on magnitude of the problem on drug resistance tuberculosis. ST UDY DESIGN: A cross sectional observational study carried out over a period of 2 years in a tertiary care hospital. SUBJECTS & METHODS : In this study 428 sputum positive cases of pulmonary tuberculosis who were potential MDR suspect were included , there sp utum samples were collected and tested by GeneXpert MTB/RIF assay , which is an automated cartridge based nucleic acid amplification test to detect presence of mycobacterium tuberculosis and status of Rifampicin resistance. The results are statistically ana lyzed. RESULTS : Out of 428 patients , mycobacterium tuberculosis was detected in 328 patients (76.63% & out of these 328 patients , Rifampicin resistance was found in 98 cases (29.87%. Male and female ratio was 6:1 among Rifampicin resistant cases. Regardi ng age distribution , maximum no. of patients with Rifampicin resistance were in the age group of 21 - 30 yrs (26.53% followed by 31 - 40 yrs (22.44%. In this study among cases of Rifampicin resistance , 23.47% of cases were new smear positive failure patients , retreatment cases smear positive at 4 months were 8.16% , 22.44% of cases were retreatment cases smear positive at diagnosis , 41.83% of cases were retreatment failure cases , 1.03% patient had history of contact with MDR TB and 3.06% patient was HIV seropositive. CONCLUSIONS: Rifampicin resistance cases are found

  12. Gender and HIV-associated pulmonary tuberculosis: presentation and outcome at one year after beginning antituberculosis treatment in Uganda

    Directory of Open Access Journals (Sweden)

    Ellner Jerrold J

    2002-09-01

    Full Text Available Abstract Background Tuberculosis is responsible for more female deaths around the earth than any other infectious disease. Reports have suggested that responses to tuberculosis may differ between men and women. We investigated gender related differences in the presentation and one year outcomes of HIV-infected adults with initial episodes of pulmonary tuberculosis in Uganda. Methods We enrolled and followed up a cohort of 105 male and 109 female HIV-infected adults on treatment for initial episodes of culture-confirmed pulmonary tuberculosis between March 1993 and March 1995. A favorable outcome was defined as being cured and alive at one year while an unfavorable outcome was not being cured or dead. Subjects were followed-up by serial medical examinations, complete blood counts, serum β2 microglobulin, CD4+ cell counts, sputum examinations, and chest x-rays. Results Male patients were older, had higher body mass indices, and lower serum β2 microglobulin levels than female patients at presentation. At one year, there was no difference between male and female patients in the likelihood of experiencing a favorable outcome (RR 1.02, 95% CI 0.89–1.17. This effect persisted after controlling for symptoms, serum β2 microglobulin, CD4+ cell count, and severity of disease on chest x-ray (OR 1.07, 95% CI 0.54–2.13 with a repeated measures model. Conclusions While differences existed between males and females with HIV-associated pulmonary tuberculosis at presentation, the outcomes at one year after the initiation of tuberculosis treatment were similar in Uganda. Women in areas with a high HIV and tuberculosis prevalence should be encouraged to present for screening at the first sign of tuberculosis symptoms.

  13. Fc gamma receptors regulate immune activation and susceptibility during Mycobacterium tuberculosis infection.

    Science.gov (United States)

    Maglione, Paul J; Xu, Jiayong; Casadevall, Arturo; Chan, John

    2008-03-01

    The critical role of cellular immunity during tuberculosis (TB) has been extensively studied, but the impact of Abs upon this infection remains poorly defined. Previously, we demonstrated that B cells are required for optimal protection in Mycobacterium tuberculosis-infected mice. FcgammaR modulate immunity by engaging Igs produced by B cells. We report that C57BL/6 mice deficient in inhibitory FcgammaRIIB (RIIB-/-) manifested enhanced mycobacterial containment and diminished immunopathology compared with wild-type controls. These findings corresponded with enhanced pulmonary Th1 responses, evidenced by increased IFN-gamma-producing CD4+ T cells, and elevated expression of MHC class II and costimulatory molecules B7-1 and B7-2 in the lungs. Upon M. tuberculosis infection and immune complex engagement, RIIB-/- macrophages produced more of the p40 component of the Th1-promoting cytokine IL-12. These data strongly suggest that FcgammaRIIB engagement can dampen the TB Th1 response by attenuating IL-12p40 production or activation of APCs. Conversely, C57BL/6 mice lacking the gamma-chain shared by activating FcgammaR had enhanced susceptibility and exacerbated immunopathology upon M. tuberculosis challenge, associated with increased production of the immunosuppressive cytokine IL-10. Thus, engagement of distinct FcgammaR can divergently affect cytokine production and susceptibility during M. tuberculosis infection.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Objective: Diabetes is associated with pulmonary tuberculosis (TB), possibly due to impaired immunity, and diabetes may exacerbate the clinical manifestations of TB. Our aim was to assess the role of diabetes in the clinical manifestations of TB. Methods: We studied 1250 patients with pulmonary TB...... in an urban population in a cross-sectional study in Tanzania. All participants were tested for diabetes and HIV co-infection, and TB culture intensity was assessed. Levels of white blood cells, haemoglobin, acute phase reactants, CD4 count and HIV viral load were measured, and a qualitative morbidity...... questionnaire was used to identify the prevalence of disease-related symptoms. Results: Tuberculosis patients with diabetes had a higher neutrophil count (B 0.5 x 10 9 cells/ l, 95% CI 0.2; 0.9, P = 0.001) than non-diabetic TB patients. Serum C-reactive protein (B 18.8 mg / l, CI 95% 8.2; 29.4, P = 0...

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

    Directory of Open Access Journals (Sweden)

    Catherine W M Ong

    2015-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    钟红苗; 黄图华; 叶朝红

    2013-01-01

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

  17. Applying patient centered approach in management of pulmonary tuberculosis: A case report from Malaysia.

    Science.gov (United States)

    Atif, M; Sulaiman, Sas; Shafi, Aa; Muttalif, Ar; Ali, I; Saleem, F

    2011-06-01

    A 24 year university student with history of productive cough was registered as sputum smear confirmed case of pulmonary tuberculosis. During treatment, patient suffered from itchiness associated with anti tuberculosis drugs and was treated with chlorpheniramine (4mg) tablet. Patient missed twenty eight doses of anti tuberculosis drugs in continuation phase claiming that he was very busy in his studies and assignments. Upon questioning he further explained that he was quite healthy after five months and unable to concentrate on his studies after taking prescribed medicines. His treatment was stopped based on clinical improvement, although he did not complete six months therapy. Two major reasons; false perception of being completely cured and side effects associated with anti TB drugs might be responsible for non adherence. Non sedative anti histamines like fexofenadine, citrizine or loratidine should be preferred over first generation anti histamines (chlorpheniramine) in patients with such lifestyle. Patient had not completed full course of chemotherapy, which is preliminary requirement for a case to be classified as "cure" and "treatment completed". Moreover, patient had not defaulted for two consecutive months. Therefore, according to WHO treatment outcome categories, this patient can neither be classified as "cure" or "treatment completed" nor as "defaulter". Further elaboration of WHO treatment outcome categories is required for adequate classification of patients with similar characteristics. Likelihood of non adherence can be significantly reduced by applying the WHO recommended "Patient Centered Approach" strategy. Close friend, class mate or family member can be selected as treatment supporter to ensure adherence to treatment.

  18. [Thoracic standard radiology and x-ray computed tomography in mediastino-pulmonary tuberculosis in infants].

    Science.gov (United States)

    Bourlière-Najean, B; Boespflug, M D; Dubus, J C; Roybet, D; Panuel, M; Fauré, F; Kervella, H; Devred, P

    1995-06-01

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

  19. Immunological Roles of Elevated Plasma Levels of Matricellular Proteins in Japanese Patients with Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Beata Shiratori

    2016-12-01

    Full Text Available Elevated matricellular proteins (MCPs, including osteopontin (OPN and galectin-9 (Gal-9, were observed in the plasma of patients with Manila-type tuberculosis (TB previously. Here, we quantified plasma OPN, Gal-9, and soluble CD44 (sCD44 by enzyme-linked immunosorbent assay (ELISA, and another 29 cytokines by Luminex assay in 36 patients with pulmonary TB, six subjects with latent tuberculosis (LTBI, and 19 healthy controls (HCs from Japan for a better understanding of the roles of MCPs in TB. All TB subjects showed positive results of enzyme-linked immunospot assays (ELISPOTs. Spoligotyping showed that 20 out of 36 Mycobacterium tuberculosis (MTB strains belong to the Beijing type. The levels of OPN, Gal-9, and sCD44 were higher in TB (positivity of 61.1%, 66.7%, and 63.9%, respectively than in the HCs. Positive correlations between OPN and Gal-9, between OPN and sCD44, and negative correlation between OPN and ESAT-6-ELISPOT response, between chest X-ray severity score of cavitary TB and ESAT-6-ELISPOT response were observed. Instead of OPN, Gal-9, and sCD44, cytokines G-CSF, GM-CSF, IFN-α, IFN-γ, IL-12p70, and IL-1RA levels were higher in Beijing MTB-infected patients. These findings suggest immunoregulatory, rather than inflammatory, effect of MCPs and can advance the understanding of the roles of MCPs in the context of TB pathology.

  20. Genetic diversity of Mycobacterium tuberculosis complex strains isolated from patients with pulmonary tuberculosis in Anambra State, Nigeria.

    Science.gov (United States)

    Uzoewulu, Gertrude N; Lawson, Lovett; Nnanna, Ibeh S; Rastogi, Nalin; Goyal, Madhu

    2016-03-01

    In this study, we analyzed Mycobacterium tuberculosis complex (MTC) genetic diversity in Anambra State, Nigeria based on spoligotyping followed by 5-loci exact tandem repeats (ETRs). Spoligotyping of 180 MTC strains isolated in 2009-2011 from pulmonary tuberculosis (TB) patients led to a total of 31 distinct patterns. A comparison with the SITVIT2 international database showed that all the 31 patterns could be classified as Shared-types (SITs) in this database; briefly, 26/31 SITs (n=174 isolates) matched a preexisting shared-type in the database, whereas 5/31 SITs (n=6 isolates) were newly created due to 2 or more strains belonging to an identical new pattern within this study (SIT3396) or after a match with an orphan in the database (SIT3397, SIT3398, SIT3399 and SIT3400). A total of 18/31 SITs containing 167 or 92.8% isolates were clustered within this study (2-89 isolates per cluster) while 13/31 SITs contained unique strains. Using VNTR typing, a total of 36 distinct patterns were identified; 27 patterns (n=157 isolates) matched a pattern already reported in the SITVIT2 database. Combination of both the methods generated 47 combined patterns for the 180 strains: 17 belonged to clustered isolates (n=127 isolates or 70.5%) while 30 corresponded to as many unique strains (note 23 strains could not be typed using 5-loci ETRs). No correlation was found between the spoligotyping pattern and the HIV status of the patient or drug sensitivity of the strain. This study showed that the LAM10-CAM prototype SIT61 accounted for highest number of isolates (n=89) in Anambra State, showing its relative contribution to the TB burden in the study.

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

    Directory of Open Access Journals (Sweden)

    Ameh James

    2015-05-01

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

  2. [An outbreak of pulmonary tuberculosis in the dormitory of construction labors suspected to have been due to exogenous reinfection].

    Science.gov (United States)

    Kurasawa, T; Sato, A; Nakatani, K; Ikeda, T; Yoshimatsu, H; Ikeda, N; Inoue, T; Kanai, K

    2000-05-01

    We report an outbreak of pulmonary tuberculosis (TB) in a dormitory of construction labors, and this outbreak is suspected to have been caused by exogenous reinfection, based on the restriction fragment length polymorphism (RFLP) analysis and other findings. After a patient entered our hospital with active TB, 12 new other patients were discovered by contacts examination. These patients lived together in the same dormitory. They were all male and single, and were aged from 43 to 63 years old. Except one patient (No. 3) previously treated for TB for three months about 2 years ago and was suspected to be the index case of this outbreak, 12 other patients did not have a medical history of TB. The bacilli cultured from 11 patients (No. 1-11) were tested by RFLP analysis, three patterns were identified, and the fingerprints from 9 patients (No. 1-9) were identical, and the patterns of incomplete resistance of some antituberculous drugs were quite similar between No. 1-9 and No. 12 and between No. 10 and No. 13, respectively. The locations of the main lesions of TB on chest X-ray pictures were the apico-posterior segments of bilateral upper lobes. No signs suspected to indicate primary tuberculosis were detected. Considering the rate of tuberculous infection in Japan among the middle age and above as well as the identical RFLP results, most of patients in this outbreak except the index case No. 3 were suspected to have TB due to the exogenous reinfection.

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

    Directory of Open Access Journals (Sweden)

    Clark Tamara D

    2004-12-01

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

  4. CONTRAST ENHANCED CT UNVEILED GIANT RASMUSSEN’S ANEURYSM: A RARE COMPLICATION AND CAUSE OF DEATH IN PULMONARY TUBERCULOSIS

    OpenAIRE

    2014-01-01

    Rasmussen’s aneurysm is a rare complication of pulmonary tuberculosis. Often the aneurysm ruptures in the bronchial tree causing massive hemoptysis resulting in death. We are reporting a case of partially thrombosed giant Rasmussen’s aneurysm which arose in the vicinity of a tuberculous cavity along with empyema necessitans. Unfortunately the patient died of massive hemoptysis within two days of his diagnosis.

  5. Auxiliary diagnostic value of monocyte chemoattractant protein-1 of whole blood in active tuberculosis.

    Science.gov (United States)

    Wang, Ying; Li, Hang; Bao, Hong; Jin, Yufen; Liu, Xiaoju; Wu, Xueqiong; Yu, Ting

    2015-01-01

    The aim of this study was to study the expression level of interferon-γ (IFN-γ) and monocyte chemoattractant protein-1 (MCP-1) in peripheral blood and its auxiliary diagnostic value in active tuberculosis. A chemiluminescence enzyme immunoassay method was used to detect the levels of IFN-γ and MCP-1 in peripheral blood. Then the receiver operating characteristic curve were drawn to determine the threshold of IFN-γ and MCP-1 for diagnosis of active tuberculosis and to evaluate their diagnostic performance. The specific IFN-γ and MCP-1 levels in the active tuberculosis group were significantly higher than those in the non-tuberculous pulmonary disease group (P 0.05), but the MCP-1 levels in the non-tuberculous respiratory disease group were significantly higher than those of the healthy control group (P < 0.05). The specific IFN-γ and MCP-1 level cut off values were 256 pg/ml and 389 pg/ml as an active tuberculosis diagnostic standard. The sensitivities of IFN-γ and MCP-1 were 57.3% and 92.8%, respectively; specificities were 80% and 80.7%, respectively; the positive predictive values were 76.9% and 84.9%, respectively; negative predictive values were 61.7% and 78.7%, respectively; and accuracy rates were 76.9% and 84.9%, respectively. Compared with the detection of IFN-γ, we observed a better diagnostic performance of MCP-1 in peripheral blood in active tuberculosis. MCP-1 may become one of the active tuberculosis auxiliary diagnostic targets.

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

    Directory of Open Access Journals (Sweden)

    Korpusenko I.V

    2015-03-01

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

  7. PROFILE OF SPUTUM POSITIVE PULMONARY TUBERCULOSIS PATIENTS ON RE - TREATMENT REGIMEN

    Directory of Open Access Journals (Sweden)

    Kiran

    2015-10-01

    in our study was 86.75 %.10.8% of the patient have normal ESR and 95.1 % of patient blood were positive for CRP.42.1% of patient was ha ving clinical evidence of pulmonary tuberculosis. 8% of patients were diabetics. CONCLUSION: Many factors are responsible for recurrence of pulmonary tuberculosis Patient with HIV and Diabetes Mellitus have high chances of recurrence of pulmonary tuberculo sis due to decreased immunity. Defaulters have maximum chances of recurrence followed by Relapse cases . Treatment failure is uncommon cause of recurrent TB. Alcoholic are more likely to Default. ESR can be normal in recurrent pulmonary tuberculosis patient s.

  8. Concurrent evaluation of microscopic observation of drug susceptibility assay for pulmonary and extrapulmonary tuberculosis

    Science.gov (United States)

    Zadbuke, Sonali Sudhir; Set, Reena; Khan, Nishat; Shastri, Jayanthi

    2017-01-01

    BACKGROUND: Methods for detection and drug susceptibility of tuberculosis (TB) with solid media are inexpensive but slow and laborious. Rapid methods to diagnose TB and multidrug-resistant TB (MDR-TB) are a global priority for TB control. OBJECTIVES: A study was performed to compare the sensitivity of detection of mycobacterial growth and time of culture positivity by microscopic observation of drug susceptibility (MODS) assay with that of Lowenstein–Jensen (LJ) culture in pulmonary and extrapulmonary TB and to evaluate the concordance of the susceptibilities to isoniazid (INH) and rifampicin (RIF) by MODS and proportion method on LJ. MATERIALS AND METHODS: A prospective, laboratory-based study was conducted on a total of 300 samples from suspected cases of pulmonary and extrapulmonary TB. Samples were inoculated on LJ medium as per the standard guidelines and MODS assay was performed. RESULTS: Sensitivity of MODS assay was 80% and 83.3% and specificity was 92.9% and 83.3% for pulmonary and extrapulmonary samples, respectively. Difference between mean time to detection of Mycobacterium TB (MTB) by LJ medium and MODS was statistically significant, with MODS being faster. drug susceptibility testing (DST) by MODS when compared to economic variant of proportion method was 87.87% for RIF, 90.9% for INH, and 96.96% for MDR-TB detection. CONCLUSION: MODS assay provides rapid, safe, and sensitive detection of TB faster than the existing gold standard. It is extremely promising in effectively diagnosing MDR-TB.

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

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Myung Jin; Lee, Kyung Soo; Kim, Tae Sung; Kim, Sung Mok [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea); Koh, Won-Jung; Kwon, O Jung [Sungkyunkwan University School of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Seoul (Korea); Kang, Eun Young [Korea University Guro Hospital, Department of Diagnostic Radiology, Korea University College of Medicine, Seoul (Korea); Kim, Seonwoo [Sungkyunkwan University School of Medicine, Biostatistics Unit of the Samsung Biomedical Research Institute, Samsung Medical Center, Seoul (Korea)

    2006-09-15

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

  10. Analysis of 305 cases of hematogenous disseminated pulmonary tuberculosis complicated with pulmonary tuberculosis%血行播散性肺结核合并肺外结核的305例分析

    Institute of Scientific and Technical Information of China (English)

    陈镇永; 李琼; 杨红霞

    2014-01-01

    目的血行播散型肺结核是结核分枝杆菌(以下简称结核菌)一次或反复多次进入血液循环,造成肺部病变以及相应的病理、病理生理学改变和临床表现者称为血行播散型肺结核,造成全身多脏器病变时则称血行播散型结核病。血行播散型肺结核是一种危重结核病,由原发型肺结核发展而来,也可由其它结核干酪样灶破溃到血源引起。%Objective Hematogenous disseminated pulmonary tuberculosis (HdPt) is caused by Mycobacterium tuberculosis diffusely inifltrating bilateral lung lobes through blood circulation once or repeatedly, which leads to pulmonary pathological changes and systemic clinical manifestations, whereas hematogenous disseminated tuberculosis involves systemic multi-organ disease. HdPt is a type of severe tuberculosis, deteriorating from primary tuberculosis or caseous lesions eroding adjacent vessels.

  11. Is there a rationale for pulmonary rehabilitation following successful chemotherapy for tuberculosis?

    Science.gov (United States)

    Muñoz-Torrico, Marcela; Rendon, Adrian; Centis, Rosella; D'Ambrosio, Lia; Fuentes, Zhenia; Torres-Duque, Carlos; Mello, Fernanda; Dalcolmo, Margareth; Pérez-Padilla, Rogelio; Spanevello, Antonio; Migliori, Giovanni Battista

    2016-01-01

    The role of tuberculosis as a public health care priority and the availability of diagnostic tools to evaluate functional status (spirometry, plethysmography, and DLCO determination), arterial blood gases, capacity to perform exercise, lesions (chest X-ray and CT), and quality of life justify the effort to consider what needs to be done when patients have completed their treatment. To our knowledge, no review has ever evaluated this topic in a comprehensive manner. Our objective was to review the available evidence on this topic and draw conclusions regarding the future role of the "post-tuberculosis treatment" phase, which will potentially affect several million cases every year. We carried out a non-systematic literature review based on a PubMed search using specific keywords (various combinations of the terms "tuberculosis", "rehabilitation", "multidrug-resistant tuberculosis", "pulmonary disease", "obstructive lung disease", and "lung volume measurements"). The reference lists of the most important studies were retrieved in order to improve the sensitivity of the search. Manuscripts written in English, Spanish, and Russian were selected. The main areas of interest were tuberculosis sequelae following tuberculosis diagnosis and treatment; "destroyed lung"; functional evaluation of sequelae; pulmonary rehabilitation interventions (physiotherapy, long-term oxygen therapy, and ventilation); and multidrug-resistant tuberculosis.The evidence found suggests that tuberculosis is definitively responsible for functional sequelae, primarily causing an obstructive pattern on spirometry (but also restrictive and mixed patterns), and that there is a rationale for pulmonary rehabilitation. We also provide a list of variables that should be discussed in future studies on pulmonary rehabilitation in patients with post-tuberculosis sequelae. RESUMO O papel da tuberculose como uma prioridade de saúde pública e a disponibilidade de ferramentas diagnósticas para avaliar o estado

  12. Osteoarticular manifestations of Mycobacterium tuberculosis infection.

    Science.gov (United States)

    Zychowicz, Michael E

    2010-01-01

    Mycobacterium tuberculosis has affected humans for much of our existence. The incidence of global tuberculosis infection continues to rise, especially in concert with HIV coinfection. Many disease processes, such as diabetes, increase the likelihood of tuberculosis infection. Tuberculosis bacteria can infect any bone, joint, tendon, or bursa; however, the most common musculoskeletal site for infection includes the spine and weight-bearing joints of the hip and knee. Many patients who present with osteoarticular tuberculosis infection will have a gradual onset of pain at the site of infection. Many patients who develop a musculoskeletal tuberculosis infection will have no evidence of a pulmonary tuberculosis infection on x-ray film and many will have very mild symptoms with the initial infection. Healthcare providers must remember that many patients who develop tuberculosis infection do not progress to active tuberculosis disease; however, the latent infection may become active with immune compromise.

  13. Expression of miR-29a in serum of patients with pulmonary tuberculosis and prediction of its function with bioinformatics analysis

    Institute of Scientific and Technical Information of China (English)

    付玉荣

    2013-01-01

    Objective To analyze the expression of miR-29a in serum of patients with pulmonary tuberculosis,and to predict and analyze function of its target genes for further studying of its biological function and regulatory

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-03-15

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

  15. Use of several immunological markers to model the probability of active tuberculosis.

    Science.gov (United States)

    Petruccioli, Elisa; Navarra, Assunta; Petrone, Linda; Vanini, Valentina; Cuzzi, Gilda; Gualano, Gina; Palmieri, Fabrizio; Girardi, Enrico; Goletti, Delia

    2016-10-01

    Blood-based biomarkers tests are attractive alternative for diagnosing tuberculosis to assays depending on mycobacteria detection. Given several immunological markers we used logistic regression to model the probability of active tuberculosis in a cohort of patients with active or latent tuberculosis, showing an increased accuracy in distinguishing active from latent tuberculosis.

  16. Tuberculosis

    Directory of Open Access Journals (Sweden)

    C. Robert Horsburgh, Jr

    2014-03-01

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

  17. Tuberculosis

    OpenAIRE

    C. Robert Horsburgh, Jr

    2014-01-01

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

  18. Calcified Pulmonary Nodules Identified in a 350-Year-Old-Joseon Mummy: the First Report on Ancient Pulmonary Tuberculosis from Archaeologically Obtained Pre-modern Korean Samples

    Science.gov (United States)

    2016-01-01

    We found calcified pulmonary nodules in a middle-aged female mummy discovered from 350-yr-old Joseon tomb of Korea. In the CT scan, we found six radiopaque nodules in right lung, through the levels of thoracic vertebrae 1 to 6. We also found presumptive pleural adhesions in right thoracic cavity of CT images. We re-confirmed radiological findings by our post-factum dissection on the same mummy. By the differential diagnosis, we speculate that the radiopaque calcification nodules and associated pleural adhesion could have been caused by tuberculosis. This is the first-ever report on the pulmonary tuberculosis identified in archaeologically obtained, pre-modern Korean samples. PMID:26770051

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

    Directory of Open Access Journals (Sweden)

    Shaik KU

    2016-01-01

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

  20. Gender differentials of pulmonary tuberculosis transmission and reactivation in an endemic area

    Science.gov (United States)

    Jiménez‐Corona, M‐E; García‐García, L; DeRiemer, K; Ferreyra‐Reyes, L; Bobadilla‐del‐Valle, M; Cano‐Arellano, B; Canizales‐Quintero, S; Martínez‐Gamboa, A; Small, P M; Sifuentes‐Osornio, J; Ponce‐de‐León, A

    2006-01-01

    Background In most low income countries there are twice as many cases of tuberculosis (TB) reported among men than among women, a difference commonly attributed to biological and epidemiological characteristics as well as socioeconomic and cultural barriers in access to health care. The World Health Organization has encouraged gender specific comparisons in TB rates to determine whether women with TB are less likely than men with TB to be diagnosed, reported, and treated. A study was undertaken to identify gender based differences in patients with pulmonary TB and to use this information to improve TB control efforts. Methods Individuals with a cough for more than 2 weeks in southern Mexico were screened from March 1995 to April 2003. Clinical and mycobacteriological information (isolation, identification, drug susceptibility testing and IS6110 based genotyping, and spoligotyping) was collected from those with bacteriologically confirmed pulmonary TB. Patients were treated in accordance with official norms and followed to ascertain treatment outcome, retreatment, and vital status. Results 623 patients with pulmonary TB were enrolled. The male:female incidence rate ratio for overall, reactivated, and recently transmitted disease was 1.58 (95% CI 1.34 to 1.86), 1.64 (95% CI 1.36 to 1.98), and 1.41 (95% CI 1.01 to 1.96), respectively. Men were more likely than women to default from treatment (adjusted OR 3.30, 95% CI 1.46 to 7.43), to be retreated (hazard ratio (HR) 3.15, 95% CI 1.38 to 7.22), and to die from TB (HR 2.23, 95% CI 1.25 to 3.99). Conclusions Higher rates of transmitted and reactivated disease and poorer treatment outcomes among men are indicators of gender differentials in the diagnosis and treatment of pulmonary TB, and suggest specific strategies in endemic settings. PMID:16449260

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

    Directory of Open Access Journals (Sweden)

    Muna Mohammed Buzayan

    2012-09-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    for this problem. The goal of the present study was to apply MDR to mining high-order epistatic interactions in a population-based genetic study of tuberculosis (TB). Results The study used a previously published data set consisting of 19 candidate single-nucleotide polymorphisms (SNPs) in 321 pulmonary TB cases......Background Identifying high-order genetics associations with non-additive (i.e. epistatic) effects in population-based studies of common human diseases is a computational challenge. Multifactor dimensionality reduction (MDR) is a machine learning method that was designed specifically...... and 347 healthy controls from Guniea-Bissau in Africa. The ReliefF algorithm was applied first to generate a smaller set of the five most informative SNPs. MDR with 10-fold cross-validation was then applied to look at all possible combinations of two, three, four and five SNPs. The MDR model with the best...

  3. Prevalence of melioidosis in patients with suspected pulmonary tuberculosis and sputum smear negative for acid-fast bacilli in northeast Thailand.

    Science.gov (United States)

    Suntornsut, Pornpan; Kasemsupat, Kriangsak; Silairatana, Santi; Wongsuvan, Gumphol; Jutrakul, Yaowaruk; Wuthiekanun, Vanaporn; Day, Nicholas P J; Peacock, Sharon J; Limmathurotsakul, Direk

    2013-11-01

    The clinical and radiological features of pulmonary melioidosis can mimic tuberculosis. We prospectively evaluated 118 patients with suspected pulmonary tuberculosis who were acid-fast bacilli (AFB) smear negative at Udon Thani Hospital, northeast Thailand. Culture of residual sputum from AFB testing was positive for Burkholderia pseudomallei in three patients (2.5%; 95% confidence interval [CI] 0.5-7.3%). We propose that in melioidosis-endemic areas, residual sputum from AFB testing should be routinely cultured for B. pseudomallei.

  4. Risk factors for pulmonary tuberculosis: a clinic-based case control study in The Gambia

    Directory of Open Access Journals (Sweden)

    Adegbola Richard A

    2006-06-01

    Full Text Available Abstract Background The tuberculosis (TB epidemic in Africa is on the rise, even in low-HIV prevalence settings. Few studies have attempted to identify possible reasons for this. We aimed to identify risk factors for pulmonary tuberculosis in those attending a general outpatients clinic in The Gambia, a sub-Saharan African country with relatively low HIV prevalence in the community and in TB patients. Methods We conducted a case control study at the Medical Research Council Outpatients' clinic in The Gambia. Pulmonary TB cases were at least 15 years old, controls were age and sex matched clinic attendees. Participants were interviewed using a structured questionnaire. Results 100 sputum smear positive TB cases and 200 clinic controls were recruited. HIV prevalence was 6.1% in cases and 3.3% in controls. Multivariable assessment of host factors showed that risk of TB was increased among the Jola ethnic group and smokers, and decreased in those in a professional occupation. Assessment of environmental factors showed an increased risk with household crowding, history of household exposure to a known TB case, and absence of a ceiling in the house. In a combined multivariable host-environment model, the risk of TB increased with crowding, exposure to a known TB case, as well as amongst the Jola ethnic group. Conclusion In The Gambia, household crowding and past household exposure to a known TB case are the standout risk factors for TB disease. Further research is needed to identify why risk of TB seems to differ according to ethnicity.

  5. A Prediction Rule to Stratify Mortality Risk of Patients with Pulmonary Tuberculosis.

    Science.gov (United States)

    Bastos, Helder Novais; Osório, Nuno S; Castro, António Gil; Ramos, Angélica; Carvalho, Teresa; Meira, Leonor; Araújo, David; Almeida, Leonor; Boaventura, Rita; Fragata, Patrícia; Chaves, Catarina; Costa, Patrício; Portela, Miguel; Ferreira, Ivo; Magalhães, Sara Pinto; Rodrigues, Fernando; Sarmento-Castro, Rui; Duarte, Raquel; Guimarães, João Tiago; Saraiva, Margarida

    2016-01-01

    Tuberculosis imposes high human and economic tolls, including in Europe. This study was conducted to develop a severity assessment tool for stratifying mortality risk in pulmonary tuberculosis (PTB) patients. A derivation cohort of 681 PTB cases was retrospectively reviewed to generate a model based on multiple logistic regression analysis of prognostic variables with 6-month mortality as the outcome measure. A clinical scoring system was developed and tested against a validation cohort of 103 patients. Five risk features were selected for the prediction model: hypoxemic respiratory failure (OR 4.7, 95% CI 2.8-7.9), age ≥50 years (OR 2.9, 95% CI 1.7-4.8), bilateral lung involvement (OR 2.5, 95% CI 1.4-4.4), ≥1 significant comorbidity-HIV infection, diabetes mellitus, liver failure or cirrhosis, congestive heart failure and chronic respiratory disease-(OR 2.3, 95% CI 1.3-3.8), and hemoglobin <12 g/dL (OR 1.8, 95% CI 1.1-3.1). A tuberculosis risk assessment tool (TReAT) was developed, stratifying patients with low (score ≤2), moderate (score 3-5) and high (score ≥6) mortality risk. The mortality associated with each group was 2.9%, 22.9% and 53.9%, respectively. The model performed equally well in the validation cohort. We provide a new, easy-to-use clinical scoring system to identify PTB patients with high-mortality risk in settings with good healthcare access, helping clinicians to decide which patients are in need of closer medical care during treatment.

  6. A Prediction Rule to Stratify Mortality Risk of Patients with Pulmonary Tuberculosis

    Science.gov (United States)

    Osório, Nuno S.; Castro, António Gil; Ramos, Angélica; Carvalho, Teresa; Meira, Leonor; Araújo, David; Almeida, Leonor; Boaventura, Rita; Fragata, Patrícia; Chaves, Catarina; Costa, Patrício; Portela, Miguel; Ferreira, Ivo; Magalhães, Sara Pinto; Rodrigues, Fernando; Sarmento-Castro, Rui; Duarte, Raquel; Guimarães, João Tiago; Saraiva, Margarida

    2016-01-01

    Tuberculosis imposes high human and economic tolls, including in Europe. This study was conducted to develop a severity assessment tool for stratifying mortality risk in pulmonary tuberculosis (PTB) patients. A derivation cohort of 681 PTB cases was retrospectively reviewed to generate a model based on multiple logistic regression analysis of prognostic variables with 6-month mortality as the outcome measure. A clinical scoring system was developed and tested against a validation cohort of 103 patients. Five risk features were selected for the prediction model: hypoxemic respiratory failure (OR 4.7, 95% CI 2.8–7.9), age ≥50 years (OR 2.9, 95% CI 1.7–4.8), bilateral lung involvement (OR 2.5, 95% CI 1.4–4.4), ≥1 significant comorbidity—HIV infection, diabetes mellitus, liver failure or cirrhosis, congestive heart failure and chronic respiratory disease–(OR 2.3, 95% CI 1.3–3.8), and hemoglobin <12 g/dL (OR 1.8, 95% CI 1.1–3.1). A tuberculosis risk assessment tool (TReAT) was developed, stratifying patients with low (score ≤2), moderate (score 3–5) and high (score ≥6) mortality risk. The mortality associated with each group was 2.9%, 22.9% and 53.9%, respectively. The model performed equally well in the validation cohort. We provide a new, easy-to-use clinical scoring system to identify PTB patients with high-mortality risk in settings with good healthcare access, helping clinicians to decide which patients are in need of closer medical care during treatment. PMID:27636095

  7. April 2015 Phonenix pulmonary journal club: endo-bronchial ultrasound in diagnosing tuberculosis

    Directory of Open Access Journals (Sweden)

    Mathew M

    2015-04-01

    Full Text Available No abstract available. Article truncated after 150 words. Lin SM, Chung FT, Huang CD, Liu WT, Kuo CH, Wang CH, Lee KY, Liu CY, Lin HC, Kuo HP. Diagnostic value of endobronchial ultrasonography for pulmonary tuberculosis. J Thorac Cardiovasc Surg. 2009;138(1:179-84. The diagnosis of tuberculosis in patients with inability to produce sputum or in patients that remain acid-fast bacilli (AFB smear negative with high index of clinical suspicion remains a challenge and often results in treatment delay. This study examined the role in using endobronchial ultrasound (EBUS to locate parenchymal infiltrates to allow for more accurate sampling of bronchial lavage fluid and transbronchial biopsies. The study examined 121 patients divided into 2 groups, 73 patients received EBUS guided bronchoscopy and 48 pts received conventional bronchoscopy with bronchoalveolar lavage (BAL and transbronchial biopsies. It should be noted that patients undergoing transbronchial biopsies in the non-EBUS group appeared to have biopsies done without the use of fluoroscopy. The results showed ...

  8. Surgical interventions for pulmonary tuberculosis in Mumbai, India: surgical outcomes and programmatic challenges

    Science.gov (United States)

    Shirodkar, S.; Anande, L.; Dalal, A.; Desai, C.; Corrêa, G.; Laxmeshwar, C.; Mansoor, H.; Remartinez, D.; Trelles, M.; Isaakidis, P.

    2016-01-01

    Setting: While surgery for pulmonary tuberculosis (PTB) is considered an important adjunct for specific cases, including drug-resistant tuberculosis, operational evidence on its feasibility and effectiveness is limited. Objective: To describe surgical outcomes and programmatic challenges of providing surgery for PTB in Mumbai, India. Design: A descriptive study of routinely collected data of surgical interventions for PTB from 2010 to 2014 in two Mumbai hospitals, one public, one private. Results: Of 85 patients, 5 (6%) died and 17 (20%) had complications, with wound infection being the most frequent. Repeat operation was required in 12 (14%) patients. Most procedures were performed on an emergency basis, and eligibility was established late in the course of treatment. Median time from admission to surgery was 51 days. Drug susceptibility test (DST) patterns and final treatment outcomes were not systematically collected. Conclusion: In a high-burden setting such as Mumbai, important data on surgery for PTB were surprisingly limited in both the private and public sectors. Eligibility for surgery was established late, culture and DST were not systematically offered, the interval between admission and surgery was long and TB outcomes were not known. Systematic data collection would allow for proper evaluation of surgery as adjunctive therapy for all forms of TB under programmatic conditions. PMID:27695683

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

    Science.gov (United States)

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

    2016-01-01

    Rationale Rapid diagnosis of pulmonary tuberculosis (TB) is critical for timely initiation of treatment and interruption of transmission. Yet, despite recent advances, many patients remain undiagnosed. Culture, usually considered the most sensitive diagnostic method, is sub-optimal for paucibacillary disease. Methods We evaluated the Totally Optimized PCR (TOP) TB assay, a new molecular test that we hypothesize is more sensitive than culture. After pre-clinical studies, we estimated TOP’s per-patient sensitivity and specificity in a convenience sample of 261 HIV-infected pulmonary TB suspects enrolled into a TB diagnostic study in Mbarara, Uganda against MGIT culture, Xpert MTB/RIF and a composite reference standard. We validated results with a confirmatory PCR used for sequencing M. tuberculosis. Measurements and Results Using culture as reference, TOP had 100% sensitivity but 35% specificity. Against a composite reference standard, the sensitivity of culture (27%) and Xpert MTB/RIF (27%) was lower than TOP (99%), with similar specificity (100%, 98% and 87%, respectively). In unadjusted analyses, culture-negative/TOP-positive patients were more likely to be older (P<0·001), female (P<0·001), have salivary sputum (P = 0·05), sputum smear-negative (P<0.001) and less advanced disease on chest radiograph (P = 0.05). M. tuberculosis genotypes identified in sputum by DNA sequencing exhibit differential growth in culture. Conclusions These findings suggest that the TOP TB assay is accurately detecting M. tuberculosis DNA in the sputum of culture-negative tuberculosis suspects. Our results require prospective validation with clinical outcomes. If the operating characteristics of the TOP assay are confirmed in future studies, it will be justified as a “TB rule out” test. PMID:27391604

  10. Exposure to cigarette smoke inhibits the pulmonary T-cell response to influenza virus and Mycobacterium tuberculosis.

    Science.gov (United States)

    Feng, Yan; Kong, Ying; Barnes, Peter F; Huang, Fang-Fang; Klucar, Peter; Wang, Xisheng; Samten, Buka; Sengupta, Mayami; Machona, Bruce; Donis, Ruben; Tvinnereim, Amy R; Shams, Homayoun

    2011-01-01

    Smoking is associated with increased susceptibility to tuberculosis and influenza. However, little information is available on the mechanisms underlying this increased susceptibility. Mice were left unexposed or were exposed to cigarette smoke and then infected with Mycobacterium tuberculosis by aerosol or influenza A by intranasal infection. Some mice were given a DNA vaccine encoding an immunogenic M. tuberculosis protein. Gamma interferon (IFN-γ) production by T cells from the lungs and spleens was measured. Cigarette smoke exposure inhibited the lung T-cell production of IFN-γ during stimulation in vitro with anti-CD3, after vaccination with a construct expressing an immunogenic mycobacterial protein, and during infection with M. tuberculosis and influenza A virus in vivo. Reduced IFN-γ production was mediated through the decreased phosphorylation of transcription factors that positively regulate IFN-γ expression. Cigarette smoke exposure increased the bacterial burden in mice infected with M. tuberculosis and increased weight loss and mortality in mice infected with influenza virus. This study provides the first demonstration that cigarette smoke exposure directly inhibits the pulmonary T-cell response to M. tuberculosis and influenza virus in a physiologically relevant animal model, increasing susceptibility to both pathogens.

  11. The correlation analysis between semi-quantitative score of high-resolution and spot forming cells in ELISPOT of patients with pulmonary tuberculosis%肺结核高分辨率CT半定量评分与酶联免疫斑点形成细胞数的相关性分析

    Institute of Scientific and Technical Information of China (English)

    方文春; 马威; 陆普选; 彭程; 邓群益; 魏方军; 陈心春

    2014-01-01

    Objective To study of HRCT findings of pulmonary tuberculosis, the relationship between CT findings with semi-quantitative score of pulmonary tuberculosis and enzyme-linked immunosorbent spot forming cell number, in order to provide proofs for pulmonary tuberculosis activity. Methods Two hundrend and three patients with pulmonary tuberculosis, who had HRCT and enzyme-linked immunospat assay, were enrolled in this study. Semi-quantitative score of CT finding were compared with enzyme-linked immanospat assay. Results There were well correction between CT findings and enazyme-linked immunospot observed in group of one side secondary pulmonary tuberculosis , two side secondary pulmonary tuberculosis, tuberculosis pleuritis and control group. The correction of hematogenous disseminated pulmonary tuberculosis was poor. Conclusion Except hematogenous disseminated pulmonary tuberculosis, semi-quantitative score of CT findings can be used as a biomarker for pulmonary tuberculosis activity.%目的:探讨肺结核高分辨率CT(HRCT)表现、半定量评分及其与酶联免疫斑点形成细胞数的相关性,为活动性肺结核临床诊断提供依据。方法①对203例临床诊断为肺结核患者进行HRCT检查和酶联免疫斑点形成细胞数分组检测。②对肺结核各组CT评分与酶联免疫斑点形成细胞数进行统计分析,比较各组间的相关性及有无差异。结果①一侧继发性肺结核组、两侧继发性肺结核组、结核性胸膜炎组及结核控制组HRCT评分分值与不同抗原的酶联免疫斑点形成细胞数检测值一致性较好。②血行播散性肺结核组HRCT评分与不同抗原的酶联免疫斑点形成细胞数检测值一致性较低。结论 HRCT评分分值中除血行播散性肺结核组外,其他各组评分分值与酶联免疫斑点形成细胞数的相关性较好,提示活动性结核病的可能性大。

  12. [Computed tomography in the differential diagnosis of disseminated pulmonary tuberculosis and fibrosing alveolitis].

    Science.gov (United States)

    Mursalova, G Kh

    2007-01-01

    The differential diagnostic signs of disseminated pulmonary processes were defined by computed tomography. A hundred and sixty-seven patients, including 117 (70%) with disseminated pulmonary tuberculosis (DPT) and 50 (30%) with alveolitis, were examined. Their mean age was 32.3 +/- 5.1 years; the history of disease averaged 4.6 +/- 1.2 years. Acute, subacute, and chronic DPT was observed in 17 (14.5%), 32 (27.3%), and 68 (58.1%) patients, respectively. Idiopathic fibrosing alveolitis (IFA) was seen in 38 patients; 12 patients had exogenous allergic alveolitis (EAA). IFA and EAA were chronic. Patients with DPT had most commonly signs, such as focal masses (45.3%), intra- and interlobular septal thickening (35%), lung tissue reticulation (35%), centrilobular empyema (29%), only focal masses being detected in its acute form, and other signs being more pronounced in its subacute and particularly chronic form. Glassy dark patches, the opal glass syndrome, were a common sign in patients with alveolitis. Septal thickening, lung tissue meshwork, and centrilobular emphysema were encountered only in patients with IDA and small-nodular focal masses and bronchial wall thickening were present in those with EAA.

  13. SPATIAL DISTRIBUTION OF PULMONARY TUBERCULOSIS IN URBAN AREAS: A CASE FROM BELÉM, BRAZIL

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Arbage LOBO

    2016-12-01

    Full Text Available The precise location of areas with high incidence of pulmonary tuberculosis (TB is important to improve public health actions. Official data records of the addresses and neighborhoods where the infected people live allow the mapping of the disease on this spatial scale. However, great socioeconomic diversity often exists inside neighborhoods, wherein high- and low-income families reside. This situation hampers the location of those areas that require close attention. Objective: This study aimed to estimate the risk of pulmonary TB infections in census tracts in Belém City (Brazil from data on neighborhoods. Methods: A partial least-squares regression model was constructed in the scale of neighborhoods based on the record of addresses of TB-infected people and socioeconomic data from official sources. The model was then slightly modified and used to estimate the risk of TB prevalence in urban census tracts. The results were mapped using a geographical information system. Results: The percentages of explained variance of the set of independent variables and dependent variable were 86.4% and 30.2%, respectively. These values indicated that the model was acceptable for its purpose. Conclusion: The model’s results were consistent with the spatial distribution of socioeconomic and environmental characteristics of Belém City.

  14. Prevalence of multidrug resistance among retreatment pulmonary tuberculosis cases in a tertiary care hospital, Hyderabad, India

    Directory of Open Access Journals (Sweden)

    Subhakar Kandi

    2013-01-01

    Full Text Available Background: India is one of the high tuberculosis (TB burden countries in the world. India ranks second in harboring multi drug resistant (MDR-TB cases. About 50,000 of MDR cases are recorded in retreatment pulmonary TB cases. This study was conducted in a tertiary care facility (Government General and Chest Hospital in Hyderabad, India. Objectives: Toassess: Proportion of the TB patients having MDR-TB at the initiation of retreatment regimen; the prevalence of isoniazid (INH resistance in this geographical area. Materials and Methods: An analytical, observational, prospective cohort study of patients attending the out-patient department from December 2010 to March 2011. Results: Sputum samples from 100 patients were subjected to acid fast bacilli (AFB culture and drug sensitivity testing. Of these, 28 (28% were MDR-TB, 42 (42% were non-MDR-TB and 39% being INH resistance. Conclusions: In conclusion, one third of the retreatment pulmonary TB cases attending a tertiary care institute for TB will be MDR-TB at the initiation of treatment and there is a need to include ethambutol in the continuation phase of new TB case treatment in view of high INH resistance.

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

    Directory of Open Access Journals (Sweden)

    Radovic M

    2016-06-01

    Full Text Available Milan Radovic,1,2 Lidija Ristic,1,2 Zorica Ciric,1,2 Violeta Dinic-Radovic,3 Ivana Stankovic,1,2 Tatjana Pejcic,1,2 Milan Rancic,1,2 Dragan Bogdanovic4 1Department of Internal Medicine, Faculty of Medicine, University of Nis, 2Clinic for Lung Diseases, 3Clinic for Gastroenterology and Hepatology, Clinical Centre of Nis, 4Public Health Institute Nis, Nis, Republic of Serbia Background: During the treatment phase of active pulmonary tuberculosis (PTB, respiratory function impairment is usually restrictive. This may become obstructive, as a PTB-associated airflow obstruction (AFO or as a later manifestation of underlying COPD.Purpose: The aim of the study was to examine the potential causes and risks for AFO development in PTB by exploring the aspects of spirometry limitations and clinical implications for the underlying COPD detection, taking into account various confounding factors.Patients and methods: Prospective, nest case–control study on 40 new cases of PTB with initial restrictive respiratory function impairment, diagnosed and treated according to the directly observed treatment short course (DOTS strategy.Results: From all observed patients, 37.5% of them developed AFO upon the completion of PTB treatment, with significantly increased average of forced vital capacity (% (P<0.01. Their changes in forced expiratory volume in the first second (% during the PTB treatment were strongly associated with the air pollution exposure in living (0.474%–20.971% for 95% confidence interval [CI]; P=0.041 and working environments (3.928%–20.379% for 95% CI; P=0.005, initial radiological extent of PTB lesions (0.018%–0.700% for 95% CI; P=0.047, leukocyte count (0.020%–1.328% for 95% CI; P=0.043, and C-reactive protein serum level (0.046%–0.205% for 95% CI; P=0.003 compared to the other patients. The multivariate logistic regression analysis model shows initial radiological extent of pulmonary tuberculosis lesions (OR 1.01–1.05 for 95% CI; P=0

  16. The adrenal gland and the patient with pulmonary tuberculosis infected with human immunodeficiency virus

    Directory of Open Access Journals (Sweden)

    Ifedayo Adeola Odeniyi

    2017-01-01

    Full Text Available Background: The adrenal gland is not spared from the involvement by tuberculosis. One of the recognized causes of adrenal insufficiency (AI is tuberculosis. AI, mostly at the subclinical level, is common in persons with pulmonary tuberculosis (PTB infection, occurring in about 23% of patients. Coinfection with PTB and human immunodeficiency virus (HIV may compromise adrenocortical function and produce significant adrenocortical insufficiency. Objective: To determine if coinfection with tuberculosis and HIV have a compound effect on adrenocortical function in persons with HIV and PTB coinfection. Materials and Methods: Persons with sputum-positive PTB, treatment naive, who met our inclusion criteria, were selected. All the recruited patients were screened for HIV and those positive for HIV infection had confirmatory test. A baseline blood samples for cortisol, fasting plasma glucose, full blood count, and electrolytes were collected between 8.00 h and 9.00 h immediately before administration of adrenocorticotropic hormone (ACTH. The persons received an intravenous bolus injection of 1 μg ACTH (Alliance Pharmaceuticals Ltd., Chippenham, Wiltshire SN15 2BB and blood sample was drawn for cortisol level at 30 min. Results: Forty-four people with PTB infection and forty people with PTB and HIV coinfection met the inclusion criteria of the study. The adrenal response to 1 μg ACTH stimulation in participants with PTB and PTB and HIV coinfection showed that the mean basal cortisol level in the 2 groups was not statistically significant; however, 30-min post-ACTH stimulation cortisol level was 630.84 ± 372.17 and 980.36 ± 344.82 nmol/L (P < 0.001 and increment was 367.79 ± 334.87 and 740.77 ± 317.97 nmol/L (P < 0.001, respectively. Fourteen persons (31.8% with PTB has subnormal adrenal response to ACTH stimulation while only 2 (5% persons with PTB and HIV coinfection has subnormal response. Conclusion: AI, at subclinical level, was less frequent in

  17. Immune parameters differentiating active from latent tuberculosis infection in humans.

    Science.gov (United States)

    Lee, Ji Yeon; Jung, Young Won; Jeong, Ina; Joh, Joon-Sung; Sim, Soo Yeon; Choi, Boram; Jee, Hyeon-Gun; Lim, Dong-Gyun

    2015-12-01

    Tuberculosis remains a highly prevalent infectious disease worldwide. Identification of the immune parameters that differentiate active disease from latent infection will facilitate the development of efficient control measures as well as new diagnostic modalities for tuberculosis. Here, we investigated the cytokine production profiles of monocytes and CD4(+) T lymphocytes upon encountering mycobacterial antigens. In addition, cytokines and lipid mediators with immune-modulating activities were examined in plasma samples ex vivo. Comparison of these parameters in active tuberculosis patients and healthy subjects with latent infection revealed that, active tuberculosis was associated with diminished Th1-type cytokine secretion from CD4(+) T cells and less augmented inflammatory cytokine secretion from monocytes induced by IFN-γ than that in latent tuberculosis infection. In addition, a higher plasma concentration of lipoxin A4 and lower ratio of prostaglandin E2 to lipoxin A4 were observed in active cases than in latent infections. These findings have implications for preparing new therapeutic strategies and for differential diagnosis of the two types of tuberculosis infection.

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

    Science.gov (United States)

    Gao, Limin; Li, Huifang; Li, Gandi; Liu, Weiping; Li, Jinnan; Zhang, Wenyan

    2015-01-01

    We report an uncommon 22-year-old male Pulmonary Langerhans Cell Histiocytosis (PLCH) case which co-existed with pulmonary tuberculosis (TB). Unlike the common PLCH cases, this PLCH case has cervical lymph node involvement and right pneumothorax. The diagnosis was established by the imaging of lung and the biopsies of the lung and left neck lymph node. Imaging of the chest showed characteristic small nodules and thin-walled cysts and right pneumothorax. The LCH cells in the lung and left neck lymph node were characterized by large convoluted nuclei with cerebriform indentations of the nuclear envelope and longitudinal grooves. The nuclei contained small eosinophilic nucleoli and moderate amount cytoplasm. Immunohistochemically, the histiocytoid cells were positive for Langerin, CD1a and S-100. Acid-fast bacilli were found in sputum and lung biopsy tissue. To the best of our knowledge, this is the first case of PLCH with cervical lymph node involvement, and coexisted with pulmonary tuberculosis, right pneumothorax. A contribution of this case and review three of the five cases of PLCH with extrapulmonary involvement to lymph nodes resolved spontaneously after smoking cessation constitute a novel addition that it is inappropriate to regard pulmonary/nodal LCH as multi-organ or disseminated disease, and the treatment methods are the same whether the PLCH patient with lymph node involvement or not.

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

    Science.gov (United States)

    Gao, Limin; Li, Huifang; Li, Gandi; Liu, Weiping; Li, Jinnan; Zhang, Wenyan

    2015-01-01

    We report an uncommon 22-year-old male Pulmonary Langerhans Cell Histiocytosis (PLCH) case which co-existed with pulmonary tuberculosis (TB). Unlike the common PLCH cases, this PLCH case has cervical lymph node involvement and right pneumothorax. The diagnosis was established by the imaging of lung and the biopsies of the lung and left neck lymph node. Imaging of the chest showed characteristic small nodules and thin-walled cysts and right pneumothorax. The LCH cells in the lung and left neck lymph node were characterized by large convoluted nuclei with cerebriform indentations of the nuclear envelope and longitudinal grooves. The nuclei contained small eosinophilic nucleoli and moderate amount cytoplasm. Immunohistochemically, the histiocytoid cells were positive for Langerin, CD1a and S-100. Acid-fast bacilli were found in sputum and lung biopsy tissue. To the best of our knowledge, this is the first case of PLCH with cervical lymph node involvement, and coexisted with pulmonary tuberculosis, right pneumothorax. A contribution of this case and review three of the five cases of PLCH with extrapulmonary involvement to lymph nodes resolved spontaneously after smoking cessation constitute a novel addition that it is inappropriate to regard pulmonary/nodal LCH as multi-organ or disseminated disease, and the treatment methods are the same whether the PLCH patient with lymph node involvement or not. PMID:25973117

  20. Seasonal variation of newly notified pulmonary tuberculosis cases from 2004 to 2013 in Wuhan, China.

    Directory of Open Access Journals (Sweden)

    Xiaobing Yang

    Full Text Available BACKGROUND: Although there was a report about the seasonal variation in Wuhan city, it only analyzed the prevalence data of pulmonary tuberculosis (TB cases, and just studied the seasonality by subgroup of smear positive and negative from 2006 to 2010 by spectral analysis. In this study, we investigated the seasonality of the total newly notified pulmonary TB cases by subgroups such as time period, sex, age, occupation, district, and sputum smear result from 2004 to 2013 in Wuhan by a popular seasonal adjustment model (TRAMO-SEATS. METHODS: Monthly pulmonary TB cases from 2004 to 2013 in Wuhan were analyzed by the TRAMO-SEATS seasonal adjustment program. Seasonal amplitude was calculated and compared within the subgroups. RESULTS: From 2004 to 2013, there were 77.76 thousand newly notified pulmonary TB cases in Wuhan, China. There was a dominant peak spring peak (March with seasonal amplitude of 56.81% and a second summer peak (September of 43.40%, compared with the trough month (December. The spring seasonal amplitude in 2004-2008 was higher than that of 2009-2013(P0.05. However, there were significant differences in spring seasonal amplitude by occupation, with amplitude ranging from 59.37% to 113.22% (P0.05. There were significant differences in summer seasonal amplitude by age, with amplitude ranging from 36.05% to 100.09% (P<0.05. Also, there were significant differences in summer seasonal amplitude by occupation, with amplitude ranging from 43.40% to 109.88% (P<0.05. CONCLUSIONS: There was an apparent seasonal variation in pulmonary TB cases in Wuhan. We speculated that spring peak in our study was most likely caused by the increased reactivation of the latent TB due to vitamin D deficiency and high PM2.5 concentration, while the summer peak was mainly resulted from the enhanced winter transmission due to indoor crowding in winter, overcrowding of public transportation over the period of the Spring Festival and health care seeking delay in

  1. Treatment delay among pulmonary tuberculosis patients in pastoralist communities in Bale Zone, Southeast Ethiopia

    Directory of Open Access Journals (Sweden)

    Hussen Awol

    2012-06-01

    Full Text Available Abstract Background Tuberculosis (TB is a major public health problem in Africa with Ethiopia being the most affected. Treatment delay is an important indicator of access to TB diagnosis and treatment. However, little is known about factors associated with treatment delay of pulmonary TB among pastoralists. Health facility based cross sectional study was conducted on 129 pulmonary TB patients in pastoralist community. The study was conducted in three health centers and a hospital. Time between onset of TB symptoms and first visit to a professional health care provider (patient delay, and the time between first visits to the professional health care provider to the date of diagnosis (provider's delay were analyzed using SPSS 16.0 statistical software. Findings A total of 129 new smear positive pulmonary TB patients participated in the study. The median total delay was 97 days. The median patient and health provider delays were 63 and 34 days, respectively. Ninety six percent of the patients were delayed for more than the twenty one days cutoff point. Patient delay was positively associated with first visit to traditional healer/private clinic/drug shop, rural residence, being illiterate, living in more than 10 kilometers from health facility; severity of illness at first presentation to health facility. Provider delay was positively associated with rural residence, being illiterate, patient with good functional status, patients in contact with more than two health providers, and place of first visit being traditional healer/private clinic/drug shop. Conclusions This study showed that majority of smear positive patients delayed either for diagnosis or treatment, thus continue to serve as reservoirs of infection. This indicates that there is a need for intervention to decrease patient and provider delays. Effort to reduce delays in pastoralist communities should focus on improving access to services in rural communities, engaging traditional and

  2. Prevalence of latent tuberculosis infection among health care workers in a hospital for pulmonary diseases

    Directory of Open Access Journals (Sweden)

    Diel Roland

    2009-01-01

    Full Text Available Abstract Background Little is known about the prevalence of latent tuberculosis infections (LTBI in health care workers (HCW in low-incidence countries especially in hospitals for pulmonary diseases. With Interferon-gamma release assays (IGRA, a new method for diagnosis of LTBI is available which is more specific than the tuberculin skin test (TST. Objectives The study was designed to estimate prevalence of LTBI among 270 HCW in a Hospital of Pulmonary Diseases routinely screened for TB. Methods LTBI was assessed by the QuantiFERON-Gold In Tube (QFT-IT. Information on gender, age, workplace, job title, BCG vaccination and history of both TB and TST were collected using a standardised questionnaire. Adjusted odds ratios for potential risk factors for LTBI were calculated. Results The prevalence of LTBI was 7.2%. In HCW younger than 30 years LTBI prevalence was 3.5% and in those older than 50 years 22%. Physicians and nurses showed a higher prevalence rate than other professions (10.8% to 4.5%. The putative risk factors for LTBI were age (>50 year OR 9.3, 95%CI 2.5–33.7, working as physicians/nurses (OR 3. 95%CI 1.2–10.4 and no previous TST in medical history (OR 4.4, 95%CI 1.01–18.9 when compared to those with a negative TST. Conclusion Prevalence of LTBI assessed by QFT-IT is low, this indicates a low infection risk even in hospitals for pulmonary diseases. No statement can be made regarding the occupational risk as compared to the general population because there are no LTBI prevalence data from Germany available. The higher LTBI prevalence rate in older HCWs might be due to the cohort effect or the longer time at risk.

  3. Histopathological yield in different types of bronchoscopic biopsies in proven cases of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Nalini Gupta

    2015-01-01

    Full Text Available Background: Diagnosis of pulmonary tuberculosis (TB is difficult and often requires a lung biopsy. The goal of this retrospective study was to determine the histopathological parameters useful for diagnosis of pulmonary TB in different types of bronchoscopic biopsies (transbronchial lung biopsy [TBLB], transbronchial needle aspiration [TBNA], and bronchial biopsy [BB]. Materials and Methods: The records of patients diagnosed to have pulmonary TB, over a period of 1-year were evaluated. Patients with positive acid-fast bacilli (AFB culture and with three bronchoscopic biopsies including TBLB, TBNA, and BB were included in the study. Selected (14 histological parameters were evaluated retrospectively in a total of 27 biopsies from 9 patients with TB after hematoxylin-eosin and Ziehl-Neelsen staining. Results: Diagnostic yield in TBLBs and TBNA was similar for granulomas detection (66.6% each. Granulomas in TBNA were larger, caseating and confluent as compared to small interstitial granulomas seen in TBLB. AFB was demonstrated in only one patient in TBNA. Lymphocytic cell cuffing was seen around most TBLB granulomas. One patient also showed microfilaria in blood vessel in TBLB. BBs in all patients showed the presence of goblet cell metaplasia and increased peribronchial plasma cell infiltrate with or without eosinophils may be indicative of chronic injury. The yield of granulomas was low in BBs seen in only 2 patients (22.2%. Conclusion: Diagnostic yield of TBNA and TBLB for granulomas was similar; however, caseation was seen more frequently in TBNA than on TBLB. Of other histological parameters, bronchial metaplastic changes and peribronchial plasma cells infiltrate were constant findings in all tubercular biopsies indicative of chronic injury.

  4. Oral Tolerance to Environmental Mycobacteria Interferes with Intradermal, but Not Pulmonary, Immunization against Tuberculosis.

    Directory of Open Access Journals (Sweden)

    Dominique N Price

    2016-05-01

    Full Text Available Bacille Calmette-Guérin (BCG is currently the only approved vaccine against tuberculosis (TB and is administered in over 150 countries worldwide. Despite its widespread use, the vaccine has a variable protective efficacy of 0-80%, with the lowest efficacy rates in tropical regions where TB is most prevalent. This variability is partially due to ubiquitous environmental mycobacteria (EM found in soil and water sources, with high EM prevalence coinciding with areas of poor vaccine efficacy. In an effort to elucidate the mechanisms underlying EM interference with BCG vaccine efficacy, we exposed mice chronically to Mycobacterium avium (M. avium, a specific EM, by two different routes, the oral and intradermal route, to mimic human exposure. After intradermal BCG immunization in mice exposed to oral M. avium, we saw a significant decrease in the pro-inflammatory cytokine IFN-γ, and an increase in T regulatory cells and the immunosuppressive cytokine IL-10 compared to naïve BCG-vaccinated animals. To circumvent the immunosuppressive effect of oral M. avium exposure, we vaccinated mice by the pulmonary route with BCG. Inhaled BCG immunization rescued IFN-γ levels and increased CD4 and CD8 T cell recruitment into airways in M. avium-presensitized mice. In contrast, intradermal BCG vaccination was ineffective at T cell recruitment into the airway. Pulmonary BCG vaccination proved protective against Mtb infection regardless of previous oral M. avium exposure, compared to intradermal BCG immunization. In conclusion, our data indicate that vaccination against TB by the pulmonary route increases BCG vaccine efficacy by avoiding the immunosuppressive interference generated by chronic oral exposure to EM. This has implications in TB-burdened countries where drug resistance is on the rise and health care options are limited due to economic considerations. A successful vaccine against TB is necessary in these areas as it is both effective and economical.

  5. Oral Tolerance to Environmental Mycobacteria Interferes with Intradermal, but Not Pulmonary, Immunization against Tuberculosis.

    Science.gov (United States)

    Price, Dominique N; Kusewitt, Donna F; Lino, Christopher A; McBride, Amber A; Muttil, Pavan

    2016-05-01

    Bacille Calmette-Guérin (BCG) is currently the only approved vaccine against tuberculosis (TB) and is administered in over 150 countries worldwide. Despite its widespread use, the vaccine has a variable protective efficacy of 0-80%, with the lowest efficacy rates in tropical regions where TB is most prevalent. This variability is partially due to ubiquitous environmental mycobacteria (EM) found in soil and water sources, with high EM prevalence coinciding with areas of poor vaccine efficacy. In an effort to elucidate the mechanisms underlying EM interference with BCG vaccine efficacy, we exposed mice chronically to Mycobacterium avium (M. avium), a specific EM, by two different routes, the oral and intradermal route, to mimic human exposure. After intradermal BCG immunization in mice exposed to oral M. avium, we saw a significant decrease in the pro-inflammatory cytokine IFN-γ, and an increase in T regulatory cells and the immunosuppressive cytokine IL-10 compared to naïve BCG-vaccinated animals. To circumvent the immunosuppressive effect of oral M. avium exposure, we vaccinated mice by the pulmonary route with BCG. Inhaled BCG immunization rescued IFN-γ levels and increased CD4 and CD8 T cell recruitment into airways in M. avium-presensitized mice. In contrast, intradermal BCG vaccination was ineffective at T cell recruitment into the airway. Pulmonary BCG vaccination proved protective against Mtb infection regardless of previous oral M. avium exposure, compared to intradermal BCG immunization. In conclusion, our data indicate that vaccination against TB by the pulmonary route increases BCG vaccine efficacy by avoiding the immunosuppressive interference generated by chronic oral exposure to EM. This has implications in TB-burdened countries where drug resistance is on the rise and health care options are limited due to economic considerations. A successful vaccine against TB is necessary in these areas as it is both effective and economical.

  6. A case of pulmonary tuberculosis presenting as diffuse alveolar haemorrhage: is there a role for anticardiolipin antibodies?

    Directory of Open Access Journals (Sweden)

    Lauria Francesco N

    2010-02-01

    Full Text Available Abstract Background Diffuse alveolar haemorrhage (DAH has been rarely reported in association with pulmonary infections. Case Presentation We report the case of a 43 year old immunocompetent man presenting with dyspnoea, fever and haemoptysis. Chest imaging showed bilateral ground glass opacities. Microbiological and molecular tests were positive for Mycobacterium tuberculosis and treatment with isoniazid, rifampicin, ethambutol and pyrazinamide was successful. In this case the diagnosis of DAH relies on clinical, radiological and endoscopic findings. Routine blood tests documented the presence of anticardiolipin antibodies. In the reported case the diagnostic criteria of antiphospholipid syndrome were not fulfilled. Conclusions The transient presence of anticardiolipin antibodies in association with an unusual clinical presentation of pulmonary tuberculosis is intriguing although a causal relationship cannot be established.

  7. Cost Effectiveness of DOTS and Non-DOTS Strategies for Smear-positive Pulmonary Tuberculosis in Beijing

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The cost-effectiveness of DOTS (Directly Observed Treatment, short course) and non-DOTS strategies for smear-positive pulmonary tuberculosis in Beijing was evaluated. Cost calculation was based on the expenses of drugs, chest X-ray films, sputum smears and cultures for the patients. Effectiveness of the intervention was assessed in two aspects: direct benefits to the patients treated and indirect benefits to the others through reduced transmission of tuberculosis; disability adjusted life of year (DALY) was used as an index. The results showed that one DALY could be saved with 45.7 Yuan by DOTS and 471.4 Yuan by non-DOTS. DOTS is a good control strategy for smear-positive tuberculosis.

  8. Differential combination of cytokine and interferon- γ +874 T/A polymorphisms determines disease severity in pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Ambreen Ansari

    Full Text Available BACKGROUND: Mycobacterium tuberculosis infects nearly 1/3 of the world population and this reservoir forms the largest pool from which new cases arise. Among the cytokines, IFN-γ is a key determinant in protection against tuberculosis. Single nucleotide polymorphisms (SNPs in IFN-γ gene (+874 T/A which determine TT high ((hi, AA low ((lo and TA intermediate ((int responder phenotypes have shown variable associations with tuberculosis disease outcome in different ethnic populations. The objective of the current study was to analyze IFN-γ gene combinations with other IFN-γ regulating cytokine genes (IL-10, TNF -α, IL-6 to see the effect of gene- combinations on disease severity outcome in pulmonary tuberculosis. METHODS AND FINDINGS: Study groups comprised of pulmonary TB patients stratified according to lung tissue involvement into mild (Pmd = 74 or advance (Pad = 23 lung disease and compared with healthy controls (TBNA = 166. Genotype analysis was carried out using amplification refractory mutation system-PCR (ARMS-PCR. IFN-γ gene (+874 T/A functional SNP combinations in TNFα (-308 G/A, IL-10 (-1082 A/G and IL-6 (-174 G/C were analyzed. Single gene analysis (Pearson χ² showed a dominant association of IFN-γ TT (hi genotype (p = 0.001 and T allele (p = 0.001 with mild disease. IFN-γ(lo -IL-10(lo genotype combination was associated with advanced disease (p = 0.002. IFN-γ(hi -IL-6(hi combination was associated with mild disease (p = 0.0005 while IFN-γ(lo -IL-6(int was associated with protection against both forms of pulmonary disease (p = 0.002. CONCLUSION: Our results show that a limited number of IFN-γ gene combinations with other cytokine functional SNPs determine the outcome of disease severity in tuberculosis.

  9. Extra-pulmonary tuberculosis infection in the dialysis patients with end stage renal diseases: case reports and literature review

    Institute of Scientific and Technical Information of China (English)

    Wen-fang YANG; Fei HAN; Xiao-hui ZHANG; Ping ZHANG; Jiang-hua CHEN

    2013-01-01

    The diagnosis of extra-pulmonary tuberculosis (TB) seems relatively difficult due to the absence of specific symptoms and signs in patients on peritoneal dialysis or hemodialysis.We report four cases of extra-pulmonary tuberculosis on dialysis,with two cases on peritoneal dialysis and two cases on hemodialysis.The presentations,therapy,and outcomes of TB infection in these patients were reviewed.Otherwise,the English literature published in the PubMed database associating extra-pulmonary tuberculosis on dialysis over the last three decades is reviewed.A total of 61 studies containing 70 cases were included.The most common primary disease was diabetic nephropathy (22.86%,16/70).The peritoneum (31.42%,22/70),bone (21.42%,15/70),and lymph node (20%,14/70) were the most frequently infected.Single organ infection was common (90%,63/70).Fever (58.57%,41/70),pain (35.71%,25/70),and enlarged lymph node (20%,14/70) were the most common symptoms.Biopsy (67.14%,47/70) and culture (40%,28/70) provided most reliable methods for clear diagnosis of tuberculosis.The combined treatment of isoniazid,rifampicin,pyrazinamide,and ethambutol (44.29%,31/70) was the most common therapy.The majority of patients improved (82.86%,58/70); however,12 cases got worse (17.14%),with 10 of them dying (14.29%).Physicians should be aware of the non-specific symptoms and location of infection,and consider tuberculosis in their differential diagnoses in dialysis patients presenting with symptoms such as fever,pain,and weight loss.

  10. A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis

    OpenAIRE

    2014-01-01

    Background Effective protocols for the isolation and de-isolation of patients with suspected pulmonary tuberculosis (PTB) are essential determinants of health-care costs. Early de-isolation needs to be balanced with the need to prevent nosocomial transmission of PTB. The aim of our study was to evaluate the efficiency of our hospital’s current protocol for isolating and de-isolating patients with suspected PTB, in particular assessing the timeliness to de-isolation of patients with AFB smear ...

  11. CONTRAST ENHANCED CT UNVEILED GIANT RASMUSSEN’S ANEURYSM: A RARE COMPLICATION AND CAUSE OF DEATH IN PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Sanjeev

    2014-05-01

    Full Text Available Rasmussen’s aneurysm is a rare complication of pulmonary tuberculosis. Often the aneurysm ruptures in the bronchial tree causing massive hemoptysis resulting in death. We are reporting a case of partially thrombosed giant Rasmussen’s aneurysm which arose in the vicinity of a tuberculous cavity along with empyema necessitans. Unfortunately the patient died of massive hemoptysis within two days of his diagnosis.

  12. Prevalence of acute epiglottitis and its association with pulmonary tuberculosis in adults in a tertiary care hospital of Nepal

    Directory of Open Access Journals (Sweden)

    Thapa, Narmaya

    2008-12-01

    Full Text Available Introduction: Acute epiglottitis is a relatively uncommon disease in both children and adults. It can be a serious life threatening disease because of its potential for sudden upper airway obstruction. Objective: To determine the prevalence of acute epiglottitis and to find out its association with Pulmonary Tuberculosis. Methods: All cases of acute epiglottitis admitted in ENT and Head and Neck Surgery ward of TUTH, Kathmandu, Nepal, from April 2001 to September 2007, were enrolled. Routine investigations including x-rays and blood cultures were done. The patients were further investigated to rule out the presence of Pulmonary Tuberculosis.The standard treatment protocol we used included Injection Ampicillin 500 mg intravenously six hourly for 72 hours followed by oral Ampicillin 500mg for 7 days, with analgesics and intravenous steroid (Hydrocortisone 200mg if required. Study Design: Prospective longitudinal study. Results: Majority of the patients presented with a history sore throat (83.3%, dysphagia (78.6% and odynophagia (78.6%. On examination all the patients were found to have swollen and congested epiglottis. Positive "Thumb sign" on plain X-ray soft tissue neck lateral view was found in almost all the patients (95.2%. Four patients presented with stridor and patient needed emergency tracheostomy. None of the investigations done to detect Pulmonary Tuberculosis was found to be positive. Conclusion: Acute epiglottitis is a rare disease which now occurs more commonly in adults. The annual prevalence of Acute Epiglottitis in adult in TUTH is 4.8 per 1000. This study did not find any association of acute epiglottitis with pulmonary tuberculosis.

  13. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review

    NARCIS (Netherlands)

    Tiemersma, E.W.; van der Werf, M.J.; Borgdorff, M.W.; Williams, B.G.; Nagelkerke, N.J.D.

    2011-01-01

    Background The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting epid

  14. Sociodemographic, Epidemiological, and Clinical Risk Factors for Childhood Pulmonary Tuberculosis in Severely Malnourished Children Presenting With Pneumonia

    Directory of Open Access Journals (Sweden)

    Mohammod Jobayer Chisti MBBS, MMed, PhD

    2015-07-01

    Full Text Available We aimed to evaluate sociodemographic, epidemiological, and clinical risk factors for pulmonary tuberculosis (PTB in children presenting with severe acute malnutrition (SAM and pneumonia. Children aged 0 to 59 months with SAM and radiologic pneumonia from April 2011 to July 2012 were studied in Bangladesh. Children with confirmed PTB (by culture and/or X-pert MTB/RIF (cases = 27 and without PTB (controls = 81; randomly selected from 378 children were compared. The cases more often had the history of contact with active PTB patient (P < .01 and exposure to cigarette smoke (P = .04 compared with the controls. In logistic regression analysis, after adjusting for potential confounders, the cases were independently associated with working mother (P = .05 and positive tuberculin skin test (TST; P = .02. Thus, pneumonia in SAM children is a common presentation of PTB and further highlights the importance of the use of simple TST and/or history of contact with active TB patients in diagnosing PTB in such children, especially in resource-limited settings.

  15. Tuberculose pulmonar: achados na tomografia computadorizada de alta resolução do tórax em pacientes com doença em atividade comprovada bacteriologicamente Pulmonary tuberculosis: findings on high resolution computerized tomography of active disease on patients with bacteriological confirmation

    Directory of Open Access Journals (Sweden)

    CRISTIANE ALÓ CAMPOS

    2002-01-01

    Full Text Available Objetivo: Descrever os achados em pacientes com tuberculose pulmonar em atividade na tomografia computadorizada de alta resolução e o padrão de distribuição das lesões pelo parênquima pulmonar. Casuística e método: Foram analisadas retrospectivamente as tomografias de alta resolução de 42 pacientes com diagnóstico bacteriológico de tuberculose pulmonar ou forte suspeita clínica, com posterior confirmação bacteriológica. Resultados: Os principais sinais sugestivos de atividade encontrados foram nódulos do espaço aéreo (83%, nódulos centrolobulares (74%, aspecto de árvore em brotamento (67%, cavitações (67%, espessamento das paredes brônquicas (55%, consolidações (48%, opacidade em vidro fosco (21%, e espessamento do interstício pulmonar (9%. Conclusão: A tomografia computadorizada de alta resolução do tórax pode sugerir fortemente atividade da doença, sendo particularmente útil nos pacientes com baciloscopias negativas e/ou radiografias indeterminadas, permitindo a instituição de tratamento adequado, antes mesmo do crescimento da micobactéria em meio de cultura.Background: The aim of this study was to describe the signs of active tuberculosis in patients submitted to high resolution computerized tomography and the distribution of lesions along the pulmonary parenchyma. Material and methods: The high resolution CTs performed on 42 patients with tuberculosis either bacteriologically diagnosed or clinical suspected and later confirmed by bacteriological tests were studied. Results: The signs of disease activity observed were airspace nodule (83%, centrilobular nodule (74%, tree-in-bud pattern (67%, cavitations (67%, bronchial thickening (55%, parenchymal consolidations (48%, ground glass opacity (21% and thickening of the inter and intralobular septa (9%. Conclusion: High resolution computed tomography can be strongly suggestive of disease activity, is particularly helpful in patients with negative smear and

  16. Adjunctive micronutrient supplementation for pulmonary tuberculosis Suplementación con micronutrientes como tratamiento adjunto para tuberculosis pulmonar

    Directory of Open Access Journals (Sweden)

    Rodrigo X Armijos

    2010-06-01

    Full Text Available OBJECTIVE: To assess the effect of micronutrient supplementation on tuberculosis (TB patient outcomes. MATERIAL AND METHODS: The randomized, double-blinded, placebo-controlled study was conducted in pulmonary TB patients undergoing directly observed treatment short course/ tratamiento acortado estrictamente supervisado (TAES/ DOTS at IMSS in Ciudad Juarez, Chihuahua, Mexico, who were recruited during August 2005-July 2006. Consecutive patients received zinc and vitamin A supplements or matched placebo for four months. Dietary intake, blood zinc and vitamin A, immune response (IFN-γ,TNF-α, and IL-10 mRNA, and sputum smear conversion were measured. RESULTS: The proportion of micronutrient compared to placebo group subjects with a negative sputum smear by month 3 was significantly increased (p= 0.03. This occurred subsequent to increased TNF-α and IFN-γ and decreased IL-'0 observed at month 2. Micronutrient supplementation appeared to accelerate the beneficial therapeutic effect of chemotherapy. CONCLUSIONS: The earlier elimination of bacilli from sputum was associated with improved zinc status and Th' immune response. The therapeutic effect of vitamin A was less evident.OBJETIVO: Determinar el efecto de la suplementación con zinc y vitamina A o placebo en pacientes tratados por tuberculosis (TB. MATERIAL Y MÉTODOS: Se realizó un ensayo aleatorizado en pacientes tuberculosos que iniciaron el tratamiento acortado estrictamente supervisado/ directly observed treatment short course (TAES/DOTS en las clínicas del IMSS, Ciudad Juárez, Chihuahua, México, reclutados durante agosto 2005-julio 2006. A cada paciente en forma aleatoria se le designó un código para recibir ya sea micronutrientes o placebo por cuatro meses, bajo el diseño doble ciego. Se evaluó la ingesta dietética, niveles de zinc y vitamina A en sangre, respuesta inmune (IFN-γ,TNF-α, IL-l0 mRNA en sangre y bacilo ácido alcohol resistente (BAAR en esputo. RESULTADOS: Al

  17. Prevalence of Pre-Extensively Drug-Resistant Tuberculosis (Pre XDR-TB) and Extensively Drug-Resistant Tuberculosis (XDR-TB) among Pulmonary Multidrug Resistant Tuberculosis (MDR-TB) at a Tertiary Care Center in Mumbai

    OpenAIRE

    Unnati D. Desai; Joshi, Jyotsna M

    2016-01-01

    Background: India is a high burden country for Tuberculosis (TB). As per the World Health Organization (WHO) statistics, 24000 cases of Multi Drug Resistant (MDR) TB were diagnosed in India in 2014. MDR-TB patients consist of a heterogeneous cohort and management has its challenges. Aims and objectives: We studied the prevalence of PreExtensively Drug Resistant TB (Pre XDR-TB) and Extensively Drug Resistant TB (XDR-TB) among patients of pulmonary MDR-TB not previous...

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  19. Association of HLA-A, -B, and -DRB1 with pulmonary tuberculosis in western Javanese Indonesia.

    Science.gov (United States)

    Yuliwulandari, Rika; Sachrowardi, Qomariyah; Nakajima, Humiaki; Kashiwase, Koichi; Hirayasu, Kouyuki; Mabuchi, Akihiko; Sofro, Abdul Salam Mudzakir; Tokunaga, Katsushi

    2010-07-01

    Genetic studies of pulmonary tuberculosis (PTB), including those of human leukocyte antigen (HLA) genes, have been reported in several populations. Some studies also have reported these genes to have a stronger role in severe tuberculosis. We investigated HLA class I and II alleles and haplotypes to ascertain their role in susceptibility and resistance to new and recurrent PTB in 257 PTB patients (216 new and 41 recurrent PTB patients) and 236 healthy controls in Western Javanese (Indonesia). HLA-B*4006 was associated with new PTB (p = 0.044, p(adj) = ns), whereas HLA-B*1802, HLA-B*4001 and HLA-DRB1*1101 were associated with recurrent PTB (p = 0.013, p(adj) = 0.016; p = 0.015, p(adj) = 0.028; and p = 0.008, p(adj) = 0.027 for new PTB vs recurrent PTB, respectively). Except for HLA-B*4006, those associations remained significant after adjustment for age and gender by logistic regression analysis, although they disappeared after correction for multiple testing. Haplotype HLA-B*1802-DRB1*1202 was associated with susceptibility to recurrent PTB (p = 0.014, odds ratio = 3.8, 95% confidence interval = 1.18-12.27). In contrast, HLA-DRB1*1202 in the absence of HLA-B*1802 showed a significant association with resistance to recurrent PTB (p = 8.2 x 10(-4), odds ratio = 0.32, 95% confidence interval = 0.16-0.64), suggesting that stronger susceptibility effect of HLA-B*1802 masked the protective effect of HLA-DRB1*1202. Further studies using larger number of patients with recurrent PTB will be needed to confirm our findings.

  20. Expression and function of the purinergic receptor P2X7 in patients with pulmonary tuberculosis.

    Science.gov (United States)

    Franco-Martínez, S; Niño-Moreno, P; Bernal-Silva, S; Baranda, L; Rocha-Meza, M; Portales-Cervantes, L; Layseca-Espinosa, E; González-Amaro, R; Portales-Pérez, D

    2006-11-01

    P2X(7) is a channel receptor gated by adenosine triphosphate (ATP) that is involved in the killing of intracellular mycobacteria. To explore further the role of P2X(7) in immunity against Mycobacterium tuberculosis, we studied its expression and function in 19 patients with pulmonary tuberculosis (TB) and 19 healthy contacts. Flow cytometry analysis showed a similar and variable expression of P2X(7) in TB patients and healthy subjects. In contrast, P2X(7) mARN levels were significantly higher in TB patients. When the function of the P2X(7) receptor in peripheral blood mononuclear cells (PBMC) was assessed by the effect of exogenous ATP on apoptosis, the uptake of the fluorescent marker Lucifer yellow or extracellular signal regulated kinase (ERK) phosphorylation, no significant differences were detected in patients and controls. However, mRNA macroarray analysis showed that upon stimulation with ATP, the PBMC from TB patients showed a significant induction of a higher number of cytokine genes (27 of 96), and a lower number of apoptosis genes (20 of 96) compared to healthy controls (17 and 76 genes, respectively). These results suggest that although the PBMC from TB patients do not show apparent abnormalities in the expression of P2X(7), and the intracellular signals generated through it, the pattern of gene expression induced by ATP in these cells is different from that found in healthy contacts. This phenomenon suggests a defective function of P2X(7) in the immune cells from TB patients, a condition that may contribute to the inability of these patients to eliminate the mycobacteria.

  1. ROLE OF IL-5 AND EOTAXIN IN DEVELOPMENT OF BLOOD EOSINOPHILIC REACTION DURING PULMONARY TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    U. V. Kolobovnikova

    2011-01-01

    Full Text Available Abstract. The  study  considers  some  aspects  of  pathogenetic  mechanisms  underlying  blood  eosinophilic  reactions  developing  in  pulmonary  tuberculosis,  taking  into  account  some  novel  data  obtained  by  means  of  modern  immunological  techniques.  It  was  revealed  that  IL-5  is  among  key  factors  determining  eosinophilic  reactions  of  blood  following  infection  with  M.  tuberculosis.  Blood  serum  IL-5  concentrations  proved  to  be  significantly  higher  in  patients  with  tuberculosis  accompanied  by  eosinophilia.  In  these  cases,  eotaxin  is  a  chemokine,  which  selectively  acts  upon  eosinophilic  cells.  Its  effects  include  prolonged  persistence  of  eosinophils  in  bloodstream,  along  with  initiation  of  eosinophil  adherence  to  vascular  endothelium,  thus  enabling  subsequent  migration  of  eosinophilic  leukocytes  to  the  foci  of  specific  granulomatous  inflammation.  (Med.  Immunol.,  2011,  vol.  13,  N  2-3,  pp  273-278

  2. 52例影像学病灶稳定痰菌阳性肺部结核分析%52 cases shows the of Analysis of 52 cases of sputum positive pulmonary tuberculosis with lesion stability in iconography

    Institute of Scientific and Technical Information of China (English)

    陈永忠

    2012-01-01

    目的 探讨影像学肺部病灶提示稳定而痰菌阳性肺部结核患者的原因.方法 对52例影像学(胸部CT、胸片)提示肺部无结核病灶或结核病灶稳定而痰找结核菌两次阳性或一次涂阳合并培养阳性的病例进行临床分析.结果 影像学表现肺部无病灶或提示肺部病灶稳定的患者仍有可能痰找结核菌阳性,为活动性的肺部结核病患者.结论 肺部影像学表现对判断结核病活动与否有一定的局限性,支气管内膜结核肺部影像无异常表现.对肺部表现为陈旧性病灶的患者和有临床表现而无病灶的患者一定要反复多次痰找结核菌,以防误诊.%Objective To explore the etiological fart or of sputum positive pulmonary tuberculosis with lesion stability in iconogra phy. Methods Clinical data in 52 cases of sputum positive pulmonary tuberculosis with lesion stability in iconography were analyzed. Results Some sputum positive pulmonary tuberculosis with lesion stability in iconography may be activitive pulmonary TB. Conclusion Lung imaging findings to judge whether or not TB activities has some limitations. Patients with old lesions, and with pulmonary manifesta tions, but without lesions must be repeated for sputum finding Mycobacterium tuberculosis to prevent misdiagnosis.

  3. Differential diagnosis of acute miliary pulmonary tuberculosis from widespread-metastatic cancer for postoperative lung cancer patients: two cases

    Science.gov (United States)

    Zhao, Wei; Tian, Yuke; Peng, Feng; Long, Jianlin; Liu, Lan; Lu, You

    2017-01-01

    Pulmonary infections and lung cancer can resemble each other on radiographic images, which makes it difficult to diagnosis accurately and apply an appropriate therapy. Here we report two cases that two postoperative patients with lung adenocarcinoma developed diffuse nodules in bilateral lungs in a month which needed to be distinguished between metastatic malignancies and infectious diseases. Although there are much similarities in disease characteristics of two cases, patient in case one was diagnosed as acute miliary pulmonary tuberculosis (TB) while patient in case two was diagnosed as metastatic disease. The symptoms and pulmonary foci on CT scan of patient in case one improved distinctly after the immediate anti-TB treatment, but the disease of patient in case two progressed after chemotherapy. These findings caution us that differential diagnosis is crucial and have significance in guiding clinical work.

  4. CD4 lymphocyte dynamics in Tanzanian pulmonary tuberculosis patients with and without HIV co-infection

    DEFF Research Database (Denmark)

    Andersen, Aase B.; Range, Nyagosya; Changalucha, John;

    2012-01-01

    ABSTRACT: BACKGROUND: The interaction of HIV and tuberculosis (TB) on CD4 levels over time has previously been divergently reported and only in small study populations with short or no follow-up. METHODS: CD4 counts were assessed from time of diagnosis till the end of TB treatment in a cohort...... of pulmonary TB patients with and without HIV co-infection and compared with cross-sectional data on age- and sex-matched non-TB controls from the same area. RESULTS: Of 1605 study participants, 1250 were PTB patients and 355 were non-TB controls. At baseline, HIV was associated with 246 (95% CI: 203; 279......) cells per uL lower CD4 counts. All PTB patients had 100 cells per uL lower CD4 counts than the healthy controls. The CD4 levels were largely unchanged during five-months of TB treatment. HIV infected patients not receiving ART at any time and those already on ART at baseline had no increase in CD4...

  5. Adjuvant interferon gamma in patients with drug – resistant pulmonary tuberculosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Carbonell Dalia

    2004-10-01

    Full Text Available Abstract Background Tuberculosis (TB is increasing in the world and drug-resistant (DR disease beckons new treatments. Methods To evaluate the action of interferon (IFN gamma as immunoadjuvant to chemotherapy on pulmonary DR-TB patients, a pilot, open label clinical trial was carried out in the Cuban reference ward for the management of this disease. The eight subjects existing in the country at the moment received, as in-patients, 1 × 106 IU of recombinant human IFN gamma intramuscularly, daily for one month and then three times per week up to 6 months as adjuvant to the indicated chemotherapy, according to their antibiograms and WHO guidelines. Sputum samples collection for direct smear observation and culture as well as routine clinical and thorax radiography assessments were done monthly. Results Sputum smears and cultures became negative for acid-fast-bacilli before three months of treatment in all patients. Lesion size was reduced at the end of 6 months treatment; the lesions disappeared in one case. Clinical improvement was also evident; body mass index increased in general. Interferon gamma was well tolerated. Few adverse events were registered, mostly mild; fever and arthralgias prevailed. Conclusions These data suggest that IFN gamma is useful and well tolerated as adjunctive therapy in patients with DR-TB. Further controlled clinical trials are encouraged.

  6. [Side effects of chemotherapy in patients with pulmonary tuberculosis and concomitant diseases].

    Science.gov (United States)

    Nikolaeva, O D

    2003-01-01

    As many as 395 patients with pulmonary tuberculosis concurrent with other illnesses were examined. It has been ascertained that in 57.8 percent of cases there occurs a side effect in the wake of the antituberculous drug administration. The following were recognized as ill effects of the drugs employed--allergic reactions, candidiasis, disbacteriosis, toxic reactions,--in 25.44%, 3.07%, 7.02%, and 64.47% of cases respectively. Revealed in the above series was a marked side effect on the digestive organs, neurotoxic reactions, toxic effect on the cardiovascular system in 28.08%, 15.35%, 10.53% of cases respectively. The most frequently seen side effect was due to rifampicin (23.25%), streptomycin (18.42%), isoniazid (17.08%). The least number of complications was with taking etambutol--3.94%. In 43.42% of cases, the identified side effect necessitates withdrawal of the drug, in 56.58% of cases, the management of the concomitant medical problems, a change in routes of administration of medicines, and combined employment of antihistaminic drugs and hyposensitizing methodological approaches to the management of the condition permitted carrying on with the therapy instituted.

  7. The Poor Survival among Pulmonary Tuberculosis Patients in Chiapas, Mexico: The Case of Los Altos Region

    Science.gov (United States)

    Nájera-Ortiz, J. C.; Sánchez-Pérez, H. J.; Ochoa-Díaz-López, H.; Leal-Fernández, G.; Navarro-Giné, A.

    2012-01-01

    Objective. To analyse survival in patients with pulmonary tuberculosis (PTB) and factors associated with such survival. Design. Study of a cohort of patients aged over 14 years diagnosed with PTB from January 1, 1998 to July 31, 2005. During 2004–2006 a home visit was made to each patient and, during 2008-2009, they were visited again. During these visits a follow-up interview was administered; when the patient had died, a verbal autopsy was conducted with family members. Statistical analysis consisted of survival tests, Kaplan-Meier log-rank test and Cox regression. Results. Of 305 studied patients, 68 had died due to PTB by the time of the first evaluation, 237 were followed-up for a second evaluation, and 10 of them had died of PTB. According to the Cox regression, age (over 45 years) and treatment duration (under six months) were associated with a poorer survival. When treatment duration was excluded, the association between poorer survival with age persisted, whereas with having been treated via DOTS strategy, was barely significant. Conclusions. In the studied area it is necessary that patients receive a complete treatment scheme, and to give priority to patients aged over 45 years. PMID:22701170

  8. Prospective cross-sectional evaluation of the small membrane filtration method for diagnosis of pulmonary tuberculosis.

    Science.gov (United States)

    Jones-López, Edward; Manabe, Yukari C; Palaci, Moises; Kayiza, Carol; Armstrong, Derek; Nakiyingi, Lydia; Ssengooba, Willy; Gaeddert, Mary; Kubiak, Rachel; Almeida Júnior, Pedro; Alland, David; Dietze, Reynaldo; Joloba, Moses; Ellner, Jerrold J; Dorman, Susan E

    2014-07-01

    Smear microscopy has suboptimal sensitivity, and there is a need to improve its performance since it is commonly used to diagnose tuberculosis (TB). We prospectively evaluated the diagnostic accuracy of the small membrane filtration (SMF) method, an approach that uses a vacuum manifold and is designed to concentrate bacilli onto a filter that can be examined microscopically. We enrolled hospitalized adults suspected to have pulmonary TB in Kampala, Uganda. We obtained a clinical history and three spontaneously expectorated sputum specimens for smear microscopy (direct, concentrated, and SMF), MGIT (mycobacterial growth indicator tube) 960 and Lowenstein-Jensen (LJ) cultures, and Xpert MTB/RIF testing. We performed per-specimen (primary) and per-patient analyses. From October 2012 to June 2013, we enrolled 212 patients (579 sputum specimens). The participants were mostly female (63.2%), and 81.6% were HIV infected; their median CD4 cell count was 47 cells/μl. Overall, 19.0%, 20.4%, 27.1%, 25.2%, and 25.9% of specimens tested positive by direct smear, concentrated smear, MGIT culture, LJ culture, and Xpert test, respectively. In the per-specimen analysis, the sensitivity of the SMF method (48.5%; 95% confidence interval [CI], 37.4 to 59.6) was lower than those of direct smear (60.9%; 51.4 to 70.5 [P = 0.0001]) and concentrated smear (63.3%; 53.6 to 73.1 [P filtration failure rate.

  9. Predictors of favorable results in pulmonary tuberculosis treatment (Recife, Pernambuco, Brazil, 2001-2004).

    Science.gov (United States)

    Sassaki, Cinthia Midori; Scatena, Lucia Marina; Gonzales, Roxana Isabel Cardozo; Ruffino-Netto, Antonio; Hinos, Paula; Villa, Tereza Cristina Scatena

    2010-06-01

    Based on data available in the Information System for Notifiable Diseases, predictive factors of favorable results were identified in the treatment of pulmonary tuberculosis, diagnosed between 2001 and 2004 and living in Recife-PE, Brazil. Uni- and multivariate logistic regression methods were used. In multivariate analysis, the following factors remained: Age (years), 0 to 9 (OR = 4.27; p = 0.001) and 10 to 19 (OR = 1.78; p = 0.011), greater chance of cure than over 60; Education (years), 8 to 11 (OR = 1.52; p = 0.049), greater chance of cure than no education; Type of entry, ne wcase s (OR = 3.31; p abandonment; Time (months) 2, 5--6 (OR = 9.15; p < 0.001); 6--9 (OR = 27.28; p < 0.001) and More than 9 (OR = 24.78; p < 0.001), greater chances of cure than less than 5; Health Unit District, DSII (OR = 1.60; p = 0.018) and DSIIV (OR = 2.87; p < 0.001), greater chance sof cure than DS II.

  10. The Poor Survival among Pulmonary Tuberculosis Patients in Chiapas, Mexico: The Case of Los Altos Region

    Directory of Open Access Journals (Sweden)

    J. C. Nájera-Ortiz

    2012-01-01

    Full Text Available Objective. To analyse survival in patients with pulmonary tuberculosis (PTB and factors associated with such survival. Design. Study of a cohort of patients aged over 14 years diagnosed with PTB from January 1, 1998 to July 31, 2005. During 2004–2006 a home visit was made to each patient and, during 2008-2009, they were visited again. During these visits a follow-up interview was administered; when the patient had died, a verbal autopsy was conducted with family members. Statistical analysis consisted of survival tests, Kaplan-Meier log-rank test and Cox regression. Results. Of 305 studied patients, 68 had died due to PTB by the time of the first evaluation, 237 were followed-up for a second evaluation, and 10 of them had died of PTB. According to the Cox regression, age (over 45 years and treatment duration (under six months were associated with a poorer survival. When treatment duration was excluded, the association between poorer survival with age persisted, whereas with having been treated via DOTS strategy, was barely significant. Conclusions. In the studied area it is necessary that patients receive a complete treatment scheme, and to give priority to patients aged over 45 years.

  11. Classification and regression tree (CART model to predict pulmonary tuberculosis in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Aguiar Fabio S

    2012-08-01

    Full Text Available Abstract Background Tuberculosis (TB remains a public health issue worldwide. The lack of specific clinical symptoms to diagnose TB makes the correct decision to admit patients to respiratory isolation a difficult task for the clinician. Isolation of patients without the disease is common and increases health costs. Decision models for the diagnosis of TB in patients attending hospitals can increase the quality of care and decrease costs, without the risk of hospital transmission. We present a predictive model for predicting pulmonary TB in hospitalized patients in a high prevalence area in order to contribute to a more rational use of isolation rooms without increasing the risk of transmission. Methods Cross sectional study of patients admitted to CFFH from March 2003 to December 2004. A classification and regression tree (CART model was generated and validated. The area under the ROC curve (AUC, sensitivity, specificity, positive and negative predictive values were used to evaluate the performance of model. Validation of the model was performed with a different sample of patients admitted to the same hospital from January to December 2005. Results We studied 290 patients admitted with clinical suspicion of TB. Diagnosis was confirmed in 26.5% of them. Pulmonary TB was present in 83.7% of the patients with TB (62.3% with positive sputum smear and HIV/AIDS was present in 56.9% of patients. The validated CART model showed sensitivity, specificity, positive predictive value and negative predictive value of 60.00%, 76.16%, 33.33%, and 90.55%, respectively. The AUC was 79.70%. Conclusions The CART model developed for these hospitalized patients with clinical suspicion of TB had fair to good predictive performance for pulmonary TB. The most important variable for prediction of TB diagnosis was chest radiograph results. Prospective validation is still necessary, but our model offer an alternative for decision making in whether to isolate patients with

  12. ASSESSMENT OF CLINICAL PROFILE AND TREATMENT OUTCOME OF EXTRA PULMONARY TUBERCULOSIS PATIENTS UNDER RNTCP IN RURAL MEDICAL COLLEGE, SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Siddeswaraswamy

    2014-09-01

    Full Text Available : BACKGROUND: Few reports exist detailing the clinical profile and treatment outcome of extra pulmonary tuberculosis (EPTB registered in DOTS centers in a rural medical college. AIM: The primary objective of this study was to describe the demographic, clinical profile and treatment outcome of EPTB. MATERIALS AND METHODS: A cross sectional study that reviewed the routinely collected data of patients with EPTB registered for treatment under DOTS for the period of 1 November 2010 to 31 September 2013 was carried out at Sri Siddhartha medical college. RESULTS: Among 747 cases registered for treatment of all forms of tuberculosis, 406 (54.35% had EPTB, majority of cases were aged 20 -40 years (193, 47.50% and males (239, 58.9% but lymph node and genitourinary TB most commonly affected females. In the present study pleural effusion (35.70% was most common followed by CNS involvement (19.50%. All patients were treated with the standard RNTCP treatment regimen. The observed treatment outcomes were treatment completion of 82.01%, default of 8.86%, and failure of 0.24% and death 8.86%. Patient treated with category II, HIV-positive patients and diabetic patients had adverse treatment outcomes. CONCLUSION: The burden of EPTB is more among the productive age group and in males. Plural TB is most common followed by CNS involvement. A well-defined program specified protocols for the diagnosis and treatment of extra pulmonary tuberculosis cases should be more effectively addressed in RNTCP.

  13. Real-time fluorescence Loop-Mediated Isothermal Amplification (LAMP) for rapid and reliable diagnosis of pulmonary tuberculosis.

    Science.gov (United States)

    Cao, Donglin; Hu, Liangshan; Lin, Maorui; Li, Mingyou; Ye, Zebing; Sun, Hongtao; Huang, Jiwei; Yang, Huawen; Tian, Junzhang

    2015-02-01

    A reliable, simple and rapid diagnostic method that can be helpful in pulmonary tuberculosis diagnosis is urgently needed. Loop-mediated Isothermal Amplification (LAMP) allows DNA to be amplified rapidly at a constant temperature. In this study, real-time fluorescence LAMP was evaluated to rapidly detect Mycobacterium tuberculosis in sputum and was compared to the performance of real-time fluorescence quantitative PCR (Q-PCR). All the standard MTB strains were successfully detected and limit of detection (LOD) was 10(2)CFU/mL by real-time fluorescence LAMP within 20min. In light of MTB in sputum, the real-time fluorescence LAMP method yielded a sensitivity of 98.0% and a specificity of 78.3%, compared to Q-PCR assay, which yielded a sensitivity of 96.0% and a specificity of 82.6% for PTB diagnosis. There was an excellent overall agreement between LAMP and Q-PCR for PTB (κ=0.315) and non-PTB (κ=0.862). Therefore, the real-time fluorescence LAMP assay is a rapid, sensitive, and specific method to detect pulmonary tuberculosis.

  14. Diagnosis and Treatment of Childhood Pulmonary Tuberculosis: A Cross-Sectional Study of Practices among Paediatricians in Private Sector, Mumbai

    Science.gov (United States)

    Tauro, Carolyn Kavita; Gawde, Nilesh Chandrakant

    2015-01-01

    Majority of children with tuberculosis are treated in private sector in India with no available data on management practices. The study assessed diagnostic and treatment practices related to childhood pulmonary tuberculosis among paediatricians in Mumbai's private sector in comparison with International Standards for Tuberculosis Care (ISTC) 2009. In this cross-sectional study, 64 paediatricians from private sector filled self-administered questionnaires. Cough was reported as a symptom of childhood TB by 77.8% of respondents. 38.1% request sputum smear or culture for diagnosis and fewer (32.8%) use it for patients positive on chest radiographs and 32.8% induce sputum for those unable to produce it. Sputum negative TB suspect is always tested with X-ray or tuberculin skin test. 61.4% prescribe regimen as recommended in ISTC and all monitor progress to treatment clinically. Drug-resistance at beginning of treatment is suspected for child in contact with a drug-resistant patient (67.7%) and with prior history of antitubercular treatment (12.9%). About half of them (48%) request drug-resistance test for rifampicin in case of nonresponse after two to three months of therapy and regimen prescribed by 41.7% for multidrug-resistant TB was as per ISTC. The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among paediatricians in private sector. PMID:26379705

  15. The social determinants of knowledge and perception on pulmonary tuberculosis among females in Jakarta, Indonesia

    NARCIS (Netherlands)

    A.H. Fuady (Ahmad); Pakasi, T.A. (Trevino A.); Mansyur, M. (Muchtaruddin)

    2014-01-01

    markdownabstract__Background:__ Indonesia has not resolved tuberculosis burden since its prevalence and incidence has remained high. As the capital of Indonesia with a large population and a high number of tuberculosis cases, Jakarta has a distinctive condition of tuberculosis burden. This study aim

  16. Effect of Antioxidant Vitamins C and E Supplementation on its Plasma Levels and on Lipid Profile in Pulmonary Tuberculosis Patients26

    Directory of Open Access Journals (Sweden)

    M. Madhavi

    2009-01-01

    Full Text Available Problem statement: Patients with active pulmonary Tuberculosis (TB are malnourished as indicated by reductions in lean mass, anthropometric indices and micronutrient status. Supplementation with vitamins may prove to be beneficial. Limited information is available on the supplementation of vitamin C and E in pulmonary TB patients. Hence, the present study was undertaken to address the question whether any benefit could be demonstrated with supplementation of antioxidant vitamins C and E and in combination in pulmonary TB patients. Approach: A five arm study was carried out for a period of 6 months in which the normal healthy volunteers served as control group and the sputum positive category I pulmonary TB patients served as the treatment group. Three out of the four patient groups received the antioxidant vitamin supplementation of either vitamin C, vitamin E or in combination along with ATT, whereas fourth group received ATT alone. Plasma concentrations of vitamin C and E were analyzed pre, during and post Anti-Tuberculosis Therapy (ATT to establish the role of oral supplementation of these vitamins. Sputum culture was also done at all the three times points for Mycobacterium tuberculosis. To study the possible interaction and influence of the supplemented vitamins on LDL-C and HDL-C and other lipid parameters a lipid profile was carried out. Results: (1 All the patients in the treatment groups turned sputum at the end of 2 months of treatment. (2 There was a significant improvement in the body weights of the patients upon supplementation with antioxidant vitamins. (3 There was a significant increase in the of plasma ascorbic acid and α-tocopherol levels after 6 months of treatment in the vitamin C and vitamin E supplemented groups. (4 The HDL-C levels increased significantly in the antioxidant vitamin supplemented groups. (5 Lower levels of LDL-C were observed in the antioxidant vitamin supplemented groups when compared to the un

  17. Isoniazid Mono-Resistant Tuberculosis: Impact on Treatment Outcome and Survival of Pulmonary Tuberculosis Patients in Southern Mexico 1995-2010

    Science.gov (United States)

    Báez-Saldaña, Renata; Delgado-Sánchez, Guadalupe; García-García, Lourdes; Cruz-Hervert, Luis Pablo; Montesinos-Castillo, Marlene; Ferreyra-Reyes, Leticia; Bobadilla-del-Valle, Miriam; Canizales-Quintero, Sergio; Ferreira-Guerrero, Elizabeth; Téllez-Vázquez, Norma; Montero-Campos, Rogelio; Yanes-Lane, Mercedes; Mongua-Rodriguez, Norma; Martínez-Gamboa, Rosa Areli; Sifuentes-Osornio, José; Ponce-de-León, Alfredo

    2016-01-01

    Background Isoniazid mono-resistance (IMR) is the most common form of mono-resistance; its world prevalence is estimated to range between 0.0 to 9.5% globally. There is no consensus on how these patients should be treated. Objective To describe the impact of IMR tuberculosis (TB) on treatment outcome and survival among pulmonary TB patients treated under programmatic conditions in Orizaba, Veracruz, Mexico. Materials and Methods We conducted a prospective cohort study of pulmonary TB patients in Southern Mexico. From 1995 to 2010 patients with acid-fast bacilli or culture proven Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and microbiological evaluation. We included patients who harbored isoniazid mono-resistant (IMR) strains and patients with strains susceptible to isoniazid, rifampicin, ethambutol and streptomycin. All patients were treated following Mexican TB Program guidelines. We performed annual follow-up to ascertain treatment outcome, recurrence, relapse and mortality. Results Between 1995 and 2010 1,243 patients with pulmonary TB were recruited; 902/1,243 (72.57%) had drug susceptibility testing; 716 (79.38%) harbored pan-susceptible and 88 (9.75%) IMR strains. Having any contact with a person with TB (adjusted odds ratio (aOR)) 1.85, 95% Confidence interval (CI) 1.15–2.96) and homelessness (adjusted odds ratio (aOR) 2.76, 95% CI 1.08–6.99) were associated with IMR. IMR patients had a higher probability of failure (adjusted hazard ratio (HR) 12.35, 95% CI 3.38–45.15) and death due to TB among HIV negative patients (aHR 3.30. 95% CI 1.00–10.84). All the models were adjusted for socio-demographic and clinical variables. Conclusions The results from our study provide evidence that the standardized treatment schedule with first line drugs in new and previously treated cases with pulmonary TB and IMR produces a high frequency of treatment failure and death due to tuberculosis. We recommend re-evaluating the optimal

  18. THE SOCIAL AND CLINICAL CHARACTERISTIC OF PATIENTS WITH THE ISOLATED GENITAL TUBERCULOSIS ASSOCIATED WITH INFERTILITY, THE ACTIVE AND CLINICALLY CURED TUBERCULOSIS OF RESPIRATORY ORGANS IN COMBINATION WITH PREGNANCY

    Directory of Open Access Journals (Sweden)

    A. V. Mordyk

    2015-01-01

    Full Text Available Due to the high incidence of tuberculosis of women of reproductive age research at 270 patients was conducted. The group of research included women with infertility and genital tuberculosis, pregnant women with active tuberculosis of lungs, pregnant women with clinically cured tuberculosis of respiratory organs. Pregnant women with tuberculosis of lungs were more often from sociopathic families, had venereal diseases, HIV infection, hepatitises.

  19. Dietary Vitamin D3 suppresses pulmonary immunopathology associated with late stage tuberculosis in C3HeB/FeJ mice

    Science.gov (United States)

    Reeme, Allison E.; Robinson, Richard T.

    2015-01-01

    Tuberculosis (TB) is a significant human disease caused by inhalation of Mycobacterium tuberculosis (Mtb). Left untreated, TB mortality is associated with a failure to resolve pulmonary immunopathology. There is currently widespread interest in using Vitamin D3 (VitD3) as an adjunct therapy for TB, as numerous in vitro studies have shown that VitD3 has direct and indirect mycobactericidal activities. However, to date there have been no in vivo studies addressing whether VitD3 affects experimental TB outcome. Here we use C3HeB/FeJ mice to determine if dietary VitD3 influences the outcome of experimental TB. We observed that although Mtb burdens did not differ between mice on a VitD3-replete diet (VitDHI mice) and mice on a VitD3-deficient diet (VitDLO mice), the inflammatory response in VitDHI mice was significantly attenuated relative to VitDLO controls. Specifically, the expression of multiple inflammatory pathways was reduced in the lungs at later disease stages, as were splenocyte IL12/23p40- and IFNγ-levels following ex vivo restimulation. Dietary VitD3 also suppressed the accumulation of T cells in the mediastinal lymph nodes and lung granulomatous regions, while concomitantly accelerating the accumulation of F4/80+ and Ly6C/Ly6G+ lineages. The altered inflammatory profile of VitDHI mice also associated with reductions in pulmonary immunopathology. VitD receptor deficient (vdr−/−) radiation bone marrow chimeras demonstrate that reductions in pulmonary TB-immunopathology are dependent on hematopoietic VitD-responsiveness. Collectively, our data support a model wherein the in vivo role of VitD3 during TB is not to promote Mtb killing, but rather to function through hematopoietic cells to reduce Mtb-elicited immunopathology. PMID:26729807

  20. Nutritional status in multi-drug resistance-pulmonary tuberculosis patients

    Directory of Open Access Journals (Sweden)

    Amit Kumar

    2014-12-01

    Full Text Available Introduction: Malnutrition and tuberculosis are the major concerns of underdeveloped regions of the world. Undernutrition increases the risk of tuberculosis (TB and in turn TB can lead to Malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and severe form viz. MDR-TB. Undernutrition is a predictor of increased risk of death and TB relapse. Objectives: To study the effect of nutrition in MDR-TB patients at DR-TB centre, Dehradun. Methodology: The Observational cross sectional study was conducted at Drug Resistant Tuberculosis (DR-TB Centre of HIMS, Dehradun over a   period of 12 months to include all the cases reported from 1st October, 2011 (start of DR-TB Centre at HIMS, Dehradun to 30th April, 2014. 376 Subjects were recruited from 1598 suspected MDR TB subjects who were screened by Drug Susceptibility Testing (DST results. Results: Out of 376 MDR-TB patients, 258 (68.6% subjects were found to be undernourished. The mean body mass index (BMI was 17.33+1.99 kg/m2. Though undernutrition was more common among Males (61.2% but female’s BMI was more affected by MDR in comparison to males. Treatment success was better amongst males between 21- 60 year age group with normal BMI having mono drug resistance with no adverse reaction. The majority 47 (18.2% of adverse effect was found in undernourished patients. Treatment outcome was also poor among undernourished (76.9% MDR-TB patients. Conclusion: Prevalence of undernutrition was high (68.6% among subjects and the mean BMI was lower in female. Adverse drug reaction, poor treatment outcome are attributes of Undernutrition.

  1. Diagnostic value of serum adenosine deaminase levels in sputum smear negative pulmonary tuberculosis patients in Nepalese population

    Institute of Scientific and Technical Information of China (English)

    Anil Chander; Chandrika Devi Shrestha

    2012-01-01

    Objective: To assess the levels of adenosine deaminase (ADA) in serum in patients with sputum smear negative pulmonary tuberculosis (SNPTB) and to compare it with serum ADA levels in patients with non-tuberculous pulmonary disease - chronic obstructive pulmonary disease (COPD) and with healthy control group and to explore its validity as a diagnostic marker in serum in SNPTB patients.Methods:Three groups of study populations were made. Group I: SNPTB - 142 cases, Group II:non-tubercular pulmonary disease - COPD - 40 cases, Group III: healthy controls - 80 cases. Serum samples were collected and ADA assay was done by the method of Guisti and Galanti. Results: ADA levels (Mean±SD, U/L) in the three groups were as follows: Group I: 42.26±21.22, Group II: 23.31±8.22, Group III: 18.88±6.67. Difference between Group I and Group III was statistically significant (P < 0.0001). The test showed a high specificity 91.25% (95% confidence interval - CI 83.00 - 95.7) and a sensitivity of 83.10% (95% CI 76.08-88.37) in Group I. Positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and accuracy in Group I were 94.00%, 69.52%, 9.49, 0.18 and 82.43% respectively.Conclusions: Overall assessment of the use of serum ADA levels as a diagnostic biochemical marker in smear-negative pulmonary tuberculosis patients showed promising results. Studies with a larger population group are required to validate its use as a routine diagnostic test in these cases.

  2. Native New Zealand plants with inhibitory activity towards Mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    Swift Simon

    2010-06-01

    Full Text Available Abstract Background Plants have long been investigated as a source of antibiotics and other bioactives for the treatment of human disease. New Zealand contains a diverse and unique flora, however, few of its endemic plants have been used to treat tuberculosis. One plant, Laurelia novae-zelandiae, was reportedly used by indigenous Maori for the treatment of tubercular lesions. Methods Laurelia novae-zelandiae and 44 other native plants were tested for direct anti-bacterial activity. Plants were extracted with different solvents and extracts screened for inhibition of the surrogate species, Mycobacterium smegmatis. Active plant samples were then tested for bacteriostatic activity towards M. tuberculosis and other clinically-important species. Results Extracts of six native plants were active against M. smegmatis. Many of these were also inhibitory towards M. tuberculosis including Laurelia novae-zelandiae (Pukatea. M. excelsa (Pohutukawa was the only plant extract tested that was active against Staphylococcus aureus. Conclusions Our data provide support for the traditional use of Pukatea in treating tuberculosis. In addition, our analyses indicate that other native plant species possess antibiotic activity.

  3. Cost-effectiveness of chemotherapy for sputum smear-positive pulmonary tuberculosis in Malawi, Mozambique and Tanzania.

    Science.gov (United States)

    de Jonghe, E; Murray, C J; Chum, H J; Nyangulu, D S; Salomao, A; Styblo, K

    1994-01-01

    The cost-effectiveness of chemotherapy for pulmonary sputum smear-positive tuberculosis was examined in the national tuberculosis control programmes of Malawi, Mozambique and Tanzania. In these three programmes, routine cure rates have exceeded 80 per cent. Average, average incremental and marginal unit costs for standard, short-course and retreatment regimens with and without hospitalization have been measured. The average incremental cost per year of life saved through chemotherapy ranged from US $0.90-3.10. In all conditions, short-course chemotherapy is preferable to standard 12-month chemotherapy. When hospitalization during the intensive phase of chemotherapy increases the cure rate by 10-15 percentage points, it can be relatively cost-effective. Analysing the cost-effectiveness of short-course and standard chemotherapy, where the depth of the margin of benefit is different, illustrates some of the dangers of simplistic use of cost-effectiveness ratios.

  4. Cost Effectiveness of DOTS and Non—DOTS Strategies for Smear—Positive Pulmonary Tuberculosis in Beijing

    Institute of Scientific and Technical Information of China (English)

    XU-QUN; JINSHUI-GAO; 等

    2000-01-01

    The cost-effectiveness of DOTS(Directly Observed Treatment,short course)and nonDOTS strategies for smear-positive pulmonary tuberculosis in Beijing was evaluated.Cost calculation was based on the experses of drugs ,chest X-ray films,sputm smears and cultures for the patients.Effectiveness of the intervention was assessed in two aspects:direct benefits to the patients treated and indirect benefits to the others through reduced transmission of tuberculsis;disability adjusted life of year(DALY) was used as an index.The results showed that one DALY could be saved with 45.7 Yuan by DOTS and 471.4 Yuan by non-DOTS.DOTS is a good control strategy for smear-positive tuberculosis.

  5. Evaluación en salud pública: lecciones aprendidas de la gestión de la tuberculosis pulmonar Measurement in Public Health: what pulmonary tuberculosis management has taught us

    Directory of Open Access Journals (Sweden)

    C. Patrick Chaulk

    2008-08-01

    Full Text Available Las tasas de tuberculosis pulmonar están aumentando en todo el mundo, incluida España. Uno de los retos principales al tratar esta enfermedad es conseguir un buen cumplimiento terapéutico, puesto que alrededor de un 30-35% de los pacientes no sigue la pauta de medicación prescrita. Este artículo revisa un conjunto de estrategias de evaluación y medidas de la práctica para valorar la efectividad de los programas comunitarios orientados a reforzar el cumplimiento terapéutico de los pacientes con tuberculosis pulmonar activa. Se revisan 4 estrategias de evaluación tradicionales (estudio de un caso, estudio retrospectivo y de casos controles, predicción/pronóstico y análisis de coste-efectividad y 2 enfoques de evaluación emergentes y prometedores (evaluación de calidad de vida e indicadores de continuidad de la asistencia. Varias de las estrategias de evaluación revisadas indican que los programas de tratamiento mediante la terapia de observación directa (directly observed therapy [DOT], amplios, comunitarios y centrados en el paciente, alcanzan los índices más altos de cumplimiento terapéutico. Se recomienda la utilización conjunta de varias de estas estrategias de evaluación para crear un cuerpo de evidencia que refleje el impacto de los programas de intervención comunitaria en la mejora de los resultados de salud, en este caso concreto para los pacientes con tuberculosis pulmonar.Pulmonary tuberculosis rates are increasing worldwide, including in Spain. One of the main challenges when treating this disease is achieving treatment completion, since studies have shown that approximately 30-35% of all patients do not take their medications as intended. The present article explores a continuum of evaluation strategies and performance measures for assessing the effectiveness of community-based programs designed to enhance treatment completion in patients with active pulmonary tuberculosis. Four traditional evaluation strategies

  6. Systematic review: Comparison of Xpert MTB/RIF, LAMP and SAT methods for the diagnosis of pulmonary tuberculosis.

    Science.gov (United States)

    Yan, Liping; Xiao, Heping; Zhang, Qing

    2016-01-01

    Technological advances in nucleic acid amplification have led to breakthroughs in the early detection of PTB compared to traditional sputum smear tests. The sensitivity and specificity of loop-mediated isothermal amplification (LAMP), simultaneous amplification testing (SAT), and Xpert MTB/RIF for the diagnosis of pulmonary tuberculosis were evaluated. A critical review of previous studies of LAMP, SAT, and Xpert MTB/RIF for the diagnosis of pulmonary tuberculosis that used laboratory culturing as the reference method was carried out together with a meta-analysis. In 25 previous studies, the pooled sensitivity and specificity of the diagnosis of tuberculosis were 93% and 94% for LAMP, 96% and 88% for SAT, and 89% and 98% for Xpert MTB/RIF. The I(2) values for the pooled data were >80%, indicating significant heterogeneity. In the smear-positive subgroup analysis of LAMP, the sensitivity increased from 93% to 98% (I(2) = 2.6%), and specificity was 68% (I(2) = 38.4%). In the HIV-infected subgroup analysis of Xpert MTB/RIF, the pooled sensitivity and specificity were 79% (I(2) = 72.9%) and 99% (I(2) = 64.4%). In the HIV-negative subgroup analysis for Xpert MTB/RIF, the pooled sensitivity and specificity were 72% (I(2) = 49.6%) and 99% (I(2) = 64.5%). LAMP, SAT and Xpert MTB/RIF had comparably high levels of sensitivity and specificity for the diagnosis of tuberculosis. The diagnostic sensitivity and specificity of three methods were similar, with LAMP being highly sensitive for the diagnosis of smear-positive PTB. The cost effectiveness of LAMP and SAT make them particularly suitable tests for diagnosing PTB in developing countries.

  7. Therapeutic Drug Monitoring in the Treatment of Active Tuberculosis

    Directory of Open Access Journals (Sweden)

    Aylin Babalik

    2011-01-01

    Full Text Available Therapeutic drug monitoring ensures optimal dosing while aiming to reduce toxicity. However, due to the high costs and complexity of testing, therapeutic drug monitoring is not routinely used in the treatment of individuals with active tuberculosis, despite the efficacy demonstrated in several randomized trials. This study reviewed data spanning five years regarding the frequency of finding low drug levels in patients with tuberculosis, the dosing adjustments that were required to achieve adequate levels and the factors associated with low drug levels.

  8. Extra pulmonary tuberculosis: Rapid identification of Mycobacterium tuberculosis grown in Mycobacterium growth indicator tube 960 and Lowenstein-Jensen media, employing Standard diagnostics Bioline Mycobacterium tuberculosis protein 64 antigen detection kit

    Directory of Open Access Journals (Sweden)

    G Kandhakumari

    2015-01-01

    Full Text Available Background: Investigation of extra pulmonary tuberculosis (EPTB in and around Pondicherry is being carried out since August 2011 in our tertiary care super specialty hospital. Objectives: To compare the rapid Kit SD Bio-Line MPT 64 Ag with conventional and time consuming biochemical tests. Confirmation of Mycobacterium tuberculosis at a reasonable time frame is the main thrust. Materials and Methods: Thirty three Mycobacterium tuberculosis and four Non-Tuberculous Mycobacteria (NTM grown in MGIT960 system/Lowenstein-Jensen media (LJ were examined by the rapid MPT 64 antigen detection as well as a battery of conventional tests like niacin, nitrate reduction, paraminobenzoic acid susceptibility and cord formation. Results and Conclusion: . Both the rapid kit and conventional tests correctly identified 33 M.tuberculosis isolates. Keeping conventional identification as reference, sensitivity and specificity for rapid kit was 100%. Rapid kit which takes only 15 minutes is accurate, cost effective, and facilitates early treatment for these EPTB patients, whose clinical specimens are paucibacillary.

  9. Lesion-Specific Immune Response in Granulomas of Patients with Pulmonary Tuberculosis: A Pilot Study.

    Directory of Open Access Journals (Sweden)

    Selvakumar Subbian

    Full Text Available The formation and maintenance of granulomas is central to the host response to Mycobacterium tuberculosis (Mtb infection. It is widely accepted that the lungs of patients with tuberculosis (TB usually contain multiple infection foci, and that the granulomas evolve and differentiate independently, resulting in considerable heterogeneity. Although gene expression profiles of human blood cells have been proposed as biomarkers of Mtb infection and/or active disease, the immune profiles of discrete lesion types has not been studied extensively. Using histology, immunopathology and genome-wide transcriptome analysis, we explored the immunological profile of human lung TB granulomas. We show that although the different granulomas share core similarities in their immunological/inflammatory characteristics, they also exhibit significant divergence. Despite similar numbers of CD68+ macrophages in the different lesions, the extent of immune reactivity, as determined by the density of CD3+ T cells in the macrophage rich areas, and the extent of fibrosis, shows considerable variation. Both quantitative and qualitative differences among significantly differentially expressed genes (SDEG were noted in each of the lesion types studied. Further, network/pathway analysis of SDEG revealed differential regulation of inflammatory response, immune cell trafficking, and cell mediated immune response in the different lesions. Our data highlight the formidable challenges facing ongoing efforts to identify peripheral blood biomarkers due to the diversity of lesion types and complexity of local immune responses in the lung.

  10. Prevalence of tuberculous peritonitis in the North of Iraq and sociodemographic comparison with pulmonary tubercu-losis

    Institute of Scientific and Technical Information of China (English)

    Abdulqadir Maghded Zangana; Tariq SAl-Hadithi MSc; Sherzad Ali Ismail

    2009-01-01

    Objective:Tuberculosis continues to be an important health problem in the world.Despite the widespread im-pression that abdominal tuberculosis is rare today,the disease is still endemic in developing world and is re-emerging in the West.The aim is to review our local experience with tuberculous peritonitis.Methods:Be-tween January 2000 and December 2006,the case records of histologically documented tuberculous peritonitis (TBP)diagnosed and treated at the tuberculosis coordinating center in Erbil city,Iraq were reviewed.Com-parisons were made with pulmonary tuberculosis patients regarding socio-demographic,clinical and laboratory findings.Results:Forty one cases of TBP were diagnosed during the study period.Their age range was 26-72 years (46 ±17),with a male:female ratio of 1.5:1.The median duration of symptoms before diagnosis was 6 weeks (range:10 days to 18 months.).Eleven patients (26.8%)had comorbid conditions and 6 patients (14.6%)had a history of positive contact with Tuberculosis(TB)case.Presenting symptoms were abdominal distension (70%),abdominal pain (65%),fever (68%),anorexia (65%)and weight loss (44%).Four patients had pulmonary symptoms:cough and /dyspnoea (n =2)and cough (n =2).Chest X-ray changes consistent with pulmonary tuberulosis(PTB)were seen in 25%.Tuberculous peritonitis was diagnosed by lap-aroscopy (n =29)and laparotomy (n =12).Adverse effects of TB drugs occurred in nearly 40%,consisting of hepatitis (n =2),nausea /vomiting (n =11),rash (n =2)and encephalopathy (n =1).Hemoglobin and serum albumin levels were significantly lower in tuberculous peritonitis(TBP)TBP patients (P =0.027 and 0. 003,respectively).There was a significantly greater occurrence of adverse effects (P <0.001)in TBP pa-tients.No significant differences between TBP and PTB were demonstrated in regard to age and sex distribu-tion,non-specific symptoms (fever,weight loss,and anorexia)and erythrocyte sedimentation rate.All were treated with standard regimens and responded

  11. Same day sputum microscopy approach for the diagnosis of Pulmonary Tuberculosis in a microscopy centre at a tertiary care hospital in Bareilly

    Directory of Open Access Journals (Sweden)

    Vijayesh Kumar Tiwari

    2015-03-01

    Full Text Available Background : TB is major public health problem. Smear microscopy is the easiest, quickest and a reliable tool for the diagnosis of pulmonary tuberculosis. This requires two (spot and morning sputum sample examinations over two days. Collection of two spot samples on same day increases the patient compliance. Methods: we compared the yield of same day diagnostic and standard approach for the diagnosis of pulmonary tuberculosis. Results: Out of 300 patients, same day approach could identify 67 cases, whereas standard approach could identify 70 cases. Conclusion: Both the approaches are equally effective (p>0.05. [Natl J Med Res 2015; 5(1.000: 22-24

  12. Immunochromatographic IgG/IgM test for rapid diagnosis of active tuberculosis.

    Science.gov (United States)

    Ben-Selma, Walid; Harizi, Hedi; Boukadida, Jalel

    2011-12-01

    For rapid diagnosis and discrimination between active tuberculosis (TB) and other pulmonary diseases, we evaluated the clinical usefulness of detection of serum immunoglobulin IgG and IgM antibodies raised against mycobacterial 38-kDa, 16-kDa, and 6-kDa antigens by a commercial rapid immunochromatographic IgG/IgM test (Standard Diagnostics, South Korea) in 246 serum samples from three groups of patients: (i) 171 patients with active TB (128 with pulmonary TB [pTB] and 43 with extrapulmonary TB [epTB]), (ii) 73 patients with pulmonary non-TB diseases, and (iii) two leprosy patients. The sensitivities of IgG and IgM in patients with active TB (pTB and epTB) were 68.4% and 2.3%, respectively. IgG had the best performance characteristics, with sensitivities of 78.1% and 39.5% in sera from patients with active pTB and epTB, respectively, and a specificity of 100%. The sensitivities of IgM were poor and were similar for pTB and epTB (2.3%). In contrast, specificity was very elevated (100%). The combination of IgG with IgM did not improve its sensitivity. IgG-mediated responses against the mycobacterial 38-kDa, 16-kDa, and 6-kDa antigens might constitute a clinically useful tool for presumptive diagnosis and discrimination of active pTB from other pulmonary diseases. Moreover, based on its simplicity and rapidity of application, it could be a screening tool for active pTB in poorly equipped laboratories.

  13. A Cerebral Air Embolism That Developed Following Defecation in a Patient with Extensive Pulmonary Tuberculosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ji Young; Park, Dong Woo; Hahm, Chang Kok; Park, Choong Ki; Lee, Seung Ro; Lee, Young Jun [Hanyang University College of Medicine, Guri Hospital, Guri (Korea, Republic of)

    2010-08-15

    Cerebral air embolisms generally result from invasive procedures such as a percutaneous needle biopsy, chest tube insertion, central venous catheter access or removal, operations and so on. Likewise, they are mostly iatrogenically induced and present various degrees of severity depending on the number of air bubbles. With the exception of divers, the occurrence of a cerebral air embolism in the absence of invasive procedures is very rare. We report a case of a cerebral air embolism that developed following defecation and was detected by CT in a patient with extensive pulmonary tuberculosis

  14. Tuberculosis

    OpenAIRE

    Latorre Tortello, Pablo

    2011-01-01

    Por definición, la tuberculosis pulmonar es la localizaci6n del M. tuberculosis en el tracto respiratorio, la forma más común y principal de la afección y la única capaz de contagiar a otras personas. El M. tuberculosis, descubierto por Robert Koch en 1882, el bacilo de Koch, es un bacilo delgado, inmóvil, de 4 micras de longitud media, aerobio obligado, que se tiñe de rajo por la tinción de Ziehl-Neelsen. Debido a la coraza lipídica de su pared, lo hace resistente a la decoloración con ácido...

  15. Tuberculosis in the lung (image)

    Science.gov (United States)

    Tuberculosis is caused by a group of organisms: Mycobacterium tuberculosis, M bovis , M africanum and a few other rarer subtypes. Tuberculosis usually appears as a lung (pulmonary) infection. However, ...

  16. Retrospective cohort evaluation on risk of pneumonia in patients with pulmonary tuberculosis.

    Science.gov (United States)

    Chang, Tsui-Ming; Mou, Chih-Hsin; Shen, Te-Chun; Yang, Chien-Lung; Yang, Min-Hui; Wu, Fang-Yang; Sung, Fung-Chang

    2016-06-01

    Pulmonary tuberculosis (PTb) and pneumonia are diseases that may exist concomitantly. Population study investigating the subsequent pneumonia development in PTb patients is limited. This study compares the risk of pneumonia between cohorts with and without PTb.We used the claims data of the Taiwan National Health Insurance to identify a cohort with PTb (N = 3417) newly diagnosed in 2000-2006 without pneumonia history, and a randomly selected comparison cohort (N = 6834) free of PTb and pneumonia, frequency matched by propensity score. Incidence rates and hazard ratios of pneumonia were calculated by sex, age, and comorbidity starting in the 7th month after the cohorts being established until the end of 2011.We found the incidence of pneumonia to be 1.9-fold higher in the PTb cohort than in the PTb free cohort (51.6 vs 27.0 per 1000 person-years). The PTb cohort had a Cox method estimated adjusted hazard ratio of 2.14 (95% confidence interval = 1.96-2.32). We also found that the risk was greater for men than for women, but lower for young adults aged 20-39 years. Comorbidity interacted with PTb by aggravating the pneumonia risk, particularly for those with asthma. For PTb patients comorbid with asthma, the pneumonia incidence was 2.5-fold higher than for PTb patients free of comorbidities (75.9 vs 29.3 per 1000 person-years).Our results display that PTb patients have an elevated risk of developing pneumonia. Adequate follow-up should be provided to the PTb patients, especially those with comorbidity.

  17. Pulmonary tuberculosis incidence and risk factors in rural areas of China: a cohort study.

    Science.gov (United States)

    Chen, Wei; Shu, Wen; Wang, Min; Hou, Yongchun; Xia, Yinyin; Xu, Weiguo; Bai, Liqiong; Nie, Shaofa; Cheng, Shiming; Xu, Yihua

    2013-01-01

    The incidence of tuberculosis (TB) and its risk factors in China remains unclear. This study examined TB incidence and relative risk factors in rural areas of China. Participants (n = 177,529) were recruited in Xiangtan County (in the central area of China) and in Danyang County (in the eastern area of China) in 2009 and a followed-up study was conducted for one year. The incidence density of pulmonary TB and smear-positive TB were 91.6 (95% CI: 78.7, 106.0) per 100,000 person-year and 36.7 (95% CI: 33.1, 52.4) per 100,000 person-year respectively in Xiangtan, and 47.3 (95% CI: 38.2, 57.5) per 100,000 person-year and 22.7 (95% CI: 16.5, 30.8) per 100,000 person-year in Danyang. The medical history of TB was associated with TB, with the relative risk (RR) of 7.00 (95% CI: 2.76, 17.18) in Xiangtan and that of 31.08 (95% CI: 13.22, 73.10) in Danyang. The association between TB and per capita living space over median was found in Xiangtan, with the RR of 1.86 (95% CI: 1.15, 3.01). No association was found between TB and the insurance status, the contact history with TB, the history of diabetes, smoking, or per capita annual income. The host genetic susceptibility, and social factors such as education and income could be considered in future studies.

  18. Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Bruno Horta Andrade

    2013-08-01

    Full Text Available Introduction This study evaluated the efficacy of retreatment of pulmonary tuberculosis (TB with regard to treatment outcomes and antimicrobial susceptibility testing (ST profiles. Methods This retrospective cohort study analyzed 144 patients treated at a referral hospital in Brazil. All of them had undergone prior treatment, were smear-positive for TB and received a standardized retreatment regimen. Fisher's 2-tailed exact test and the χ2 test were used; RRs and 95% CIs were calculated using univariate and multivariate binary logistic regression. Results The patients were cured in 84 (58.3% cases. Failure was associated with relapsed treatment and abandonment (n=34. Culture tests were obtained for 103 (71.5% cases; 70 (48.6% had positive results. ST results were available for 67 (46.5% cases; the prevalence of acquired resistance was 53.7%. There were no significant differences between those who achieved or not therapeutic success (p=0.988, despite being sensitive or resistant to 1 or more drugs. Rifampicin resistance was independently associated with therapeutic failure (OR: 4.4, 95% CI:1.12-17.37, p=0.034. For those cases in which cultures were unavailable, a 2nd model without this information was built. In this, return after abandonment was significantly associated with retreatment failure (OR: 3.59, 95% CI:1.17-11.06, p=0.026. Conclusions In this cohort, the general resistance profile appeared to have no influence on treatment outcome, except in cases of rifampicin resistance. The form of reentry was another independent predictor of failure. The use of bacterial culture identification and ST in TB management must be re-evaluated. The recommendations for different susceptibility profiles must also be improved.

  19. Prevalence of and risk factors for pulmonary tuberculosis among newly diagnosed HIV-1 infected Nigerian children

    Science.gov (United States)

    Ebonyi, Augustine O.; Oguche, Stephen; Ejeliogu, Emeka U.; Agbaji, Oche O.; Shehu, Nathan Y.; Abah, Isaac O.; Sagay, Atiene S.; Ugoagwu, Placid O.; Okonkwo, Prosper I.; Idoko, John A.; Kanki, Phyllis J.

    2016-01-01

    Introduction Studies on the prevalence of and risk factors for tuberculosis (TB) among newly diagnosed human immunodeficiency virus (HIV)-infected children in sub-Saharan Africa are scarce and in Nigeria there is paucity of reported data. We determined the prevalence of and risk factors for pulmonary TB (PTB) in newly diagnosed (treatment-naïve) HIV-1 infected children at the pediatric HIV clinic of the Jos University Teaching Hospital (JUTH) in Nigeria. Methods We performed a retrospective analysis of 876 children, aged 2 months – 13 years, diagnosed with HIV-1 infection between July 2005 and December 2012, of which 286 were diagnosed with PTB at presentation after TB screening. The study site was the AIDS Prevention Initiative in Nigeria (APIN)-supported Pediatric HIV clinic at JUTH, Jos. A multivariate forward logistic regression modelling was used to identify risk factors for PTB-HIV co-infection. Results The prevalence of PTB-HIV co-infection was 32% (286/876). Severe immunosuppression (SI) and World Health Organization (WHO) HIV clinical stage 3/4 were identified as independent risk factors for PTB-HIV co-infection in HIV infected children. The odds of PTB-HIV co-infection was increased two-fold in HIV-infected children with WHO clinical stage 3/4 compared to those with stage 1/2 (adjusted odds ratio (AOR) 1.76 [1.31-2.37], p<0.001) and 1.5-fold in children with SI compared to those without SI (AOR 1.52 [1.12-2.06], p=0.007). Conclusion In our setting, the burden of PTB was high among newly diagnosed HIV-infected children, and late WHO HIV clinical stage and severe immunosuppression were associated with PTB-HIV co-infection. Therefore there is a clear need to improve strategies for early diagnosis of both HIV and PTB to optimize clinical outcomes. PMID:27019829

  20. Diabetes is a risk factor for pulmonary tuberculosis: a case-control study from Mwanza, Tanzania.

    Directory of Open Access Journals (Sweden)

    Daniel Faurholt-Jepsen

    Full Text Available BACKGROUND: Diabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent. METHODS: A case-control study was conducted in an urban population in Tanzania among culture-confirmed pulmonary TB patients and non-TB neighbourhood controls. Participants were tested for diabetes according to WHO guidelines and serum concentrations of acute phase reactants were measured. The association between diabetes and TB, and the role of HIV as an effect modifier, were examined using logistic regression. Since blood glucose levels increase during the acute phase response, we adjusted for elevated serum acute phase reactants. RESULTS: Among 803 cases and 350 controls the mean (SD age was 34.8 (11.9 and 33.8 (12.0 years, and the prevalence of diabetes was 16.7% (95% CI: 14.2; 19.4 and 9.4% (6.6; 13.0, respectively. Diabetes was associated with TB (OR 2.2, 95% CI: 1.5; 3.4, p<0.001. However, the association depended on HIV status (interaction, p = 0.01 due to a stronger association among HIV uninfected (OR 4.2, 95% CI: 1.5; 11.6, p = 0.01 compared to HIV infected (OR 0.1, 95% CI: 0.01; 1.8, p = 0.13 after adjusting for age, sex, demographic factors and elevated serum acute phase reactants. CONCLUSION: Diabetes is a risk factor for TB in HIV uninfected, whereas the association in HIV infected patients needs further study. The increasing diabetes prevalence may be a threat to TB control.

  1. CD4 lymphocyte dynamics in Tanzanian pulmonary tuberculosis patients with and without hiv co-infection

    Directory of Open Access Journals (Sweden)

    Andersen Aase B

    2012-03-01

    Full Text Available Abstract Background The interaction of HIV and tuberculosis (TB on CD4 levels over time is complex and has been divergently reported. Methods CD4 counts were assessed from time of diagnosis till the end of TB treatment in a cohort of pulmonary TB patients with and without HIV co-infection and compared with cross-sectional data on age- and sex-matched non-TB controls from the same area. Results Of 1,605 study participants, 1,250 were PTB patients and 355 were non-TB controls. At baseline, HIV was associated with 246 (95% CI: 203; 279 cells per μL lower CD4 counts. All PTB patients had 100 cells per μL lower CD4 counts than the healthy controls. The CD4 levels were largely unchanged during a five-month of TB treatment. HIV infected patients not receiving ART at any time and those already on ART at baseline had no increase in CD4 counts after 5 months of TB treatment, whereas those prescribed ART between baseline and 2 months, and between 2 and 5 months increased by 69 (22;117 and 110 (52; 168 CD4 cells per μL after 5 months. Conclusions The increase in circulating CD4 levels observed in PTB in patients is acquired after 2 months of treatment irrespective of HIV status. Initiation of ART is the strongest factor correlated with CD4 increase during TB treatment. Trial registration number Clinical trials.gov: NCT00311298

  2. Response to region of difference 1 (RD1) epitopes in human immunodeficiency virus (HIV)-infected individuals enrolled with suspected active tuberculosis: a pilot study

    Science.gov (United States)

    Vincenti, D; Carrara, S; Butera, O; Bizzoni, F; Casetti, R; Girardi, E; Goletti, D

    2007-01-01

    Tuberculosis is the most frequent co-infection in human immunodeficiency virus (HIV)-infected individuals, and which still presents diagnostic difficulties. Recently we set up an assay based on interferon (IFN)-γ response to region of difference 1 (RD1) peptides selected by computational analysis which is associated with active Mycobacterium tuberculosis replication. The objective of this study was to investigate the response to RD1 selected peptides in HIV-1-infected individuals in a clinical setting. The mechanisms of this immune response and comparison with other immune assays were also investigated. A total of 111 HIV-infected individuals with symptoms and signs consistent with active tuberculosis were enrolled prospectively. Interferon (IFN)-γ responses to RD1 selected peptides and recall antigens were evaluated by enzyme-linked immunospot assay. Results were correlated with CD4− T cell counts, individuals' characteristics, tuberculin skin test, QuantiFERON-TB Gold and T-SPOT.TB. Results from 21 (19%) individuals were indeterminate due to in vitro cell anergy. Among ‘non-anergic’ individuals, sensitivity for active tuberculosis of the assay based on RD1 selected peptides was 67% (24 of 36), specificity was 94% (three of 54). The assay also resulted positive in cases of extra-pulmonary and smear-negative pulmonary active tuberculosis. The response was mediated by CD4− effector/memory T cells and correlated with CD4− T cell counts, but not with plasma HIV-RNA load. Moreover, the RD1 selected peptides assay had the highest diagnostic odds ratio for active tuberculosis compared to tuberculin skin test (TST), QuantiFERON-TB Gold and T-SPOT.TB. RD1 selected peptides assay is associated with M. tuberculosis replication in HIV-infected individuals, although T cell anergy remains an important obstacle to be overcome before the test can be proposed as a diagnostic tool. PMID:17680823

  3. Clinical Characteristics and Diagnosis of Pulmonary Tuberculosis and the Invasive Pulmonary Fungal Infection%肺结核并侵袭性肺部真菌感染的临床特点及诊治

    Institute of Scientific and Technical Information of China (English)

    蒋秀群

    2013-01-01

    Objective:To analyze the effect of clinical characteristics and diagnosis of pulmonary tuberculosis and the invasive pulmonary fungal infection. Methods:From 2007 April to 2012 May admitted to hospital for treatment of pulmonary tuberculosis and the invasive pulmonary fungal infection in 30 patients as the research object were analyzed retrospectively. Results:Pulmonary tuberculosis and invasive pulmonary fungal infection relapse rate, long disease history, many complications, the clinical diagnosis is difficult, must be combined with the etiology, imaging to enhance the accuracy rate of diagnosis. Conclusion: Pulmonary tuberculosis and invasive pulmonary fungal infection clinical misdiagnosis or missed diagnosis, with high probability, need treatment combined with a variety of means, enhance the efficiency and the quality of life of patients with clinical diagnosis and treatment.%目的:分析肺结核并侵袭性肺部真菌感染的临床特点及诊治效果。方法:选取2007年4月~2012年5月间入院进行治疗的肺结核并侵袭性肺部真菌感染患者30例为研究对象进行回顾性分析。结果:肺结核并侵袭性肺部真菌感染复治比例高,病史长,合并症多,临床诊断较为困难,必须结合病原学、影像学检查提升诊断准确率。结论:肺结核并侵袭性肺部真菌感染临床漏诊、误诊几率高,需结合多种手段进行诊治,提升临床诊治效率和患者生存质量。

  4. Active and latent tuberculosis among HIV-positive injecting drug users in Indonesia

    NARCIS (Netherlands)

    Meijerink, H.; Wisaksana, R.; Lestari, M.; Meilana, I.; Chaidir, L.; Ven, A.J. van der; Alisjahbana, B.; Crevel, R. van

    2015-01-01

    INTRODUCTION: Injecting drug use (IDU) is associated with tuberculosis but few data are available from low-income settings. We examined IDU in relation to active and latent tuberculosis (LTBI) among HIV-positive individuals in Indonesia, which has a high burden of tuberculosis and a rapidly growing

  5. Evaluation of 5 Novel protein biomarkers for the rapid diagnosis of pulmonary and extra-pulmonary tuberculosis: preliminary results

    Science.gov (United States)

    Singh, Amit; Kumar Gupta, Anil; Gopinath, Krishnamoorthy; Sharma, Pawan; Singh, Sarman

    2017-01-01

    Improved methods are required for the early and accurate diagnosis of tuberculosis, especially in the patients with smear-negative disease. Several biomarkers have been tried but most have shown poor sensitivity or specificity. In present study we aimed to evaluate the diagnostic utility of five novel antigens identified earlier by us. This is an initial study conducted on 250 subjects. The five recombinant antigens, named as rSS1 (Rv2145c), rSS2 (Rv0164), rSS3 (Rv1437), rSS4 (Rv1827) and rSS5 (Rv2970c), were expressed in pQE-30 expression vector, purified and their sero-diagnostic efficacy was evaluated in an unblinded manner using dot-blot and ELISA methods. The sensitivity and specificity of these novel antigens were compared with commercially available standard esat6 and 38 kDa antigens. Bacteriologically confirmed TB patients, non-TB disease controls and healthy individuals were included. which are based on novel antigen or novel technology, Area under curve (AUC) of the selected antigens were 0.98 (0.98–0.99) for rSS1, 0.88 (0.84–0.92) for rSS2, 0.88 (0.84–0.92) for rSS3, 0.95 (0.93–0.98) for rSS4 and 0.99 (0.98–1.0) for rSS5. Receiver operative characteristic (ROC) curve showed highly significant difference between TB and healthy subjects (p = <0.001). These initial findings, show that the recombinant antigens rSS1, rSS4 and rSS5 could be used as highly potential biomarkers for the serological diagnosis of active TB. PMID:28337993

  6. The Effect of Low CD4+ Lymphocyte Count on the Radiographic Patterns of HIV Patients with Pulmonary Tuberculosis among Nigerians

    Directory of Open Access Journals (Sweden)

    Christopher Affusim

    2013-01-01

    Full Text Available Objective. To assess the radiographic features in patients with Human Immunodeficiency Virus (HIV complicated by pulmonary tuberculosis (PTB, and the association with CD4 lymphocyte count and sputum smear. Method. A prospective study was carried out on 89 HIV positive patients with PTB. The demographics, smoking history, sputum smear result, chest radiographic findings and CD4 lymphocyte count were documented. Results. Out of the 89 patients recruited in the study, 41 were males and 48 were females. Eighteen (18 patients had typical radiographic features, 60 patients had atypical radiographic features while only 11 of them had normal radiographic films. Sixty eight (68 patients had CD4 count <200 cells/mm3, 19 patients had CD4 count between 200–499 cells/mm3, while only 2 patients had CD4 count from 500 cells/mm3 upwards. The association between low CD4 count and radiographic finding was statistically significant, ( value . Sixty (60 patients had negative sputum smear for Acid and Alcohol Fast Bacilli (AAFB, while the remaining 29 patients had positive smear. The association between low CD4 count and negative smear was statistically significant ( value . Conclusion. The radiographic pattern and the result of the sputum smear for AAFB has a significant relationship and association with the immune status of patients with Human Immunodeficiency Virus (HIV complicated by pulmonary tuberculosis.

  7. Improving diagnosis of pulmonary tuberculosis among HIV/AIDS patients: literature review and experience in a teaching hospital in Indonesia.

    Science.gov (United States)

    Rewata, Lidya; Rutherford, Merrin; Apriani, Lika; Janssen, Willem; Rahmadi, Andri; Parwati, Ida; Yuwono, Arto; van Crevel, Reinout

    2009-07-01

    HIV infection hampers diagnosis of pulmonary tuberculosis (PTB) because many pathogens cause pulmonary infection in HIV people and the load of Mycobacterium tuberculosis is lower in HIV patients. We conducted a literature review and prospectively examined clinical, radiological, and laboratory diagnosis of PTB in 71 HIV-patients (29 inpatients and 42 outpatients) in a teaching hospital in West Java, Indonesia. For both in- and outpatients, signs and symptoms were sensitive but not specific for PTB. Chest X-ray (CXR) was sensitive but less specific. Among hospitalized PTB suspects, 28,8% could not expectorate sputum. Compared to culture, ZN had a sensitivity of 11.1% and 66.7% for in- and outpatients, respectively. From the literature, fluorescence microscopy, liquid culture, and nucleic acid assays can improve diagnosis of PTB in HIV, while IFNg-release assays lack sensitivity, especially in advanced HIV. The current practice of using CXR and microscopy lacks sensitivity for diagnosing PTB in HIV patients. Sputum culture is more sensitive but slow. Fluorescence microscopy might be a quick, relatively sensitive and feasible option in Indonesia. However, because of the frequent absence of sputum, especially in patients with advanced HIV-AIDS patients, there is an urgent need for alternative diagnostic methods using blood or urine.

  8. Factors influencing quality of life in patients with active tuberculosis

    OpenAIRE

    Cox Victoria C; Marra Fawziah; Marra Carlo A; Palepu Anita; FitzGerald J Mark

    2004-01-01

    Abstract Background With effective treatment strategies, the focus of tuberculosis (TB) management has shifted from the prevention of mortality to the avoidance of morbidity. As such, there should be an increased focus on quality of life (QoL) experienced by individuals being treated for TB. The objective of our study was to identify areas of QoL that are affected by active TB using focus groups and individual interviews. Methods English, Cantonese, and Punjabi-speaking subjects with active T...

  9. Smears and cultures for diagnosis of pulmonary tuberculosis in an asymptomatic immigrant population

    Directory of Open Access Journals (Sweden)

    Assael R

    2013-09-01

    Full Text Available Roberto Assael, Joaquin Cervantes, Gerardo Barrera Clinica Medica Internacional, Ciudad Juarez, Mexico Background: The World Health Organization estimated in 2010 that 8.8 million new tuberculosis (TB cases. About one-third of the world's population is infected and 10% will develop active TB disease. While cultures remain the international gold standard for diagnosing TB disease, in many other low-income countries, sputum smears remain the only and most accessible tool with which to diagnose active TB disease. As a consequence, in patients with TB who have negative smears, their TB remains undetected. Aim: The objective of the study reported here was to demonstrate the proportion of smear-positive/culture-positive cases compared with smear-negative/culture-positive TB cases in Mexican immigrants bound for the USA. Methods: A retrospective study was undertaken of the medical records of 122 active TB cases diagnosed at a clinic in Ciudad Juarez, Mexico, from 2009 to 2012. All cases were confirmed by culture, regardless of the sputum smear results. Results: Of the cases, 80% (97 active TB cases had negative sputum smears, while only 25 cases (20% had at least one positive smear. All of the cultures were confirmed as positive for Mycobacterium tuberculosis complex. Conclusion: The fact that 80% of the TB cases were smear negative and 20% smear positive shows that there is a clear gap between the actual state of active TB disease within patients under screening conditions, meaning that eight out of ten actual cases are being missed when sputum smear is the only diagnostic tool in asymptomatic patients with abnormal chest X-rays. Based on these results, it is highly recommended that countries that have not standardized culturing as the gold standard for the diagnosis of active TB do so, so that TB cases – which may endanger global public health – are not missed. It is also recommended that further studies be undertaken to determine the clinical

  10. TUBERCULIN RESPONSIVENESS AS A PROGNOSTIC INDICATOR IN HIV POSITIVE PULMONARY TUBERCULOSIS, KIMS, AMALAPURUM

    Directory of Open Access Journals (Sweden)

    Nagaraja

    2014-11-01

    Full Text Available With the emergence of HIV pandemic there is an alarming increase in both HIV and Tuberculosis cases cause’s major health problems due to poor socio-economic status in developing and resource poor countries. HIV and Tuberculosis infection hand in hand kills more population than all other infections combined. Both HIV and Tuberculosis is a major health problem. So the present study is under taken to know present scenario of HIV and TB in the rural set up, Amalapuram, East Godavari District, Andhra Pradesh. Out of 100 suspected cases with HIV and Tuberculosis with malnutrition, 10 samples were found to be HIV positive by rapid and ELISA. Among 10 positive HIV cases 6 cases were found to be positive for AFB by ZN stain indicating both HIV and Tuberculosis go hand in hand.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  12. Extra pulmonary tuberculosis in a tertiary teaching hospital:A five years review

    Institute of Scientific and Technical Information of China (English)

    Siti Suraiya Md Noor; Zaidah Abdul Rahman; Sarimah Abdullah; Zakuan Zainy Deris; Che Wan Aminuddin

    2009-01-01

    Objective:To investigate the prevalence,clinical and bacteriological features and outcome of extrapulmonary tuberculosis in patients attending a tertiary care hospital at Kota Bharu,Kelantan.Methods:All culture posi-tive tuberculosis cases recorded in Hospital Universiti Sains Malaysia at Kota Bharu during five years period from 2003-2007 were included in the study.Mycobacterium detected in samples originating from sites other than lungs was considered as a case of extrapulmonary tuberculosis.Age,site of infection,bacteriological find-ings and outcomes were analyzed.Results:Out of 437 tuberculosis cases recorded from 2002-2006,59 cases had culture positive extrapulmonary tuberculosis.Their mean age was 37 years and 44% were between the ages of 20-40 years.About 63% were negative for acid-fast bacilli by Z-N stain.Of the 59,97% was Mycobacteri-um tuberculosisc (M.tuberculosis)while two (3%)were atypical Mycobacterium Runyon Group-IV.Only 3 (5%)were isoniazid resistant.Extrapulmonary sites involved were lymph nodes 19 (31%),central nervous system 12 (20%),pleural 11(19%)spine 8 (14%),renal 3 (5.1%)and others 6 (10.2%).In this se-ries,11(18%)were positive for HIV.There was no significant association between extrapulmonary tuberculo-sis and HIV status.The outcome of CNS tuberculosis was the poorest with a mortality rate of 25%.Conclu-sion:M.tuberculosis is the predominant organism in extrapulmonary tuberculosis and culture is the most effec-tive method for its diagnosis.

  13. Interleukin 12B (IL12B) Genetic Variation and Pulmonary Tuberculosis: A Study of Cohorts from The Gambia, Guinea-Bissau, United States and Argentina

    DEFF Research Database (Denmark)

    Morris, Gerard A J; Edwards, Digna R Velez; Hill, Philip C;

    2011-01-01

    We examined whether polymorphisms in interleukin-12B (IL12B) associate with susceptibility to pulmonary tuberculosis (PTB) in two West African populations (from The Gambia and Guinea-Bissau) and in two independent populations from North and South America. Nine polymorphisms (seven SNPs, one inser...

  14. Diagnostic accuracy of the rapid urine lipoarabinomannan test for pulmonary tuberculosis among HIV-infected adults in Ghana-findings from the DETECT HIV-TB study

    DEFF Research Database (Denmark)

    Bjerrum, Stephanie; Kenu, Ernest; Lartey, Margaret

    2015-01-01

    BACKGROUND: Rapid diagnostic tests are urgently needed to mitigate HIV-associated tuberculosis (TB) mortality. We evaluated diagnostic accuracy of the rapid urine lipoarabinomannan (LAM) test for pulmonary TB and assessed the effect of a two-sample strategy. METHODS: HIV-infected adults eligible...

  15. Tuberculosis.

    Science.gov (United States)

    Jacobson, Karen R

    2017-02-07

    This issue provides a clinical overview of tuberculosis, focusing on screening, prevention, diagnosis, and treatment. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  16. SOCIO - DEMOGRAPHIC PROFILE AND BASAL METABOLIC INDEX CHARACTERISTICS OF PATIENTS WITH PULMONARY TUBERCULOSIS AND THEIR TREATMENT OUTCOME IN MEDICAL COLLEGE HOSPITAL, AMRITSAR, INDIA

    Directory of Open Access Journals (Sweden)

    Kajal

    2015-03-01

    Full Text Available INTRODUCTION: Tuberculosis is an ancient disease associated with high degree of morbidity and mortality worldwide, more so in developing countries having overwhelming problems of poverty, poor living conditions, illiteracy, malnutrition, drug addiction. OBJECTIVES: To evaluate the socio - demographic profile and BMI characteristics of patients with pulmonary tuberculosis and their treatment outcome. MATERIAL & METHOD: This prospective study was conducted on 200 new sputum smear positive patients having ag e >15 years. OBSERVATIONS & RESULT: The present study (n= 200 with 121 males and 79 female revealed that 75.8% of males and 87.5% of females were in the age group of 15 - 45 years, being the most productive years of life. 60.5% cases lived in overcrowded houses with inadequate ventilation (7 3%, poor lighting (68.5%, majority with lower socio - economic status (72.5%. 66% were from medium to large sized families, 65% joint family while 35% with nuclear families. 57.5% were working & thus were included in income generating activity group. illi teracy was observed in 40% & addiction in 47%. 69.5% of the cases were underweight (BMI < 18.5kg/m2 at initiation of treatment and percentage improved to 62.5% at the end of anti - tubercular treatment. CONCLUSION: The study findings emphasise the associati on of the socio - demographic profile including overcrowding, inadequate ventilation of the dwellings, ill - ventilated kitchens, under - nutrition with poor BMI, poor level of education (illiteracy, ignorance, poor knowledge about the disease, low socio - econom ic status with poverty contributing as significant risk factors for tuberculosis & its spread in family & community.

  17. [Hodgkin's disease of mediastino-pulmonary onset associated with tuberculosis of unusual presentation].

    Science.gov (United States)

    Roncoroni, A J; Barcat, J A; Quadrellis, A

    1994-01-01

    A 36 year-old non-smoker woman was admitted because of a rapidly growing mass at the left hilum. Fiberoptic bronchoscopy did not show any abnormality. A percutaneous Rotex needle biopsy and a cutting needle biopsy showed atypical cells suggestive of an anaplastic tumor, possibly a sarcoma. A thoracotomy biopsy demonstrated nodal and pulmonary involvement by Hodgkin lymphoma (nodular-sclerosis form) and pulmonary TBC (granulomas with caseum and acid fast bacilli (AFB)). The patient started treatment with isoniazid, rifampin and pirazynamide and then she received chemotherapy and radiotherapy. One year later her chest and abdominal CT were normal. Twelve months after that she developed severe dyspnea with a chest x-ray film with interstitial infiltrates and a mass at the left-hilum. She worsened quickly and died. At autopsy no evidence of active TBC was found and extensive involvement by lymphoma was demonstrated. The diagnosis in this patient was not obtained by clinical-radiological signs or by non-invasive tests but only by surgical biopsy. The association between neoplasm and TBC is well known, but now is very rare. In Argentina TBC prevalence in lymphomas is 1.2% (higher than control population). TBC diagnosis can occasionally be difficult. In most of undiagnosed patients TBC is the main contributor to death. In this patient the mediastinopulmonary mass was adequately diagnosed only after an open biopsy which showed it to be caused by two coexistent diseases, previously unsuspected and both amenable of effective treatment. This case shows the heterogeneity of TBC presentation and stresses the need to consider it in each non-defined mediastino-pulmonary lesion in countries where TBC is highly prevalent.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. OSTEOARTROPATIA HIPERTRÓFICA ASSOCIADA A TUBERCULOSE PULMONAR Hypertrophic osteoarthropathy in association with pulmonary tuberculosis: a case report

    Directory of Open Access Journals (Sweden)

    Luiza Beatriz Melo Moreira

    2002-01-01

    Full Text Available Neste artigo é descrito um caso de osteoartropatia hipertrófica associada a tuberculose pulmonar. Esta alteração é uma complicação rara da tuberculose e pode estar associada à forma grave e fulminante da doença. Entre os métodos de imagem utilizados no diagnóstico estavam radiografias dos membros inferiores, que mostravam reação periosteal bilateralmente, e radiografias e tomografia computadorizada do tórax, que evidenciaram massa no lobo superior do pulmão direito. Embora a punção aspirativa por agulha fina tivesse sido sugestiva de tuberculose, o diagnóstico definitivo foi dado pelo exame histopatológico da massa, após a realização de toracotomia. O paciente evoluiu com melhora sintomática e radiológica após o tratamento com drogas tuberculostáticas.In this article the authors report a case of a patient with hypertrophic osteoarthropathy associated with pulmonary tuberculosis. This disorder is a rare complication of tuberculosis and may be associated with severe and fulminant disease. The imaging methods used in the diagnosis of this disease included lower limbs radiographies that showed bilateral periosteal reaction, and chest radiographies and computed tomography that revealed a mass in the upper lobe of the right lung. Although a fine needle aspiration was suggestive of tuberculosis, the definitive diagnosis was made after thoracotomy and hystopathological examination of the mass. The patient presented symptomatic and radiological improvement after treatment of tuberculosis.

  19. Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course: Systematic Review and Meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Zhuang-Li Si; Ling-Ling Kang; Xu-Bo Shen; Yuan-Zhong Zhou

    2015-01-01

    Background: Malnutrition and tuberculosis (TB) tend to interact with each other.TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions.Nutrition support can promote recovery in the subject being treated for TB.The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy.Methods: English database of the Cochrane Controlled Trials Register, PubMed, EMBASE, and Chinese database ofCBM, CNKI, VIP, and WANFANG were searched.Randomized controlled trials comparing nutrition support (given for more than 2 weeks) with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included.Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer.Data were entered and analyzed by RevMan 5.2 software, and meta-analysis was done using risk ratios (RRs) for dichotomous variables and mean differences (MDs) for continuous variables with 95% confidence intervals (CIs).Results: A total of 19 studies (3681 participants) were included.In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears-or culture-negative conversion rate and chest X-ray (CXR) absorption rate were 1.10 (1.04, 1.17) and 1.22 (1.08, 1.39), respectively, the pooled MD and its 95% CI of body mass index (BMI) and time of sputum smears or culture negativity were 0.59 (0.16, 1.2) and-5.42 (-7.93,-2.92), respectively, compared with the control group.The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant (P =0.76, 0.24, 0.28, and 0.20, respectively) between the intervention group and the control group.No systemic adverse events were recorded.Conclusions: During anti-TB course, nutrition support may be helpful in treatment of TB patients by

  20. Cost-effectiveness analysis of PCR for the rapid diagnosis of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Vater Claudia

    2009-12-01

    Full Text Available Abstract Background Tuberculosis is one of the most prominent health problems in the world, causing 1.75 million deaths each year. Rapid clinical diagnosis is important in patients who have co-morbidities such as Human Immunodeficiency Virus (HIV infection. Direct microscopy has low sensitivity and culture takes 3 to 6 weeks 123. Therefore, new tools for TB diagnosis are necessary, especially in health settings with a high prevalence of HIV/TB co-infection. Methods In a public reference TB/HIV hospital in Brazil, we compared the cost-effectiveness of diagnostic strategies for diagnosis of pulmonary TB: Acid fast bacilli smear microscopy by Ziehl-Neelsen staining (AFB smear plus culture and AFB smear plus colorimetric test (PCR dot-blot. From May 2003 to May 2004, sputum was collected consecutively from PTB suspects attending the Parthenon Reference Hospital. Sputum samples were examined by AFB smear, culture, and PCR dot-blot. The gold standard was a positive culture combined with the definition of clinical PTB. Cost analysis included health services and patient costs. Results The AFB smear plus PCR dot-blot require the lowest laboratory investment for equipment (US$ 20,000. The total screening costs are 3.8 times for AFB smear plus culture versus for AFB smear plus PCR dot blot costs (US$ 5,635,760 versus US$ 1,498, 660. Costs per correctly diagnosed case were US$ 50,773 and US$ 13,749 for AFB smear plus culture and AFB smear plus PCR dot-blot, respectively. AFB smear plus PCR dot-blot was more cost-effective than AFB smear plus culture, when the cost of treating all correctly diagnosed cases was considered. The cost of returning patients, which are not treated due to a negative result, to the health service, was higher in AFB smear plus culture than for AFB smear plus PCR dot-blot, US$ 374,778,045 and US$ 110,849,055, respectively. Conclusion AFB smear associated with PCR dot-blot associated has the potential to be a cost-effective tool in the

  1. Characterization of the genetic diversity of extensively-drug resistant Mycobacterium tuberculosis clinical isolates from pulmonary tuberculosis patients in Peru.

    Directory of Open Access Journals (Sweden)

    Omar Cáceres

    Full Text Available BACKGROUND: Peru holds the fourth highest burden of tuberculosis in the Americas. Despite an apparently well-functioning DOTS control program, the prevalence of multidrug resistant tuberculosis (MDR-TB continues to increase. To worsen this situation, cases of extensively drug resistance tuberculosis (XDR-TB have been detected. Little information exists about the genetic diversity of drug-susceptible vs. MDR-TB and XDR-TB. METHODS: Cryopreserved samples of XDR strains from 2007 to 2009 (second semester, were identified and collected. Starting from 227 frozen samples, a total of 142 XDR-TB strains of Mycobacterium tuberculosis complex (MTBC; 1 isolate per patient were retained for this study. Each strain DNA was analyzed by spoligotyping and the 15-loci Mycobacterial Interspersed Repetitive Unit (MIRU-15. RESULTS: Among the 142 isolates analyzed, only 2 samples (1.41% could not be matched to any lineage. The most prevalent sublineage was Haarlem (43.66%, followed by T (27.46%, LAM (16.2%, Beijing (9.15%, and X clade (1.41%. Spoligotype analysis identified clustering for 128/142 (90.1% isolates vs. 49/142 (34.5% with MIRUs. Of the samples, 90.85% belonged to retreated patients. The drug resistant profile demonstrated that 62.67% showed resistance to injectable drugs capreomycin (CAP and kanamycin (KAN vs. 15.5% to CAP alone and 21.8% to KAN alone. The SIT219/T1 and SIT50/H3 were the most prevalent patterns in our study. The spoligoforest analysis showed that SIT53/T1 was at the origin of many of the T lineage strains as well as a big proportion of Haarlem lineage strains (SIT50/H3, followed by SIT47/H1, SIT49/H3, and SIT2375/H1, as opposed to the SIT1/Beijing strains that did not appear to evolve into minor Beijing sublineages among the XDR-TB strains. CONCLUSION: In contrast with other Latin-American countries where LAM sublineage is the most predominant, we found the Haarlem to be the most common followed by T sublineage among the XDR-TB strains.

  2. Mycobacterium genotypes in pulmonary tuberculosis infections and their detection by trained African giant pouched rats.

    Science.gov (United States)

    Mgode, Georgies F; Cohen-Bacrie, Stéphan; Bedotto, Marielle; Weetjens, Bart J; Cox, Christophe; Jubitana, Maureen; Kuipers, Dian; Machang'u, Robert S; Kazwala, Rudovick; Mfinanga, Sayoki G; Kaufmann, Stefan H E; Drancourt, Michel

    2015-02-01

    Tuberculosis (TB) diagnosis in low-income countries is mainly done by microscopy. Hence, little is known about the diversity of Mycobacterium spp. in TB infections. Different genotypes or lineages of Mycobacterium tuberculosis vary in virulence and induce different inflammatory and immune responses. Trained Cricetomys rats show a potential for rapid diagnosis of TB. They detect over 28 % of smear-negative, culture-positive TB. However, it is unknown whether these rats can equally detect sputa from patients infected with different genotypes of M. tuberculosis. A 4-month prospective study on diversity of Mycobacterium spp. was conducted in Dar es Salaam, Tanzania. 252 sputa from 161 subjects were cultured on Lowenstein-Jensen medium and thereafter tested by rats. Mycobacterial isolates were subjected to molecular identification and multispacer sequence typing (MST) to determine species and genotypes. A total of 34 Mycobacterium spp. isolates consisting of 32 M. tuberculosis, 1 M. avium subsp. hominissuis and 1 M. intracellulare were obtained. MST analyses of 26 M. tuberculosis isolates yielded 10 distinct MST genotypes, including 3 new genotypes with two clusters of related patterns not grouped by geographic areas. Genotype MST-67, shared by one-third of M. tuberculosis isolates, was associated with the Mwananyamala clinic. This study shows that diverse M. tuberculosis genotypes (n = 10) occur in Dar es Salaam and trained rats detect 80 % of the genotypes. Sputa with two M. tuberculosis genotypes (20 %), M. avium hominissuis and M. intracellulare were not detected. Therefore, rats detect sputa with different M. tuberculosis genotypes and can be used to detect TB in resource-poor countries.

  3. Association between TNF -308G/A polymorphism and susceptibility to pulmonary tuberculosis in the Lur population of Iran

    Institute of Scientific and Technical Information of China (English)

    Farhad Shahsavar; Ali Mohammad Varzi; Alireza Azargoon

    2016-01-01

    Objective: To investigate whether tumor necrosis factor-a (TNFa) -238G/A and -308G/A polymorphisms are associated with susceptibility to pulmonary tuberculosis (TB) in the Lur ethnic population of Iran. Methods: TNF polymorphisms genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism method in 100 pulmonary TB patients and 100 healthy controls from the Lur population. Results: The allelic and genotypic frequencies of TNFa -238G/A polymorphism were not significantly different between the pulmonary TB patients and the healthy controls. However, the TNFa -308G/A polymorphism showed a significantly higher frequency of genotype GG in TB subjects compared to healthy controls (94% in the patients vs. 62% in the controls, P = 0.0001, odds ratio = 0.104, confidence interval = 0.028–0.382). Moreover, in the TNFa -308G/A polymorphism, a significantly higher frequency of G allele was measured in the patient group compared with the control group (97% in the patient group vs. 81% in the control group, P = 0.0001, odds ratio = 0.132, confidence interval = 0.038–0.462). Conclusions: Our findings suggest that TNFa -308G/A polymorphism may increase the susceptibility to pulmonary TB in the Lur population of Iran. Despite TNFa poly-morphisms and susceptibility to pulmonary TB, we suggest that more studies with larger sample size are needed in the future. Increasing our understanding of susceptibility risk factors may help to improve current preventive measures and treatment for TB.

  4. Gastric lavage in the diagnosis of pulmonary tuberculosis in children : a systematic review

    OpenAIRE

    Ethel Leonor Noia Maciel; Léia Damasceno de Aguiar Brotto; Carolina Maia Martins Sales; Eliana Zandonade; Clemax Couto Sant'Anna

    2010-01-01

    Objetivo: Analisar a padronização da coleta do lavado gástrico para diagnóstico de tuberculose em crianças. Métodos: Estudo de revisão sistemática referente aos anos de 1968 a 2008. O levantamento de artigos científicos foi feito nas bases de dados Lilacs, SciELO e Medline, utilizando-se a estratégia de busca ("gastric lavage and tuberculosis" ou "gastric washing and tuberculosis", com o limite "crianças com idade até 15 anos"; e "gastric lavage and tuberculosis and childhood" ou "gastric was...

  5. O ressurgimento da tuberculose e o impacto do estudo da imunopatogenia pulmonar The resurgence of tuberculosis and the impact of the study of pulmonary immunopathogenesis

    Directory of Open Access Journals (Sweden)

    José Roberto Lapa e Silva

    2004-08-01

    Universidade Federal do Rio de Janeiro has been dedicated to investigating the pathogenic mechanisms involved in pulmonary tuberculosis. Due to its frequency and role in transmission, pulmonary tuberculosis is the most serious form of the disease. Our hypothesis is that the establishment of latent infection and its progression to active disease depend on an imbalance between activating and deactivating cytokines at the disease site. Despite the presence of protective mechanisms such as the macrophage expression of phenotypes (denoting cellular and molecular activation of agents involved in protection, such as nitric oxide and interferon-g, tuberculosis progresses. A possible explanation for this is the concomitant presence at the site of infection of molecules such as interleukin-10 and TGF-b, which are able to deactivate previously activated macrophages. Recent data suggest that mycobacteria secrete proteins capable of inducing interleukin-10, thus contributing to overcoming host protective mechanisms. Susceptible individuals would be more able to produce larger amounts of these molecules due to genetic polymorphisms that facilitate interleukin-10 production at infection onset. The understanding of these mechanisms could advance the prevention and discovery of new therapeutic targets for the control of tuberculosis.

  6. Decreased Expression of T-Cell Costimulatory Molecule CD28 on CD4 and CD8 T Cells of Mexican Patients with Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    German Bernal-Fernandez

    2010-01-01

    Full Text Available Patients with tuberculosis frequently develop anergy, a state of T-cell hyporesponsiveness in which defective T-cell costimulation could be a factor. To know if the expression of T-cell costimulatory molecules was altered in tuberculosis, we analyzed the peripheral blood T-cell phenotype of 23 Mexican patients with pulmonary tuberculosis. There was severe CD4 (P<.001 and CD8 (P<.01 lymphopenia and upregulation of costimulatory molecule CD30 on CD4 and CD8 T cells (P<.05; this increase was higher in relapsing tuberculosis. The main finding was severe downregulation of the major costimulatory molecule CD28 on both CD8 and CD4 T cells (P<.001. Depletion of the CD4/CD28 subset, a hitherto undescribed finding, is relevant because CD4 T cells constitute the main arm of the cell-mediated antimycobacterial immune response.

  7. Primary tuberculosis involving epiglottis: a rare case report.

    Science.gov (United States)

    Edizer, Deniz Tuna; Karaman, Emin; Mercan, Hasan; Alimoglu, Yalcin; Esen, Tugce; Cansiz, Harun

    2010-09-01

    The case of a 29-year-old patient with active laryngeal tuberculosis predominantly involving the epiglottis, without pulmonary disease, is presented. The predominant symptoms are dysphagia, odynophagia, and hoarseness. Laryngeal carcinoma, which shares almost the same symptoms and signs, should be ruled out immediately. Laryngeal tuberculosis is discussed with a brief literature review.

  8. Diabetes is a risk factor for pulmonary tuberculosis: a case-control study from mwanza, Tanzania

    DEFF Research Database (Denmark)

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

    2011-01-01

    Diabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB) is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent.......Diabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB) is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent....

  9. T-cell recognition of Mycobacterium tuberculosis culture filtrate fractions in tuberculosis patients and their household contacts

    DEFF Research Database (Denmark)

    Demissie, A; Ravn, P; Olobo, J;

    1999-01-01

    We examined the immune responses of patients with active pulmonary tuberculosis (TB) and their healthy household contacts to short-term culture filtrate (ST-CF) of Mycobacterium tuberculosis or molecular mass fractions derived from it. Our goal was to identify fractions strongly recognized by don...

  10. 糖尿病合并肺结核的影像学探讨%Investigation of the imaging features of diabetes complicated with pulmonary tuberculosis

    Institute of Scientific and Technical Information of China (English)

    张红梅; 张学兰

    2014-01-01

    目的:探讨糖尿病合并肺结核病的影像学特征。方法:收治糖尿病合并肺结核病患者36例,回顾性分析其临床资料。同时选择年龄、病变范围相当的单纯肺结核患者进行对比观察。结果:36例糖尿病合并肺结核患者病灶以双上野分布的30例,病灶形态呈大片融合或斑块的有32例,发现空洞的有33例,单一病灶内多发虫蚀样空洞有31例,支气管播散多见。结论:糖尿病合并肺结核具有一定的影像学特征,如以炎性渗出、干酪变质为主,空洞发生率高,糖尿病合并肺结核于结核非好发部位的发病率高。%To explore the imaging features of diabetes complicated with pulmonary tuberculosis.Methods:36 cases with diabetes complicated with pulmonary tuberculosis were selected.We retrospectively analyzed the clinical data.At the same time, pulmonary tuberculosis patients with the same age and extent of disease were selected,and the clinical data were compared be-tween the two groups.Results:In 36 cases of diabetes complicated with pulmonary tuberculosis,30 cases of lesions was double Ue-no distribution;the lesions of 32 cases were large fusion or plaques;33 cases had single lesion cavity;31 cases were multiple eroded hole in single lesions;bronchial dissemination was common.Conclusion:Diabetes complicated with pulmonary tuberculosis has cer-tain imaging characteristics,such as inflammatory exudation and cheese metamorphism are the main,and empty rate is high.In pa-tients with diabetes complicated with pulmonary tuberculosis,the incidence rate at non predilection sites of tuberculosis is high.

  11. Mental health problems and coping strategies in patients with pulmonary tuberculosis%肺结核患者的心理健康问题及应对策略

    Institute of Scientific and Technical Information of China (English)

    王琰

    2015-01-01

    目的:探讨肺结核患者的心理健康问题及应对策略。方法:收治肺结核患者160例,采用SCL-90量表进行调查,对存在不良健康问题的患者进行心理疏导、结核病的健康教育、结核病患者现身说法教育、劝导其积极参加锻炼等。结果:患者入院后心理健康问题主要表现为恐惧、焦虑、抑郁和人际关系敏感,经过相应的应对策略后,再进行SCL-90量表调查,差异均与国内常模无统计学意义(P>0.05)。结论:恐惧、焦虑、抑郁和人际关系敏感是结核病患者的主要心理健康问题,加强心理疏导、结核病的健康教育、结核病患者现身说法教育、锻炼是有效的应对策略。%Objective:To explore the mental health problems and coping strategies in patients with pulmonary tuberculosis. Methods:160 patients with pulmonary tuberculosis were selected,and they were investigated by SCL-90,the patients with adverse health problems were given psychological counseling,health education about tuberculosis,making personal examples by tuberculosis patients,active exercise and so on.Results:After hospital admission,the mental health problems of the patients were mainly expressed as fear,anxiety,depression and interpersonal sensitivity,after the corresponding coping strategies,the results showed that there was no statistical significance on the SCL-90 scale with domestic norm(P>0.05).Conclusion:Fear,anxiety, depression and interpersonal sensitivity were the main mental health problems of tuberculosis patients,strengthening psychological counseling,health education about tuberculosis,making personal examples by tuberculosis patients,active exercise were effective coping strategies.

  12. The role of Xpert MTB/RIF in diagnosing pulmonary tuberculosis in post-mortem tissues.

    Science.gov (United States)

    García-Basteiro, Alberto L; Ismail, Mamudo R; Carrilho, Carla; Ussene, Esperança; Castillo, Paola; Chitsungo, Dércio; Rodríguez, Cristina; Lovane, Lucília; Vergara, Andrea; López-Varela, Elisa; Mandomando, Inacio; Lorenzoni, Cesaltina; Ordi, Jaume; Menéndez, Clara; Bassat, Quique; Martínez, Miguel J

    2016-02-10

    The extent to which the Xpert MTB/RIF (Gene Xpert) contributes to tuberculosis (TB) diagnosis in samples other than sputum and cerebrospinal fluid remains uncertain. We aimed to assess the role of Xpert MTB/RIF for detecting M. tuberculosis in post-mortem tissues. We conducted a study among 30 complete diagnostic autopsies (CDA) performed at the Maputo Central Hospital (Mozambique). Lung tissues were screened for TB in all cases. In addition other tissues were tested when compatible lesions were identified in the histological exam. We used in-house real time PCR and LAMP assays to confirm the presence of M. tuberculosis DNA. The diagnosis of tuberculosis at death was established based on microbiological and histopathological results. Eight out of 30 cases (26.7%) were diagnosed of tuberculosis. Xpert had a sensitivity to detect TB in lung tissue of 87.5% (95% CI 47.3-99.7) and a specificity of 95.7% (95% CI: 78.1-99.9). In-house DNA amplification methods and Xpert showed 93.6% concordance for lung tissue and 100% concordance for brain and liver tissues. The final cause of death was attributable to tuberculosis in four cases. Xpert MTB/RIF may represent a valuable, easy-to perform technique for post-mortem TB diagnosis.

  13. Avaliação audiométrica de pacientes em tratamento para tuberculose pulmonar Audiometric evaluation of patients treated for pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Karla Anacleto de Vasconcelos

    2012-02-01

    Full Text Available OBJETIVO: Analisar a condição auditiva de uma população em tratamento para tuberculose pulmonar em dois hospitais de referência no Brasil. MÉTODOS: Estudo descritivo envolvendo 97 pacientes de ambos os sexos, com idade entre 18 anos e 60 anos, que estivessem em tratamento para tuberculose pulmonar ativa, internados ou em acompanhamento ambulatorial em dois hospitais de referência no estado do Rio de Janeiro. Os participantes foram entrevistados e realizaram audiometria tonal liminar. RESULTADOS: Na população estudada, 65 pacientes (67% eram homens, 52 (54% estavam em tratamento de primeira linha e 45 (46% estavam em tratamento de segunda linha, o qual incluía aminoglicosídeos. Tabagismo, uso de bebidas alcoólicas, exposição a ruído e uso de medicamentos ototóxicos foram identificados respectivamente em 65 (67%, 51 (53%, 53 (55% e 45 (46,4% pacientes. As queixas auditivas e vestibulares mais frequentemente mencionadas foram tontura, em 28 (28,8%; zumbido, em 27 (27,8%; e hipoacusia, em 23 (23,7%. CONCLUSÕES: Devido ao elevado número de casos de perda auditiva encontrado neste estudo, recomenda-se que todos os pacientes em tratamento para tuberculose sejam submetidos a monitoramento auditivo.OBJECTIVE: To evaluate the hearing status of patients being treated for pulmonary tuberculosis at referral hospitals in Brazil. Methods: This was a descriptive study involving 97 male and female inpatients/outpatients between 18 and 60 years of age who were undergoing treatment for active pulmonary tuberculosis at one of two referral hospitals in the state of Rio de Janeiro. After being interviewed, all of the patients underwent pure tone audiometry. Results: Of the 97 patients studied, 65 (67% were male, 52 (54% were receiving first-line treatment, and 45 (46% were receiving second-line treatment, which included aminoglycosides. Smoking, alcohol consumption, exposure to noise, and ototoxic medication use were identified in 65 (67%, 51 (53

  14. 支气管肺泡灌洗液诊断肺结核的诊断的价值应用%Diagnostic Value of Rapid Culture for Mycobacterium Tuberculosis in BALF in Atypical Pulmonary Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    傅文

    2015-01-01

    Objective To evaluate diagnostic significance of rapid culture for Mycobacterium tuberculosis in bronchoalveolar lavage fluid (BALF)for atypical pulmonary tuberculosis.Methods Bronchial brushing ,and rapid culture for Mycobacterium tuberculosis were performed for 98 cases with atpical pulmonary tuberculosis who han no sputum or negative sputum acid-fast staining,of them 30 casea underwent transbronchial lung biopsy.Results The 20cases ,66.3% were confirmde by bronchial brushing,84.8% were confirm by rapid culture for Mycobacterium tuberculosis in BALF.Among the20casea who underwent transbronchial lung biopsy,pulmonary tuberculosis was confirmde in 66.7%. Conclusion Rapid culture for Mycobacterium tuberculosis in BALF is of significant value for the diagnosis of atypical pulmonary tuberculosis with no sputum or negative sputum acid-fast staining.%目的评价纤维支气管镜防污染支气管肺泡灌洗液技术对肺结核分支杆菌快速培养和痰菌阴的不典型肺结核的诊断价值应用。方法对98例肺结核患者采用支气管镜进行检查,并对病变部位灌洗标本液,并且培养出结核杆菌。结果98例结核分支杆菌检出率为66.3%、84.8%,其中30例活检,20例确诊为结核内芽肿,检出率为66.7%。结论纤支镜下进行BALF快培对不典型肺结核具有良好的诊断及时,阳性率较高,通过支气管镜下不同的取材方法能够有效的提高诊断率。

  15. Nitroprusside modulates pulmonary vein arrhythmogenic activity

    Directory of Open Access Journals (Sweden)

    Chen Yao-Chang

    2010-03-01

    Full Text Available Abstract Background Pulmonary veins (PVs are the most important sources of ectopic beats with the initiation of paroxysmal atrial fibrillation, or the foci of ectopic atrial tachycardia and focal atrial fibrillation. Elimination of nitric oxide (NO enhances cardiac triggered activity, and NO can decrease PV arrhythmogensis through mechano-electrical feedback. However, it is not clear whether NO may have direct electrophysiological effects on PV cardiomyocytes. This study is aimed to study the effects of nitroprusside (NO donor, on the ionic currents and arrhythmogenic activity of single cardiomyocytes from the PVs. Methods Single PV cardiomyocytes were isolated from the canine PVs. The action potential and ionic currents were investigated in isolated single canine PV cardiomyocytes before and after sodium nitroprusside (80 μM, using the whole-cell patch clamp technique. Results Nitroprusside decreased PV cardiomyocytes spontaneous beating rates from 1.7 ± 0.3 Hz to 0.5 ± 0.4 Hz in 9 cells (P Conclusion Nitroprusside regulates the electrical activity of PV cardiomyocytes, which suggests that NO may play a role in PV arrhythmogenesis.

  16. Anti-Mycobacterium tuberculosis activity of fungus Phomopsis stipata

    Directory of Open Access Journals (Sweden)

    Karina Andrade de Prince

    2012-03-01

    Full Text Available Our purpose was to determine the anti-Mycobacterium tuberculosis activity of the metabolites produced by the endophitic fungus Phomopsis stipata (Lib. B. Sutton, (Diaporthaceae, cultivated in different media. The antimycobacterial activity was assessed through the Resazurin Microtiter Assay (REMA and the cytotoxicity test performed on macrophage cell line. The extracts derived from fungi grown on Corn Medium and Potato Dextrose Broth presented the smallest values of Minimum Inhibitory Concentration (MIC and low cytotoxicity, which implies a high selectivity index. This is the first report on the chemical composition and antitubercular activity of metabolites of P. stipata, as well as the influence of culture medium on these properties.

  17. Low plasma selenium concentrations, high plasma human immunodeficiency virus load and high interleukin-6 concentrations are risk factors associated with anemia in adults presenting with pulmonary tuberculosis in Zomba district, Malawi.

    NARCIS (Netherlands)

    Lettow, M.H.E. van; West, C.E.; Meer, J.W.M. van der; Wieringa, F.; Semba, R.D.

    2005-01-01

    BACKGROUND: Although anemia is common among adults with pulmonary tuberculosis and human immunodeficiency virus (HIV) infection in sub-Saharan Africa, the factors contributing to its pathogenesis have not been well characterized. OBJECTIVE: To characterize the antioxidant micronutrient status, inter

  18. Clinical Study of Drug-resistant Pulmonary Tuberculosis Treated by Combination of Anti-Tuberculosis Chemicals and Compound Astragalus Capsule(复方黄芪胶囊)

    Institute of Scientific and Technical Information of China (English)

    姜艳; 李新; 于志勇; 尹红义; 韩玉庆

    2004-01-01

    Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared. Results: In the treated group, the sputum bacterial negative conversion rate was 84. 8%, focal absorption effective rate 91.3 %, cavity closing rate 58. 7 % and 10-day symptom improving rate 54.4%, while in the control group, the corresponding rates were 65.2%,73.9 %, 37. 0% and 26.1%, respectively. Comparison between the groups showed significant difference in all the parameters ( P<0.05, P<0.05, P<0.05 and P<0.01 ). The incidence of adverse reaction and 2year bacteriological recurrence rate in the treated group were 23.9 % and 2.6 % respectively, while those in the control group 50.0% and 16.7%, which were higher than the former group with significant difference ( P<0.01 and P<0.05, respectively). Conclusion: The therapeutic effect of combined treatment with antiTB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice.

  19. Assess drug resistance pattern and genetic profile of Mycobacterium tuberculosis clinical isolates by molecular typing methods using direct repeats and IS6110 in pulmonary tuberculosis cases

    Science.gov (United States)

    Kalo, Deepika; Kant, Surya; Srivastava, Kanchan; Sharma, Ajay K

    2017-01-01

    Background: Tuberculosis (TB), a highly contagious disease that sees no gender, age, or race is mainly a disease of lungs. According to World Health Organization, a TB patient can be completely cured with 6–9 months of anti-TB treatment under directly observed treatment short course. Objectives: The aim of this study was to check the mono, multi- and triple-drug resistance to first line drugs (FLDs) among TB patients and to access their genetic profile using DR 3074, DR 0270, DR 0642, DR 2068, and DR 4110 using molecular techniques. Material and Methods: To gain a better understanding of drug resistant TB, we characterized 121 clinical isolates recovered from 159 drug resistant pulmonary tuberculosis patients by IS6110 genotyping. MTB isolates recovered from HIV- negative, and smear positive cases of both genders, age varied from 18 to 70 years with drug resistant-TB that was refractory to chemotherapy given for > 12 months. Of a total of 159 sputum smear positive patients sum number of male and female patients was 121 (76.10%) and 38 (23.89%), respectively. Among these patients, number of literate and illiterate patients were 123 (77.3%) and 36 (22.6%). 25 (15.7%) patients had farming as their occupation, 80 (50.3%) had nonagricultural occupation and 54 (33.9%) women were housewives. Results: Mono drug resistant, multi-drug resistant, and totally drug resistant (TDR) cases of TB were calculated as 113.83%, 125.1%, and 67.9%. Isoniazid showed the highest percentage of resistance among the patients. Conclusion: Any noncompliance to TB medications, lack of knowledge, and poor management in health centers, etc., results in the emergence of deadly direct repeat forms of TB, which are further complicated and complex to treat.

  20. Comparison of Sputum Smear Microscopy and Rapid Tuberculosisantibody Detection Test Kits for Diagnosis of Pulmonary Tuberculosis in Abia State, Nigeria

    Institute of Scientific and Technical Information of China (English)

    Emmanuel Olufemi Ekundayo[1; Sam D. Abbey[2; Onuka Okorie[3

    2014-01-01

    The SSM (sputum smear microscopy) and five immunochromatographic tuberculosis antibody detection tests (DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB) were compared for diagnosis of active TB at the Leprosy and Tuberculosis Referral Hospital, Uzuakoli, Abia State, Nigeria. Sputum specimens from 150 study participants (male/female ratio, 0.81) were cultured on Lowenstein-Jensen slopes and direct smears were stained by Ziehl-Neelsen technique and examined by light microscopy. Sera were tested for anti-TB antibodies using the rapid TB tests. A total of 91 participants were culture positive, 79 (86.8%) for M. tuberculosis and 12 (13.2%) for nontuberculous mycobacteria. The sensitivity of SSM was 50% (95% CI: 39.0-61.0) and specificity was 92.3% (95% CI: 86.4-98.2) in those culture positive for M. tuberculosis. The sensitivity and specificity of the Rapid TB tests ranged from 24.1-39.2% and 78.4-87.8%, respectively. None of the five rapid TB tests had acceptable level of accuracy for diagnosis of active TB. The sensitivity of SSM though moderate is inadequate for long term TB control in this setting.

  1. Secondary pulmonary tuberculosis mainly with pulmonary interstitial changes:one case report and literature review%以间质性改变为主要表现的肺结核一例并文献复习

    Institute of Scientific and Technical Information of China (English)

    吴迪; 李学玲; 林忠惠; 翁丽珍; 陈晓红; 刘坦业

    2015-01-01

    Objective This paper aims at deepening the understanding of the secondary pulmonary tuberculosis mainly with pulmonary interstitial changes. Methods A case of secondary pulmonary tuberculosis mainly with pulmonary interstitial changes diagnosed in 2011 was reported and the related literatures were reviewed. The literature review was carried out respectively with “interstitial”,“pulmonary tuberculosis”as the search terms in Wanfang med online and PubMed database by May 2014. Results A case of 31 year-old female patient, who had been misdiagnosed as having chronic pharyngitis, chronic bronchitis and bronchial asthma, was admitted to the hospital because of cough production for 6 months, and aggravating with anhelation for 20 days. After admission, the chest computerized tomography showed extensive pulmonary interstitial changes, and blurred patchy shadow, part of ground-glass opacity. TBLB: granulomatous inflammation with focal necrosis, consider tuberculosis. The symptoms of cough and anhelation were disappeared after anti-tuberculosis treatment (HRZE), and the interstitial changes would also be absorbed. So far, there was no recurrence within 29 months follow-up. Thirteen related literatures were received in Wanfang Med Online, including one of case report, and the others were misdiagnosis analysis or computed tomography study;but no related literatures were received in Pubmed,which means there were no relevant reports overseas. Conclusion It is a special kind of secondary tuberculosis which mainly manifested interstitial changes tend to happen to young and middle-aged males, and has a subacute onset. The clinical symptoms were not typical, often manifested with cough, dyspnea and fever. The key to early diagnosis is chest CT. And 0n chest CT scan, interlobular thin reticulation、centrilobular lesions, pleural adhesions, tree-in-bud are the mainly manifested of the active interstitial TB. In the case of difficult diagnosis of diffuse lung disease, the key

  2. Otorhinolaryngological Manifestation of Tuberculosis

    Directory of Open Access Journals (Sweden)

    K.Akbar Khan, Nazir Ahmad Khan, Mohamad Maqbool

    2002-07-01

    Full Text Available The present study included 135 patients who presented to the ENT department of SHMS Hospital.Srinagar with tuberculosis ofear, nose and throat region. In addition 69 patients with pulmonary tuberculosiswho were registered and treated at chest disease hospital were also detected having tuberculosis ofthe ear nose and throat. The majority of the cases in the study consisted of cervical lymphadenopathy.(79.7%, tuberculous laryngitis (8.3%, tuberculosis ofcervical spine with associated retro pharyngealabscess (6.8%, tuberculosis of nose and middle ear (2.9.% and 1.96% respectively. Majority of thesepatients (44.1 % belonged to the lower socioeconomic status. Mantoux test was positive in 96% ofcases. Chest x-rays showed evidence of active or healed pulmonary tuberculosis in 28.9% cases. Theoverall diagnostic index oftubercular bacilli on microscopic examination and culture was 30%. Majorityofthe patients suffering from tuberculous cervicallymphadenits were diagnosed by fine needle aspirationcytology. Both subjective as well as objective improvement was noted with the anti-tuberculartherapy.

  3. Social Determinants of Pulmonary Tuberculosis in Families of Migrants participating in Mexico-Canada Seasonal Agricultural Workers Program: A Study in Guadalupe Zaragoza

    Directory of Open Access Journals (Sweden)

    Rodolfo Gines Martínez Fernández

    2010-04-01

    Full Text Available Objective: To analyze the social determinants of pulmonary tuberculosis in the families of migrant laborers registered in the Seasonal Agricultural Workers Program (SAWP and residing in Guadalupe Zaragoza Tlahuapan, Puebla, México. Methods: An exploratory cross-sectional study of the interaction between migration, social determinants, and pulmonary tuberculosis. Results: In this poor and patriarchal community, the SAWP offers financial opportunities for the men of Guadalupe Zaragoza. The remittances of these migrant workers have enabled their families to live in adequate housing, but their health situation is still vulnerable. Only half of the families have access to public health services or the special health programs for migrant worker families. 13% of migrant family members were infected with pulmonary tuberculosis as measured by the Quantiferon-TB test. The female partners of migrants typically do not study past elementary school, become housewives with no pay, are forced to take on added work in the household, and experience subjective symptoms of stress and fatigue. The children of Guadalupe Zaragoza are also vulnerable; the number of children in this community who can regularly attend school is below the national average because many children have to work. These families end up paying more for education, housing, and health services than the average Mexican family. Conclusions: In the families of SAWP migrant workers, the prevalence of latent pulmonary tuberculosis was found to be lower than the national average based on studies using the tuberculin test; this may be due to the greater specificity of the Quantiferon-TB Gold test. There is a significant risk of reactivation tuberculosis in these families due to the inequity in the social determinants of health.

  4. Treatment Delay for Patients With Pulmonary Tuberculosis in Poverty -stricken Areas%贫困地区肺结核病患者就诊延误分析

    Institute of Scientific and Technical Information of China (English)

    冯斌炜; 李侠采; 饶逾; 高晓凤

    2012-01-01

    Objective To understand the tendency of diagnostic delay of pulmonary tuberculosis in poverty -stricken areas. Method Fixed base and period on period growth were adopted for dynamic analysis on the data of pulmonary tuberculosis reported from two state -designated impoverished counties during 2001 -2009. Results From 2001 to 2009, the rates of tuberculosis treatment delay and dignostic delay of untreated pulmonary tuberculosis patients rose to a relatively stable level firstly and then showed a decreasing tendency. The average rates of treatment delay and dignostic delay were 86. 83% and 13. 4% respectively. Conclusion The treatment delay of pulmonary tuberculosis in poverty - stricken areas is serious, integrated measures should be taken.%目的 了解贫困地区肺结核患者就诊及诊断延误变化趋势.方法 以2001 - 2009年在西部2个国家级疾病县疾病控制中心登记的初治肺结核病患者为研究对象,采用定基比和环比增长速度进行动态分析,同期人口学资料来自南充市统计年鉴.结果 2001-2009年来,2个贫困县初治肺结核病患者就诊延误率及确诊延误率呈现出上升趋势后维持一个相对稳定的水平,然后再呈下降趋势,年均就诊延误率及确诊延误率分别为86.83%及13.4%.结论 贫困地区初治肺结核病患者存在较为严重的就诊延误现象,需采取措施.

  5. Non-HIV AIDS presenting with adrenal histoplasmosis and pulmonary tuberculosis: a mesmerising case report and discussion

    Directory of Open Access Journals (Sweden)

    Arnab Banerjee

    2015-09-01

    Full Text Available Non-HIV AIDS or idiopathic CD4 lymphocytopenia (ICL is an acquired immunodeficiency syndrome resulting in CD4 lymphopenia without any evidence of HIV infection or any other apparent cause of immunosuppression. A non-diabetic patient presented with adrenal histoplasmosis and UTI leading to adrenal failure. No immediate cause of immunosuppression was found, HIV, HTLV screening were negative. A CD4 count was done and the patient was found to be having non-HIV AIDS (idiopathic CD4 lymphocytopenia. He was treated and discharged. Few months later the patient presented again with adrenal failure and pulmonary tuberculosis. Adrenal FNAC showed persisting adrenal histoplasmosis. CD4 count found to be low again, but this time it was worse than the previous scenario. [Int J Res Med Sci 2015; 3(9.000: 2463-2467

  6. Blocking TNF in vitro with infliximab determines the inhibition of expansion and interferon gamma production of Vγ9/Vδ2 T lymphocytes from patients with active rheumatoid arthritis. A role in the susceptibility to tuberculosis?

    Directory of Open Access Journals (Sweden)

    A. Principato

    2011-06-01

    Full Text Available Biological therapeutic agents neutralising tumour necrosis factor (TNF are highly active in treating chronic inflammatory diseases, such as Crohn’s disease, rheumatoid arthritis, ankylosing spondylitis, uveitis, and psoriasis (1-3. From the beginning, side effects of TNF neutralisation - mostly infectious complications - were recognized, the most important being, however, pulmonary tuberculosis infections (4.

  7. Pancreatic and pulmonary mast cells activation during experimental acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Inmaculada; Lopez-Font; Sabrina; Gea-Sorlí; Enrique; de-Madaria; Luis; M; Gutiérrez; Miguel; Pérez-Mateo; Daniel; Closa

    2010-01-01

    AIM:To study the activation of pancreatic and pulmonary mast cells and the effect of mast cell inhibition on the activation of peritoneal and alveolar macrophages during acute pancreatitis.METHODS:Pancreatitis was induced by intraductal infusion of 5% sodium taurodeoxycholate in rats.The mast cell inhibitor cromolyn was administered intraperitoneally(i.p.) 30 min before pancreatitis induction.The pancreatic and pulmonary tissue damage was evaluated histologically and mast cells and their state of activation...

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

    Directory of Open Access Journals (Sweden)

    Selvakumar Subbian

    2016-02-01

    Conclusions: Adjunctive CC-11050 therapy significantly improves the response of rabbits with experimental pulmonary TB to INH treatment. We propose that CC-11050 may be a promising candidate for host directed therapy of patients with pulmonary TB, reducing the duration and improving clinical outcome of antibiotic treatment.

  9. National guidelines not always followed when diagnosing smear-negative pulmonary tuberculosis in patients with HIV in Botswana.

    Directory of Open Access Journals (Sweden)

    Taurayi A Tafuma

    Full Text Available BACKGROUND: Diagnosis of smear negative pulmonary tuberculosis (SNPTB is challenging, especially in patients with HIV. The Botswana National Tuberculosis Program (BNTP guidelines give guidance in diagnosing and treating SNPTB. Patients with chronic cough should be screened for TB by 3 sputum smear investigations. If negative, a chest x-ray (CXR should be performed. If negative for TB, antimicrobial treatment for other infections should be started. We investigated the clinicians' use of the guidelines in clinical practice. METHODS: Data regarding the medical history (coughing period, requested and conducted investigations concerning tuberculosis diagnosis (sputum smear or culture or CXR or alternative diagnoses (sputum microscopy or blood or sputum culture for diagnosis of other organisms, in SNPTB HIV-positive patients (outpatients and admitted patients from 2006-2009 in a district hospital in Botswana were extracted from all available hospital medical records. Additionally, a survey was done in all doctors diagnosing SNPTB in this hospital using a self-administered questionnaire with questions regarding the application of the BNTP guidelines in practice. Descriptive analyses of collected data were performed to test the compliance to the guidelines. RESULTS: Data from medical records showed that in 47.0% (132/281 of patients, TB treatment was started without microbiological results from sputum smears. Other methods to rule out or confirm PTB were used in 2.1% (6/281; and 99.6% (280/281 of SNPTB patients had received a CXR. The survey in 7 clinicians found that all always used CXR, and all clinicians requested three sputum results only sometimes. Six out of 7 clinicians started antibiotics before starting TB treatment. Reasons clinicians gave for difficulties in following the guidelines included inability of patients to produce sputum; and laboratory delays in releasing sputum results. CONCLUSION: Between 2006 and 2009 a high proportion of SNPTB

  10. Clnical Analyses of the 48 Cases of Pulmonary Tuberculosis Combined with Lung Cancer%肺结核合并肺癌48例临床分析

    Institute of Scientific and Technical Information of China (English)

    沈国斌; 李真斌

    2012-01-01

    Objective To observe the clinical characteristics and the relationship between pulmonary tu- berculosis and primar lung cancer. Methods The clinical data of 48 cases of pulmonary tuberculosis complicated with primary lung cancer were retrospectively analyzed. Results Twenty - eight cases of pulmonary tuberculosis complicat- ed with primary lung cancer were mainly the male, pulmonary tuberculosis, and primary lung cancer were found in the same side in 36 cases (75%), and the cell type of patients with prmary lung cancer mainly was the type of squamous cell carci- noma. Conclusion The pulmonary tuberculosismay could be concerned with the development of primary lung cancer partly. The atypical clinical appearance is liable to be misdiagnosed for the pulmonar tuberculosis complicated with lung cancer, so more attention should be paid to th at coexistence.%目的探讨肺结核并存肺癌的关系及I临床特点。方法回顾性分析48例肺结核合并肺癌患者的临床资料。结果肺结核合并肺癌男性病例多见占62.5%,两者并存同一肺者75%,以鳞癌为主。结论肺结核与肺癌有一定的因果关系,因临床表现不典型,致误诊率较高,故应高度警惕两者并存。

  11. Pulmonary Tuberculosis in a Young Pregnant Female: Challenges in Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Manogna Maddineni

    2008-01-01

    Full Text Available Background. With the world becoming a global village, tuberculosis is no longer limited to endemic areas. Our case emphasizes the impact of immigration on infectious disease epidemiology and challenges associated with diagnosis and treatment in pregnancy. Case. A 21-year-old Hispanic female presented in preterm labor and was found to be hypoxic. Chest X-ray revealed a paratracheal mass which a CT scan confirmed. PPD test was positive. Bronchoalveolar lavage did not reveal acid-fast bacilli and biopsy revealed caseating granulomas. Diagnosis and treatment were challenging due to constraints in radiological investigations, lack of initial evidence of acid-fast bacilli, and toxic profile of medications. Due to her high risk, she was started on antituberculosis regimen. The diagnosis was confirmed on Day 26 when Mycobacterium tuberculosis was isolated by DNA probe. Conclusion. A high index of suspicion is required to recognize the changing face and disease spectrum of tuberculosis and initiate treatment for better outcomes.

  12. 37例肺结核婴幼患儿临床分析%Clinical analysis of 37 cases with pulmonary tuberculosis in infant

    Institute of Scientific and Technical Information of China (English)

    王崇忠; 胥亚福

    2012-01-01

    目的 总结婴幼儿肺结核的临床特点.方法 对37例婴幼儿肺结核的结核接触史、临床表现、卡介苗接种情况、PPD试验结果、实验室检查、影像学特点进行回顾性分析.结果 37例患儿有结核接触史者22倒(59.4%),高原常住儿童37例(100%),卡介苗接种者3例(8.1%);发热34例(91.9%),有呼吸道症状者31倒(83.8%),有神经系统症状者7例(18.9%),CRP升高者23例(62.1%),血常规检查白细胞升高28例(75.7%),胸部CT检查异常者37例(100%),头部CT异常者5例(13.5%),头部MRI异常者6例(16.2%),PPD(+)者25倒(67.5%).最后诊断为原发性肺结核4倒(10.8%),血行播散型肺结核11例(29.7%),继发性肺结核22例(59.5%),并发结核性胸膜炎者5例(13.5%),并发结核性脑膜炎者9例(24.3%).结论 婴幼儿结核有一定的临床特点,临床医生应高度重视,作出早期诊断;同时应加强高原常住儿童的结核病防治工作,提高高原常住儿童的卡介苗接种率.%Objective To analyze the clinical features of pulmonary tuberculosis in infant. Methods The clinical features of 37 cases with pulmonary tuberculosis in infant were analyzed, including contact history with tuberculosis, clinical manifestation, including BCGvaccine. PPD test, laboratory examination and imaging. Results 22 cases (59. 4%) had contact history with tuberculosis, 37 cases(100%) were infant frequently reside in altiplano, 3 cases(8. l%)were found with BCG vaccine, 34 cases(91. 9%) were found with fever, 31 cases(83. 8%) with respiratory symptom, 7 cases (18.8%) with nerve system symptom, 23 cases(62.1%) with elevatory CRP, 28 cases(75.7%) with leucocytosis. Chest CT examination was performed in 37 cases and 37cases(100%) were abnormal, five cases(13. 5%) showed the signs of abnormal by CT on Head, six cases(16. 2%) showed the signs of abnormal by MRI on Head. 25 cases(67. 5%) were found with positive PPD test. Finally, 4 casesd(10. 8%) were diagnosed

  13. Value of immunodiagnostic techniques on diagnosis of pulmonary and extrapulmonary tuberculosis%免疫诊断技术在肺结核及肺外结核诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    程小星; 蒋静

    2011-01-01

    Serological diagnostic techniques and T-cell interferon gamma release assays (IGRAs)are main immunodiagnostic techniques for tuberculosis. Serological tests are simple and fast, however,they have low specificity and sensitivity in the diagnosis of tuberculosis. Based on cellular immune responses, IGRAs are important breakthrough of immunodiagnostic techniques for tuberculosis. The value of IGRAs in the diagnosis of latent tuberculosis infection has been widely recognized. The diagnostic specificity is 89% in IGRAs, which is significantly higher than that in tuberculin test. However,peripheral blood monouclear cell IGRAs could not be used to differentiate active tuberculosis, latent infection and previous infection, so the poor specificity of diagnosis of active tuberculosis is the main problem. Tuberculosis local immune cell IGRAs has better specificity and sensitivity in the diagnosis of pulmonary and extrapulmonary tuberculosis, so it is worth further study.%目前结核病免疫学诊断技术的研究热点是血清学诊断技术和基于细胞免疫反应的干扰素-γ释放试验.血清学诊断方法具有简单快速的优点,易于推广应用,是研究比较多的结核病诊断方法之一,但现有血清学试验试剂在结核病诊断的特异性和敏感性方面还有待提高.基于细胞免疫反应的干扰素-γ释放试验是结核免疫诊断技术的重要突破,在诊断结核潜伏感染中的价值已经得到广泛的认可,诊断的特异性可达89%,显著高于结核菌素试验.但基于外周血单个核细胞的干扰素-γ释放试验不能区分活动性肺结核、潜伏感染及以往感染,因此诊断活动性结核病的特异性差是其主要问题.基于结核病变局部免疫细胞的干扰素-γ释放试验在肺结核及肺外结核的诊断中具有更好的特异性和敏感性,值得进一步研究.

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

    DEFF Research Database (Denmark)

    Laub, Rasmus Rude; Sivapalan, Pradeesh; Wilcke, Torgny

    2015-01-01

    associated with M. tuberculosis cultures, we did an analysis of tests obtained by FOB and other invasive procedures (endoscopic ultrasound (EUS)-guided needle biopsy via the oesophagus or trachea and percutaneous needle lung biopsy (PNLB)). METHODS: All patients tested positive for M. tuberculosis by culture...... positive. Of the 57 patients, 40.3% (n = 23) presented with isolated upper lobe infiltrates and 29.8% (17) with cavitating infiltrates. Isolated chest lymphadenopathy was seen in 8.8% (n = 5). In 33.3% (n = 19) of the patients, radiography was not typical of TB (not upper lobe, no cavity, not isolated...

  15. Evaluation of a new commercial assay for diagnosis of pulmonary and nonpulmonary tuberculosis

    DEFF Research Database (Denmark)

    Johansen, I S; Thomsen, V Ø; Johansen, A;

    2002-01-01

    A new commercial assay for the diagnosis of tuberculosis, the BDProbeTec ET Direct Detection assay (Becton Dickinson, USA), was evaluated using 351 respiratory and 372 nonrespiratory specimens. The results were compared to detection of Mycobacterium tuberculosis complex (MTC) by conventional...... by reviewing the patients' histories, the specificity was 98.9%. The sensitivity was 98.5% in microscopy-positive specimens and 40.3% in microscopy-negative specimens. The overall inhibition rate was 0.3%. The BDProbeTec ET assay is a fast, effective, and user-friendly system that can be used for rapid...

  16. Interferon Gamma Release Assays in active Tuberculosis: new medical insights

    Directory of Open Access Journals (Sweden)

    Sandro Pierdomenico

    2011-09-01

    Full Text Available Since first presentation, Interferon γ Release Assays (IGRAs have had basic and wide application to LTBI, in accordance with international consensus and CDC recommendations, leaving their use in active TB to the field of study and research.We reviewed the results of 633 patients investigated from 2004 to 2008 targeting active TB, with the objective to highlight immunological data supporting test performances.We evaluated Quantiferon TB Gold (1st generation IGRA kit in association to Culture (MGIT 960 and Lowenstein Jensen and PCR (Probetec-ET having the positivity of culture plus clinical diagnosis as the standard true value to compare. QTB Gold was studied in 69 TB positive patients (42 pulmonary and 27 extra-pulmonary, with Sensitivity, Specificity, PPV and NPV average to 61.8%, 94.5%, 54.3% and 95.9% respectively, after indeterminate results discharging. Significant statistical differences didn’t emerge between pulmonary and extra-pulmonary infections (CI 95%.The overall indeterminate ratio arose up to 20.3% in patients with active TB vs 2.7% of global population (p<0.001. In 22% of patients with active pulmonary disease, IGRA conversed to positivity after 15 days in replicated tests, in spite of current treatment. 4 patients, with pulmonary TB and Quantiferon persistent negativities, underwent 18 months follow-up as not respondent although SIRE phenotypic susceptibilities and enough DOT compliance. Molecular DST documented hetero resistance for rpoB (MUT 1, MUT 3 plus wild lines and katG (MUT 1 plus wild in association to lack of inhA wild lines (Genotype MTBDR plus, Hain Lifescience. These reports suggest a mutational relationship between Rv3874 – 3875 cassette, encoding ESAT-6 / CFP-10, and rpoB, katG, inhA genes plausibly implying weak or absent selective clonal Th 1 activation to IGRA antigens. Our data seem to point out: 1 positive results are able to match true active TB in less than 50% of patients; 2 negative results could leave

  17. Activation of the Wnt Pathway by Mycobacterium tuberculosis: A Wnt–Wnt Situation

    Science.gov (United States)

    Villaseñor, Tomás; Madrid-Paulino, Edgardo; Maldonado-Bravo, Rafael; Urbán-Aragón, Antonio; Pérez-Martínez, Leonor; Pedraza-Alva, Gustavo

    2017-01-01

    Mycobacterium tuberculosis (M. tuberculosis), an intracellular pathogenic Gram-positive bacterium, is the cause of tuberculosis (TB), a major worldwide human infectious disease. The innate immune system is the first host defense against M. tuberculosis. The recognition of this pathogen is mediated by several classes of pattern recognition receptors expressed on the host innate immune cells, including Toll-like receptors, Nod-like receptors, and C-type lectin receptors like Dectin-1, the Mannose receptor, and DC-SIGN. M. tuberculosis interaction with any of these receptors activates multiple signaling pathways among which the protein kinase C, the MAPK, and the NFκB pathways have been widely studied. These pathways have been implicated in macrophage invasion, M. tuberculosis survival, and impaired immune response, thus promoting a successful infection and disease. Interestingly, the Wnt signaling pathway, classically regarded as a pathway involved in the control of cell proliferation, migration, and differentiation in embryonic development, has recently been involved in immunoregulatory mechanisms in infectious and inflammatory diseases, such as TB, sepsis, psoriasis, rheumatoid arthritis, and atherosclerosis. In this review, we present the current knowledge supporting a role for the Wnt signaling pathway during macrophage infection by M. tuberculosis and the regulation of the immune response against M. tuberculosis. Understanding the cross talk between different signaling pathways activated by M. tuberculosis will impact on the search for new therapeutic targets to fuel the rational design of drugs aimed to restore the immunological response against M. tuberculosis. PMID:28203237

  18. Cloning and expression of pab gene of M. tuberculosis isolated from pulmonary TB patient in E.coli DH5α

    Directory of Open Access Journals (Sweden)

    Tri Y. M. Raras

    2011-11-01

    Full Text Available Background: Mycobacterium tuberculosis antigen38 is a potent serodiagnostic agent containing two M. tuberculosisspecific B-cell epitopes. The high price of imported diagnostic agents hinders realization of fast clinical TB diagnosis in developing countries. Therefore, we produced recombinant antigen38 (recAg38M from M. tuberculosis local strain, which might be used to produce economical tuberculosis serodiagnostic kit.Methods: Pab gene that was isolated from pulmonary TB patient in Malang was cloned into a plasmid vector (pGEMTeasy to construct pMB38. The E.coli DH5α clone carrying pMb38 was selected on X-gal medium. The expression of pab was mediated using pPRoExHTc under the control of Trc promoter and E.coli DH5α as host.Results: Alignment of the pab sequence from the white E.coli DH5α clones with that of M. tuberculosis H37Rv showed 98% homology. The recombinant protein in which the signal peptide has been deleted to prevent the protein being secreted into medium was found in the cytoplasm.Conclusion: pab gene of M. tuberculosis isolated from a TB patient could be expressed in heterologous system in E.coliDH5α. (Med J Indones 2011; 20:247-54Keywords: Mycobacterium tuberculosis, Pab gene expression, recombinant antigen38

  19. Vitamin D accelerates clinical recovery from tuberculosis: results of the SUCCINCT Study [Supplementary Cholecalciferol in recovery from tuberculosis]. A randomized, placebo-controlled, clinical trial of vitamin D supplementation in patients with pulmonary tuberculosis’

    Directory of Open Access Journals (Sweden)

    Salahuddin Nawal

    2013-01-01

    Full Text Available Abstract Background Vitamin D enhances host protective immune responses to Mycobacterium tuberculosis by suppressing Interferon-gamma (IFN-g and reducing disease associated inflammation in the host. The objectives of this study were to determine whether vitamin D supplementation to patients with tuberculosis (TB could influence recovery. Methods Two hundred and fifty nine patients with pulmonary TB were randomized to receive either 600,000 IU of Intramuscular vitamin D3 or placebo for 2 doses. Assessments were performed at 4, 8 and 12 weeks. Early secreted and T cell activated 6 kDa (ESAT6 and Mycobacterium tuberculosis sonicate (MTBs antigen induced whole blood stimulated IFN-g responses were measured at 0 and 12 weeks. Statistical comparisons between outcome variables at 0 and 12 weeks were performed using Student’s t-test and Chi2 tests. Results After 12 weeks, the vitamin D supplemented arm demonstrated significantly greater mean weight gain (kg + 3.75, (3.16 – 4.34 versus + 2.61 (95% CI 1.99 – 3.23 p 0.009 and lesser residual disease by chest radiograph; number of zones involved 1.35 v/s 1.82 p 0.004 (95% CI 0.15, 0.79 and 50% or greater reduction in cavity size 106 (89.8% v/s 111 (94.8%, p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline ‘Deficient’ 25-hydroxyvitamin D serum levels (p 0.021. Conclusions Supplementation with high doses of vitamin D accelerated clinical, radiographic improvement in all TB patients and increased host immune activation in patients with baseline ‘Deficient’ serum vitamin D levels. These results suggest a therapeutic role for vitamin D in the treatment of TB. Trial registration ClinicalTrials.gov; No. NCT01130311; URL: clinicaltrials.gov

  20. Mycobacterium Szulgai Pulmonary Infection: Case Report of an Uncommon Pathogen in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Jae; Lee, Jae Chun; Jeong, Sun Young [Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2014-10-15

    Mycobacterium szulgai (M. szulgai) is an unusual pathogen in a human non-tuberculous mycobacterial infection. Pulmonary infection due to M. szulgai may be clinically and radiologically confused with active pulmonary tuberculosis. In contrast to other non-tuberculous mycobacteria, M. szulgai infection is well controlled by combination antimycobacterial therapy. Most of the previously reported cases of M. szulgai pulmonary infection showed cavitary upper lobe infiltrates. We herein describe a case of pulmonary M. szulgai infection that shows clinical and radiological presentations similar to active pulmonary tuberculosis.

  1. Nutritional status of adult patients with pulmonary tuberculosis in rural central India and its association with mortality.

    Science.gov (United States)

    Bhargava, Anurag; Chatterjee, Madhuri; Jain, Yogesh; Chatterjee, Biswaroop; Kataria, Anju; Bhargava, Madhavi; Kataria, Raman; D'Souza, Ravi; Jain, Rachna; Benedetti, Andrea; Pai, Madhukar; Menzies, Dick

    2013-01-01

    Under-nutrition is a known risk factor for TB and can adversely affect treatment outcomes. However, data from India are sparse, despite the high burden of TB as well as malnutrition in India. We assessed the nutritional status at the time of diagnosis and completion of therapy, and its association with deaths during TB treatment, in a consecutive cohort of 1695 adult patients with pulmonary tuberculosis in rural India during 2004 - 2009.Multivariable logistic regression was used to obtain adjusted estimates of the association of nutritional status with deaths during treatment. At the time of diagnosis, median BMI and body weights were 16.0 kg/m(2)and 42.1 kg in men, and 15.0 kg/m(2)and 34.1 kg in women, indicating that 80% of women and 67% of men had moderate to severe under-nutrition (BMInutrition. Half of women and one third of men remained moderately to severely underweight at the end of treatment. 60 deaths occurred in 1179 patients (5%) in whom treatment was initiated. Severe under-nutrition at diagnosis was associated with a 2 fold higher risk of death. Overall, a majority of patients had evidence of chronic severe under-nutrition at diagnosis, which persisted even after successful treatment in a significant proportion of them. These findings suggest the need for nutritional support during treatment of pulmonary TB in this rural population.

  2. [Pulmonary tuberculosis among residents of municipalities in Mato Grosso do Sul State, Brazil, bordering on Paraguay and Bolivia].

    Science.gov (United States)

    Marques, Marli; Ruffino-Netto, Antonio; Marques, Ana Maria Campos; Andrade, Sonia Maria Oliveira de; Silva, Baldomero Antonio Kato da; Pontes, Elenir Rose Jardim Cury

    2014-12-01

    This study analyzed the epidemiological profile of pulmonary tuberculosis from 2007 to 2010 in municipalities (counties) in Mato Grosso do Sul State, Brazil, that border on Paraguay and Bolivia. In the border region, the incidence rate (49.1/100,000 inhabitants), mortality rate (4.0/100,000 inhabitants), and treatment dropout rate (11.3%) were 1.6, 1.8, and 1.5 times higher than in the non-border region. Among indigenous individuals in the border region, the rates for incidence (253.4/100,000 inhabitants), mortality (11.6/100,000 inhabitants), and HIV/TB co-infection (1.9/100,000 inhabitants) were 6.4, 3.2, and 1.9 times higher than in non-indigenous individuals in this region. Living in the border regions was inversely associated with HIV/TB co-infection. Indigenous ethnicity was associated statistically with not abandoning TB treatment. The study concludes that the population residing in these municipalities along the border is exposed to high risk of pulmonary TB and TB mortality and treatment dropout, thus requiring special health surveillance interventions.

  3. CD4 lymphocyte dynamics in Tanzanian pulmonary tuberculosis patients with and without HIV co-infection

    DEFF Research Database (Denmark)

    Andersen, Aase; Range, Nyagosya S; Changalucha, John

    2012-01-01

    ABSTRACT: BACKGROUND: The interaction of HIV and tuberculosis (TB) on CD4 levels over time has previously been divergently reported and only in small study populations with short or no follow-up. METHODS: CD4 counts were assessed from time of diagnosis till the end of TB treatment in a cohort of ...

  4. Pneumocystis carinii pneumonia, pulmonary tuberculosis and visceral leishmaniasis in an adult HIV negative patient

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Toledo Jr.

    2001-06-01

    Full Text Available This is a case report of a 29 year old male with pneumocystis pneumonia and tuberculosis, and who was initially suspected of having HIV infection, based on risk factor analyses, but was subsequently shown to be HIV negative. The patient arrived at the hospital with fever, cough, weight loss, loss of appetite, pallor, and arthralgia. In addition, he was jaundiced and had cervical lymphadenopathy and mild heptosplenomegaly. He had interstitial infiltrates of the lung, sputum smears positive for Mycobacterium tuberculosis and Pneumocystis carinii, and stool tests were positive for Strongyloides stercoralis and Schistosoma mansoni. He was diagnosed as having AIDS, and was treated for tuberculosis, pneumocystosis, and strongyloidiasis with a good response. The patient did not receive anti-retroviral therapy, pending outcome of the HIV tests. A month later, he was re-examined and found to have worsening hepatosplenomegaly, pancytopenia, fever, and continued weight loss. At this time, it was determined that his HIV ELISA antibody tests were negative. A bone marrow aspirate was done and revealed amastigotes of leishmania, and a bone marrow culture was positive for Leishmania species. He was treated with pentavalent antimony, 20 mg daily for 20 days, with complete remission of symptoms and weight gain. This case demonstrates that immunosuppression from leishmaniasis and tuberculosis may lead to pneumocystosis, and be misdiagnosed as HIV infection. The occurrence of opportunistic infections in severely ill patients without HIV must always be considered and alternate causes of immunosuppression sought.

  5. Early Diagnosis of Nosocomial Infection Caused by Pulmonary Tuberculosis in Patients with Diabetes Mellitus%唐尿病患者医院感染肺结核的早期诊断指标分析

    Institute of Scientific and Technical Information of China (English)

    张常然; 牛媛媛; 黄知敏; 林建聪; 谭清华; 邢艳利; 李延兵; 刘霞; 李鸣

    2009-01-01

    目的 减少肺结核的医院感染,研究有助于糖尿病合并活动型肺结核的早期诊断指标.方法 回顾分析某三甲医院内分泌科10年糖尿病合并活动型和非活动型肺结核316例患者的临床资料.结果 活动型和非活动型肺结核组的平均年龄分别为(55.01±12.77)岁和(61.92±11.18)岁;非活动型肺结核多有肺结核病史(22.6%),明显多于活动型肺结核组患者(13.4%)(P<0.05);活动型和非活动型肺结核患者咳嗽、咳痰症状、痰涂片找分枝杆菌的阳性率分别为48.4%、80.0%,25.2%、10.0%;活动型和非活动型肺结核组的糖化血红蛋白(GHBA1c)、C肽、空腹血糖分别为(10.74±2.95)%、(0.56±0.38)nmol/L、(13.11±5.63)mmol/L、(8.68±2.08)%、(0.66±0.48)nmol/L、(10.33±9.41)mmol/L,上述指标两组相比,差异均有统计学意义(P<0.05).结论 出现咳嗽、咳痰症状、痰涂片找分枝杆菌、无明显诱因的血糖控制差等指标有助于糖尿病合并活动型肺结核的早期诊断,尽早检查这些指标,及时隔离,可减少肺结核的医院感染.%OBJECTIVE To reduce the nosocomial infection caused by Mycobacterium tuberculosis in patients with diabetes mellitus, and study the some characteristics for early diagnosis of nosocomial infection. METHODS The clinical data of a total of 316 diabetes mellitus patients with pulmonary tuberculosis from Jan 1998 to Dec 2007 were made a retrospectively investigation. RESULTS The age was (55.01±12.77) and (61.92±11.18) years old in the patients with active and inactive pulmonary tuberculosis, respectively. The pulmonary tuberculosis history was more frequent in the patients with inactive pulmonary tuberculosis (22.6%) than those with active one (13.4%). There was significant difference for pulmonary tuberculosis history between two groups(P<0.05). The frequency of cough with profuse sputum and the sputum positive rate with M. tuberculosis were 48.4% and 80.0% vs 25.2% and 10.0% between two groups

  6. Pulmonary granulomatous diseases and pulmonary manifestations of systemic granulomatous disease. Including tuberculosis and nontuberculous mycobacteriosis; Pulmonale granulomatoese Erkrankungen und pulmonale Manifestationen systemischer Granulomatosen. Inklusive Tuberkulose und nichttuberkuloese Mykobakteriosen

    Energy Technology Data Exchange (ETDEWEB)

    Piel, S. [Universitaet Heidelberg, Zentrum fuer interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik, Heidelberg (Germany); Kreuter, M.; Herth, F. [Universitaet Heidelberg, Zentrum fuer interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Kauczor, H.U. [Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Heussel, C.P. [Universitaet Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany)

    2016-10-15

    Granulomas as signs of specific inflammation of the lungs are found in various diseases with pulmonary manifestations and represent an important imaging finding. The standard imaging modality for the work-up of granulomatous diseases of the lungs is most often thin-slice computed tomography (CT). There are a few instances, e. g. tuberculosis, sarcoidosis and silicosis, where a chest radiograph still plays an important role. Further radiological modalities are usually not needed in the routine work-up of granulomatous diseases of the chest. In special cases magnetic resonance imaging (MRI) and positron emission tomography (PET)-CT scans play an important role, e. g. detecting cardiac sarcoidosis by cardiac MRI or choline C-11 PET-CT in diagnosing lung carcinoma in scar tissue after tuberculosis. The accuracy of thin-slice CT is very high for granulomatous diseases. In cases of chronic disease and fibrotic interstitial lung disease it is important to perform thin-slice CT in order to diagnose a specific disease pattern. Thin-slice CT is also highly sensitive in detecting disease complications and comorbidities, such as malignancies. Given these indications thin-slice CT is generally accepted in the routine daily practice. A thin-slice CT and an interdisciplinary discussion are recommended in many cases with a suspected diagnosis of pulmonary granulomatous disease due to clinical or radiographic findings. (orig.) [German] Granulome als Zeichen der spezifischen Entzuendung im Lungengewebe treten bei zahlreichen Erkrankungen mit pulmonaler Manifestation auf und stellen einen wichtigen Befund in der Bildgebung dar. Das radiologische Standardverfahren bei pulmonalen Granulomatosen ist meistens die Duennschichtcomputertomographie, in wenigen Faellen, wie z. B. bei Tuberkulose, Sarkoidose und Silikose, spielt die Roentgenthoraxuebersicht immer noch eine wichtige Rolle. Bei der Standardabklaerung der meisten Granulomatosen ist die Hinzunahme weiterer Verfahren nicht

  7. Improving tuberculosis diagnostics with biomarkers

    Directory of Open Access Journals (Sweden)

    Shu CC

    2015-05-01

    Full Text Available Chin-Chung Shu,1,2 Jann-Yuan Wang,2 Li-Na Lee,2,3 Chong-Jen Yu,2 Kwen-Tay Luh3 1Department of Traumatology, 2Department of Internal Medicine, 3Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan Abstract: Although many laboratory methods have been developed to expedite the diagnosis of active tuberculosis (TB and Mycobacterium tuberculosis (Mtb infection, delays in diagnosis remain a major problem in clinical practice. Biomarkers may contribute favorably or unfavorably to TB diagnosis in a clinical suspect TB case with inconclusive diagnostic findings. A good understanding of the effectiveness and practical limitations of these biomarkers is important to improve diagnosis. This review summarizes currently used biomarkers, mainly as validation, and focuses on latent TB infection, active pulmonary TB, and tuberculous pleural effusion. Keywords: tuberculosis, biomarker, diagnosis, latent tuberculosis infection, pleural effusion 

  8. Fatores associados à tuberculose pulmonar em pacientes que procuraram serviços de saúde de referência para tuberculose Factors associated with pulmonary tuberculosis among patients seeking medical attention at referral clinics for tuberculosis

    Directory of Open Access Journals (Sweden)

    Cid Carlos Soares de Alcântara

    2012-10-01

    Full Text Available OBJETIVO: A identificação de fatores comportamentais e clínicos associados à tuberculose pulmonar pode melhorar a detecção e o tratamento dessa doença, consequentemente reduzindo sua duração e transmissão. Nosso objetivo foi identificar fatores sociodemográficos, clínicos e comportamentais associados à tuberculose pulmonar. MÉTODOS: Estudo transversal realizado entre abril de 2008 e março de 2009 em três unidades de saúde na cidade de Fortaleza (CE. Foram selecionados 233 pacientes maiores de 14 anos que procuraram atendimento médico espontaneamente e que apresentavam tosse por > 2 semanas. Foram coletados dados sociodemográficos, clínicos e comportamentais. Foram realizadas baciloscopia direta para BAAR e cultura de micobactérias, bem como testes tuberculínicos e radiografias de tórax. Os pacientes foram divididos em dois grupos (com e sem tuberculose pulmonar. As variáveis categóricas foram comparadas com o teste do qui-quadrado, seguido de análise de regressão logística quando as variáveis foram consideradas significativas. RESULTADOS: A prevalência de tuberculose pulmonar foi 41,2%. As OR não ajustadas indicaram que as seguintes variáveis foram fatores de risco significativos para tuberculose pulmonar: febre (OR = 2,39; IC95%: 1,34-4,30, anorexia (OR = 3,69; IC95%: 2,03-6,75 e perda de peso (OR = 3,37; IC95%: 1,76-6,62. Na análise multivariada, apenas perda de peso (OR = 3,31; IC95%: 1,78-6,14 associou-se significativamente com tuberculose pulmonar. CONCLUSÕES: Em áreas com elevada prevalência de tuberculose, a perda de peso poderia ser utilizada como um indicador de tuberculose pulmonar em pacientes com tosse crônica por > 2 semanas.OBJECTIVE: The identification of behavioral and clinical factors that are associated with pulmonary tuberculosis might improve the detection and treatment of the disease, thereby reducing its duration and transmission. Our objective was to identify sociodemographic, clinical

  9. Profound peripheral T-lymphocyte depletion and activation in disseminated tuberculosis

    Directory of Open Access Journals (Sweden)

    Denise Silva Rodrigues

    2006-02-01

    Full Text Available Three HIV-1-seronegative patients with disseminated tuberculosis presented significant depletion of T-cell counts, in CD4+ and/or CD8+ cells, associated with increased expression of activation marker CD38 on CD8+ T-lymphocytes. This finding raises the question of potential mechanisms involved in the activation or loss of T-cells in disseminated tuberculosis.

  10. 38 CFR 3.374 - Effect of diagnosis of active tuberculosis.

    Science.gov (United States)

    2010-07-01

    ... Considerations Relative to Specific Diseases § 3.374 Effect of diagnosis of active tuberculosis. (a) Service... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Effect of diagnosis of active tuberculosis. 3.374 Section 3.374 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF...

  11. DC-SIGN (CD209), pentraxin 3 and vitamin D receptor gene variants associate with pulmonary tuberculosis risk in West Africans

    DEFF Research Database (Denmark)

    Olesen, R; Wejse, C; Velez, D R;

    2007-01-01

    We investigated the role of DC-SIGN (CD209), long pentraxin 3 (PTX3) and vitamin D receptor (VDR) gene single nucleotide polymorphisms (SNPs) in susceptibility to pulmonary tuberculosis (TB) in 321 TB cases and 347 healthy controls from Guinea-Bissau. Five additional, functionally relevant SNPs...... within toll-like receptors (TLRs) 2, 4 and 9 were typed but found, when polymorphic, not to affect host vulnerability to pulmonary TB. We did not replicate an association between SNPs in the DC-SIGN promoter and TB. However, we found that two polymorphisms, one in DC-SIGN and one in VDR, were associated...

  12. The Impact of Coexisting Asthma, Chronic Obstructive Pulmonary Disease and Tuberculosis on Survival in Patients with Lung Squamous Cell Carcinoma.

    Directory of Open Access Journals (Sweden)

    Jing-Yang Huang

    Full Text Available Pulmonary diseases [asthma, chronic obstructive pulmonary disease (COPD, and tuberculosis (TB] are associated with lung cancer mortality. However, the relationship between coexisting pulmonary diseases and survival in patients with lung squamous cell carcinoma (SqCC has not been well defined.Patients newly diagnosed with SqCC between 2003 and 2008 were identified by linking the National Health Insurance Research Database and Taiwan Cancer Registry Database. Cases with SqCC were followed up until death, loss to follow-up, or study end in 2010. Information on health status, date of death and the main causes of death was ascertained from the National Death Registry Database. Cox proportional hazard regression was used to calculate the hazard ratio (HR of coexisting asthma, COPD and/or TB.During the study period, a total of 5406 cases with SqCC were enrolled. For all cause-mortality, HRs were 1.08 [95% confidence interval (CI, 0.99-1.18], 1.04 (95% CI, 0.97-1.12, and 1.14 (95% CI, 1.00-1.31 for individuals with asthma, COPD, and TB, respectively. Specifically, among men with coexisting pulmonary diseases, the HRs were 1.56 (95% CI, 1.23-1.97 and 1.11 (95% CI, 1.00-1.24 for individuals with asthma+COPD+TB and asthma+COPD, respectively. Among male patients with stage III SqCC, HRs were 3.41 (95%CI, 1.27-9.17 and 1.65 (95%CI, 1.10-2.47 for individuals with asthma+TB and asthma+COPD+TB, respectively. Among male patients with stage IV SqCC, HRs were 1.40 (95%CI, 1.00-1.97 and 1.25 (95%CI, 1.03-1.52 for individuals with asthma+ COPD+TB and asthma. Among female patients with stage I and II, HR was 0.19 (95%CI, 005-0.77 for individuals with asthma.Coexisting pulmonary diseases increased the risk of mortality from SqCC in male patients. For female patients with early stage SqCC, pre-existing asthma decreased mortality. These patients deserve greater attention while undergoing cancer treatment.

  13. High prevalence of pulmonary tuberculosis but low sensitivity of symptom screening among HIV-infected pregnant women in South Africa.

    Directory of Open Access Journals (Sweden)

    Christopher J Hoffmann

    Full Text Available Symptom screening is a recommended component of intensified case-finding (ICF for pulmonary tuberculosis (TB among HIV-infected individuals. Symptomatic individuals are further investigated to either exclude or diagnose pulmonary TB, thus reducing the number of individuals requiring costly laboratory investigation. Those with laboratory evaluations negative for pulmonary TB or who lack symptoms may be eligible for antiretroviral therapy (ART and/or TB isoniazid preventive therapy (IPT. A four-part symptom screen has been recommended by the World Health Organization (WHO for identifying TB suspects and those unlikely to have TB. A meta-analysis of studies among HIV-infected individuals calculated a sensitivity of 90.1% for the four-part symptoms screen--of any of cough, fever, night sweats, or weight loss--among patients in clinical care, making it an effective tool for identifying most patients with TB. An important population for intensified case-finding not included in that meta-analysis was HIV-infected pregnant women. We undertook a cross-sectional survey among HIV-infected pregnant women receiving prenatal care at community clinics in South Africa. We obtained a four-symptom review and sputum smear microscopy and mycobacterial culture on all participants. Among 1415 women, 226 (16% had a positive symptom screen, and 35 (2.5% were newly diagnosed with culture-positive TB. Twelve were on TB treatment at the time of screening, yielding 47 (3.3% women with prevalent TB. Symptom screening among women without known TB had a sensitivity of 28% and specificity of 84%. The poor performance of symptom screening to identify women with TB suggests that other approaches may be needed for intensified case-finding to be effective for this population.

  14. 51例肺结核合并肺癌临床分析%Clinical Analysis of 51 Cases With Pulmonary Tuberculosis Complicated With Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    李成会

    2015-01-01

    Objective To study the clinical features of pulmonary tuberculosis complicated with lung cancer, to encourage early diagnosis and treatment, and avoid misdiagnosis and wrong diagnosis. Methods From 2011 March to 2014 May, 51 cases with pulmonary tuberculosis complicated with lung cancerwere were selected in Liaoyang city tuberculosis hospital, a retrospective analysis of clinical characteristics and clinical manifestation of the disease were carried. Results The main clinical manifestations of pulmonary tuberculosis with lung cancer were cough, expectoration, hemoptysis, chest tightness, chest pain, weight loss, fever and so on. Pulmonary tuberculosis was mainly the invasion type, and lung cancer was mainly adenocarcinoma and squamous cell carcinoma. The male patients amount was more than female, the mean age was (55.9+5.3) years old. Conclusion Pulmonary tuberculosis with lung cancer mainly occured in middle-aged men, no obvious speciifcity in clinical manifestations, X-ray examination, and clinical attention should be further examination to conifrm the diagnosis, to avoid misdiagnosis and delayed treatment.%目的:探讨肺结核合并肺癌的临床特征,以便早日确诊治疗,避免误诊、漏诊。方法选取2011年3月~2014年5月于本院进行治疗的51例肺结核合并肺癌患者,回顾性分析患者的临床特点、临床表现等。结果肺结核合并肺癌的主要临床表现为咳嗽、咳痰、咳血、胸闷、胸痛、消瘦、低热等;肺结核以侵润型为主,肺癌以腺癌和鳞癌为主;男性多于女性,平均年龄为(55.9±5.3)岁。结论肺结核合并肺癌好发于中年男性,在临床表现、X线检查等方面无明显特异性,临床应注意进一步检查以明确诊断,以免误诊延误治疗。

  15. 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.

  16. A comparative study of itraconazole in various dose schedules in the treatment of pulmonary aspergilloma in treated patients of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Prahlad Rai Gupta

    2015-01-01

    Full Text Available Introduction: The optimal dose, duration, and efficacy of itraconazole in Indian patients of pulmonary aspergilloma (PA are not clearly defined. Therefore, a study was carried out, to resolve these issues in diagnosed cases of PA complicating old treated patients of pulmonary tuberculosis. Materials and Methods: The study patients randomly received itraconazole either in a fixed dose schedule of 200 mg (group I, 200 mg twice daily (group II or a variable dose schedule (group III, for 12 months. All the patients were followed up for the entire duration of the study for clinical, radiological, and immunological response. The side effects were recorded as and when reported by the patients and managed symptomatically. Results: A total of 60 patients were enrolled, 20, in each group. There were no intergroup differences with regard to age, sex, body weight, smoking status, alcohol intake, symptoms, Potassium hydroxide (KOH mount, fungal culture, pattern of radiological lesions or anti-aspergillus antibodies (anti-Asp-Ab titers. The radiological response was poor in group I patients, as compared to the other groups, at two months (P < 0.05. The dose of itraconazole was increased in five of the patients in group I due to poor response. A higher number of group II patients suffered side effects and the dose of itraconazole had to be decreased in three of these patients, but none of the patients on a variable dose schedule required a change in dose schedule. Conclusion: Thus, a weight-based variable dose schedule of itraconazole was found to be a more effective and safer modality in the management of PA than a fixed dose schedule.

  17. Mycobacterium tuberculosis lipolytic enzymes as potential biomarkers for the diagnosis of active tuberculosis.

    Directory of Open Access Journals (Sweden)

    Belinda Brust

    Full Text Available BACKGROUND: New diagnosis tests are urgently needed to address the global tuberculosis (TB burden and to improve control programs especially in resource-limited settings. An effective in vitro diagnostic of TB based on serological methods would be regarded as an attractive progress because immunoassays are simple, rapid, inexpensive, and may offer the possibility to detect cases missed by standard sputum smear microscopy. However, currently available serology tests for TB are highly variable in sensitivity and specificity. Lipolytic enzymes have recently emerged as key factors in lipid metabolization during dormancy and/or exit of the non-replicating growth phase, a prerequisite step of TB reactivation. The focus of this study was to analyze and compare the potential of four Mycobacterium tuberculosis lipolytic enzymes (LipY, Rv0183, Rv1984c and Rv3452 as new markers in the serodiagnosis of active TB. METHODS: Recombinant proteins were produced and used in optimized ELISA aimed to detect IgG and IgM serum antibodies against the four lipolytic enzymes. The capacity of the assays to identify infection was evaluated in patients with either active TB or latent TB and compared with two distinct control groups consisting of BCG-vaccinated blood donors and hospitalized non-TB individuals. RESULTS: A robust humoral response was detected in patients with active TB whereas antibodies against lipolytic enzymes were infrequently detected in either uninfected groups or in subjects with latent infection. High specifity levels, ranging from 93.9% to 97.5%, were obtained for all four antigens with sensitivity values ranging from 73.4% to 90.5%, with Rv3452 displaying the highest performances. Patients with active TB usually exhibited strong IgG responses but poor IgM responses. CONCLUSION: These results clearly indicate that the lipolytic enzymes tested are strongly immunogenic allowing to distinguish active from latent TB infections. They appear as potent

  18. The impact of HIV infection and CD4 cell count on the performance of an interferon gamma release assay in patients with pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Martine G Aabye

    Full Text Available BACKGROUND: The performance of the tuberculosis specific Interferon Gamma Release Assays (IGRAs has not been sufficiently documented in tuberculosis- and HIV-endemic settings. This study evaluated the sensitivity of the QuantiFERON TB-Gold In-Tube (QFT-IT in patients with culture confirmed pulmonary tuberculosis (PTB in a TB- and HIV-endemic population and the effect of HIV-infection and CD4 cell count on test performance. METHODOLOGY/PRINCIPAL FINDINGS: 161 patients with sputum culture confirmed PTB were subjected to HIV- and QFT-IT testing and measurement of CD4 cell count. The QFT-IT was positive in 74% (119/161; 95% CI: 67-81%. Sensitivity was higher in HIV-negative (75/93 than in HIV-positive (44/68 patients (81% vs. 65%, p = 0.02 and increased with CD4 cell count in HIV-positive patients (test for trend p = 0.03. 23 patients (14% had an indeterminate result and this proportion decreased with increasing CD4 cell count in HIV-positive patients (test for trend p = 0.03. Low CD4 cell count (<300 cells/microl did not account for all QFT-IT indeterminate nor all negative results. Sensitivity when excluding indeterminate results was 86% (95% CI: 81-92% and did not differ between HIV-negative and HIV-positive patients (88 vs. 83%, p = 0.39. CONCLUSIONS/SIGNIFICANCE: Sensitivity of the QFT-IT for diagnosing active PTB infection was reasonable when excluding indeterminate results and in HIV-negative patients. However, since the test missed more than 10% of patients, its potential as a rule-out test for active TB disease is limited. Furthermore, test performance is impaired by low CD4 cell count in HIV-positive patients and possibly by other factors as well in both HIV-positive and HIV-negative patients. This might limit the potential of the test in populations where HIV-infection is prevalent.

  19. In Vivo Molecular Dissection of the Effects of HIV-1 in Active Tuberculosis.

    Directory of Open Access Journals (Sweden)

    Lucy C K Bell

    2016-03-01

    Full Text Available Increased risk of tuberculosis (TB associated with HIV-1 infection is primarily attributed to deficient T helper (Th1 immune responses, but most people with active TB have robust Th1 responses, indicating that these are not sufficient to protect against disease. Recent findings suggest that favourable outcomes following Mycobacterium tuberculosis infection arise from finely balanced inflammatory and regulatory pathways, achieving pathogen control without immunopathology. We hypothesised that HIV-1 and antiretroviral therapy (ART exert widespread changes to cell mediated immunity, which may compromise the optimal host protective response to TB and provide novel insights into the correlates of immune protection and pathogenesis. We sought to define these effects in patients with active TB by transcriptional profiling of tuberculin skin tests (TST to make comprehensive molecular level assessments of in vivo human immune responses at the site of a standardised mycobacterial challenge. We showed that the TST transcriptome accurately reflects the molecular pathology at the site of human pulmonary TB, and used this approach to investigate immune dysregulation in HIV-1/TB co-infected patients with distinct clinical phenotypes associated with TST reactivity or anergy and unmasking TB immune reconstitution inflammatory syndrome (IRIS after initiation of ART. HIV-1 infected patients with positive TSTs exhibited preserved Th1 responses but deficient immunoregulatory IL10-inducible responses. Those with clinically negative TSTs revealed profound anergy of innate as well as adaptive immune responses, except for preservation of type 1 interferon activity, implicated in impaired anti-mycobacterial immunity. Patients with unmasking TB IRIS showed recovery of Th1 immunity to normal levels, but exaggerated Th2-associated responses specifically. These mechanisms of immune dysregulation were localised to the tissue microenvironment and not evident in peripheral

  20. Latent and Active Tuberculosis Infection Increase Immune Activation in Individuals Co-Infected with HIV

    Directory of Open Access Journals (Sweden)

    Zuri A. Sullivan

    2015-04-01

    Significance: Latent tuberculosis, which affects an estimated 1/3 of the world's population, has long been thought to be a relatively benign, quiescent state of M. tuberculosis infection. While HIV co-infection is known to exacerbate M. tuberculosis infection and increase the risk of developing active TB, little is known about the potential effect of latent TB infection on HIV disease. This study shows that HIV-infected individuals with both active and latent TB have elevated levels of inflammation and immune activation, biomarkers of HIV disease progression and elevated risk of mortality. These results suggest that, in the context of HIV, latent TB infection may be associated with increased risk of progression to AIDS and mortality.

  1. Evaluation of Biphasic Culture System for Mycobacterial Isolation from the Sputum of Patients with Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ghatole M

    2005-01-01

    Full Text Available Mycobacterial diseases continue to cause high morbidity and mortality. Isolation, identification and sensitivity testing form the backbone of laboratory investigations. M. tuberculosis isolation needs 6-8 weeks on conventional egg containing media. For rapid isolation various methods have been evaluated. We evaluated biphasic system (Middlebrook 7H11 agar slant + Middlebrook 9H broth in comparison with Lowenstein - Jensen (LJ medium. In smear positive cases biphasic system showed the recovery rate of 97.05% as against 79.41% on LJ on incubation for 21± 4.44 and 28±3.76 days respectively. In smear negative and culture positive cases biphasic system and LJ showed isolation rates of 91.66% and 66.6% after 36±3.44 and 41± 4.09 days respectively. Biphasic system showed lower contamination rate (1.33%. Biphasic medium is superior to LJ medium in isolation of M. tuberculosis .

  2. Pulmonary tuberculosis in Romania at the dawn of the millennium--a major public health issue.

    Science.gov (United States)

    Marica, C

    2009-01-01

    TB incidence in our country is still quite high compared to the average of the European Union countries (1st place among EU countries and 3rd place among WHO European Region countries), which means that a national coordinated response against this disease needs to become the priority of the current health care policy. The multi-factorial conditioning, which includes the social and economic dimensions of TB spreading, requires a multi-disciplinary and inter-sectorial approach to this pathology, going beyond healthcare services. The National Tuberculosis Control Strategy is a part of Romania's Country Strategy based on the guidelines set out in WHO's 2006-2015 Global Plan to Stop Tuberculosis (MDGs 2015) and it provides the necessary framework for refining and harmonizing the national legislation and regulations with the European laws after Romania's integration in the EU.

  3. Evaluation of the diagnostic value of measuring IgG, IgM, and IgA antibodies to mycobacterial A60 antigen in active tuberculosis.

    Science.gov (United States)

    Ben-selma, Walid; Harizi, Hedi; Marzouk, Manel; Ben Kahla, Imen; Ben Lazreg, Foued; Ferjeni, Asma; Boukadida, Jalel

    2010-09-01

    The purpose of the present study was to evaluate the clinical usefulness of detection of serum immunoglobulin A (IgA), IgG, and IgM antibodies raised against the mycobacterial A60 antigen for the diagnosis and discrimination of active tuberculosis (TB) from other pulmonary diseases. Three commercially available ELISA kits (IgA, IgG, and IgM) (ANDA Biologicals, Strasbourg, France) were evaluated simultaneously in 246 serum samples from 3 groups of patients: group I, 171 patients with active TB (128 pulmonary TB and 43 extrapulmonary TB); group II, 73 patients with pulmonary non-TB diseases; and group III, 2 leprosies patients. The sensitivities of tests ranged from 31.3% (IgA) to 94% (IgG) in pulmonary TB patients and from 21% (IgA) to 84% (IgG) in extrapulmonary TB patients. The specificities of assays varied from 92% (IgG) to 96% (IgA) in the pulmonary non-TB group. Combination of IgG with IgA and/or IgM does not improve its sensitivity. Clinical use of the A60-based serodiagnostic IgG assay is of great value for the rapid diagnosis and discrimination between active TB and pulmonary non-TB diseases. Moreover, this test could be used to increase diagnostic accuracy, especially for smear-negative TB cases, which are difficult to diagnose.

  4. New regimens for reducing the duration of the treatment of drug-susceptible pulmonary tuberculosis

    OpenAIRE

    Conde, Marcus B.; Lapa e Silva, José R.

    2011-01-01

    Tuberculosis (TB) remains an important health problem worlwide. The structure necessary for delivering TB treatment and implementing the directly observed treatment accounts for more than two-thirds of its final cost. Furthemore, although with efficacy greater than 90%, the effectiveness of present treatment regimens ranges from 55–85%, depending on the setting, mainly due to poor adherence. Duration of treatment with the current first-line anti-TB drugs is a minimum of 6 months. Reducing the...

  5. Pulmonary aspergilloma

    Science.gov (United States)

    ... grows on dead leaves, stored grain, bird droppings, compost piles, and other decaying vegetation. Cavities in the ... Histoplasmosis Lung cancer - small cell Pulmonary tuberculosis Sarcoidosis Review Date 8/31/2014 Updated by: Jatin M. ...

  6. [Factors associated to pulmonary tuberculosis in patients with diabetes mellitus from Veracruz, México].

    Science.gov (United States)

    Pérez-Navarro, Lucía Montserrat; Fuentes-Domínguez, Francisco; Morales-Romero, Jaime; Zenteno-Cuevas, Roberto

    2011-01-01

    In Mexico, 20% of cases of tuberculosis (TB) are associated with diabetes mellitus (DM). However, the behavior of the factors related to this comorbidity is unknown, so the aim of this study was to estimate the risk factors and outcome for TB-DM in a population from the state of Veracruz, Mexico. We developed a double-design study: cases and controls for the estimation of risk factors, and a retrospective cohort for the outcome factors. The populations surveyed were 67 patients with the comorbidity TB-DB and 109 with TB. The risk factors for tuberculosis in the diabetic population studied were: age ≥ 35 with an OR of 2.5 (95% CI: 1.4-4.3) and IMC ≥ 25 with an OR of 8.5 (95% CI: 3.1-23.3). According to the outcome variables, the patients with TB-DM showed an increased risk of 2.8 (95% CI: 2.2-3.4) for the development of drug resistance against tuberculosis. In conclusion, age and overweight are important risk factors, and drug resistance is an important outcome factor for the binomial TB-DM in the population from Veracruz. This information will have important effects on the development of surveillance programs against TB, with emphasis on the characteristics of the diabetic population.

  7. Application of a geographical information system for information management on pulmonary tuberculosis Aplicación de un sistema de información geográfica a la gestión informativa de la tuberculosis pulmonar

    Directory of Open Access Journals (Sweden)

    Alina Esther González Hermida

    2010-12-01

    Full Text Available Background: tuberculosis program is a priority for the National Health System in Cuba. The difficulties encountered in dealing with the disease are associated, directly or indirectly, to a restricted knowledge management by the health system. Objective: to implement a geographical information system to manage information on pulmonary tuberculosis. Methods: retrospective, descriptive and correlational study conducted between January 1, 1996 and December 31, 2007. It included the 155 new cases of pulmonary tuberculosis in 15 years old patients and on in the province of Cienfuegos. MapInfo 8.5 software was used to design the geographical information system. Theoretical, empirical and statistical methods were combined. Results: the elimination of the geographical aspect as an obstacle for carrying out preventive actions established in the program and for the stratification of pulmonary tuberculosis according to its incidence in districts and neighbourhoods of the city. Conclusions: the designed geographical information system is an auxiliary technological tool that improves information management on pulmonary tuberculosis in Cienfuegos as the basis for a variety of analysis and the generation of new knowledgeFundamento: el programa de la tuberculosis está priorizado dentro del Sistema Nacional de Salud en Cuba. Las dificultades identificadas en el enfrentamiento a la enfermedad están asociadas, directa o indirectamente, a una restringida gestión del conocimiento en el sistema de salud.
    Objetivo:
    aplicar un sistema de información geográfica a la gestión de la información para la tuberculosis pulmonar.
    Métodos:
    estudio retrospectivo descriptivo-correlacional realizado entre el 1 de enero de 1996 y el 31 de diciembre del 2007 que incluyó a los 155 casos nuevos de tuberculosis pulmonar ocurridos en

  8. Diagnosis of pulmonary tuberculosis by score system in children and adolescents: a trial in a reference center in Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Clemax Couto Sant'Anna

    2004-08-01

    Full Text Available Since 2002, the Brazilian Ministry of Health has recommended a score system for tuberculosis diagnosis of children and adolescents that does not need bacteriological positivity, because most cases in this age group have few bacteria. An observational, transversal study was carried out at the outpatient health care service of the reference medical service in Salvador, Bahia, including 164 patients with pulmonary tuberculosis, with ages ranging between 1 and 15 years of age, who were treated from 1990 to 2001. The gold standard used to establish the diagnosis was clinical, radiological, epidemiological and based on follow-up data. The score system for diagnosis purposes was tested retrospectively. The median age and the average age of the 164 patients were 6 and 6.62 years (SD ± 4.33, respectively. About 65% of the sample reported a history of close contact with a tuberculous adult. The BCG vaccine coverage was 70.7% (116/164. It was found that 26% (43/164 of the patients had severe malnutrition. Out of this group, 26/43 (60.47% were < 5mm reactive to the tuberculin test. On the other hand, out of the 91 patients with tuberculin test < 5mm, 29% (26/ 91 had severe malnutrition. The use of the score gave the following distribution: a TB very likely in 81.7% (134/164 of the patients; b possible TB in 15.9% (26/164 and TB unlikely in 2.4% (4/164. Among patients who had been vaccinated more than 2 years before, there was a 9 times higher risk of finding a tuberculin test above 10 mm in individuals with probable TB in comparison with the patients with possible or unlikely TB.

  9. Intestinal parasite co-infection among pulmonary tuberculosis cases without human immunodeficiency virus infection in a rural county in China.

    Science.gov (United States)

    Li, Xin-Xu; Chen, Jia-Xu; Wang, Li-Xia; Tian, Li-Guang; Zhang, Yu-Ping; Dong, Shuang-Pin; Hu, Xue-Guang; Liu, Jian; Wang, Feng-Feng; Wang, Yue; Yin, Xiao-Mei; He, Li-Jun; Yan, Qiu-Ye; Zhang, Hong-Wei; Xu, Bian-Li; Zhou, Xiao-Nong

    2014-01-01

    Epidemiologic studies of co-infection with tuberculosis (TB) and intestinal parasites in humans have not been extensively investigated in China. A cross-section study was conducted in a rural county of Henan Province, China. Pulmonary TB (PTB) case-patients receiving treatment for infection with Mycobacterium tuberculosis and healthy controls matched for geographic area, age, and sex were surveyed by using questionnaires. Fecal and blood specimens were collected for detection of intestinal parasites, routine blood examination, and infection with human immunodeficiency virus. The chi-square test was used for univariate analysis and multivariate logistic regression models were used to adjust for potential confounding factors. A total of 369 persons with PTB and 366 healthy controls were included; all participants were negative for human immunodeficiency virus. The overall prevalence of intestinal parasites in persons with PTB was 14.9%, including intestinal protozoa (7.9%) and helminthes (7.6%). The infection spectrum of intestinal parasites was Entamoeba spp. (1.4%), Blastocystis hominis (6.2%), Trichomon