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Sample records for pulmonary tuberculosis patients

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

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    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.

  2. Cost of Care Among Patients With Pulmonary Tuberculosis in Lagos ...

    African Journals Online (AJOL)

    Cost of Care Among Patients With Pulmonary Tuberculosis in Lagos, Nigeria. ... Open Access DOWNLOAD FULL TEXT Subscription or Fee Access ... and Cost- Effectiveness Analysis of Tuberculosis Control, converting at US$1=N120. Result

  3. Pulmonary tuberculosis

    Science.gov (United States)

    ... ray Pulmonary nodule, solitary - CT scan Miliary tuberculosis Tuberculosis of the lungs Erythema nodosum associated with sarcoidosis Respiratory system Tuberculin skin test References Fitzgerald DW, Sterling TR, Haas DW. ...

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

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    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.

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

    NARCIS (Netherlands)

    Shi, Dongmei; Zhang, Wei; Lu, Guixia; de Hoog, G Sybren; Liang, Guanzhao; Mei, Huan; Zheng, Hailin; Shen, Yongnian; Liu, Weida

    2016-01-01

    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.

  6. Prevalence of nutritional deficiency in patients with pulmonary tuberculosis

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    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.

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

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    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.

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

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

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    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.

  10. Pulmonary tuberculosis in patients with chronic renal failure at Zagazig University Hospitals

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    Abdelreheem I. Yousef

    2014-01-01

    Conclusion: Patients with chronic renal failure are at increased risk for pulmonary and extra pulmonary tuberculosis and should be screened routinely and carefully for early detection of TB infection.

  11. outcomes of patients with pulmonary tuberculosis

    African Journals Online (AJOL)

    The impact of functional performance, HIV status, malnutrition, and .... Interrupted or default (patient whose treatment was interrupted .... fever, night sweat, and chest pain were not associated ... need of special care and attention. Such patients ...

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

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    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

  13. 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...

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

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    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.

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

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    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

  17. 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...

  18. Keloidal plaque in a patient with pulmonary tuberculosis: A rare morphological variant of tuberculosis verrucosa cutis

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    Sundeep Chowdhry

    2014-01-01

    Full Text Available Tuberculosis verrucosa cutis (TVC, also known as warty tuberculosis, anatomist's wart or prosector's wart is characterized by the presence of verrucous plaque-like lesions, resulting from direct inoculation of the causative organism into the skin of a previously infected patient. A 59-year-old man presented with a hyperpigmented plaque on the chest wall which closely mimicked a keloid. He was a case of sputum-positive pulmonary tuberculosis and had repeatedly been applying early morning saliva on the lesion as a part of the indigenous practices for quick healing. There was further progression of the lesion with discharge from several sites. A smear for acid fast bacilli was positive from the discharge and growth on Lowenstein Jensen medium revealed growth of Mycobacterium tuberculosis. Biopsy was compatible with TVC and the patient was started on 6 months anti-tubercular therapy. However, the plaque continued to persist with continuing discharge from multiple openings which necessitated surgical intervention, finally leading to near complete resolution of the plaque of TVC.

  19. Pulmonary Tuberculosis in Children

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    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.

  20. [Therapy and Rehabilitation of Patients with Pulmonary Tuberculosis and Different Treatment Adherence].

    Science.gov (United States)

    Rubleva, N V; Kolomiets, V M; Kochetkova, E Ya

    2016-01-01

    The pulmonary tuberculosis process as dependent on the disease form and the therapy efficacy with the use of Cycloferon in the treatment scheme were investigated. The study had two stages. At the first stage the data concerning 358 patients with primary pulmonary tuberculosis and infiltration (93 patients) or degradation (89 patients) and 176 patients with pulmonary fibrocavernous tuberculosis were analysed. At the second stage the efficacy of the treatment schemes applied to the patients with pulmonary fibrocavernous tuberculosis was compared. The etiotropic therapy intensive phase was applied to all the patients. Moreover, 56 patients (group 1) under the therapy and rehabilitatinon were treated with Cycloferon in a dose of 0.25 administered intramuscularly twice a week (not less than 16 injections for the course), 60 patients (group 2) were treated with Omega 3, 30 patients (group 3) were given the standard complex (vitamins and tonics), 30 patients (group 4) were under the etiotropic therapy alone. The following additional factors promoting progression and aggravation of the tuberculosis process were confirmed: degradation at the time of the disease diagnosis, high resistance of the pathogen to antituberculosis drugs, low adherence to the treatment, social desadaptation and especially psychofunctional state of the patients. The use of Cycloferon in the schemes of the intensive phase treatment of the primary fibrocavernous tuberculosis resulted in reduction of the intoxication signs, bacteria isolation, positive dynamics of the cavity healing, lower lung infiltration and consequently high frequency of the treatment positive outcomes (94.1 ± 3.33%).

  1. Factors of Suppression of Immune Response in Patients with Pulmonary Tuberculosis and Eosinophilia.

    Science.gov (United States)

    Urazova, O I; Novitskii, V V; Kolobovnikova, Yu V; Churina, E G

    2015-07-01

    We studied possible mechanisms of immunosuppression mediated by regulatory T cells that promotes suppression of antigen-specific immune response to Mycobacterium tuberculosis in patients with pulmonary tuberculosis and eosinophilia. It was shown that the number of CD4(+)CD25(+)Foxp3(+) regulatory T cells with immunosuppressive activity (Treg) increased in the peripheral blood of patients with disseminated destructive forms of pulmonary tuberculosis with multiple resistance of the causative agent to antituberculosis substances and eosinophilia. These changes were accompanied by imbalance in secretion of Treg-associated cytokines (in vitro) manifested in hyperproduction of TGFβ and IL-10 and decreased production of IL-2.

  2. 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.

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

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    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.

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

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    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.

  5. Natural History of Tuberculosis: Duration and Fatality of Untreated Pulmonary Tuberculosis in HIV Negative Patients: A Systematic Review

    Science.gov (United States)

    Tiemersma, Edine W.; van der Werf, Marieke J.; Borgdorff, Martien W.; Williams, Brian G.; Nagelkerke, Nico 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 epidemiological data. Methodology and Principal Findings To estimate the duration and case fatality of untreated pulmonary tuberculosis in HIV negative patients we reviewed studies from the pre-chemotherapy era. Untreated smear-positive tuberculosis among HIV negative individuals has a 10-year case fatality variously reported between 53% and 86%, with a weighted mean of 70%. Ten-year case fatality of culture-positive smear-negative tuberculosis was nowhere reported directly but can be indirectly estimated to be approximately 20%. The duration of tuberculosis from onset to cure or death is approximately 3 years and appears to be similar for smear-positive and smear-negative tuberculosis. Conclusions Current models of untreated tuberculosis that assume a total duration of 2 years until self-cure or death underestimate the duration of disease by about one year, but their case fatality estimates of 70% for smear-positive and 20% for culture-positive smear-negative tuberculosis appear to be satisfactory. PMID:21483732

  6. Prevalence of pulmonary tuberculosis in rheumatoid arthritis

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    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

  7. Sputum Conversion Among Patients With Smear Positive Pulmonary Tuberculosis

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    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. EFFICIENCY OF NEW IMMOBILIZED PROBIOTIC AS A PART OF TREATMENT OF PULMONARY TUBERCULOSIS PATIENTS

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    I. V. Belovа

    2017-01-01

    Full Text Available The study was conducted in order to evaluate the efficiency of adding immobilized probiotic biologically active food supplement of LB-Complex L to integral treatment of pulmonary tuberculosis. Changes of colon microorganism community in pulmonary tuberculosis patients including those with multiple drug resistance were studied in two groups of patients: receiving only basic treatment and basic treatment with the immobolized probiotic of LB-Complex L as a food supplement. The algorithm of probiotic intake has been offered with the consideration of pharmacodynamics of anti-tuberculosis drugs. The offered algorithm proved to be effective for prevention of disorders in microorganism community, enhancement of adherence to treatment, reduction of frequency, severity and duration of side effects to anti-tuberculosis drugs. 

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

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    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

  11. 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...

  12. 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.

  13. 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....

  14. 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.

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

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    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.

  16. 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

  17. [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.

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

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    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.

  19. Hookworm infection among patients with pulmonary tuberculosis: Impact of co-infection on the therapeutic failure of pulmonary tuberculosis

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    Ahmad Farooq Alsayed Hasanain

    2015-01-01

    Conclusion: In conclusion, the rate of therapeutic failure of pulmonary TB is high. Besides older age and DM, hookworm infection can reduce the therapeutic response of pulmonary TB. Screening for and control of DM and hookworm infection among patients with pulmonary TB may improve their therapeutic response.

  20. 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

  1. 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

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

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    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

  3. 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

  4. Population structure among mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Colombia.

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    Teresa Realpe

    Full Text Available 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

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

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    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

  6. 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...

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

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    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

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

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    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

  9. 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.

  10. [Use of essential oil of peppermint (Mentha piperita) in the complex treatment of patients with infiltrative pulmonary tuberculosis].

    Science.gov (United States)

    Shkurupiĭ, V A; Odintsova, O A; Kazarinova, N V; Tkrachenko, K G

    2006-01-01

    The paper describes the effects of peppermint (Mentha piperita) essential oil inhaled by patients with infiltrative pulmonary tuberculosis in the penitentiary system. This procedure is shown to be most effective in infiltrative pulmonary tuberculosis in the phase of resorption of infiltrates and/or closure of decay cavities. The efficiency is determined by the rapid positive changes in a tuberculous process, which appear as a rapider regression of tuberculous inflammation, causing small residual changes. This procedure may be used to prevent recurrences and exacerbations of pulmonary tuberculosis.

  11. 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.

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

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    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.

  13. Crescentic Glomerulonephritis Associated with Pulmonary Tuberculosis.

    Science.gov (United States)

    Kanodia, K V; Vanikar, A V; Patel, R D; Suthar, K S; Trivedi, H L

    2016-01-01

    Tuberculosis of kidney and urinary tract is caused by members of the Mycobacterium tuberculosis complex. Kidney is usually infected by haematogenous spread of bacilli from focus of infection in the lungs. Glomerular involvement in tuberculosis presenting as a rapidly progressive glomerulonephritis is a rare entity. We report a rare case of crescentic glomerulonephritis associated with pulmonary tuberculosis in a 26-year-old man. Patient was treated with corticosteroids, haemodialysis, intravenous immunoglobulin and four cycles of plasmapheresis. He did not respond to 4-drug anti-tuberculosis treatment for renal pathology and was switched over to maintenance haemodialysis. However, he responded to pulmonary TB.

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

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    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.

  15. Primary drug resistance among pulmonary treatment-naïve tuberculosis patients in Amazonas State, Brazil.

    Science.gov (United States)

    da Silva Garrido, M; Ramasawmy, R; Perez-Porcuna, T M; Zaranza, E; Chrusciak Talhari, A; Martinez-Espinosa, F E; Bührer-Sékula, S

    2014-05-01

    Multidrug-resistant tuberculosis (MDR-TB) is the main indicator of previous treatment in tuberculosis (TB) patients. MDR-TB among treatment-naïve patients indicates infection with drug-resistant Mycobacterium tuberculosis strains, and such cases are considered primary drug-resistant cases. To estimate the prevalence of drug resistance in pulmonary TB (PTB) treatment-naïve patients and to identify the socio-demographic and clinical characteristics of the resistant population. A total of 205 treatment-naïve PTB patients from Manaus, Amazonas State, Brazil, were enrolled. Drug susceptibility testing (DST) was performed on all positive mycobacterial cultures using the 1% proportion method. Positive M. tuberculosis cultures were obtained from only 175 patients for DST. The prevalence of primary MDR-TB was 1.7% (3/175); 14.3% (25/175) of the cultures presented resistance to at least one of the drugs. Resistance to streptomycin, isoniazid, rifampicin and ethambutol was respectively 8.6%, 6.9%, 3.4% and 2.3%. An association between TB patients with resistance to more than one drug and known previous household contact with a TB patient was observed (P= 0.008, OR 6.7, 95%CI 1.2-67.3). Although the prevalence of primary MDR-TB currently is relatively low, it may become a major public health problem if tailored treatment is not provided, as resistance to more than one drug is significantly associated with household contact.

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

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    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.

  17. CT findings of the pulmonary tuberculosis in patients with diabetes mellitus

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    Yang, Chang Kyu; Hong, Deok Hwa; Kim, Yeong Tong; Kim, Hyung Lyul; Lee, Jong Myeong; Kim, Jong Kun; Lee, So Hyun; Jeong, Gun Young [Taejon Sun General Hospital, Taejon (Korea, Republic of)

    1998-07-01

    To evaluate the CT findings of pulmonary tuberculosis in patients with diabetes mellitus (MD),according to the diabetic control state. Materials and Methods: We retrospectively studied 34 cases of pulmonary tuberculosis accompanied by DM. We divided the right lung three lobes and ten segments and the left into two lobes and eight segments and analyzed CT findings of bronchogenic spread, cavitary lesion, ill-defined nodule, lobular consolidation, lobar and segmental consolidation, atelectasis, interlobular septal thickening, fibrotic band, and associated findings such as lymph node enlargement, pleural effusion and empyema. We also tried to determine the typical CT findings of pulmonary tuberculosis according to diabetic duration and controlled state of DM focusing by FBS 160 and HbA1C 8.0. Results: Among 34 CT scans, bronchogenic spread was seen on 29 (85.3%), cavitary lesion on 26 (76.5%), ill-defined nodules on 11 (32.4%), lobular consolidation on 14 (41.2%), lobar and segmental consolidation on 12 (35.3%), atelectasis on four (14.7%), and fibrotic band on eight (23.5%). Multiple cavities were present in 76.9% of total cavitary lesions, and consolidation with bronchogenic spread in 75%; associated findings were as follows: lymph node enlargement (n=1), pleural effusion (n=10), empyema (n=2), and pericardial effusion (n=2). In 46.7% of cases, general tubercular lesions were in an unusual location, but among cases of secondary pulmonary tuberculosis, 73.9% of lesions were in the usual location. More lobular consolidation was seen in patients with less than FBS 160 on admission, and this result was statistically significant (p<0.05); CT findings did not, however, differ according to diabetic duration and HbA1C. Conclusion: In patients with DM,general fubercular lesions were found infrequently, but in secondary tubereulosis, multiple cavitary lesions-in the usual location-were very frequent. In patients with DM, CT findings of pulmonary tuberculosis did not vary

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

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    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

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

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    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.

  20. BTLA exhibits immune memory for αβ T cells in patients with active pulmonary tuberculosis.

    Science.gov (United States)

    Zeng, Jin-Cheng; Lin, Dong-Zi; Yi, Lai-Long; Liu, Gan-Bin; Zhang, Hui; Wang, Wan-Dang; Zhang, Jun-Ai; Wu, Xian-Jing; Xiang, Wen-Yu; Kong, Bin; Chen, Zheng W; Wang, Cong-Yi; Xu, Jun-Fa

    2014-01-01

    Despite past extensive studies, the role of B and T lymphocyte attenuator (BTLA) in αβ T cells in patients with active pulmonary tuberculosis (ATB) remains poorly understood. Here we demonstrate that BTLA expression on αβ T cells is decreased in patients with M. tuberculosis (Mtb) infection. Particularly, BTLA expression levels are likely critical for αβ T cells to manifest and maintain an active central memory phenotype with high capacity for secretion of IFN-γ and perforin, which are important for immune memory against TB infection. BTLA(high) αβ T cells also exhibited higher capacity in response to Mtb peptide stimulation. In contrast to the role of BTLA played for negative regulation of immune responses, our data in the current studies suggest that BTLA expression on αβ T cells is likely associated with protective immune memory against Mtb infection in the setting of patients with active pulmonary tuberculosis. This previous unappreciated role for BTLA may have implications for prevention and treatment of patients with Mtb infection.

  1. 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.

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

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    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.

  3. 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.

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

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    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.

  5. 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...

  6. [Anorexia nervosa complicated with pulmonary tuberculosis].

    Science.gov (United States)

    Ishii, Y; Yoneda, T; Tsukaguchi, K; Fu, A; Takeuchi, S; Tomoda, K; Tokuyama, T; Narita, N

    1994-02-01

    A study was made on a patient with anorexia nervosa complicated with pulmonary tuberculosis treated with intravenous hyperalimentation (IVH). A 24-year-old female was admitted to our hospital because of progressive loss of body weight during medication for pulmonary tuberculosis at another hospital. She was diagnosed as having anorexia nervosa. After the nutritional assessment IVH was performed. As a result of IVH, her body weight increased and her nutritional deprivation, (i.e., low visceral proteins, low branched amino acids, etc.) recovered. Nutritional support was effective upon treating pulmonary tuberculosis.

  7. Causes of Delay in Diagnosis of Smear-Positive Pulmonary Tuberculosis Patients Referred to the Tuberculosis Center of Zahedan

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    Mosayeb Shahriyar

    2012-08-01

    Full Text Available Background: Tuberculosis is now the major cause of mortality in the world. This study has tried to identify the factors affecting the diagnosis of this disease by determining the relationship between delay in diagnosis and factors associated with patient and health system.Materials and Methods: This research was a cross-sectional study conducted on smear positive pulmonary tuberculosis patients referred to the tuberculosis center in the first half of 2008. Required information was completed through patient records and patient interviews.Results: A total 98 patients were studied including 42 males and 56 females. Average age of patients was 51.6±19.57. Average delay in diagnosis was 2.8±1.78 months. The average delay of patients and health system was respectively 2.6±1.76 months and 6±4.27days. Data analysis showed that there is no relationship between the delay in diagnosis and individual variables such as age, gender, occupation, etc., and examination of sputum smears at the first visit. However, there is a significant relationship between patient delay with different factors such as education (p=0.03, marital status (p=0.03, existence of hospital or medical centers in the residence (p=0.02, distance to the medical center (p=0.02 and between health system delay and residence in the city (p=0.01, distance to this medical center (p=0.03 and obtaining chest X-ray (CXR in the first visit (p=0.003.Conclusion: The results showed that with the increase of literacy, the establishment of new hospitals and health centers in remote areas and suburbs as well as chest X-ray in the first visit, the amount of delay in diagnosis can be reduced.

  8. 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

  9. Evaluation of drug resistance in pulmonary tuberculosis patients at Sureyyapasa Chest Diseases Hospital, Istanbul, Turkey.

    Science.gov (United States)

    Karagoz, T; Pazarli, P; Mocin, O Y; Duman, D; Duman, G; Salturk, C; Unal, O

    2008-06-01

    Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey. To determine levels of Mycobacterium tuberculosis resistance to first-line drugs in patients with pulmonary tuberculosis (PTB). Between 1 January and 31 December 2005, all hospitalised PTB patients with culture-positive M. tuberculosis specimens and corresponding drug susceptibility tests (DST) for isoniazid (INH), rifampicin (RMP), streptomycin (SM) and ethambutol, routinely performed for every tuberculosis (TB) case at our centre, were included. Of a total of 1513 cases, 1277 (84.4%) were new and 236 (15.6%) were previously treated cases. Of the 1513 isolates, 290 (19%) isolates were resistant to at least one of the drugs tested. Resistance among new and previously treated cases was respectively 16.3% (209 of 1277) and 34.3% (81/236). Any SM resistance and any INH resistance were the most common drug resistance in new cases, while any RMP resistance was the most common drug resistance in previously treated cases. Multidrug resistance was detected in 3.2% (n = 41) of new cases and in 13.5% (n = 32) of previously treated cases. Planning for TB control requires an assessment of the number and distribution of drug-resistant cases, with laboratories providing accurate and reliable results.

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

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    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.

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

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    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.

  12. 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.

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

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    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

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

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    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.

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

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    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.

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

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    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

  17. Non‑Adherence of New Pulmonary Tuberculosis Patients to Anti ...

    African Journals Online (AJOL)

    Patients on ATT may have unpleasant side effects of the drugs.[2] As a result, many TB patients start ATT but do not finish it. ... therapeutic drug intake coincides with prescribed treatment. It ..... New York: McGraw‑Hill Companies. 2004. 24.

  18. Measurement of levels of fractional exhaled nitric oxide in patients with pulmonary tuberculosis.

    Science.gov (United States)

    Yhi, J Y; Park, D W; Min, J-H; Park, Y K; Kim, S-H; Kim, T-H; Sohn, J W; Yoon, H J; Shin, D H; Moon, J-Y

    2016-09-01

    The role of fractional exhaled nitric oxide (FeNO) in the diagnosis and treatment of pulmonary tuberculosis (PTB) is uncertain. To examine the value of FeNO as a biomarker for PTB. Baseline FeNO levels were compared in 69 PTB patients and 118 healthy controls. The correlation between baseline FeNO levels and clinical variables of tuberculosis were studied. FeNO levels were checked twice in the PTB group, at diagnosis and after 2 months of anti-tuberculosis medication, and factors affecting changes in FeNO levels after treatment were analysed. FeNO levels were not significantly different in the PTB group and controls (mean ± standard deviation 27.7 ± 17.6 parts per billion [ppb] vs. 27.0 ± 10.8 ppb, P = 0.531). In a multivariate regression analysis, no variable was shown to affect FeNO levels at diagnosis. FeNO levels did not significantly change after 2 months of treatment (26.8 ± 18.3 ppb vs. 24.0 ± 10.7 ppb, P = 0.257). Only PTB with a high FeNO level (>25 ppb) was related to a decline in FeNO levels after 2 months of treatment. FeNO levels do not appear to be affected in PTB patients.

  19. 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.

  20. Prediction Model of Drug-Induced Liver Injury in Patients with Pulmonary Tuberculosis: Evaluation of the Incidence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Farzaneh Dastan

    2017-03-01

    Full Text Available Introduction and objectives:Tuberculosis (TB still remains a major health concern both in developing and developed countries. The rate of the liver injury due to anti-TB drugs in developed countries has been reported up to 4%. The goal of this study is to assess the rate and risk factors for anti-tuberculosis drug-induced liver injury (DILI. Also, a model has been designed to predict DILI in patients with pulmonary tuberculosis.Methods:We conducted an observational study. The investigation was carried out in the National Research Institute of Tuberculosis and Lung Disease, Tehran, Iran. Anti-tuberculosis drug treatment course and patients’ demographic data, medical and drug history, and social habits were extracted from their medical records. DILI was defined as an increase in serum alanine aminotransfrase (ALT or aspartate aminotransfrase (AST greater than three times of the upper limit of normal (ULN, with symptoms of liver injury, or five times of the ULN without symptoms.Results:In this study, 87 patients (33 male, 54 female, mean age 54.29±21.79 years with tuberculosis diagnosis were followed. Anti-tuberculosis induced liver injury was detected in 14 (16.1% patients. Concomitant use of hepatotoxic drugs (Isoniazid, Rifampin and Pyrazinamide and the abnormal baseline serum liver enzyme levels before the initiation of therapy were found as risk factors for anti-tuberculosis induced liver injury.Conclusion:Anti-tuberculosis induced liver injury is a major problem in tuberculosis patients which lead to treatment interruption in 14 (16.1% patients. Due to the lack of evidence regarding the mechanism of this side effect, we recommend to monitor anti-tuberculosis drug levels in order to study their probable correlations with DILI.   

  1. Plasma melatonin and urinary 6-hydroxymelatonin levels in patients with pulmonary tuberculosis.

    Science.gov (United States)

    Ozkan, Esin; Yaman, Halil; Cakir, Erdinc; Deniz, Omer; Oztosun, Muzaffer; Gumus, Seyfettin; Akgul, Emin Ozgur; Agilli, Mehmet; Cayci, Tuncer; Kurt, Yasemin Gulcan; Aydin, Ibrahim; Arslan, Yakup; Ilhan, Nevin; Ilhan, Necip; Erbil, Mehmet Kemal

    2012-08-01

    Tuberculosis (TB) is the second most frequent cause of death in the world, after AIDS. Delay in diagnosing TB is an important worldwide problem. It seriously threatens public health. Cell-mediated immune responses play an important role in the pathogenesis of TB infection. The course of Mycobacterium tuberculosis (MTb) infection is regulated by two distinct T cell cytokine patterns. Melatonin is a biomolecule (mainly secreted by the pineal gland) with free radical scavenging, antioxidant and immunoregulatory properties. Melatonin has both its direct and indirect immunomodulatory effects on the immune system. In this study, we measured plasma melatonin and urine 6-hydroxy melatonin sulphate (6-HMS) concentrations in patients with newly diagnosed TB for the purpose of investigating whether there was a relationship between their levels and MTb infection. Thirty-one newly diagnosed patients presenting with active TB and 31 healthy subjects as the control group were included in this study. Blood and 24-h urine samples were collected from all individuals. Plasma melatonin levels and urine 6-HMS were measured. Our results show that in patients with TB, mean melatonin and 6-HMS concentrations were significantly lower than in the control subjects (p = 0.037, p treatment of TB patients with melatonin might result in a wide range of health benefits including improved quality of life and reduced severity of infection in these patients. Supplementation with melatonin may be considered as an adjunctive therapy to classic treatment of pulmonary TB, especially during the acute phase of infection.

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

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    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

  3. 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.

  4. 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

  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. 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.

  7. Thyroid function in pulmonary tuberculosis.

    Science.gov (United States)

    Sajid, Khan Mohammad; Parveen, Riffat; Sabih, Durr-e-; Mahmood, Rubaida

    2006-10-01

    To evaluate the thyroid hormone economy in pulmonary tuberculosis (PTB). Cohort comparative study. Multan Institute of Radiotherapy and Nuclear Medicine (MINAR) from January 2003 to June 2005. The study included 266 confirmed cases of pulmonary tuberculosis (PTB), aged between 11 and 65 years, who had completed short course of chemotherapy. Two samples were collected from each patient, first after final diagnosis and second after completion of the treatment. Initial analysis of samples showed that 31 samples had both T3 (triiodothyronine) and T4 (thyroxine) in lower than normal range. One more sample in the middle of treatment was collected for these patients. Radioimmunoassays and immunoradiometeric assays were applied to estimate mean TT3, TT4 and TSH (thyroid stimulating hormone) levels. Students t-test was used to compare patient and normal values derived from 713 volunteers. The age had no effect on levels of T3, T4 and TSH in normal persons. Mean T3 and T4 values (0.74 nmol/l and 91.9 nmol/l) in PTB patients were significantly decreased (p deiodination of T4). The levels improved after chemotherapy.

  8. 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.

  9. 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

  10. 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

  11. 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.

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

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    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.

  13. 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.

  14. Treatment outcome of new smear positive pulmonary tuberculosis patients in Penang, Malaysia.

    Science.gov (United States)

    Atif, Muhammad; Sulaiman, Syed Azhar Syed; Shafie, Asrul Akmal; Ali, Irfhan; Asif, Muhammad; Babar, Zaheer-Ud-Din

    2014-07-19

    According to the World Health Organization's recent report, in Malaysia, tuberculosis (TB) treatment success rate for new smear positive pulmonary tuberculosis (PTB) patients is still below the global success target of 85%. In this study, we evaluated TB treatment outcome among new smear positive PTB patients, and identified the predictors of unsuccessful treatment outcome and longer duration of treatment (i.e., > 6 months). The population in this study consisted of all new smear positive PTB patients who were diagnosed at the chest clinic of Penang General Hospital between March 2010 and February 2011. During the study period, a standardized data collection form was used to obtain socio-demographic, clinical and treatment related data of the patients from their medical charts and TB notification forms (Tuberculosis Information System; TBIS). These data sources were reviewed at the time of the diagnosis of the patients and then at the subsequent follow-up visits until their final treatment outcomes were available. The treatment outcomes of the patients were reported in line with six outcome categories recommended by World Health Organization. Multiple logistic regression analysis was used to find the independent risk factors for unsuccessful treatment outcome and longer treatment duration. Data were analyzed using the PASW (Predictive Analysis SoftWare, version 19.0. Armonk, NY: IBM Corp). Among the 336 PTB patients (236 male and 100 female) notified during the study period, the treatment success rate was 67.26% (n = 226). Out of 110 patients in unsuccessful outcome category, 30 defaulted from the treatment, 59 died and 21 were transferred to other health care facilities. The mean duration of TB treatment was 8.19 (SD 1.65) months. In multiple logistic regression analysis, risk factors for unsuccessful treatment outcome were foreign nationality, male gender and being illiterate. Similarly, risk factors for mortality due to TB included high-grade sputum and presence

  15. 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)

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

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    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. 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.

  18. 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

  19. 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

  20. 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

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

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    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

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

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    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

  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. [Multifocal tuberculosis in immunocompetent patients].

    Science.gov (United States)

    Rezgui, Amel; Fredj, Fatma Ben; Mzabi, Anis; Karmani, Monia; Laouani, Chadia

    2016-01-01

    Multifocal tuberculosis is defined as the presence of lesions affecting at least two extrapulmonary sites, with or without pulmonary involvement. This retrospective study of 10 cases aims to investigate the clinical and evolutionary characteristics of multifocal tuberculosis. It included 41 cases with tuberculosis collected between 1999 and 2013. Ten patients had multifocal tuberculosis (24%): 9 women and 1 man, the average age was 50 years (30-68 years). Our patients were correctly BCG vaccinated. The evaluation of immunodepression was negative in all patients. 7 cases had lymph node tuberculosis, 3 cases digestive tuberculosis, 2 cases pericardial tuberculosis, 2 cases osteoarticular tuberculosis, 1 case brain tuberculosis, 2 cases urinary tuberculosis, 4 cases urogenital tuberculosis, 1 case adrenal tuberculosis, 1 case cutaneous and 1 case muscle tuberculosis. All patients received anti-tuberculosis treatment for a mean duration of 10 months, with good evolution. Multifocal tuberculosis is difficult to diagnose. It can affect immunocompetent patients but often has good prognosis. Anti-tuberculosis therapy must be initiated as soon as possible to avoid sequelae.

  5. 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.

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

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    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.

  7. 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...

  8. [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.

  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. 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.

  11. 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...

  12. Effect of chemotherapy on whole-blood cytokine responses to Mycobacterium tuberculosis antigens in a small cohort of patients with pulmonary tuberculosis.

    Science.gov (United States)

    Bertholet, Sylvie; Horne, David J; Laughlin, Elsa M; Savlov, Margery; Tucakovic, Ines; Coler, Rhea N; Narita, Masahiro; Reed, Steven G

    2011-08-01

    The development of genomic and proteomic tools has enabled studies that begin to characterize the molecular targets of an effective host immune response to Mycobacterium tuberculosis, including understanding the specific immune responses associated with tuberculosis (TB) disease progression, disease resolution, and the development of latency. One application of such tools is the development of diagnostic reagents and assays useful as a test of cure. Such a test could be of considerable importance for the evaluation of new therapeutics. We and others have previously described immunodominant proteins of M. tuberculosis, including both vaccine and diagnostic candidates. In the present study, we describe the changes in immune responses to a panel of 71 M. tuberculosis antigens in six patients during the course of therapy. The levels of six cytokines were measured in 24-h whole-blood assays with these antigens, revealing that gamma interferon (IFN-γ), tumor necrosis factor (TNF), and interleukin-10 (IL-10) were differentially regulated in response to a subset of antigens. Therefore, measuring the production of these three cytokines in response to a panel of carefully selected M. tuberculosis proteins during the course of TB therapy might be a promising path toward the development of a test of cure and warrants further validation in larger cohorts of pulmonary TB patients.

  13. Tuberculosis transmission by patients with smear-negative pulmonary tuberculosis in a large cohort in the Netherlands.

    NARCIS (Netherlands)

    Tostmann, A.; Kik, S.V.; Kalisvaart, N.A.; Sebek, M.M.; Verver, S.; Boeree, M.J.; Soolingen, D. van

    2008-01-01

    BACKGROUND: Sputum smear microscopy is commonly used for diagnosing tuberculosis (TB). Although patients with sputum smear-negative TB are less infectious than patients with smear-positive TB, they also contribute to TB transmission. The objective of this study was to determine the proportion of TB

  14. Adherence to tuberculosis treatment among migrant pulmonary tuberculosis patients in Shandong, China: a quantitative survey study.

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    Chengchao Zhou

    Full Text Available Adherence to TB treatment is the most important requirement for efficient TB control. Migrant TB patients' "migratory" nature affects the adherence negatively, which presents an important barrier for National TB Control Program in China. Therefore, TB control among migrants is of high importance.The aim of this study is to describe adherence to TB treatment among migrant TB patients and to identify factors associated with adherence. A total of 12 counties/districts of Shandong Province, China were selected as study sites. 314 confirmed smear positive TB patients were enrolled between August 2(nd 2008 and October 17(th 2008, 16% of whom were non-adherent to TB therapy. Risk factors for non-adherence were: the divorced or bereft of spouse, patients not receiving TB-related health education before chemotherapy, weak incentives for treatment adherence, and self supervision on treatment. Based on the risk factors identified, measures are recommended such as implementing health education for all migrant patients before chemotherapy and encouraging primary care workers to supervise patients.

  15. HTLV-1 infection is frequent among out-patients with pulmonary tuberculosis in northern Lima, Peru.

    Science.gov (United States)

    Verdonck, K; González, E; Henostroza, G; Nabeta, P; Llanos, F; Cornejo, H; Vanham, G; Seas, C; Gotuzzo, E

    2007-10-01

    Tuberculosis (TB) and human T-lymphotropic virus 1 (HTLV-1) are frequent in Peru. The prevalence of HTLV-1 among Peruvian TB patients is unknown. To determine the prevalence of HTLV-1, HTLV-2 and the human immunodeficiency virus (HIV) in out-patients with TB and to compare HTLV-1-infected patients with seronegative patients. Cross-sectional study including subjects aged 18-65 years diagnosed with smear-positive pulmonary TB at health centres in northern Lima from November 2004 to August 2005. HTLV and HIV screening was performed using enzyme-linked immunosorbent assay; HTLV-1 and HTLV-2 were confirmed using line immunoassay. There were 311 participants with a median age of 29 years; 173 (56%) were men. HTLV-1 prevalence was 5.8% (18/311, 95%CI 3.2-8.4) and HIV prevalence was 1.3% (4/304, 95%CI 0.4-3.3). HTLV-2 was not diagnosed. In comparison with HIV- and HTLV-seronegative patients, HTLV-1-infected subjects were older (median age 44 vs. 28, P < 0.001) and were more likely to have been born in the southern Andes (OR 4.4, 95%CI 1.6-11.9). They were also more likely to report a history of TB deaths in the family (OR 5.4, 95%CI 1.7-16.8) and had more sputum smear results graded as 3+ (OR 4.1, 95%CI 1.5-11.2). HTLV-1 screening among Peruvian TB patients is important. Because 3+ sputum smears are frequent and mortality is high among relatives, families of HTLV-1/TB-positive cases merit special attention.

  16. Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Yimer Solomon

    2005-12-01

    Full Text Available Abstract Background Delayed diagnosis and treatment of tuberculosis (TB results in severe disease and a higher mortality. It also leads to an increased period of infectivity in the community. The objective of this study was to determine the length of delays, and analyze the factors affecting the delay from onset of symptoms of pulmonary tuberculosis (PTB until the commencement of treatment. Methods In randomly selected TB management units (TBMUs, i.e. government health institutions which have diagnosing and treatment facilities for TB in Amhara Region, we conducted a cross sectional study from September 1-December 31/2003. Delay was analyzed from two perspectives, 1. Period between onset of TB symptoms to first visit to any health provider (health seeking period, and from the first health provider visit to initiation of treatment (health providers' delay, and 2. Period between onset of TB symptoms to first visit to a medical provider (patients' delay, and from this visit to commencement of anti-TB treatment (health systems' delay. Patients were interviewed on the same date of diagnosis using a semi-structured questionnaire. Logistics regression analysis was applied to analyze the risk factors of delays. Results A total of 384 new smear positive PTB patients participated in the study. The median total delay was 80 days. The median health-seeking period and health providers' delays were 15 and 61 days, respectively. Conversely, the median patients' and health systems' delays were 30 and 21 days, respectively. Taking medical providers as a reference point, we found that forty eight percent of the subjects delayed for more than one month. Patients' delays were strongly associated with first visit to non-formal health providers and self treatment (P Conclusion Delay in the diagnosis and treatment of PTB is unacceptably high in Amhara region. Health providers' and health systems' delays represent the major portion of the total delay. Accessing a

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

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    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.

  18. [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.

  19. 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

  20. 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.

  1. Health-related quality of life in South African patients with pulmonary tuberculosis.

    Science.gov (United States)

    Kastien-Hilka, Tanja; Rosenkranz, Bernd; Sinanovic, Edina; Bennett, Bryan; Schwenkglenks, Matthias

    2017-01-01

    The evaluation of patient-reported health-related quality of life (HRQOL) in pulmonary tuberculosis (TB) contributes to a comprehensive understanding of the burden associated with this disease. The aim of this study was to assess the overall impact of TB on the health status and on single health domains identified in the WHO definition of health, including physical, mental and social health aspects. Four instruments for HRQOL evaluation were applied in a longitudinal multicentre study during six-month standard TB treatment in South Africa. These included the generic SF-12 and EQ-5D-5L, the disease-specific St. George´s Respiratory Questionnaire (SGRQ) and the condition-specific Hospital Anxiety and Depression Scale (HADS). Statistical analysis included significance testing, univariable and multivariable analysis, and repeated measures ANOVA. Change over time in the physical component score (PCS) of SF-12 was defined as primary endpoint. A target sample size of 96 patients was estimated. HRQOL of the study participants was impaired in all physical, mental and psycho-social health domains at treatment start. HRQOL improved significantly and in a clinically meaningful manner during the course of standard TB treatment, over the period of the study. The greatest improvement (95%) was observed in mental health. Younger patients with higher education and who were employed had a better HRQOL. This study demonstrates the need for an integrative understanding of TB with HRQOL as core element to inform gaps in current TB management. Improvements in the management of TB following an integrative patient-centred approach will contribute towards meeting the United Nations Sustainable Development Goal 3 (SDG3) target and will support the End TB strategy of the WHO.

  2. 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.

  3. Patient and health system delay among patients with pulmonary tuberculosis in Beira city, Mozambique.

    Science.gov (United States)

    Saifodine, Abuchahama; Gudo, Paula Samo; Sidat, Mohsin; Black, James

    2013-06-07

    TB control is based on the rapid identification of cases and their effective treatment. However, many studies have shown that there are important delays in diagnosis and treatment of patients with TB. The purpose of this study was to assess the prevalence of and identify risk factors associated with patient delay and health system delay among newly diagnosed patients with pulmonary TB. A cross sectional study was carried out in Beira city, Mozambique between September 2009 and February 2010. Patients in the first month of treatment were consecutively selected to this study if they had a diagnosis of pulmonary TB, had no history of previous TB treatment, and were 18 years or older and provided informed consent. Data was obtained through a questionnaire administered to the patients and from patients' files. Among the 622 patients included in the study the median age was 32 years (interquartile range, 26-40) and 272 (43.7%) were females. The median total delay, patient delay and health system delay was 150 days (interquartile range, 91-240), 61 days (28-113) and 62 days (37-120), respectively. The contribution of patient delay and health system delay to total delay was similar. Farming, visiting first a traditional healer, low TB knowledge and coexistence of a chronic disease were associated with increased patient delay. More than two visits to a health facility, farming and coexistence of a chronic disease were associated with increased health system delay. This study revealed a long total delay with a similar contribution of patient delay and health system delay. To reduce the total delay in this setting we need a combination of interventions to encourage patients to seek appropriate health care earlier and to expedite TB diagnosis within the health care system.

  4. 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.

  5. Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis

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    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.

  6. 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.

  7. [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.

  8. 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

  9. Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia

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    Getinet Shewaseged Adenager

    2017-01-01

    Full Text Available Background. Early detection and diagnosis of tuberculosis (TB and the timely commencement of antituberculosis (anti-TB treatment are the parts of efficient tuberculosis prevention and control program. Delay in the commencement of anti-TB treatment worsens the prognosis and increases the risk of death and the chance of transmission in the community and among health care workers. Objective. To assess tuberculosis treatment delay and associated factors among pulmonary TB patients in Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 public and 10 private health facilities that provide TB treatment. The data were collected from 425 newly registered pulmonary TB patients using pretested structured questionnaire from April to June 2012. Data were entered in EPI info version 3.5.1 and analyzed using SPSS version 16.0. Findings. The median durations of a patient, health care system, and total treatment delays were 17, 9, and 35 days, respectively. Overall 179 (42.1%, 233 (54.8%, and 262 (61.6% of patients experienced patient delay, health care system delay, and total treatment delay, respectively. Distance more than 2.5 km from TB treatment health facility [AOR = 1.6, 95% CI (1.1–2.5] and the presence of TB-associated stigma [AOR = 2.1, 95% CI (1.3, 3.4] indicate higher odds of patient delay, whereas, being unemployed, patients with the hemoptysis symptom complain indicated lower odds of health care system delay [AOR = 0.41, 95% CI (0.24, 0.70] and [AOR = 0.61 (0.39, 0.94], respectively. Conclusions. A significant proportion of clients experienced patient and health care system delay. Thus, there is a need for designing and implementing appropriate strategies to decrease the delays. Efforts to reduce delays should give focus on integrating prevention programs such as active case detection and expanding access to TB care.

  10. 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.

  11. 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.

  12. 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

  13. 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。

  14. All eotaxins CCL11, CCL24 and CCL26 are increased but to various extents in pulmonary tuberculosis patients.

    Science.gov (United States)

    Sharifabadi, Abumoslem Rashidi; Hassanshahi, Gholamhossein; Ghalebi, Seyed Razi; Arababadi, Mohammad Kazemi; Khorramdelazad, Hossein; Zainodini, Nahid; Shabani, Ziba

    2014-01-01

    Mycobacterium tuberculosis is a pulmonary pathogen responsible for tuberculosis. Tuberculosis (TB) is characterized histologically by granulomas at the site of disease activity. Primary pathologic feature of TB is formation of a granuloma, and chemokines are known to play an important role in the formation of granulomas during infection. Therefore, the aim of this study was to evaluate the serum levels of CCL11, CCL24, and CCL26 in the TB patients in comparison to healthy controls. The population of this cross-sectional study included 300 patients suffering from TB and 100 healthy controls. Concentrations of CCL11, CCL24, and CCL26 were measured by enzyme linked immunosorbent assay (ELISA) technique. The results were analyzed using SPSS software package version 18. Differences were considered significant where p was less than 0.05. The results showed significant elevated serum levels of CCL11, CCL24, and CCL26 in TB patients compared to controls. According to the present results it can be concluded that CCL11, CCL24, and CCL26 (which are produced by Th2 cells and other cells which induce Th2 development) are increased in TB patients; hence, it seems that TB suppresses Th1 and the classic function of macrophages subsequently by inducing the chemokines' expression.

  15. [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.

  16. 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.

  17. 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

  18. The impact of HIV infection and CD4 cell count on the performance of an interferon gamma release assay in patients with pulmonary tuberculosis

    DEFF Research Database (Denmark)

    Aabye, Martine G.; Ravn, Pernille; PrayGod, George

    2009-01-01

    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...

  19. 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.

  20. 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.

  1. A 35-year-old immuno-competent male with open pulmonary tuberculosis associated with extra-ordinary extensive extra-pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Liaqat Ali Chaudhry

    2013-01-01

    Full Text Available Multifocal tuberculosis is characterized by the presence of large multifocal tuberculosis areas in the same or different adjacent or distant organs. Primary lesions are usually in the lungs in the majority of patients. Difficulty in confirming multifocal tuberculosis and consideration of other diseases may lead to a delay in diagnosis and thus in initiating treatment. Bone and joint involvement in tuberculosis is uncommon. While osteoarticular tuberculosis most commonly occurs in the vertebral column, less frequently affected sites are hip, knee, and sacroiliac joints. The following is a fascinating case of open pulmonary tuberculosis associated with extensive extra-pulmonary multifocal tuberculosis.

  2. Addison's Disease Caused by Tuberculosis with Atypical Hyperpigmentation and Active Pulmonary Tuberculosis.

    Science.gov (United States)

    Namikawa, Hiroki; Takemoto, Yasuhiko; Kainuma, Shigeto; Umeda, Sakurako; Makuuchi, Ayako; Fukumoto, Kazuo; Kobayashi, Masanori; Kinuhata, Shigeki; Isaka, Yoshihiro; Toyoda, Hiromitsu; Kamata, Noriko; Tochino, Yoshihiro; Hiura, Yoshikazu; Morimura, Mina; Shuto, Taichi

    2017-01-01

    We herein report a case of Addison's disease caused by tuberculosis characterized by atypical hyperpigmentation, noted as exacerbation of the pigmentation of freckles and the occurrence of new freckles, that was diagnosed in the presence of active pulmonary tuberculosis. The clinical condition of the patient was markedly ameliorated by the administration of hydrocortisone and anti-tuberculosis agents. When exacerbation of the pigmentation of the freckles and/or the occurrence of new freckles are noted, Addison's disease should be considered as part of the differential diagnosis. In addition, the presence of active tuberculosis needs to be assumed whenever we treat patients with Addison's disease caused by tuberculosis, despite its rarity.

  3. Characterization of the genetic diversity of extensively-drug resistant Mycobacterium tuberculosis clinical isolates from pulmonary tuberculosis patients in Peru.

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    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.

  4. 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.

  5. National guidelines not always followed when diagnosing smear-negative pulmonary tuberculosis in patients with HIV in Botswana.

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    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

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

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    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.

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

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    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...

  8. [Factors associated to pulmonary tuberculosis in patients with diabetes mellitus from Veracruz, México].

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    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.

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

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    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.

  10. Two cases of pulmonary tuberculosis caused by Mycobacterium tuberculosis subsp canetti.

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    Miltgen, Jean; Morillon, Marc; Koeck, Jean-Louis; Varnerot, Anne; Briant, Jean-François; Nguyen, Gilbert; Verrot, Denis; Bonnet, Daniel; Vincent, Véronique

    2002-11-01

    We identified an unusual strain of mycobacteria from two patients with pulmonary tuberculosis by its smooth, glossy morphotype and, primarily, its genotypic characteristics. Spoligotyping and restriction fragment length polymorphism typing were carried out with the insertion sequence IS6110 patterns. All known cases of tuberculosis caused by Mycobacterium canetti have been contracted in the Horn of Africa.

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

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    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.

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

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    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

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

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    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

  14. Decreased Expression of T-Cell Costimulatory Molecule CD28 on CD4 and CD8 T Cells of Mexican Patients with Pulmonary Tuberculosis

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    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.

  15. The Impact of Coexisting Asthma, Chronic Obstructive Pulmonary Disease and Tuberculosis on Survival in Patients with Lung Squamous Cell Carcinoma.

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    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.

  16. Multidrug-Resistant Tuberculosis in Patients with Chronic Obstructive Pulmonary Disease in China.

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    Jiang-Nan Zhao

    Full Text Available Relatively little is known about the specific relationship and impact from chronic obstructive pulmonary disease (COPD on multidrug-resistant tuberculsosis (MDR-TB.We conducted a retrospective study included patients aged ≥40 years with a confirmed pulmonary TB at three tertiary hospitals (Shandong, China between January 2011 and October 2014. Univariable and multivariable analyses were performed to identify the relationship of MDR-TB and COPD.A total of 2164 patients aged ≥ 40 years with available results of drug susceptibility test (DST and medical records were screened for this study: 268 patients with discharge diagnosis of COPD and 1896 patients without COPD. Overall, 14.2% of patients with COPD and 8.5% patients without COPD were MDR-TB. The rate of MDR-TB were significantly higher in patients with COPD (P<0.05. Migrant (odds ratios (OR 1.32, 95% confidence interval (CI 1.02-1.72, previous anti-TB treatment (OR 4.58, 95% CI 1.69-12.42, cavity (OR 2.33, 95% CI 1.14-4.75, and GOLD stage (OR 1.86, 95% CI 1.01-2.93 were the independent predictors for MDR-TB among patients with COPD.MDR-TB occurs more frequently in patients with underlying COPD, especially those with being migrant, previous anti-TB therapy, cavity and severe airway obstruction.

  17. [X-ray features of disseminated pulmonary tuberculosis at late stages of HIV infection].

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    Babaeva, I Iu; Frolova, O P; Demikhova, O V

    2006-01-01

    The paper analyzes the results of a study of X-ray features of disseminated pulmonary tuberculosis in HIV infection on the basis of a retrospective analysis of the case histories of 65 HIV-infected patients with disseminated pulmonary tuberculosis and 60 patients with disseminated tuberculosis without HIV infection, who have been followed up in the Krasnodar Territory. X-ray changes characteristic for patients with disseminated tuberculosis in HIV infection and their difference from those with disseminated tuberculosis without HIV infection have been ascertained, which assists in timely establishing the diagnosis of tuberculosis in HIV infection.

  18. Nutritional status of adult patients with pulmonary tuberculosis in rural central India and its association with mortality.

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    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.

  19. A comparative study of itraconazole in various dose schedules in the treatment of pulmonary aspergilloma in treated patients of pulmonary tuberculosis

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    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.

  20. Tuberculosis in HIV Patient

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    Bidhan Nidhi Paudel

    2013-09-01

    Full Text Available Introduction: Strict monitoring of anti tuberculosis therapy (ATT and antiretroviral therapy (ART is crucial for proper management of TB/HIV co-infected patients. Methods: Between December 2006 and December 2008 a prospective observational study was conducted among 135 TB/HIV co-infected patients visiting antiretroviral therapy in Seti Zonal Hospital, Dhangadi. The diagnosed TB patients were subjected to ATT through directly observed treatment short-course (DOTS and its response was evaluated as per WHO guidelines. Results: Among 135 studied subjects, 71.9% were males and over 88 % of the patients were in the age group 21 to 50. Of the Total TB cases 68.1% presented pulmonary TB (PTB and 37.20% of the Extra-pulmonary Tuberculosis (EPTB cases were lymph node TB. 75.5% of them had completed ATT, 8.2% transfer out and 12.6% were default. Conclusions: Majority of the patients presented PTB, and lymph node TB was found to be the most common EPTB. Comparatively, high efficacy of ATT was found in HIV patients visiting this resource poor setting. Key words: antiretroviral therapy; anti TB therapy; Dhangadi; lymph node T; treatment response.

  1. [Acute paraplegia and intramedullary cavitation in a patient with pulmonary tuberculosis].

    Science.gov (United States)

    Schapira, M; Presas, J L; Speiser, E; Klimovsky, S; Barro, A; Nogués, M

    1992-01-01

    This 42-year-old male patient voluntarily discontinued treatment for lung TBC and twenty days later developed acute paraplegia. Magnetic resonance imaging (MRI) demonstrated a large intramedullary cavity extending from T2 to the conus medullaris. Having resumed anti-TBC treatment, the patient progressed favourably, despite any change in cavity size. Tuberculous meningitis may be complicated by the appearance of intramedullary cavities by two distinct mechanisms: 1) adhesive arachnoiditis at the skull base with obstruction of Luschka and Magendie foramina, followed by hydrocephalus and hydromyelia; and 2) spinal cord arachnoiditis with the development of arachnoidal and intramedullary cysts. In either case, symptoms are of late presentation. To the best of our knowledge, this is the first report in the literature of lung tuberculosis associated with syringomyelia but without basal arachnoiditis. Acute clinical presentation with paraplegia is exceptional.

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

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    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.

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

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    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 .

  4. The relationship between perceived discrimination and psychological distress among Chinese pulmonary tuberculosis patients: the moderating role of self-esteem.

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    Feng, Danjun; Xu, Lingzhong

    2015-01-01

    This study described the prevalence of psychological distress and examined the moderating effect of self-esteem in the relationship between perceived discrimination and psychological distress among Chinese pulmonary tuberculosis (TB) patients. Seven hundred and twenty patients with TB from three cities of Shandong Province in eastern China participated in a cross-sectional survey. Patients were measured with the Kessler 10 (K10), the Rosenberg self-esteem scale, and a self-developed perceived discrimination questionnaire. A total of 58.6% of patients with TB scored above 16 on the K10, indicating moderate and serious psychological distress. Chi-square test revealed that female patients reported higher psychological distress than male patients. The structural equation modeling (SEM) analysis among the whole sample indicated that perceived discrimination was significantly related with psychological distress (β = .28, p ≤ .01). The multiple group analysis of SEM showed that perceived discrimination had a significantly substantial (β = .50, p ≤ .001), significantly moderate (β = .15, p ≤ .01), and insignificant effect (β = .05, p ≥ .05) on psychological distress among low self-esteem, moderate self-esteem, and high self-esteem patients with TB, respectively, which verified the moderating effect of self-esteem in the relationship between perceived discrimination and psychological distress.

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

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    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%).

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

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    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

  7. 刘春荣,张文新%Investigation and Nursing of Patients with Pulmonary Tuberculosis with Positive Sputum Smear Positive

    Institute of Scientific and Technical Information of China (English)

    刘春荣; 张文新

    2015-01-01

    目的调查肺结核抗酸分枝杆菌阳性老年患者的自尊水平,采取相应的护理措施,提高老年传染性肺结患者的自尊水平,从而提高其生活质量。方法采取自尊量表进行问卷调查的方法,对200例痰菌阳性老年肺结核患者(实验组)和200例老年健康者(对照组)进行调查研究。分析老年肺结核痰菌阳性患者自尊水平低下的原因。结果痰菌阳性老年患者自尊水平较低,我们采取正确的护理措施,提高患者的自尊水平,从而提高痰菌阳性老年患者的生活质量。%Objective To investigate acid mycobacterium tuberculosis positive self-esteem level of elderly patients,cor esponding nursing measures,improve the old patients with infectious lung and levels of self-esteem,so as to improve their quality of life. Methods Self-esteem scale method,the questionnaire survey on 200 sputum positive bacteria in elderly patients with pulmonary tuberculosis (experimental group)and 200 healthy subjects (control group)study.Using self-designed scale,which are of low level in elderly patients with tuberculosis bacteria sputum positive self-esteem cause to investigate. Results The positive sputum bacteria elderly patients have a relatively low level of self-esteem,we adopt the right nursing measures,improve the patient's level of self-esteem,so as to greatly to promote positive sputum bacteria of elderly patients,living quality.

  8. CLINICAL AND LABORATORY PROFILE OF SPUTUM POSITIVE PULMONARY TUBERCULOSIS AMONG HIV SEROPOSITIVE AND HIV SERONEGATIVE PATIENTS- A CROSS-SECTIONAL STUDY

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    Amit Govind Kamat

    2017-05-01

    Full Text Available BACKGROUND The global impact of the converging dual epidemics of TB and HIV is one of the major public health challenges. The increasing rate of HIV infection in many countries has had an impact on TB epidemiology. As the prevalence of pulmonary tuberculosis is increasing among HIV seropositive patients with a wide range of immune status and clinical presentations, the present study was undertaken to assess the clinical and laboratory profile of sputum positive pulmonary tuberculosis among HIV seropositive and HIV seronegative patients. MATERIALS AND METHODS The present one year cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 104 patients with sputum positive pulmonary tuberculosis patients during the period of January 2009 to December 2009. Routine investigations such as blood group, haemogram that is haemoglobin, total count, differential count, erythrocyte sedimentation rate, sputum smears for AFB and chest x-ray were done. RESULTS Seroprevalence of HIV among pulmonary tuberculosis patients was 23.08%. On examination anaemia, undernourishment, lymphadenopathy and the presence of opportunistic infections like oral candidiasis, herpes zoster stain and genital lesions were more predominant among HIV seropositives compared to HIV seronegatives. Mean Hb and TLC were significantly low among HIV seropositives compared to HIV seronegatives. Chest x-ray showed varied presentation. Upper zone infiltration, cavitation and fibrosis were more commonly involved among HIV seronegatives compared to HIV seropositives. CONCLUSION HIV seropositive PTB patients commonly present with fever, weight loss and loss of appetite, while cough with expectoration, haemoptysis, breathlessness were more common with HIV seronegative patients. Cavitation, fibrosis and fibrocavitary lesions were predominantly seen among HIV seronegatives, while infiltration and miliary mottling was

  9. Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India.

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    Nerges Mistry

    Full Text Available Timely diagnosis and treatment initiation are critical to reduce the chain of transmission of Tuberculosis (TB in places like Mumbai, where almost 60% of the inhabitants reside in overcrowded slums. This study documents the pathway from the onset of symptoms suggestive of TB to initiation of TB treatment and examines factors responsible for delay among uncomplicated pulmonary TB patients in Mumbai.A population-based retrospective survey was conducted in the slums of 15 high TB burden administrative wards to identify 153 self-reported TB patients. Subsequently in-depth interviews of 76 consenting patients that fit the inclusion criteria were undertaken using an open-ended interview schedule. Mean total, first care seeking, diagnosis and treatment initiation duration and delays were computed for new and retreatment patients. Patients showing defined delays were divided into outliers and non-outliers for all three delays using the median values.The mean duration for the total pathway was 65 days with 29% of patients being outliers. Importantly the mean duration of first care seeking was similar in new (24 days and retreatment patients (25 days. Diagnostic duration contributed to 55% of the total pathway largely in new patients. Treatment initiation was noted to be the least among the three durations with mean duration in retreatment patients twice that of new patients. Significantly more female patients experienced diagnostic delay. Major shift of patients from the private to public sector and non-allopaths to allopaths was observed, particularly for treatment initiation.Achieving positive behavioural changes in providers (especially non-allopaths and patients needs to be considered in TB control strategies. Specific attention is required in counselling of TB patients so that timely care seeking is effected at the time of relapse. Prioritizing improvement of environmental health in vulnerable locations and provision of point of care diagnostics

  10. 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.

  11. Clinical Correlates and Drug Resistance in HIV-Infected and -Uninfected Pulmonary Tuberculosis Patients in South India

    Science.gov (United States)

    Sara, Chandy; Elsa, Heylen; Baijayanti, Mishra; Lennartsdotter, Ekstrand Maria

    2016-01-01

    Objectives To examine demographics, clinical correlates, sputum AFB (acid fast bacilli) smear grading DOTS (Directly Observed Therapy Short Course) uptake, and drug resistance in a cohort of newly-diagnosed, smear positive pulmonary tuberculosis (TB) patients with respect to HIV status at baseline, and compare smear conversion rates, side effects and mortality after two months. Design A prospective study among 54 HIV positive and 41 HIV negative pulmonary TB patients. Data were collected via face-to-face interviews, review of medical records, and lab tests. Results HIVTB co-infected patients, though more symptomatic at baseline, showed more improvement in their symptoms compared to HIV-uninfected TB patients at follow-up. The HIV co-infected group had more prevalent perceived side effects, and sputum smear positivity was marginally higher compared to the HIV negative group at follow-up. Mortality was higher among the HIV-infected group. Both groups had high rates of resistance to first-line anti-tubercular drugs, particularly isoniazid. There was no significant difference in the drug resistance patterns between the groups. Conclusions Prompt initiation and provision of daily regimens of ATT (Anti-Tubercular treatment) along with ART (Anti-Retroviral treatment) via ART centers is urgently needed in India. As resistance to ART and/or ATT is directly linked to medication non-adherence, the use of counseling, regular reinforcement, early detection and appropriate intervention strategies to tackle this complex issue could help prevent premature mortality and development of resistance in HIV-TB co-infected patients. The high rate of isoniazid resistance might preclude its use in India as prophylaxis for latent TB in HIV infected persons as per the World Health Organization (WHO) guideline. PMID:27708985

  12. 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...

  13. Cloning and expression of pab gene of M. tuberculosis isolated from pulmonary TB patient in E.coli DH5α

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    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

  14. 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.

  15. 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.

  16. Multiple oral ulcers leading to diagnosis of pulmonary tuberculosis

    Science.gov (United States)

    Nagaraj, Vezhavendhan; Sashykumar, Shanthi; Viswanathan, Stalin; Kumar, Sathish

    2013-01-01

    We report a 47 year old man who presented with painful non-healing tongue ulcers of 3 months duration. Examination revealed an additional buccal ulcer that he was unaware of. Histopathology of the ulcers showed caseation necrosis. Following this report, chest radiography and sputum microscopy performed revealed pulmonary tuberculosis. From this case-study, one should be aware of coexisting pulmonary tuberculosis in patients with chronic non-healing oral ulcers, both for diagnosis as well as prevention of transmission through respiratory droplets. PMID:24883035

  17. 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.

  18. Effect of Chemotherapy on Whole-Blood Cytokine Responses to Mycobacterium tuberculosis Antigens in a Small Cohort of Patients with Pulmonary Tuberculosis▿†

    Science.gov (United States)

    Bertholet, Sylvie; Horne, David J.; Laughlin, Elsa M.; Savlov, Margery; Tucakovic, Ines; Coler, Rhea N.; Narita, Masahiro; Reed, Steven G.

    2011-01-01

    The development of genomic and proteomic tools has enabled studies that begin to characterize the molecular targets of an effective host immune response to Mycobacterium tuberculosis, including understanding the specific immune responses associated with tuberculosis (TB) disease progression, disease resolution, and the development of latency. One application of such tools is the development of diagnostic reagents and assays useful as a test of cure. Such a test could be of considerable importance for the evaluation of new therapeutics. We and others have previously described immunodominant proteins of M. tuberculosis, including both vaccine and diagnostic candidates. In the present study, we describe the changes in immune responses to a panel of 71 M. tuberculosis antigens in six patients during the course of therapy. The levels of six cytokines were measured in 24-h whole-blood assays with these antigens, revealing that gamma interferon (IFN-γ), tumor necrosis factor (TNF), and interleukin-10 (IL-10) were differentially regulated in response to a subset of antigens. Therefore, measuring the production of these three cytokines in response to a panel of carefully selected M. tuberculosis proteins during the course of TB therapy might be a promising path toward the development of a test of cure and warrants further validation in larger cohorts of pulmonary TB patients. PMID:21715581

  19. 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 ...

  20. INFILTRATE PULMONARY TUBERCULOSIS, GASTRIC ULCER AND HIV INFECTION (COMORBIDITY AND MULTIMORBIDITY

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    E. S. Skvortsova

    2016-01-01

    Full Text Available Peptic ulcer is registered in 20,5% of those suffering from infiltrate pulmonary tuberculosis and in 19,5% of HIV patients at C2 stage, ill with infiltrate pulmonary tuberculosis and presenting complaints about dyspeptic disorders. The following is typical of multimorbidity of pulmonary tuberculosis, HIV infection and peptic ulcer: oligosymptomatic start of tuberculosis, asthenic syndrome dominating among clinical symptoms, manifestations of gastric and intestinal indigestion, weight loss (2-4 times more often compared to HIV negative patients, less expressed lung tissue destruction (2 time less compared to HIV negative patients. H. pylori is a causative agent of the peptic ulcer in 62,5% of patients with infiltrate pulmonary tuberculosis and in 58,7% of HIV infected patients at C2 stage, suffering from pulmonary tuberculosis. Comorbidity of H. pilori negative peptic ulcer and infiltrate pulmonary tuberculosis differs from comorbidity of H. pilori positive peptic ulcer and infiltrate pulmonary tuberculosis since the first has confidently true unfavorable forecast of the outcome.

  1. Patient and health service delay in pulmonary tuberculosis patients attending a referral hospital: a cross-sectional study

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    Harriet Mayanja

    2005-11-01

    Full Text Available Abstract Background Delays in diagnosis and initiation of effective treatment increase morbidity and mortality from tuberculosis as well as the risk of transmission in the community. The aim of this study was to determine the time taken for patients later confirmed as having TB to present with symptoms to the first health provider (patient delay and the time taken between the first health care visit and initiation of tuberculosis treatment (health service delay. Factors relating to these 'delays' were analyzed. Methods A cross-sectional survey, of 231 newly diagnosed smear-positive tuberculosis patients was conducted in Mulago National referral Hospital Kampala, from January to May 2002. Socio-demographic, lifestyle and health seeking factors were evaluated for their association with patient delay (>2 weeks and health service delay (>4 weeks, using odds ratios with 95% confidence intervals (CI including multivariate logistic regression. Results The median total delay to treatment initiation was 12 weeks. Patients often presented to drug shops or pharmacies (39.4% and private clinics (36.8% more commonly than government health units (14% as initial contacts. Several independent predictors of 'patient delay' were identified: being hospitalized (odds ratio [0R] = 0.32; 95% CI: 0.12–0.80, daily alcohol consumption (OR = 3.7; CI: 1.57–9.76, subsistence farming (OR = 4.70; CI: 1.67–13.22, and perception of smoking as a cause of TB (OR = 5.54; CI: 2.26–13.58. Independent predictors of 'health service delay' were: >2 health seeking encounters per month (OR = 2.74; CI: 1.10–6.83, and medical expenditure on TB related symptoms >29 US dollars (OR = 3.88; CI: 1.19–12.62. Perceived TB stigma and education status was not associated with either form of delay. Conclusion Delay in diagnosis of TB is prolonged at the referral centre with a significant proportion of Health service delay. More specific and effective health education of the general

  2. Imagem em tuberculose pulmonar Pulmonary tuberculosis imaging

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    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.

  3. Tuberculosis in patients with myelodysplastic syndromes

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

    2002-05-01

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

  4. 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...

  5. Evaluation of Biphasic Culture System for Mycobacterial Isolation from the Sputum of Patients with Pulmonary Tuberculosis

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    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 .

  6. Evaluation of Microscopic Observation Drug Susceptibility (MODS) and the string test for rapid diagnosis of pulmonary tuberculosis in HIV/AIDS patients in Bolivia.

    Science.gov (United States)

    Lora, Meredith H; Reimer-McAtee, Melissa J; Gilman, Robert H; Lozano, Daniel; Saravia, Ruth; Pajuelo, Monica; Bern, Caryn; Castro, Rosario; Espinoza, Magaly; Vallejo, Maya; Solano, Marco; Challapa, Roxana; Torrico, Faustino

    2015-06-06

    Tuberculosis (TB) is the most common opportunistic infection and the leading cause of death in HIV-positive people worldwide. Diagnosing TB is difficult, and is more challenging in resource-scarce settings where culture-based diagnostic methods rely on poorly sensitive smear microscopy by Ziehl-Neelsen stain (ZN). We performed a cross-sectional study examining the diagnostic utility of Microscopic Observation Drug Susceptibility liquid culture (MODS) versus traditional Ziehl-Neelsen staining (ZN) and Lowenstein Jensen culture (LJ) of pulmonary tuberculosis (TB) and multidrug-resistant tuberculosis (MDRTB) in HIV-infected patients in Bolivia. For sputum scarce individuals we assessed the value of the string test and induced sputum for TB diagnosis. The presence of Mycobacterium tuberculosis (Mtb) in the sputum of 107 HIV-positive patients was evaluated by ZN, LJ, and MODS. Gastric secretion samples obtained by the string test were evaluated by MODS in 102 patients. The TB-HIV co-infection rate of HIV patients with respiratory symptoms by sputum sample was 45 % (48/107); 46/48 (96 %) were positive by MODS, 38/48 (79 %) by LJ, and 30/48 (63 %) by ZN. The rate of MDRTB was 9 % (4/48). Median time to positive culture was 10 days by MODS versus 34 days by LJ (p Bolivia.

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

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    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.

  8. Evaluation of serum levels of essential trace elements in patients with pulmonary tuberculosis before and after treatment by age and gender.

    Science.gov (United States)

    Pourfallah, F; Javadian, S; Zamani, Z; Saghiri, R; Sadeghi, S; Zarea, B; Mirkhani, F; Fatemi, N; Kordi, T

    2011-05-15

    The purpose of this study was to evaluate the levels of Zinc, Copper, Iron and Copper/Zinc ratio in the serum of adult patients with pulmonary tuberculosis in Iran. Serum levels of Zinc and Copper were determined by flame atomic absorption spectrophotometer and scrum iron concentration was measured by using an Auto Analyzer. The study group consisted of 50 pulmonary tuberculosis patients before treatment and after 6 months of anti-tubercular therapy. Levels of scrum Zn (p < 0.001) and Fe (p < 0.001) in TB patients were significantly increased after 6 months of anti-tubercular therapy. However, serum Cu concentration (p < 0.01) and Cu/Zn ratio (p < 0.05) were decreased after 6 months of anti-tubercular therapy. Some studies indicated a strong association of Zn, Cu, Fe and the Cu/Zn ratio with TB. In this study, we found remarkable change in Cu/Zn ratio. Some researchers mentioned that serum Cu/Zn ratio could be used as an important laboratory marker for diagnosis and treatment of tuberculosis. They also mentioned that trace element levels must be closely monitored during the process of disease.

  9. 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

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    Cid Carlos Soares de Alcântara

    2012-10-01

    , and behavioral factors that are associated with the diagnosis of pulmonary tuberculosis. METHODS: This was a cross-sectional study conducted between April of 2008 and March of 2009 at three health care clinics in the city of Fortaleza, Brazil. We selected 233 patients older than 14 years of age who spontaneously sought medical attention and presented with cough for > 2 weeks. Sociodemographic, clinical, and behavioral data were collected. Sputum smear microscopy for AFB and mycobacterial culture were also carried out, as were tuberculin skin tests and chest X-rays. The patients were divided into two groups (with and without pulmonary tuberculosis. The categorical variables were compared by the chi-square test, followed by logistic regression analysis when the variables were considered significant. RESULTS: The prevalence of pulmonary tuberculosis was 41.2%. The unadjusted OR showed that the following variables were statistically significant risk factors for pulmonary tuberculosis: fever (OR = 2.39; 95% CI, 1.34-4.30, anorexia (OR = 3.69; 95% CI, 2.03-6.75, and weight loss (OR = 3.37; 95% CI, 1.76-6.62. In the multivariate analysis, only weight loss (OR = 3.31; 95% CI, 1.78-6.14 was significantly associated with pulmonary tuberculosis. CONCLUSIONS: In areas with a high prevalence of tuberculosis, weight loss could be used as an indicator of pulmonary tuberculosis in patients with chronic cough for > 2 weeks.

  10. 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

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    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

  11. Phenotyping and genotyping identification of non-tuberculosis mycobacterium isolated from pulmonary tuberculosis suspected patients in Basrah Governorate

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    Z A Hasan

    2015-01-01

    Conclusions: This study emphasizes that NTM is present at high frequency, especially among TB-suspected patients, and this requires confirmation on a follow-up basis, along with the examination of patterns of sensitivity, and is an absolute necessity rather than the current hour in a health center in Iraq.

  12. [PARTICULARITIES OF CARBOHYDRATE METABOLISM IN PATIENTS WITH PULMONARY TUBERCULOSIS WITH PRECLINICAL DISORDERS GLICEMIA].

    Science.gov (United States)

    Petrenko, V I; Andrieieva, O H; Prystupiuk, O M; Potaĭchuk, V I

    2014-01-01

    Studied concentration of lactate and pyruvate in patiens with lung tuberculosis with disorders of tolerance to glucosis and glukemic disorders on an empty stomach and in patiens, wich had not such disorders. In patiens with preclinical disorders glicemia discovered increasing to concentrations of lactate and pyruvate in blood. This is indicative of more deep breaches of quality to oxidation the glucose in energetic aerobic reaction, in particular, in tricarboxylic acids cycle. Effect this is a deterioration energy status of the cells. Excess of the formation lactate and pyruvate on background of the effect anty-insulin hormone prevalence and relative insufficiency of the insulin realizes the independent contribution to development hyperglicemia disorders.

  13. Tuberculosis among HIV-positive patients across Europe

    DEFF Research Database (Denmark)

    Kruk, Alexey; Bannister, Wendy; Podlekareva, Daria;

    2011-01-01

    To describe temporal changes in the incidence rate of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in western Europe and risk factors of TB across Europe.......To describe temporal changes in the incidence rate of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in western Europe and risk factors of TB across Europe....

  14. Imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome%艾滋病并发肺结核播散的影像表现

    Institute of Scientific and Technical Information of China (English)

    宋文艳; 赵祖琦; 赵大伟; 刘晋新; 官宛华; 梁艺; 贾翠宇; 张瑞池

    2013-01-01

    Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.%目的 探讨艾滋病(AIDS)并发肺结核肺内播散的影像特点.方法 回顾性分析经临床及实验室检查证实的33例AIDS并发肺结核肺内播散的X线胸片及MSCT影像资料,总结其影像表现特征.结果 首诊X线胸片检查30例,29例表现异常,包括病灶呈双侧播散性分布21例,单侧多发病变8例.所有患者均行MSCT扫描,病变呈单侧和双侧肺内多发分布分别为7例和26例;病变形态包括结节(25例)、粟粒(22例)、气腔实变(22例)、空洞(11例)、纤维索条(7例)、磨玻璃影(7

  15. Pulmonary tuberculosis specificities in smokers

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    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.

  16. 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.

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

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    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.

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

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    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.

  19. Tool for objective quantification of pulmonary sequelae in monitoring of patients with tuberculosis; Ferramenta para quantificacao objetiva de sequelas pulmonares no acompanhamento de pacientes com tuberculose

    Energy Technology Data Exchange (ETDEWEB)

    Giacomini, Guilherme; Alvarez, Matheus; Pina, Diana R. de; Bacchim Neto, Fernando A.; Pereira, Paulo C.M.; Ribeiro, Sergio M.; Miranda, Jose Ricardo de A., E-mail: guigiacomini92@aluno.ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucaru, SP (Brazil)

    2014-07-01

    Tuberculosis (TB), caused by Mycobacterium tuberculosis, is an ancient infectious disease that remains a global health problem. Chest radiography is the method commonly employed in assessing the evolution of TB. However, lung damage quantification methods are usually performed on a computerized tomography (CT). This objective quantification is important in the radiological monitoring of the patient by assessing the progression and treatment of TB. However, precise quantification is not feasible by the number of CT examinations necessary due to the high dose subjected to the patient and high cost to the institution. The purpose of this work is to develop a tool to quantify pulmonary sequelae caused by TB through chest X-rays. Aiming the proposed objective, a computational algorithm was developed, creating a three-dimensional representation of the lungs, with regions of dilated sequelae inside. It also made the quantification of pulmonary sequelae of these patients through CT scans performed in upcoming dates, minimizing the differences in disease progression. The measurements from the two methods were compared with results suggest that the effectiveness and applicability of the developed tool, allowing lower doses radiological monitoring of the patient during treatment.

  20. Spatial analysis of pulmonary tuberculosis in Antananarivo Madagascar: tuberculosis-related knowledge, attitude and practice.

    Directory of Open Access Journals (Sweden)

    Sitraka Rakotosamimanana

    Full Text Available Tuberculosis infection may remain latent, but the disease is nevertheless a serious public health issue. Various epidemiological studies on pulmonary tuberculosis have considered the spatial component and taken it into account, revealing the tendency of this disease to cluster in particular locations. The aim was to assess the contribution of Knowledge Attitude and Practice (KAP to the distribution of tuberculosis and to provide information for the improvement of the National Tuberculosis Program.We investigated the role of KAP to distribution patterns of pulmonary tuberculosis in Antananarivo. First, we performed spatial scanning of tuberculosis aggregation among permanent cases resident in Antananarivo Urban Township using the Kulldorff method, and then we carried out a quantitative study on KAP, involving TB patients. The KAP study in the population was based on qualitative methods with focus groups.The disease still clusters in the same districts identified in the previous study. The principal cluster covered 22 neighborhoods. Most of them are part of the first district. A secondary cluster was found, involving 18 neighborhoods in the sixth district and two neighborhoods in the fifth. The relative risk was respectively 1.7 (p<10-6 in the principal cluster and 1.6 (p<10-3 in the secondary cluster. Our study showed that more was known about TB symptoms than about the duration of the disease or free treatment. Knowledge about TB was limited to that acquired at school or from relatives with TB. The attitude and practices of patients and the population in general indicated that there is still a stigma attached to tuberculosis.This type of survey can be conducted in remote zones where the tuberculosis-related KAP of the TB patients and the general population is less known or not documented; the findings could be used to adapt control measures to the local particularities.

  1. Diagnostic features and curative effect of senile chronic obstructive pulmonary disease in patients with pulmonary tuberculosis%老年慢性阻塞性肺疾病合并肺结核的诊断特点及疗效

    Institute of Scientific and Technical Information of China (English)

    孙砚诚

    2013-01-01

    Objective To discuss the Diagnostic features and curative effect of senile chronic obstructive pulmonary disease in patients with pulmonary tuberculosis. Methods A clinical data of 64 cases of patients with chronic obstructive pulmonary disease combined with pulmonary tuberculosis was retrospectively analyzed from June 2010 to June 2011 in our department of respiratory,and the clinical characteristics of patients with COPD combined with pulmonary tuberculosis were summarized. Results Male patients were more than female patients through retrospective analysis of the clinical data.A majority of patients had a history of smoking,combined with different severity of pulmonary infection.The positive rate of Mycobacterium tuberculosis was high through test of sputum culture. About more than 79% of patients showed different degrees of emphysema by imaging studies,no characteristic tuberculosis by chest X-ray,so it was easy to make misdiagnosis in clinic. Conclusion The clinical features of COPD combined with pulmonary tuberculosis is complicated, no characteristic clinical manifestations, which is easy to be missed,so it is important to be careful for early detection and early treatment.%目的探讨老年慢性阻塞性肺疾病合并肺结核感染的临床诊断特点及临床治疗效果。方法回顾性分析2010年6月~2011年6月我院呼吸内科收治的64例慢性阻塞性肺疾病合并肺结核患者的临床资料,并总结出慢性阻塞性肺疾病合并肺结核患者的临床诊断特点。结果经过对患者的资料进行回顾性分析后,男性患者多于女性患者,有大部分患者有吸烟史,患者还合并不同程度的肺部感染等,经痰培养试验检查结核杆菌阳性率阳性率高。影像学检查显示,约79%以上的患者结果显示不同程度的肺气肿,胸片无特征性结核表现,所以在临床诊断上容易误诊。结论临床上慢性阻塞性肺疾病合并肺结核的发病特点复杂多变

  2. 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

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

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    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.

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

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    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.

  5. Health care seeking among pulmonary tuberculosis suspects and patients in rural Ethiopia: a community-based study

    Directory of Open Access Journals (Sweden)

    Yimaldu Tilahun

    2009-12-01

    Full Text Available Abstract Background Health care seeking is a dynamic process that is influenced by socio-demographic, cultural and other factors. In Ethiopia, there are limited studies regarding the health seeking behaviour of tuberculosis (TB suspects and TB patients. However, a thorough understanding of patients' motivation and actions is crucial to understanding TB and the treatment of disease. Such insights would conceivably help to reduce delay in diagnosis, improve treatment adherence and thereby reduce transmission of TB in the community. The objective of this study was to describe and analyze health care seeking among TB suspects and pulmonary TB (PTB cases in a rural district of the Amhara Region in Ethiopia. Methods Study kebeles were randomly selected in a cross-sectional study design. House-to-house visits were conducted in which individuals aged 15 years and above in all households of the kebeles were included. Subjects with symptoms suggestive of TB were interviewed about their health seeking behaviour, socio-demographic and clinical factors using a semi-structured questionnaire. Logistics regression analysis was employed to assess associations between the independent and outcome variables. Results The majority, 787 (78%, TB suspects and 33 (82.5% PTB cases had taken health care actions for symptoms from sources outside their homes. The median delay before the first action was 30 days. In logistics regression, women (AOR 0.8, 95% CI 0.6, 0.9 were found to be less likely to visit a medical health provider than men. Those with a long duration of cough (AOR 1.5, 95% CI 1.03, 2.1 and those with a previous history of TB (AOR 1.5, 95% CI 1.03, 2.3 were more likely to visit a medical health provider compared to those with a shorter duration of cough and with no history of TB. Conclusion The majority of TB suspects and PTB cases had already taken health care actions for their symptoms at the time of the survey. The availability of a simple and rapid

  6. 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

  7. A time-to-event pharmacodynamic model describing treatment response in patients with pulmonary tuberculosis using days to positivity in automated liquid mycobacterial culture.

    Science.gov (United States)

    Chigutsa, Emmanuel; Patel, Kashyap; Denti, Paolo; Visser, Marianne; Maartens, Gary; Kirkpatrick, Carl M J; McIlleron, Helen; Karlsson, Mats O

    2013-02-01

    Days to positivity in automated liquid mycobacterial culture have been shown to correlate with mycobacterial load and have been proposed as a useful biomarker for treatment responses in tuberculosis. However, there is currently no quantitative method or model to analyze the change in days to positivity with time on treatment. The objectives of this study were to describe the decline in numbers of mycobacteria in sputum collected once weekly for 8 weeks from patients on treatment for tuberculosis using days to positivity in liquid culture. One hundred forty-four patients with smear-positive pulmonary tuberculosis were recruited from a tuberculosis clinic in Cape Town, South Africa. A nonlinear mixed-effects repeated-time-to-event modeling approach was used to analyze the time-to-positivity data. A biexponential model described the decline in the estimated number of bacteria in patients' sputum samples, while a logistic model with a lag time described the growth of the bacteria in liquid culture. At baseline, the estimated number of rapidly killed bacteria is typically 41 times higher than that of those that are killed slowly. The time to kill half of the rapidly killed bacteria was about 1.8 days, while it was 39 days for slowly killed bacteria. Patients with lung cavitation had higher bacterial loads than patients without lung cavitation. The model successfully described the increase in days to positivity as treatment progressed, differentiating between bacteria that are killed rapidly and those that are killed slowly. Our model can be used to analyze similar data from studies testing new drug regimens.

  8. A cross-sectional study of sputum handling by and supervision of patients with pulmonary tuberculosis treated at home in China.

    Science.gov (United States)

    Mei, L; Tobe, R G; Geng, H; Ma, Y B; Li, R Y; Wang, W B; Selotlegeng, L; Wang, X Z; Xu, L Z

    2012-12-01

    Disposal of sputum from patients with pulmonary tuberculosis (TB) who are treated at home is an important aspect of preventing the spread of TB. However, few studies have examined disposal of sputum by patients with TB who are treated at home. Patients with pulmonary TB who are treated at home were surveyed regarding sputum handling and supervision. A cross-sectional survey of a representative sample of patients with pulmonary TB who are treated at home was conducted in Shandong Province. Participants were individuals with TB who had been registered with a local agency responsible for TB control. Participants completed a questionnaire with both qualitative and quantitative questions. How sputum was handled was determined and factors associated with sputum disposal were analyzed using a non-parametric test, logistic regression, and content analysis. Responses were received from 720 participants. Patients expectorated sputum 4.56 ± 10.367 times a day, and 68.6% of patients responded that they correctly disposed of their sputum. Supervision as part of TB control focused on the efforts of health agencies and paid little attention to waste management by patients. A non-parametric test showed that sputum disposal was significantly associated with gender, age, education, sputum smear results, attitudes toward waste management, and attitudes toward supervision (all p handling by and supervision of patients with pulmonary TB who are treated at home is severely wanting. From a policy perspective, special attention should be given to the definition, details, and methods of supervision of waste management by patients with TB to give them relevant health education and enhance their willingness to be supervised. A financial incentive should be provided to health workers supervising management of TB-related waste.

  9. Tuberculosis in patients with chronic renal failure

    OpenAIRE

    Flávio Jota de Paula; Luiz Sérgio Fonseca de Azevedo; Luiz Estevam Ianhez; João Egidio Romão Júnior; Pedro Renato Chocair; Emil Sabbaga

    1987-01-01

    Nine cases of tuberculosis (TB) were diagnosed among 800 uremic patients, followed-up during 11 years, a prevalence of 1125%, 2.5 times higher than that in the general population. Six patients (66.7%) had lymph node involvement (4 cervical and 2 mediastinal). Three patients (33.3%) had pulmonary involvement (2 pleuro-pulmonary and 1 bilateral apical pulmonary). Eight patients were undergoing dialysis and 1 was pre-dialytic. The duration of dialysis ranged from 1 to 60 months. Three patients h...

  10. Pulmonary tuberculosis in a patient with rheumatoid arthritis undergoig immunosuppressive treatment: case report

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    Sandro Ceratti

    2014-02-01

    Full Text Available Rheumatoid arthritis is a disease which characteristically affects the joints. Because it is an autoimmune disease, immunosuppressive drugs are widely used in its treatment. The present case report illustrates the association of immunosuppressive treatment with the development of opportunistic infections in a 64-year-old patient.

  11. Hematological and Biochemistry Profile and Risk Factors Associated with Pulmonary Tuberculosis Patients in Guyana

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    Rajini Kurup

    2016-01-01

    Full Text Available Objective. To evaluate the hematological and biochemistry profile of patients with or without HIV-TB at the Georgetown Chest Clinic, Guyana. Methods. An observational, laboratory based study was designed to assess the relationship of PTB and HIV with patients routine biochemical and hematological values. The study was conducted during the period January 2013 to December 2014; a total sample size of 316 patients was enrolled following exclusion and inclusion criteria. Results. Mean age of study population was 40.1 ± 13.8 (95% CI 38.6–41.7 and most were between 40 and 49 age group (27.8%, 95% CI 23.2–33.0. More males were in the study 74.4% (95% CI 69.3–78.8 than females 81% (95% CI 21.1–30.7. 30% (95% CI 25.3–35.3 had a sputum smear grade of 3+ and 62.5% (95% CI 47.0–75.7 showed a CD4 count <200. The study demonstrated significantly low hemoglobin (Hb 91.7% (95% CI 78.2–97.1, low WBC 27.8% (95% CI 15.8–44.0, high indirect bilirubin 7.4% (95% CI 2.1–23.3, ALT 41.8% (95% CI 28.4–56.7, and AST 72.2% (95% CI 57.3–83.3 among TB-HIV patients. Homelessness RR (relative risk 2.2 (95% CI 0.48–12.3, smoking RR 1.09 (95% CI 1.01–1.19, and gender (male RR 1.2 (95% CI 0.61–2.26 were main associated risk factors. Conclusions. There is slight variation among PTB and PTB-HIV coinfected patients in some hematological and biochemistry parameters.

  12. The history of surgery for pulmonary tuberculosis.

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    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.

  13. Reactional Plasmacytosis In Plasma Cell Orificial mucositis In A Patient Of Pulmonary Tuberculosis

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    Bose Sumit Kumar

    1997-01-01

    Full Text Available Skin biopsy of a 50 year old Moroccan male patient with labial and oro-pharyngeal plasmocytosis showed hyperplastic, with papillomatous eroded epithelium. Dense infiltrates of plasma cells were seen in the dermis, with perivascular prominence. Hypopharynx, epiglottis, adenoids, and tonsils showed the same type of infiltration. Immunofluorescence (IF and peroxidase antiperoxidase (PAP techniques demonstrated the presence of mostly and infiltrate of plasma cells showing IgA (30 â€" 40%, IgM (20-30%, IgG(10-20% after staining with polyclonal antibodies along with T4 & T8 Iymphocytes with monoclonal staining. Electron microscopy showed absence of atypical plasma cells with abundant endoplasmic reticulum. Patient’s symptoms of stomtitis, dysphonia and pharyngitis were temporarily relieved by systemic corticosteroids of plasma cells suggesting a reactive type of benign plasmocytosis.

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

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    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.

  15. 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.

  16. Exercise therapy in the complex of physical rehabilitation of patients with pulmonary tuberculosis.

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    Nogas A.O.

    2012-01-01

    Full Text Available The programs of physical rehabilitation, which are directed on proceeding in the broken function of the external breathing, are appraised. In research 68 patients took part with a diagnosis the first diagnosed white plague (40 - men and 28 - women, middle ages - 29 years. The complex program of physical rehabilitation included: morning hygienical gymnastics, medical gymnastics, massotherapy, physical therapy procedures, hydropathy, manipulation interferences and educational programs. A tendency is set to more hasty growth of indexes which characterize the level of violation of bronchial ability to travel the cross-country; frequencies of breathing, respiratory volume, minute volume of breathing. It is well-proven that over application of medical physical culture brings to rapid renewal of the broken function of the external breathing, improvement of the functional state of the respiratory and cardiovascular systems, strengthening of respiratory musculature, increase of efficiency of medicinal therapy, general physical health and diminishing of development of complications level.

  17. Clinical and radiographic predictors in diagnosing sputum smear-negative pulmonary tuberculosis in HIV-negative patients: a cross-sectional study in China

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    LI Xin-xu; JIANG Shi-wen; ZHANG Hui; JING Kuan-he; WANG Li; LI Wei-bin; LIU Xiao-qiu

    2013-01-01

    Background In county-level tuberculosis (TB) dispensaries in China,the accurate diagnosis of sputum smear-negative pulmonary tuberculosis (SNPT) needs to be improved by developing and validating clinical and radiographic predictors.Methods The study was conducted simultaneously in three counties per province in Chongqing Municipality and Liaoning Province in China between May 2005 and May 2006.A total of 432 new SNPT patients who are HIV-negative and more than 15 years old diagnosed by expert panels in county-level TB dispensaries were recruited.Their sputum samples were collected for culture before anti-TB treatment,and the treatment outcomes (changes of X-rays) were followed up at the end of the 6th month.Results Of the 432 SNPT patients,sputum culture positive (9.7%) or culture negative with good changes of X-rays at the end of the 6th month (73.6%) was validated as SNPT.Four predictive variables were associated with validated SNPT in the multivariate logistic regression model:age ≤55 years old (odds ratio (OR) 5.66; 95% CI 2.69-11.91),>60 days of cough (OR 3.73; 95% CI 1.10-12.65),≥10% of pulmonary consolidation in the lungs (OR 5.40; 95% CI 2.90-10.06),and pulmonary consolidation in the upper lobe anterior segment (OR 3.00; 95% CI 1.57-5.72).The area under the receiver operating characteristic curve of the model was 0.77 (95% CI 0.71-0.83).Conclusion Four predictors of clinical and radiological characteristics that had a good diagnostic performance of SNPT deserve to be recommended as index indicators of SNPT diagnosis in county-level TB dispensaries in China.

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

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    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.

  19. Multidrug Resistant Pulmonary Tuberculosis Treatment Regimens and Patient Outcomes : An Individual Patient Data Meta-analysis of 9,153 Patients

    NARCIS (Netherlands)

    Ahuja, Shama D.; Ashkin, David; Avendano, Monika; Banerjee, Rita; Bauer, Melissa; Bayona, Jamie N.; Becerra, Mercedes C.; Benedetti, Andrea; Burgos, Marcos; Centis, Rosella; Chan, Eward D.; Chiang, Chen-Yuan; Cox, Helen; D'Ambrosio, Lia; DeRiemer, Kathy; Nguyen Huy Dung, [No Value; Enarson, Donald; Falzon, Dennis; Flanagan, Katherine; Flood, Jennifer; Garcia-Garcia, Maria L.; Gandhi, Neel; Granich, Reuben M.; Hollm-Delgado, Maria G.; Holtz, Timothy H.; Iseman, Michael D.; Jarlsberg, Leah G.; Keshavjee, Salmaan; Kim, Hye-Ryoun; Koh, Won-Jung; Lancaster, Joey; Lange, Christophe; de lange, Wiel C. M.; Leimane, Vaira; Leung, Chi Chiu; Li, Jiehui; Menzies, Dick; Migliori, Giovanni B.; Mishustin, Sergey P.; Mitnick, Carole D.; Narita, Masa; O'Riordan, Philly; Pai, Madhukar; Palmero, Domingo; Park, Seung-kyu; Pasvol, Geoffrey; Pena, Jose; Perez-Guzman, Carlos; Quelapio, Maria I. D.; Ponce-de-Leon, Alfredo; Riekstina, Vija; Robert, Jerome; Royce, Sarah; Schaaf, H. Simon; Seung, Kwonjune J.; Shah, Lena; Shim, Tae Sun; Shin, Sonya S.; Shiraishi, Yuji; Sifuentes-Osornio, Jose; Sotgiu, Giovanni; Strand, Matthew J.; Tabarsi, Payam; Tupasi, Thelma E.; van Altena, Robert; Van der Walt, Martie; Van der Werf, Tjip S.; Vargas, Mario H.; Viiklepp, Pirett; Westenhouse, Janice; Yew, Wing Wai; Yim, Jae-Joon

    Background: Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB. Methods and

  20. Riesgo nutricional en pacientes con tuberculosis pulmonar: ¿cuestión del paciente o de los servicios de salud? Nutritional risk in patients with pulmonary tuberculosis. A patient or a health services issue?

    Directory of Open Access Journals (Sweden)

    Georgina Mayela Núñez-Rocha

    2000-04-01

    Full Text Available OBJETIVO: Identificar factores de riesgo nutricional en pacientes con tuberculosis pulmonar (TBP.MATERIAL Y MÉTODOS: Se seleccionaron al azar 185 pacientes con TBP atendidos en dos instituciones de salud de Monterrey, Nuevo León, México, durante 1997. Se identificaron variables antropométricas, socioeconómicas, utilización del servicio de nutrición, accesibilidad a los alimentos, efectos secundarios de drogas antifímicas, y atribución de la enfermedad a la alimentación. El plan de análisis incluyó estadística descriptiva, análisis bivariado y multivariado de regresión logística múltiple, además se estimó razón de prevalencia e intervalos de confianza de 95%. RESULTADOS: El promedio de edad fue de 42.4±19.9 años. La media de índice de masa corporal fue de 19.8±3.2 y se encontraban desnutridos 56.8% del total de los pacientes. El 26.4% de éstos fue enviado al servicio de nutrición y, únicamente, 24.3% lo utilizó. El análisis multivariado mostró como factores de riesgo para desnutrición a los efectos secundarios de las drogas antifímicas, independientemente de la edad, sexo, escolaridad, ocupación, tiempo de evolución, accesibilidad a los alimentos, atribución de la enfermedad al tipo de alimentación y utilización del servicio de nutrición (ji²=10.58; p=0.0515, r²=0.42. CONCLUSIONES: El riesgo nutricional al que se enfrenta el paciente es responsabilidad tanto de éste, por la escasa utilización que hace del servicio de nutrición, como de los servicios de salud, debido a la existencia de barreras de tipo organizacional que dificultan el acceso al servicio de nutrición. Además, la falta de accesibilidad a los alimentos y el impacto de los efectos secundarios de las drogas antifímicas justifican la necesidad de focalizar la atención en este grupo de riesgo.OBJECTIVE: To determine nutritional risk factors in a population of patients with pulmonary tuberculosis (PT. MATERIAL AND METHODS: During 1997, one

  1. Rapid laboratory diagnosis of pulmonary tuberculosis

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    Prasanna Bhirud

    2017-01-01

    Full Text Available Background: Tuberculosis (TB ranks as the second leading cause of death from an infectious disease worldwide. Early diagnosis of Mycobacterium tuberculosis in clinical samples becomes important in the control of TB both for the treatment of patients and for curbing of disease transmission to the others in the community. The study objective was to perform Ziehl–Neelsen (ZN staining, fluorochrome staining, line probe assay (LPA, and loop-mediated isothermal amplification (LAMP assay for rapid detection of pulmonary TB (PTB and to compare the results of LPA and LAMP in terms of sensitivity, specificity, and turnaround time. Methods: A total of 891 sputum samples from clinically diagnosed/suspected cases of TB were subjected to ZN and fluorochrome staining. Smear positive samples were subjected to LPA, and smear negative were cultured on Lowenstein–Jensen media. A total of 177 samples were subjected to liquid culture and LAMP. Conventional culture was considered as “gold standard” for calculation of parameters. Results: Light-emitting diode fluorescence microscopy had the same sensitivity as ZN with similar high specificity. LPA was performed on 548 sputum samples which includes 520 smear positive and 28 smear negative culture positive samples and multidrug-resistant TB was detected in 32.64%. The sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV of TB-LAMP on direct sputum samples was found to be 98.96%, 95%, 96%, and 98.70%, respectively, when compared with ZN smear microscopy. By considering culture as “gold standard,” LAMP showed a sensitivity, specificity, PPV, and NPV of 98.94%, 96.34%, 96.90%, and 98.75%, respectively. The sensitivity and PPV of TB-LAMP were 98.97% and 96%, respectively, when compared with LPA. Conclusions: A successful rapid laboratory diagnosis of PTB is possible when one combines the available methodology of microscopy, culture as well as molecular techniques. The LAMP

  2. Avaliação audiométrica de pacientes em tratamento para tuberculose pulmonar Audiometric evaluation of patients treated for pulmonary tuberculosis

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    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

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

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    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.

  4. 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.

  5. 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.

  6. A Rare Case of Intracavitary Fungus Ball (Aspergilloma in the Old Pulmonary Tuberculosis

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    Majzoobi MM

    2017-06-01

    Full Text Available Introduction: Pulmonary fungus ball is a rare complication in pre-existing pulmonary cavitary lesions, due to some chronic pulmonary diseases including tuberculosis, lung abscess and sarcoidosis. Fungus ball is mostly caused by aspergillus. In many patients, fungus ball is asymptomatic, but in a significant number of them it can develop cough and hemoptysis, which may be massive and fatal. The cornerstone of assessment is chest imaging, along with sputum culture or aspergillus antibody in patient's serum. The purpose of this report is increment in attention to this complication in patients with previous pulmonary tuberculosis (TB. Case Presentation: The patient was a 23-year-old woman with chief complaint of fever, cough and hemoptysis, who was hospitalized in the Infectious Diseases Ward of Farshchian Sina hospital in March 2016. She had a history of anti-TB therapy from two years before. Sputum and bronchoalveolar lavage (BAL were negative for cytology and Mycobacterium tuberculosis, but cultures of both samples were positive for Aspergillus niger. Her lung contrast-enhanced computerized tomography (CECT scan revealed the presence of a fungus ball inside the upper lobe cavity of right lung. After lobectomy, fungal mass was confirmed by histopathology. Conclusions: In patients with pulmonary complaints (especially hemoptysis and history of cavitary pulmonary tuberculosis, the differential diagnosis of community-acquired pneumonia, lung abscess, reactivation of tuberculosis and lung cancer as well as fungal infections should be considered.

  7. [Drug sensitivity in Mycobacterium tuberculosis versus its viability, cytotoxicity, genotype, and the course of the process in patients with pulmonary tuberculosis].

    Science.gov (United States)

    Manicheva, O A; Lasunskaia, E B; Zhuravlev, V Iu; Otten, T F; Barnaulov, A O; Mokrousov, I V; Pavlova, M V; Vishnevskiĭ, B I; Narvskaia, O V

    2008-01-01

    The authors studied drug sensitivity, mutations in the katG, in-hA, alpC, rpoB genes, virulence via the cytotoxicity test on THP-1 cells, and the viability and genetic affiliation of 53 clinical M. tuberculosis isolates versus data on the form and dynamics of a process. Sensitive and resistant strains did not significantly differ in viability and cytotoxicity. The highest death of infected macrophages was observed was seen with infection of M. tuberculosis of the Beijing B0 genotype, the least one seen with that of LAM with the similar rate of multiple drug resistance. There was a correlation of the changes in the count of lymphocytes in patients with the genetic affiliation of a causative agent. The severest course of the tuberculous process was observed in baseline lymphopenia (before treatment) in combination with multidrug resistance of mycobacteria, high and moderate cytotoxicity and high viability. Ser-Leu 531 mutation resulted in cross resistance to rifampicin and mycobutin in most cases.

  8. 肺结核合并糖尿病患者治疗的临床疗效观察%The Clinical Effect of the Treatment of Pulmonary Tuberculosis Patients with Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    边玛措

    2016-01-01

    Objective: To investigate the clinical treatment scheme selection and its effect in patients with pulmonary tuberculosis complicated with diabetes mellitus. Methods: in 2012 and 2015 in our hospital were analyzed retrospectively for pulmonary tuberculosis and in patients with diabetes mellitus complicated with 200 cases as the research object, randomly selected 100 cases and as a group, in on the basis of routine pulmonary tuberculosis treatment combined with conventional hypoglycemic measures, remaining 100 cases of patients were divided into a and B groups, routine treatment of pulmonary tuberculosis combined with strong hypoglycemic interventions. Comparison of two treatment options for patients with pulmonary tuberculosis disease and blood glucose indicators to improve the situation. Results: patients in group A were 16 cases patients blood glucose control effect is poor, the patients of group B, 4 cases of patients with glycemic index did not reach control, group contrast data have differences (P < 0.05); a group of curative effect of pulmonary tuberculosis determine ineffective in 20 cases of patients, patients in group B decision of pulmonary tuberculosis in 6 patients with treatment failure, contrast differences (P < 0.05). Conclusion: of diabetes complicated with pulmonary tuberculosis patients in the course of treatment should pay more attention to control intervention on glycemic index and diabetes get relieved after more conducive to the improvement of pulmonary tuberculosis disease and a greater degree of patient health and daily life to provide protection.%目的:了解合并糖尿病的肺结核患者临床治疗方案选择及其效果。方法:选取于2012年-2015年期间本院收治确诊为肺结核且合并糖尿病患者200例为本次研究对象,随机抽取100例并设为 A 组,在常规肺结核治疗基础上联合常规降糖措施,余下100例患者设为 B 组,常规肺结核治疗联合强降糖干预措施。比较两

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

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    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.

  10. 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.

  11. 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.

  12. Diagnostic accuracy of an integrated respiratory guideline in identifying patients with respiratory symptoms requiring screening for pulmonary tuberculosis: a cross-sectional study

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    Majara Bosielo P

    2006-08-01

    .9–29.4. Conclusion The PALSA guideline is an effective screening tool for identifying patients requiring bacteriological screening for pulmonary tuberculosis in this primary care setting. This supports the randomized trial finding that use of the guideline increased TB case detection.

  13. [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.

  14. The impact of HIV infection and CD4 cell count on the performance of an interferon gamma release assay in patients with pulmonary tuberculosis.

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    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.

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

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

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    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.

  17. Factors influencing response to treatment of pulmonary tuberculosis.

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    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.

  18. [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.

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

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    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.

  20. Clinical value of whole-blood interferon-gamma assay in patients with suspected pulmonary tuberculosis and AFB smear- and polymerase chain reaction-negative bronchial aspirates.

    Science.gov (United States)

    Lee, Jaehee; Lee, Shin Yup; Yoo, Seung Soo; Cha, Seung Ick; Won, Dong Il; Park, Jae Yong; Lee, Won-Kil; Kim, Chang Ho

    2012-07-01

    Combining a polymerase chain reaction (PCR) test with bronchoscopy is frequently performed to allow a rapid diagnosis of smear-negative pulmonary tuberculosis (PTB). However, limited data are available concerning clinical judgment in patients with suspected PTB and AFB smear- and PCR-negative bronchial aspirates (BA). The present study evaluated the usefulness of whole-blood QuantiFERON-TB Gold In-Tube (QFT) testing in these patients. Of 166 patients with suspected PTB who had undergone bronchoscopy because of smear-negative sputum or inadequate sputum production, 93 (56%) were diagnosed with culture-positive PTB. Seventy-four patients were either AFB smear- or PCR-positive. In the 75 patients whose BA AFB smear and PCR results were both negative, 19 were finally diagnosed with PTB by culture. The QFT test had a negative predictive value of 91% for PTB. The QFT test may be useful for excluding PTB in patients with suspected PTB whose BA AFB smear and PCR results are both negative. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Patient satisfaction, feasibility and reliability of satisfaction questionnaire among patients with pulmonary tuberculosis in urban Uganda: a cross-sectional study

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    Katamba Achilles

    2011-01-01

    Full Text Available Abstract Background A comprehensive understanding of the barriers to and facilitators of poor tuberculosis (TB treatment outcome is still lacking; posing a major obstacle to finding effective solutions. Assessment of patient satisfaction in TB programs would contribute to the understanding of gaps in healthcare delivery and the specific needs of individual patients. However, tools for assessing patient satisfaction are lacking. Objective To establish patient satisfaction, the feasibility and reliability of a questionnaire for healthcare service satisfaction and a questionnaire for satisfaction with information received about TB medicines among adult TB patients attending public and private program clinics in Kampala, Uganda. Methods In a cross-sectional study, we recruited 133 patients of known HIV status and confirmed pulmonary TB receiving care at the public and private hospitals in Kampala, Uganda. Participants were enrolled based on length of TB treatment as follows: starting therapy, completed two months of therapy, and completed eight months of therapy. A translated and standardized 13-item patient healthcare service satisfaction questionnaire (PS-13 and the Satisfaction with Information about Medicines Scale (SIMS tool were administered by trained interviewers. Factor analysis was used to systematically group the PS-13 questionnaire into three factors of technical quality of care, responsiveness to patient preference, and management of patient preference satisfaction subscales. The SIMS tool was analyzed with two subscales of information about the action and usage of medication and the potential problems with medication. Results Of the 133 participants, 35% (46/133 were starting, 33% (44/133 had completed two months, and 32% (43/133 had completed eight months of TB therapy. The male to female and public to private hospital ratios in the study population were 1:1. The PS-13 and the SIMS tools were highly acceptable and easily administered

  2. Tc-99m-MIBI Uptake in Active Pulmonary Tuberculosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang Ho; Park, Chan Hee; Hwang, Hee Sung; Bae, Moon Sun [Ajou University College of Medicine, Suwon (Korea, Republic of)

    1996-06-15

    Technetium-99m MIBI was developed as a myocardiac perfusion imagine agent and has been used effectively in the detection and post-therapeutic evaluation of various neoplasm such as thyroid, lung, bone and breast tumors. As an infrequent findings, Tc-99m MIBI agent has shown in non-neoplastic pulmonary conditions including fibroding alveolitis, pulmonary actinomycosis, active pulmonary sarcoidosis, pulmonary interstitial fibrosis in progressive systemic sclerosis and active osteomyelitis. In a recent report conducted by Cetin Oncel, Tc-99m MIBI imaging is an effective method in the detection and follow-up of pulmonary tuberculosis. We have also experienced Tc-99m-MIBI uptake in active pulmonary tuberculosis incidentally found in a patient with suspected proliferative villonodular synovitis of the left ankle.

  3. Aspergilosis necrotizante crónica en un paciente con secuelas de tuberculosis pulmonar Chronic necrotizing aspergillosis in a patient with pulmonary tuberculosis sequelae

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    Alcides Zambrano F

    2007-03-01

    Full Text Available Aspergillus fumigatus puede causar diferentes patologías en el ser humano: aspergiloma, aspergilosis broncopulmonar alérgica, aspergilosis necrotizante crónica, aspergilosis invasora. En la aspergilosis necrotizante crónica hay invasión local del parénquima y destrucción. A diferencia de la aspergilosis invasora no invade vasos sanguíneos ni se disemina a otros órganos. La aspergilosis necrotizante crónica se presenta en pacientes de edad media o ancianos con patología pulmonar previa: EPOC, secuelas de tuberculosis, resección pulmonar, neumoconiosis, radioterapia, infarto pulmonar o sarcoidosis. La clínica es indolente e inespecífica, con fiebre, tos, expectoración y baja de peso. Se desconoce la incidencia de aspergilosis necrotizante crónica en nuestro medio. La aspergilosis necrotizante crónica es potencialmente fatal, por lo que requiere de un diagnóstico y tratamiento oportuno. Creemos que, debe considerarse esta entidad ante un cuadro consuntivo y febril prolongado, en pacientes con enfermedades predisponentes que producen una leve baja de la inmunidad. Describimos el caso de un paciente atendido en el Instituto Nacional del TóraxAspergillus fumigatus is the causative agent of differents pathologies in the human being: aspergilloma, allergic bronchopulmonary aspergillosis, chronic necrotizing aspergillosis and invasive aspergillosis. In chronic necrotizing aspergillosis there is local invasion of the lung tissue and parenchyma destruction. Chronic necrotizing aspergillosis is different from invasive aspergillosis, because the abscence of vascular invasion or dissemination. Chronic necrotizing aspergillosis is seen in middle-aged and elderly with underlying lung diseases: COPD, tuberculosis sequelae, lung resection, pneumoconiosis, radiotherapy, lung infarction or sarcoidosis. Clinical manifestations are non specific, being the most usual fever, cough, sputum production and weight loss. Incidence of chronic necrotizing

  4. Analysis on incidence reason of 224 pulmonary tuberculosis patients%224例肺结核病人发病原因分析

    Institute of Scientific and Technical Information of China (English)

    江秉态

    2013-01-01

    目的:探讨现阶段引起结核病发病的主要原因,为预防和控制结核病提供理论依据。方法:通过对旌阳区结核病防治所在2010年6月至2011年6月期间登记的224例新发涂阳肺结核病人进行回顾性问卷调查,对可能引起发病的原因进行分析。结果:224例肺结核病人中,有麻将史103例(46.0%),有网吧上网史38例(17.0%),有外出打工史20例(8.9%),有家人或同事患结核病14例(6.3%),同时有麻将史和打工史13例(5.8%),同时有麻将史和家庭接触史8例(3.6%),从事美容美发6例(2.6%),有在游戏厅玩游戏史的2例(0.9%),从事废品收购2例(0.9%),从事扫地工作1例(0.4%),其他17例(7.6%)。结论:在麻将馆打麻将和在网吧上网是目前引起结核病发病的主要原因,加强对麻将场馆和网吧等公共场所的监督与管理,并采取积极的干预措施势在必行。%Objective:To explore the main reason caused by tuberculosis at the present stage,to provide a theoretical basis for the prevention and control of tuberculosis. Methods:224 new smear-positive pulmonary tuberculosis patients who were registered during June 2010 to June 2011 in Jingyang District Tuberculosis Control Center were analyzed by retrospective questionnaires,to find the main reason of tuberculosis. Results:Among the 224 cases,103 cases with mahjong history(46.0%) ,38 cases with internet history (17.0%),20 cases with history of migrant workers(8.9%), 14 cases with family or colleagues suffering from tuberculosis(6.3%),13 cases with history of mahjong and migrant workers(5.8%),8 cases with history of mahjong and family or colleagues suffering from tuberculosis(3.6%), 8 cases with engaging in Beauty salon(2.6%),2 cases with history of playing games in the games room(0.9%),2 cases with engaging in the acquisition of waste(0.9%),1 case with engaging in sweeping work(0.4%), the other 17 cases(7

  5. 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.

  6. Chest wall tuberculosis; CT findings in 14 patients

    Energy Technology Data Exchange (ETDEWEB)

    Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National Univ. School of Medicine, Chonju (Korea, Republic of); Kim, Dong Woo [Daejoen Eulji Hospital, Daejon (Korea, Republic of); Juhng, Seon Kwan [Wonkwang Univ. Medical School, Iksan (Korea, Republic of)

    1996-01-01

    To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis.

  7. Shortening Isolation of Patients With Suspected Tuberculosis by Using Polymerase Chain Reaction Analysis

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Thomsen, Vibeke Østergaard;

    2015-01-01

    Background. Isolation of patients suspected for pulmonary tuberculosis is guided by serial sputum smears. This can result in isolation for days for patients with noncontagious tuberculosis. To determine whether a single sample negative for Mycobacterium tuberculosis complex at polymerase chain...... reaction (PCR) can guide isolation. Methods. We retrospectively evaluated sputum samples analyzed for M. tuberculosis complex at the International Reference Laboratory of Mycobacteriology, Copenhagen, Denmark in 2002–2011. We selected culture-confirmed tuberculosis cases with ≥3 samples within 14 days...

  8. The impact of HIV infection and CD4 cell count on the performance of an interferon gamma release assay in patients with pulmonary tuberculosis

    DEFF Research Database (Denmark)

    Aabye, Martine G.; Ravn, Pernille; PrayGod, George;

    2009-01-01

    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...

  9. IL-6 and IL-18 cytokine gene variants of pulmonary tuberculosis patients with co-morbid diabetes mellitus and their household contacts in Hyderabad.

    Science.gov (United States)

    Ponnana, Meenakshi; Sivangala, Ramya; Joshi, Lavanya; Valluri, Vijayalakshmi; Gaddam, Sumanlatha

    2017-09-05

    Association of cytokine genes reflects their susceptibility towards infection and disease in household contacts (HHC) of pulmonary tuberculosis (PTB) patients. Hyperglycemia, a common factor in diabetics might influence their risk towards mycobacterium tuberculosis infection and disease development. This study determines the association of IL-6 and IL-18 cytokine gene variants of TB patients with diabetes mellitus (TBDM) and their HHC in Hyderabad. Single nucleotide polymorphisms of IL-6 (-174 G>C and -572 G>C) and IL-18 (-137 G>C and -607 C>A) cytokine genes were genotyped by Amplification Refractory Mutation System and Restriction Fragment Length polymerase chain reaction in total of 705 subjects comprising of TBDM, their HHC, PTB, DM and Healthy controls (HC). At IL-6 -174G>C variant, GG genotype, G allele in TBDM and TBDM HHC, at -572G>C variant, C allele in TBDM and GG haplotype in TBDM HHC were showing positive association, however DM have not shown any association at IL-6 polymorphic sites. With respect to the IL-18 gene polymorphisms, at -137 G>C variant, GG genotype was positively associated in PTB while at -607 C>A variant positive association was shown with AC genotype in TBDM, their HHC and DM; GACC diplotype in TBDM and GCGC in PTB. Our findings suggest that susceptible combination of IL-6 and IL-18 cytokine genes associated with disease in the HHCs highlight their risk of inclination towards the disease. Copyright © 2017. Published by Elsevier B.V.

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

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    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. Nitric oxide production in the exhaled air of patients with pulmonary tuberculosis in relation to HIV co-infection

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    Melese Endalkachew

    2008-10-01

    Full Text Available Abstract Background Nitric oxide (NO is essential for host defense in rodents, but the role of NO during tuberculosis (TB in man remains controversial. However, earlier observations that arginine supplementation facilitates anti-TB treatment, supports the hypothesis that NO is important in the host defense against TB. Local production of NO measured in fractional exhaled air (FeNO in TB patients with and without HIV co-infection has not been reported previously. Thus, our aim was to investigate levels of FeNO in relation to clinical symptoms and urinary NO metabolites (uNO. Methods In a cross sectional study, FeNO and uNO were measured and clinical symptoms, chest x-ray, together with serum levels of arginine, tumor necrosis factor alpha (TNF-alpha and interleukin 12 (IL-12 were evaluated in sputum smear positive TB patients (HIV+/TB, n = 36, HIV-/TB, n = 59, their household contacts (n = 17 and blood donors (n = 46 from Gondar University Hospital, Ethiopia. Results The proportion of HIV-/TB patients with an increased FeNO level (> 25 ppb was significantly higher as compared to HIV+/TB patients, but HIV+/TB patients had significantly higher uNO than HIV-/TB patients. HIV+ and HIV-/TB patients both had lower levels of FeNO compared to blood donors and household contacts. The highest levels of both uNO and FeNO were found in household contacts. Less advanced findings on chest x-ray, as well as higher sedimentation rate were observed in HIV+/TB patients as compared to HIV-/TB patients. However, no significant correlation was found between FeNO and uNO, chest x-ray grading, clinical symptoms, TNF-alpha, IL-12, arginine levels or sedimentation rate. Conclusion In both HIV negative and HIV co infected TB patients, low levels of exhaled NO compared to blood donors and household were observed. Future studies are needed to confirm whether low levels of exhaled NO could be a risk factor in acquiring TB and the relative importance of NO in human TB.

  12. The effect of energy-protein supplementation on weight, body composition and handgrip strength among pulmonary tuberculosis HIV-co-infected patients

    DEFF Research Database (Denmark)

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

    2012-01-01

    Undernutrition is common among smear-positive pulmonary tuberculosis (PTB+) patients. Micronutrient supplementation may improve treatment outcomes, but it is unclear whether additional energy-protein would be beneficial. The present study aimed to assess the effect of energy-protein supplementation...... and handgrip strength were assessed at baseline and 2 and 5 months. There were no effects on any outcome at 2 months, but energy-protein supplementation was associated with a 1·3 (95 % CI - 0·1, 2·8) kg marginally significant gain in handgrip strength at 5 months. However, after 2 months, energy......-protein supplementation led to a weight gain of 1·9 (95 % CI 0·1, 3·7) kg among patients with cluster of differentiation 4 (CD4) counts ≥ 350 cells/μl, but not among patients with low CD4 counts ( - 0·2 kg; 95 % CI - 1·3, 0·8, Pinteraction = 0·03). Similarly, at 5 months, energy-protein supplementation led to a 2·3 (95...

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

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    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.

  14. 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.

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

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    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.

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

    Science.gov (United States)

    Zhang, Shao-Ru; Yan, Hong; Zhang, Jin-Jing; Zhang, Tian-Hua; Li, Xiao-Hong; Zhang, Yin-Ping

    2010-06-16

    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. 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. 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. 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.

  17. Evaluation of Smear Negative and Pozitive Pulmonary Tuberculosis Cases

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    Fulsen Bozkus

    2014-04-01

    Full Text Available Aim: To determine the relation between radiographic involvement and tuberculin skin test (TST and Bacillus Calmette Guerin (BCG results in patients with pulmonary tuberculosis (PTB. Material and Method: In 210 patients (%42,7 female, %57,6 male, mean age:40,5 ± 16,1 with smear positive and negative PTB we retrospectively analyzed the relation between radiographic findings, TST and BCG. We separated the patients into three groups as mild, moderate and severe according to their radiologic involvement and compared the radiologic extension with tuberculin skin test results. We also compared the degree of sputum smear positivity with tuberculin skin test results. Results: According to the evaluation of radiological findings of the patients, high risk is detected in 58(67,4% patients in smear-positive group and 28(32,6% patients in smear-negative group and statistically valuable relation between smear positivity and radiological findings of the patients is seen (p:0,001. According to the results of TST of the patients, high risk is detected radiologically in 53(61,6% cases of TST-negative group, 33(38,4% cases of TST-positive group and statistically valuable relation between TST results and radiological findings of the patients is seen (p:0,001. A valuable difference between BCG results and radiological findings is not seen. Discussion: It is concluded that radiology is beneficial for diagnosis especially in cases which are without bacilli and suspicious for tuberculosis and TST is shown that it can be beneficial for determining the immunity against to mycobacterium tuberculosis.

  18. 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’

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    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

  19. Tuberculosis in haemodialysis patients: A single centre experience.

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    Rao, T Manmadha; Ram, R; Swarnalatha, G; Santhosh Pai, B H; Ramesh, V; Rao, C Shyam Sunder; Naidu, G Diwaker; Dakshinamurty, K V

    2013-09-01

    We prospectively followed-up new patients of tuberculosis while on maintenance hemodialysis at a State Government-run tertiary care institute. Between 2000 and 2010, 1237 new patients were initiated on maintainence hemodialysis. The number of patients diagnosed with tuberculosis after initiation of hemodialysis was 131 (10.5% of 1237). The age was 46.4 ± 10.4 (range 8-85) years and there were 90 (68.7%) males. The number of patients diagnosed with tuberculosis on the basis of organ involvement were: Pulmonary-60, pleural effusion-31, lymph node-21, meningitis-8, pericardial effusion-7, peritoneum-2, latent tuberculosis-2. The incidence of tuberculosis in hemodialysis was found to be 105.9 per 1000 patient years. Male gender, diabetes mellitus, past history of tuberculosis, mining as an occupation, low serum albumin, and duration of hemodialysis more than 24 months, and unemployment were found to be significant risk-factors on univariate analysis.

  20. Results of the implementation of a pilot model for the bidirectional screening and joint management of patients with pulmonary tuberculosis and diabetes mellitus in Mexico.

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    Martín Castellanos-Joya

    Full Text Available Recently, the World Health Organisation and the International Union Against Tuberculosis and Lung Disease published a Collaborative Framework for the Care and Control of Tuberculosis (TB and Diabetes (DM (CFTB/DM proposing bidirectional screening and joint management.To evaluate the feasibility and effectiveness of the CFTB/DM in Mexico.Prospective observational cohort.15 primary care units in 5 states in Mexico.Patients aged ≥20 years diagnosed with DM or pulmonary TB who sought care at participating clinics.The WHO/Union CFTB/DM was adapted and implemented according to official Mexican guidelines. We recruited participants from July 2012 to April 2013 and followed up until March 2014. Bidirectional screening was performed. Patients diagnosed with TB and DM were invited to receive TB treatment under joint management.Diagnoses of TB among DM, of DM among TB, and treatment outcomes among patients with DM and TB.Of 783 DM patients, 11 (1.4% were unaware of their TB. Of 361 TB patients, 16 (4.4% were unaware of their DM. 95 TB/DM patients accepted to be treated under joint management, of whom 85 (89.5% successfully completed treatment. Multiple linear regression analysis with change in HbA1c and random capillary glucose as dependent variables revealed significant decrease with time (regression coefficients (β  = -0.660, (95% confidence interval (CI, -0.96 to -0.35; and β = -1.889 (95% CI, -2.77 to -1.01, respectively adjusting by sex, age and having been treated for a previous TB episode. Patients treated under joint management were more likely to experience treatment success than patients treated under routine DM and TB programs as compared to historical (adjusted OR (aOR, 2.8, 95%CI 1.28-6.13 and same period (aOR 2.37, 95% CI 1.13-4.96 comparison groups.Joint management of TB and DM is feasible and appears to improve clinical outcomes.

  1. Results of the Implementation of a Pilot Model for the Bidirectional Screening and Joint Management of Patients with Pulmonary Tuberculosis and Diabetes Mellitus in Mexico

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    Castellanos-Joya, Martín; Delgado-Sánchez, Guadalupe; Ferreyra-Reyes, Leticia; Cruz-Hervert, Pablo; Ferreira-Guerrero, Elizabeth; Ortiz-Solís, Gabriela; Jiménez, Mirtha Irene; Salazar, Leslie Lorena; Montero-Campos, Rogelio; Mongua-Rodríguez, Norma; Baez-Saldaña, Renata; Bobadilla-del-Valle, Miriam; González-Roldán, Jesús Felipe; Ponce-de-León, Alfredo; Sifuentes-Osornio, José; García-García, Lourdes

    2014-01-01

    Background Recently, the World Health Organisation and the International Union Against Tuberculosis and Lung Disease published a Collaborative Framework for the Care and Control of Tuberculosis (TB) and Diabetes (DM) (CFTB/DM) proposing bidirectional screening and joint management. Objective To evaluate the feasibility and effectiveness of the CFTB/DM in Mexico. Design. Prospective observational cohort. Setting. 15 primary care units in 5 states in Mexico. Participants: Patients aged ≥20 years diagnosed with DM or pulmonary TB who sought care at participating clinics. Intervention: The WHO/Union CFTB/DM was adapted and implemented according to official Mexican guidelines. We recruited participants from July 2012 to April 2013 and followed up until March 2014. Bidirectional screening was performed. Patients diagnosed with TB and DM were invited to receive TB treatment under joint management. Main outcome measures. Diagnoses of TB among DM, of DM among TB, and treatment outcomes among patients with DM and TB. Results Of 783 DM patients, 11 (1.4%) were unaware of their TB. Of 361 TB patients, 16 (4.4%) were unaware of their DM. 95 TB/DM patients accepted to be treated under joint management, of whom 85 (89.5%) successfully completed treatment. Multiple linear regression analysis with change in HbA1c and random capillary glucose as dependent variables revealed significant decrease with time (regression coefficients (β)  = −0.660, (95% confidence interval (CI), −0.96 to −0.35); and β = −1.889 (95% CI, −2.77 to −1.01, respectively)) adjusting by sex, age and having been treated for a previous TB episode. Patients treated under joint management were more likely to experience treatment success than patients treated under routine DM and TB programs as compared to historical (adjusted OR (aOR), 2.8, 95%CI 1.28–6.13) and same period (aOR 2.37, 95% CI 1.13–4.96) comparison groups. Conclusions Joint management of TB and DM is feasible and appears to

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

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    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

  3. 复治肺结核患者既往治疗情况对治疗效果的影响%The effect of previous treatment on the retreated pulmonary tuberculosis patients

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    梁汉成

    2016-01-01

    目的:研究并探讨复治肺结核患者既往治疗情况对其治疗效果的影响。方法于2012年1月—2014年12月,在我院收治的涂阳复治肺结核患者中,选取50例具有2次或以上既往抗结核治疗史的患者和50例仅有1次既往抗结核治疗史的患者进行对比研究,分别设置为对照组和观察组,两组患者均采用正规涂阳复治肺结核治疗方案:异烟肼、利福平、吡嗪酰胺、左氧氟沙星、丁胺卡那霉素进行治疗。对比两组患者的痰菌转阴率、病灶吸收率、空洞闭合率,并计算既往抗结核治疗次数与复治肺结核疗效之间的相关性系数。结果与对照组相比,观察组患者的痰菌转阴率、病灶吸收率、空洞闭合率均明显更高(P <0.05)。既往抗结核治疗次数与复治肺结核疗效之间呈负相关。结论复治肺结核的临床疗效受到既往抗结核治疗情况的影响,既往抗结核治疗次数越多,复治肺结核的临床疗效越差。%Objective:To study and discuss the effect of the treatment on the retreated pulmonary tuberculosis patients. Methods:In January 2012 - December 2014 in our hospital patients with retreated pulmonary tuberculosis,a comparative study was carried out in 50 patients with a history of more than 2 times of previous treatment of tuberculosis in the control group and 50 patients with 1 time of previous history of tuberculosis treatment were and the observation group,and two groups of patients were treated with isoniazid,rifampicin,pyrazinamide,levofloxacin and amikacin. The two groups of pa-tients were compared in sputum negative conversion rate,focus absorption,and cavity closure rate,and negative conversion rate of resistance between the previous tuberculosis treatment times and the curative effect between retreated tuberculosis sputum were calculated. Results:Compared with the control group,sputum negative conversion rate,focus absorption, cavity closure rate

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

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    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.

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

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    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.

  6. Feasibility, reliability and validity of health-related quality of life questionnaire among adult pulmonary tuberculosis patients in urban Uganda: cross-sectional study

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    Babikako Harriet M

    2010-09-01

    Full Text Available Abstract Background Despite the availability of standard instruments for evaluating health-related quality life (HRQoL, the feasibility, reliability, and validity of such instruments among tuberculosis (TB patients in different populations of sub-Saharan Africa where TB burden is of concern, is still lacking. Objective We established the feasibility, reliability, and validity of the Medical Outcomes Survey (MOS in assessing HRQoL among patients with pulmonary tuberculosis in Kampala, Uganda. Methods In a cross-sectional study, 133 patients with known HIV status and confirmed pulmonary TB disease were recruited from one public and one private hospital. Participants were enrolled based on duration of TB treatment according to the following categories: starting therapy, two months of therapy, and eight completed months of therapy. A translated and culturally adapted standardized 35-item MOS instrument was administered by trained interviewers. The visual analogue scale (VAS was used to cross-validate the MOS. Results The MOS instrument was highly acceptable and easily administered. All subscales of the MOS demonstrated acceptable internal consistency with Cronbach's alpha above 0.70 except for role function that had 0.65. Each dimension of the MOS was highly correlated with the dimension measured concurrently using the VAS providing evidence of validity. Construct validity demonstrated remarkable differences in the functioning status and well-being among TB patients at different stages of treatment, between patients attending public and private hospitals, and between men and women of older age. Patients who were enrolled from public hospital had significantly lower HRQoL scores (0.78 (95% confidence interval (CI; 0.64-0.95 for perceived health but significantly higher HRQoL scores (1.15 (95% CI; 1.06-1.26 for health distress relative to patients from private hospital. Patients who completed an 8 months course of TB therapy had significantly higher

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

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    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...

  8. Total Delay Is Associated with Unfavorable Treatment Outcome among Pulmonary Tuberculosis Patients in West Gojjam Zone, Northwest Ethiopia: A Prospective Cohort Study.

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    Senedu Bekele Gebreegziabher

    Full Text Available delay in diagnosis and treatment of tuberculosis (TB may worsen the disease, increase mortality and enhance transmission in the community. This study aimed at assessing the association between total delay and unfavorable treatment outcome among newly diagnosed pulmonary TB (PTB patients.A prospective cohort study was conducted in West Gojjam Zone, Amhara Region of Ethiopia from October 2013 to May 2015. Newly diagnosed PTB patients who were ≥15 years of age were consecutively enrolled in the study from 30 randomly selected public health facilities. Total delay (the time period from onset of TB symptoms to first start of anti-TB treatment was measured. Median total delay was calculated. Mixed effect logistics regression was used to analyze factors associated with unfavorable treatment outcome.Seven hundred six patients were enrolled in the study. The median total delay was 60 days. Patients with total delay of > 60 days were more likely to have unfavorable TB treatment outcome than patients with total delay of ≤ 60 days (adjusted odds ratio [AOR], 2.33; 95% confidence interval [CI], 1.04-5.26. Human immunodeficiency virus (HIV positive TB patients were 8.46 times more likely to experience unfavorable treatment outcome than HIV negative TB patients (AOR, 8.46; 95% CI, 3.14-22.79.Long total delay and TB/HIV coinfection were associated with unfavorable treatment outcome. Targeted interventions that can reduce delay in diagnosis and treatment of TB, and early comprehensive management of TB/HIV coinfection are needed to reduce increased risk of unfavorable treatment outcome.

  9. Total delay in treatment among smear positive pulmonary tuberculosis patients in five primary health centers, southern Ethiopia: a cross sectional study.

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    Anteneh Asefa

    Full Text Available The global burden of Tuberculosis (TB remains enormous. Delay in TB diagnosis may lead to a higher infectious pool in the community and a more advanced disease state at presentation increasing the risk of mortality. This study is conducted to determine the total delay before treatment among smear positive Pulmonary Tuberculosis (PTB patients.A health institution based cross sectional study was conducted in five primary health centers in southern Ethiopia from June to December 2012. A total of 328 smear positive PTB patients were enrolled in the study. A structured and pre-tested questionnaire was used. Median patient, diagnostic, and treatment delays were calculated to determine the total delay. Multiple logistic regression analysis was used to identify factors associated with total delay.The median patient, diagnostic, treatment and total delays measured in days were 30 (IQR 20.2, 60, 7 (IQR: 3, 14, 3 (IQR: 1, 4 and 45 (IQR: 34.5, 69.5 days respectively. Patients for whom treatment was not initiated within 45 days of onset of symptom(s (total delay constituted 49% of the study participants (59.5% among males and 39.2% among females; P<0.001. Total delay was found to be associated with: being female [AOR  = 0.34, 95% CI: 0.18-0.62], having attended tertiary level education [AOR  = 0.11, 95% CI: 0.02-0.55], perceived severity of stigma during the current TB disease course [AOR = 2. 18, 95% CI: 1.07, 4.42] and living in houses with higher family size [AOR = 0.26, 95% CI: 0.11, 0.61].Total delay in treatment of TB is still high in the study area. Patient's sex, perceived stigma, educational status and family size are significantly contributing for total delay. Therefore, a concerted effort should be taken in order to improve health seeking behavior of the community on TB and to reduce delays from seeking care after experiencing TB symptoms.

  10. Randomized clinical trial of thrice-weekly 4-month moxifloxacin or gatifloxacin containing regimens in the treatment of new sputum positive pulmonary tuberculosis patients.

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    Mohideen S Jawahar

    Full Text Available BACKGROUND: Shortening tuberculosis (TB treatment duration is a research priority. This paper presents data from a prematurely terminated randomized clinical trial, of 4-month moxifloxacin or gatifloxacin regimens, in South India. METHODS: Newly diagnosed, sputum-positive HIV-negative pulmonary TB patients were randomly allocated to receive gatifloxacin or moxifloxacin, along with isoniazid and rifampicin for 4 months with pyrazinamide for first 2 months (G or M or isoniazid and rifampicin for 6 months with ethambutol and pyrazinamide for first 2 months (C. All regimens were administered thrice-weekly. Clinical and bacteriological assessments were done monthly during treatment and for 24 months post-treatment. The Data and Safety Monitoring Board recommended termination of the trial due to high TB recurrence rates in the G and M regimens. RESULTS: Of 416 patients in intent-to-treat analysis, 6 (5% of 124, 2 (2% of 110 and 2 (2% of 137 patients with drug-susceptible TB in the G, M and C arms respectively had unfavorable response at the end of treatment; during the next 24 months, 17 (15% of 115, 11 (11% of 104 and 8 (6% of 132 patients respectively, had TB recurrence. Of 38 drug-resistant patients 1 of 8 and 3 of 26 in the G and C arms respectively had unfavourable response at the end of treatment; and TB recurrence occurred in 2 of 7 and 2 of 23 patients, respectively. The differences in TB recurrence rates between the G and C arms was statistically significant (p = 0.02. Gastro-intestinal symptoms occurred in 23%, 22% and 9% of patients in the G, M and C arms respectively, but most reactions were mild and manageable with symptomatic measures; 1% required regimen modification. CONCLUSIONS: 4-month thrice-weekly regimens of gatifloxacin or moxifloxacin with isoniazid, rifampicin and pyrazinamide, were inferior to standard 6-month treatment, in patients with newly diagnosed sputum positive pulmonary TB. TRIAL REGISTRATION: Clinical Trials Registry

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

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    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

  12. 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

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    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.)

  13. The Evaluation of Patients with Tuberculosis Treated in Batman Tuberculosis Control Dispensary in 2003 Year

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    Tekin Yıldız

    2007-01-01

    Full Text Available Tuberculosis is a very important problem for public health all around the world. In this study, 168 patients with TB who were treated in Batman Tuberculosis Control Dispensary in 2003 were retrospectively assessed. Ninety six of our cases were male, 72 were female. Eighty one patients who underwent for the tuberculous treatment were with pulmonary tuberculosis and 87 cases were with extrapulmonary tuberculosis. Acid fast bacilli (AFB at sputum was positive in 66.17% of the cavitary pulmonary TB cases before treatment and only one patient’s sputum was positive in pulmonary tuberculosis without cavity. Results of the tuberculosis treatment of cases revealed that one case left the treatment, 3 patients were inharmonious, 3 patients were dead, 161 patients were cured. Success rate of treatment was 95,83% (5 of these cases were cured and 156 patients completed the treatment. These data suggest that in order to increase the rate of the cure, bacteriological examination of the sputum should be considered at the end of the treatment like as the beginning.

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

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    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.

  15. Densely calcified tuberculous constrictive pericarditis with concurrent active pulmonary tuberculosis infection

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    S Laudari

    2015-07-01

    Full Text Available Though pulmonary tuberculosis is a common chronic infection in the developing countries like Nepal, the incidence of tubercular constrictive pericarditis is very low. Here we report a patient of active pulmonary tuberculosis with sputum positive for acid fast bacilli along with densely calcified constrictive pericarditis which has been reported as a very rare presentation in the literature.DOI: http://dx.doi.org/10.3126/jcmsn.v10i2.12955 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2; 41-43

  16. [A CLINICAL EXPERIENCE OF RIFAMPICIN SUPPOSITORY FOR THE TREATMENT OF PULMONARY TUBERCULOSIS].

    Science.gov (United States)

    Tsubota, Noriyuki; Tanimukai, Shigeatsu

    2015-06-01

    The usefulness of a rifampicin (RFP) suppository for treatment of pulmonary tuberculosis was examined in patients who had difficulty with oral consumption of medication. Among inpatients receiving first-time treatment for pulmonary tuberculosis susceptible to both isoniazid (INH) and RFP, and who underwent standard 3- or 4-drug treatments including INH and RFP, we compared the number of days required for obtaining two and three consecutive negative sputum smears and cultures, respectively, in patients who received hospital-made suppositories or standard oral RFP administration. There was no significant difference between groups in the number of days required for negative cultures and smears; although the times were equivalent, there were more number of elderly patients and those in generally poor condition in the RFP suppository group than the oral intake group. RFP suppositories may be one method for administration of standard tuberculosis treatment in patients with difficulty in oral consumption of medication.

  17. [Comparative study of concordance and costs between tuberculin skin test and QuantiFERON(®)-TB Gold In-Tube in the diagnosis of latent tuberculosis infection among contacts of patients with pulmonary tuberculosis].

    Science.gov (United States)

    Martinez Lacasa, Xavier; Canals Font, Roser; Jaen Manzanera, Angels; Cuchi Burgos, Eva; Lite Lite, Josep

    2015-11-20

    Recently diagnosis of latent tuberculosis infection (LTBI) can be made using the tuberculin skin test (TST) or by techniques known as interferon-γ release assays (IGRAS), being QuantiFERON(®)-TB Gold In-Tube (QF-G-IT) the most used. The IGRAS avoid some drawbacks of the TST, especially cross-reaction with bacillus Calmette-Guérin (BCG) vaccine, but also present some problems such as those arising from cost and the need of having an adequate infrastructure and experience. There is no clear consensus on which technique should be preferentially used for the diagnosis of LTBI. This is a comparative study between the TST and QT-G-IT in a cohort of contacts of patients with pulmonary tuberculosis during the study period. An analysis of global agreement and groups was performed according to whether the contacts were vaccinated with BCG or not. A study of costs of both techniques and diagnostic strategies based on these techniques was performed. The agreement between TST and QF-G-IT was acceptable in the whole sample yet it was very good in the unvaccinated group. Few cases of indeterminate values were recorded. The cost study showed that TST was cheaper than QF-G-IT; however when we analyzed the cost of the strategies according to each technique, the QF-G-IT showed a better cost-benefit. We suggest considering QF-G-IT as the only preferred technique for the diagnosis of LTBI in household contacts, based on good overall agreement between the 2 techniques (even if we eliminate the effect of the vaccine) and a cost analysis favorable to QF-G-IT. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. Prevalence and risk factors of intestinal protozoan and helminth infections among pulmonary tuberculosis patients without HIV infection in a rural county in P. R. China.

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    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

    2015-09-01

    Although co-infection of tuberculosis (TB) and intestinal parasites, including protozoa and helminths, in humans has been widely studied globally, very little of this phenomenon is known in China. Therefore, a cross-sectional study was conducted in a rural county of China to investigate such co-infections. Patients with pulmonary TB (PTB) undergoing anti-Mycobacterium tuberculosis (anti-MTB) treatment were surveyed by questionnaires, and their feces and blood specimens were collected for detection of intestinal protozoa and helminths, routine blood examination and HIV detection. The χ(2) test and multivariate logistic regression model were used to identify risk factors. A total of 369 patients with PTB were included and all of them were HIV negative. Overall, only 7.3% of participants were infected with intestinal protozoa, among which prevalence of Blastocystis hominis, Entamoeba spp. and Trichomonas hominis were 6.0%, 1.1% and 0.3%, respectively; 7.0% were infected with intestinal helminths, among which prevalence of hookworm, Trichuris trichiura, Ascaris lumbricoides and Clonorchis sinensis were 4.3%, 1.9%, 0.5% and 0.3%, respectively; and 0.5% were simultaneously infected with intestinal protozoa and helminths. Among patients with PTB, body mass index (BMI)≤18 (OR=3.30, 95% CI=1.44-7.54) and raised poultry or livestock (e.g., chicken, duck, pig) (OR=3.96, 95% CI=1.32-11.89) were significantly associated with harboring intestinal protozoan infection, while BMI≤18 (OR=3.32, 95% CI=1.39-7.91), anemia (OR=3.40, 95% CI=1.44-8.02) and laboring barefoot in farmlands (OR=4.54, 95% CI=1.88-10.92) were significantly associated with having intestinal helminth infection. Additionally, there was no significant relationship between duration of anti-MTB treatment and infection rates of intestinal parasites including protozoa and helminths. Therefore, preventing malnutrition, avoiding unprotected contact with reservoirs of protozoa, and improving health education for good

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

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    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.

  20. Wegener′s granulomatosis disease mimicking pulmonary tuberculosis

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    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. Tuberculosis in pediatric oncology and bone marrow transplantation patients.

    Science.gov (United States)

    Cruz, Andrea T; Airewele, Gladstone; Starke, Jeffrey R

    2014-08-01

    Five children with malignancies (3 hematologic, 1 medulloblastoma, 1 hepatoblastoma) and one bone marrow transplant patient were treated for tuberculosis over a 30-year period. Three had pulmonary disease, 3 disseminated tuberculosis, and 1 had scrofula. Four of five had positive tuberculin skin tests, cultures were positive in 5/6 children. One child died of disseminated TB after engraftment, and one child had hepatotoxicity likely related to tuberculosis therapy. All cases were potentially preventable had they been screened due to established risk factors of foreign birth (4/6) or parental foreign birth (2/6). All children should be screened for latent tuberculosis before chemotherapy.

  2. 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.

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

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    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.

  4. 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

  5. Microscopic examination and smear negative pulmonary tuberculosis in Ethiopia.

    Science.gov (United States)

    Keflie, Tibebe Seyoum; Ameni, Gobena

    2014-01-01

    Tuberculosis causes illness among millions of people each year and ranks as the second leading cause of death from infectious disease worldwide. The aim of this study was to investigate the detection rate of microscopic examination and estimate risk of transmission of TB by smear negative pulmonary TB patients. A cross-sectional study and retrospective data analysis on TB were undertaken in Northwest Shewa, Ethiopia. Microscopic examination, bacterial culture and PCR were performed. The statistical analysis was made by using STATA software version 10. A total of 92 suspected TB cases was included in the study. Of these, 27.17% (25/92) were positive for microscopic examination and 51% (47/92) for culture. The sensitivity and specificity of microscopic examination with 95% CI were 48.94% (34.08% to 63.93%) and 95.56% (84.82 to 99.33%), respectively. The positive and negative predictive values were 92% (73.93% to 98.78%) and 64.18% (51.53% to 75.53%), respectively. Of 8150 pulmonary TB cases in the retrospective study, 58.9% was smear negative. The proportion of TB-HIV co-infection was 28.66% (96/335). The sensitivity of microscopic examination was 48.94% which was very low. The poor sensitivity of this test together with the advent of HIV/AIDS elevated the prevalence of smear negative pulmonary TB. This in turn increased the risk of TB transmission.

  6. 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

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    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

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

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    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.

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

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    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.

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

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    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

  10. The prevalence of pulmonary tuberculosis in Jeonbug Province

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    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%.

  11. 302例肺结核患者的药敏试验结果分析%Drug Susceptibility Analysis of 302 Cases of Pulmonary Tuberculosis Patients

    Institute of Scientific and Technical Information of China (English)

    张东华

    2015-01-01

    Objective:To explore the drug susceptibility and risk factors of pulmonary tuberculosis patients. Methods:From 2012 to 2013, 302 cases, which were positive for microscopic examination of the sputum acid fast bacilli in our control, were analyzed with the phlegm culture, mycobacterium identification and sensitivity analysis. Then the risk factors were analyzed combining the case history. Re-sults:Pathogens were successfully isolated in all of the 302 cases, including 284 cases of mycobacterium tuberculosis, 18 cases of nontu-berculosis mycobacteria by the bacteria identification. Of the 284 cases of mycobacterium tuberculosis, 63 cases were drug resistance (22. 2%), including resistance to isoniazid alone (19 cases), rifampicin alone (10 cases), and streptomycin (23 cases) and MDR (resist-ance to at least isoniazid or rifampicin) (12 cases). there were none cases resistance to pyrazinamide alone and ethambutol alone. Conclu-sions:The occurrences of multip ledrug resistant tuberculosis were high, which was closely related to age, history of chemotherapy, and the retreatment, should call for strengthening intervention.%目的::探讨肺结核患者的药敏试验情况与耐药的危险因素。方法:选择2012年和2013年在本防治所进行诊治的302例痰镜检抗酸杆菌阳性患者进行痰培养、菌型鉴定、药敏分析,结合患者病史信息,分析耐药的危险因素。结果:302例患者都培养出菌落,经菌型鉴定后,其中结核分枝杆菌284例,非结核分枝杆菌18例。284例结核分枝杆菌患者,耐药的为63例,耐药率为22.2%,其中单耐异烟肼(H)19例,单耐利福平(R)9例,单耐链霉素(S)23例,单耐乙胺丁醇(E)0例,MDR(至少耐H与R)12例。多因素非条件Logistics回归模型分析结果显示年龄、化疗史、复治是导致肺结核耐药的独立危险因素(P<0.05)。结论:本地区耐药结核病的发生率较高,多与年龄、化疗史、复治情况有关,要积极加强干预。

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

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    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.

  13. Gender difference of pulmonary function testing in patients with pulmonary tuberculosis%肺功能检测在肺结核患者中的性别差异

    Institute of Scientific and Technical Information of China (English)

    张鑫; 赵涛; 高伟

    2015-01-01

    目的:利用肺功能检测探讨性别等因素对肺结核患者肺功能的影响,以期对肺结核患者的防治提供借鉴。方法选取在2013年7月至2014年7月入住的肺结核患者为研究对象,采集其一般资料如年龄、性别、婚姻、教育程度等,分别于2013年和2014年进行两次肺功能检查,测定指标包括:(1)用力肺活量(FVC)体积及其占预测值的百分比,(2)第1秒用力呼气容积(FEV1)体积及其占预测值百分比,(3)1秒率(FEV1/FVC),(4)RV(L),(5)DLCO(%),(6)TLC(L)。运用 t检验、方差分析、χ2检验,Logistic回归分析进行统计学处理。结果浸润型肺结核患者的肺功能基本正常,而慢性纤维空洞型肺结核患者的肺功能普遍异常,差异有统计学意义(P<0.05)。采用 Logistic回归分析,年龄、吸烟和性别均是肺功能损伤加重的危险因素,OR值分别为1.03、1.34、1.01。结论肺结核的肺功能障碍呈混合性,同时更进一步说明早期根治肺结核的重要性,以避免肺的正常结构被破坏,浸润型转化成慢性纤维空洞型,造成肺功能不可逆的损害。年龄大、吸烟和女性肺结核肺功能损伤较重。其中不同性别肺结核患者的肺功能障碍,男性患者肺功能各项指标均高于女性。%Objective To investigate the influence of the factors of gender ,etc .on the pulmonary function in tuberculosis by the lung function test in order to provide reference for the prevention and treatment of the tuberculo‐sis(TB) patients .Methods The patients with pulmonary TB admitted to our hospital from July 2013 to July 2014 were selected as the study subjects .Their general data such as age ,gender ,marital status ,educational status were col‐lected .Twice pulmonary function tests were performed in 2013 and 2014 respectively ,the measurement indicators in‐cluding(1)the forced vital capacity

  14. 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.

  15. 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.

  16. The detection of infection of human immunodeficiency virus in patients pulmonary tuberculosis%肺结核病人中人类免疫缺陷病毒(HIV)感染的检测

    Institute of Scientific and Technical Information of China (English)

    冯喋仪; 陈志诚; 陈小冰; 关玉华; 张丽好; 肖凡

    2001-01-01

    Objective To study HIV infection and occurrence of AIDS in patients with tuberculosis by HIV detection.Methods Primary screening of HIV antibody assay was carried out in 2151 patients with pulmonary tuberculosis by ELISA.The positive cases were sent to the Center Laboratory of HIV in Guangdong epidemic-prevention station for verification.Results There were 7 positive cases of HIV with 5 males and 2 females in 2151 patients with pulmonary tuberculosis,with the positive rate 3.25‰.In the 7 positive cases of HIV,3 were infected by intravenous drug injection and 4 by heterosexual behavior.Conclusion Routine HIV antibody assay in patients with tuberculosis with high-risk behaviors and venereal diseases,especially in young and middle-age patients,was helpful for early diagnosis and treatment of AIDS and preventing the spread of the two diseases.%目的了解住院肺结核患者中HIV感染及艾滋病(AIDS)发病状况。方法对2151例住院肺结核患者常规采用HIV抗体ELISA法检测进行初筛,阳性者抽血复验,并由广东省防疫站HIV检测中心确定。结果 2151例中HIV(+)7例,阳性率3.25‰,男性5例,女性2例。通过静脉吸毒血源性感染3例,多性伴4例。结论对肺结核患者的HIV感染高危对象进行HIV抗体检测,有助于HIV/AIDS的早期发现和及时采取有效的控制措施。

  17. 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)

  18. 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.

  19. Diagnosis of sputum-scarce HIV-associated pulmonary tuberculosis in Lima, Peru

    Science.gov (United States)

    Vargas, Daniel; García, Luis; Gilman, Robert H; Evans, Carlton; Ticona, Eduardo; Ñavincopa, Marcos; Luo, Robert F; Caviedes, Luz; Hong, Clemens; Escombe, Rod; Moore, David A J

    2010-01-01

    Sputum induction, bronchoalveolar lavage, or gastric aspiration are often needed to produce adequate diagnostic respiratory samples from people with HIV in whom tuberculosis is suspected. Since these procedures are rarely appropriate in less-developed countries, we compared the performances of a simple string test and the gold-standard sputum induction. 160 HIV-positive adults under investigation for tuberculosis, and 52 asymptomatic HIV-positive control patients underwent the string test followed by sputum induction. The string test detected tuberculosis in 14 patients in whom this disease was suspected; sputum induction detected only eight of them (McNemar's test, p=0·03). These preliminary data suggest that the string test is safe and effective for retrieval of useful clinical specimens for diagnosis of pulmonary tuberculosis, and is at least as sensitive as sputum induction. PMID:15639297

  20. Multidrug Resistant Pulmonary Tuberculosis Treatment Regimens and Patient Outcomes: An Individual Patient Data Meta-analysis of 9,153 Patients

    Science.gov (United States)

    Ahuja, Shama D.; Ashkin, David; Avendano, Monika; Banerjee, Rita; Bauer, Melissa; Bayona, Jamie N.; Becerra, Mercedes C.; Benedetti, Andrea; Burgos, Marcos; Centis, Rosella; Chan, Eward D.; Chiang, Chen-Yuan; Cox, Helen; D'Ambrosio, Lia; DeRiemer, Kathy; Dung, Nguyen Huy; Enarson, Donald; Falzon, Dennis; Flanagan, Katherine; Flood, Jennifer; Garcia-Garcia, Maria L.; Gandhi, Neel; Granich, Reuben M.; Hollm-Delgado, Maria G.; Holtz, Timothy H.; Iseman, Michael D.; Jarlsberg, Leah G.; Keshavjee, Salmaan; Kim, Hye-Ryoun; Koh, Won-Jung; Lancaster, Joey; Lange, Christophe; de Lange, Wiel C. M.; Leimane, Vaira; Leung, Chi Chiu; Li, Jiehui; Menzies, Dick; Migliori, Giovanni B.; Mishustin, Sergey P.; Mitnick, Carole D.; Narita, Masa; O'Riordan, Philly; Pai, Madhukar; Palmero, Domingo; Park, Seung-kyu; Pasvol, Geoffrey; Peña, Jose; Pérez-Guzmán, Carlos; Quelapio, Maria I. D.; Ponce-de-Leon, Alfredo; Riekstina, Vija; Robert, Jerome; Royce, Sarah; Schaaf, H. Simon; Seung, Kwonjune J.; Shah, Lena; Shim, Tae Sun; Shin, Sonya S.; Shiraishi, Yuji; Sifuentes-Osornio, José; Sotgiu, Giovanni; Strand, Matthew J.; Tabarsi, Payam; Tupasi, Thelma E.; van Altena, Robert; Van der Walt, Martie; Van der Werf, Tjip S.; Vargas, Mario H.; Viiklepp, Pirett; Westenhouse, Janice; Yew, Wing Wai; Yim, Jae-Joon; Ahuja, Shama D.; Ashkin, David; Avendano, Monika; Banerjee, Rita; Bauer, Melissa; Bayona, Jamie N.; Becerra, Mercedes C.; Benedetti, Andrea; Burgos, Marcos; Centis, Rosella; Chan, Eward D.; Chiang, Chen-Yuan; Cox, Helen; D'Ambrosio, Lia; DeRiemer, Kathy; Dung, Nguyen Huy; Enarson, Donald; Falzon, Dennis; Flanagan, Katherine; Flood, Jennifer; Garcia-Garcia, Maria L.; Gandhi, Neel; Granich, Reuben M.; Hollm-Delgado, Maria G.; Holtz, Timothy H.; Iseman, Michael D.; Jarlsberg, Leah G.; Keshavjee, Salmaan; Kim, Hye-Ryoun; Koh, Won-Jung; Lancaster, Joey; Lange, Christophe; de Lange, Wiel C. M.; Leimane, Vaira; Leung, Chi Chiu; Li, Jiehui; Menzies, Dick; Migliori, Giovanni B.; Mishustin, Sergey P.; Mitnick, Carole D.; Narita, Masa; O'Riordan, Philly; Pai, Madhukar; Palmero, Domingo; Park, Seung-kyu; Pasvol, Geoffrey; Peña, Jose; Pérez-Guzmán, Carlos; Quelapio, Maria I. D.; Ponce-de-Leon, Alfredo; Riekstina, Vija; Robert, Jerome; Royce, Sarah; Schaaf, H. Simon; Seung, Kwonjune J.; Shah, Lena; Shim, Tae Sun; Shin, Sonya S.; Shiraishi, Yuji; Sifuentes-Osornio, José; Sotgiu, Giovanni; Strand, Matthew J.; Tabarsi, Payam; Tupasi, Thelma E.; van Altena, Robert; Van der Walt, Martie; Van der Werf, Tjip S.; Vargas, Mario H.; Viiklepp, Pirett; Westenhouse, Janice; Yew, Wing Wai

    2012-01-01

    Background Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB. Methods and Findings Three recent systematic reviews were used to identify studies reporting treatment outcomes of microbiologically confirmed MDR-TB. Study authors were contacted to solicit individual patient data including clinical characteristics, treatment given, and outcomes. Random effects multivariable logistic meta-regression was used to estimate adjusted odds of treatment success. Adequate treatment and outcome data were provided for 9,153 patients with MDR-TB from 32 observational studies. Treatment success, compared to failure/relapse, was associated with use of: later generation quinolones, (adjusted odds ratio [aOR]: 2.5 [95% CI 1.1–6.0]), ofloxacin (aOR: 2.5 [1.6–3.9]), ethionamide or prothionamide (aOR: 1.7 [1.3–2.3]), use of four or more likely effective drugs in the initial intensive phase (aOR: 2.3 [1.3–3.9]), and three or more likely effective drugs in the continuation phase (aOR: 2.7 [1.7–4.1]). Similar results were seen for the association of treatment success compared to failure/relapse or death: later generation quinolones, (aOR: 2.7 [1.7–4.3]), ofloxacin (aOR: 2.3 [1.3–3.8]), ethionamide or prothionamide (aOR: 1.7 [1.4–2.1]), use of four or more likely effective drugs in the initial intensive phase (aOR: 2.7 [1.9–3.9]), and three or more likely effective drugs in the continuation phase (aOR: 4.5 [3.4–6.0]). Conclusions In this individual patient data meta-analysis of observational data, improved MDR-TB treatment success and survival were associated with use of certain fluoroquinolones, ethionamide, or prothionamide, and greater total number of effective drugs. However, randomized trials are urgently needed to optimize MDR-TB treatment. Please see

  1. Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients.

    Directory of Open Access Journals (Sweden)

    Shama D Ahuja

    Full Text Available BACKGROUND: Treatment of multidrug resistant tuberculosis (MDR-TB is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB. METHODS AND FINDINGS: Three recent systematic reviews were used to identify studies reporting treatment outcomes of microbiologically confirmed MDR-TB. Study authors were contacted to solicit individual patient data including clinical characteristics, treatment given, and outcomes. Random effects multivariable logistic meta-regression was used to estimate adjusted odds of treatment success. Adequate treatment and outcome data were provided for 9,153 patients with MDR-TB from 32 observational studies. Treatment success, compared to failure/relapse, was associated with use of: later generation quinolones, (adjusted odds ratio [aOR]: 2.5 [95% CI 1.1-6.0], ofloxacin (aOR: 2.5 [1.6-3.9], ethionamide or prothionamide (aOR: 1.7 [1.3-2.3], use of four or more likely effective drugs in the initial intensive phase (aOR: 2.3 [1.3-3.9], and three or more likely effective drugs in the continuation phase (aOR: 2.7 [1.7-4.1]. Similar results were seen for the association of treatment success compared to failure/relapse or death: later generation quinolones, (aOR: 2.7 [1.7-4.3], ofloxacin (aOR: 2.3 [1.3-3.8], ethionamide or prothionamide (aOR: 1.7 [1.4-2.1], use of four or more likely effective drugs in the initial intensive phase (aOR: 2.7 [1.9-3.9], and three or more likely effective drugs in the continuation phase (aOR: 4.5 [3.4-6.0]. CONCLUSIONS: In this individual patient data meta-analysis of observational data, improved MDR-TB treatment success and survival were associated with use of certain fluoroquinolones, ethionamide, or prothionamide, and greater total number of effective drugs. However, randomized trials are urgently needed to optimize MDR-TB treatment. Please see later

  2. 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

  3. 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.

  4. Analysis in Life Quality and Influencing Factors of Patients with Pulmonary Tuberculosis Complicated with Diabetes%肺结核合并糖尿病患者生存质量及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    付喜花; 刘春龙; 陈健儿; 郭健; 黄晓燕; 吴文斌

    2014-01-01

    Objective:To investigate the life quality and influencing factors of patients with pulmonary tuberculosis complicated with diabetes. Meth-ods:WHOQOL-BREF was applied to investigate the life quality of 120 patients with pulmonary tuberculosis complicated with diabetes, which was compared with 40 healthy people. Results:The physiological, psychological, social relationship and environment scores in WHOQOL-BREF scale of observation group were all significantly lower than those of control group (P<0.01). Conclusion:The life quality of patients with pulmonary tubercu-losis complicated with diabetes was worse than that of healthy people, the medical staff should pay attention to improve the life quality of patients’.%目的:探讨肺结核合并糖尿病患者的生存质量及其影响因素。方法:应用世界卫生组织生存质量测定简表(WHO-QOL-BREF)调查120例肺结核合并糖尿病患者的生存质量,并与40例正常人比较。结果:观察组WHOQOL-BREF量表生理、心理、社会关系和环境评分均显著低于对照组(P<0.01)。结论:肺结核合并糖尿病患者生存质量较正常人差,医护人员需重视全面提高患者的生存质量。

  5. 肺腺癌患者中EGFR突变与肺结核的相关性研究%Relationship between EGFR mutation and pulmonary tuberculo-sis in lung adenocarcinoma patients

    Institute of Scientific and Technical Information of China (English)

    张军; 郑锴; 张鹏; 战忠利

    2013-01-01

    Objective:To investigate the relationship between EGFR mutations and pulmonary tuberculosis in lung adenocarcino-ma. Methods:We detected EGFR mutations in 506 patients with lung adenocarcinoma by PCR amplification and sequencing and ana-lyzed the relationship between the mutations observed and pulmonary tuberculosis. Survival analysis was performed using the Ka-plan-Meier method with log-rank tests. Result:A total of 218 patients showed EGFR mutations;of these patients, 25 had a clinical his-tory of pulmonary tuberculosis. Compared with lung adenocarcinoma patients with no history of tuberculosis, patients with a history of pulmonary tuberculosis showed higher incidence rates of EGFR mutations, especially of exon 21 (P=0.047, P=0.002). Higher incidence rates of EGFR mutations, especially of exon 21, were observed in patients with lung cancer and tuberculosis in the same lobe or the same side of the lung than in those who had lung cancer and tuberculosis in opposite sides of the lung (P=0.02, P=0.03). Survival analy-sis showed that adenocarcinoma patients with a history of pulmonary tuberculosis have 2-year survival rates lower than that of adeno-carcinoma patients with no history of the disease (P=0.039). In patients adenocarcinoma associated with tuberculosis patients without EGFR-TKIs treatment, the 2-year survival rates of EGFR mutation patients and those without EGFR mutation showed no statistically significant difference (P=0.948). At the same time, we got the same results in adenocarcinoma associated with tuberculosis patients with EGFR-TKIs treatment (P=0.425). Conclusion:Lung adenocarcinoma patients with a history of pulmonary tuberculosis have high-er incidence rates of EGFR mutations, and EGFR mutations are not related to disease prognosis.%#目的:研究肺腺癌患者中表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变与肺结核在肺腺癌中的相关性。方法:采用PCR扩增及基因测序方法检测506例肺

  6. 营养风险防范在肺结核素食习惯患者中的应用观察%The application observation of the nutritional risk prevention for the pulmonary tuberculosis patients with vegetarian diet

    Institute of Scientific and Technical Information of China (English)

    翟妞荣

    2016-01-01

    ObjectiveThe purpose of this study is to discuss preventive measures of nutrition risk of vegetarian diet patients with pulmonary tuberculosis.MethodsCollect 64 vegetarian diet patients with pulmonary tuberculosis in our hospital. 32 of the patients received conventional nursing during 2010-2011,and the other 32 patients accepted preventive measures of nutrition risk during 2012-2014. Follow-up information of both group of patients was collected after 2,3,4 and 6 months after discharge. Evaluating criteria include improvement of symptoms,weight gain,negative sputum smear under microscopy of mycobacterium tuberculosis and the ability to perform social functions such as learning and housework in daily life.Results The overall response rate of the two groups was compared as an index to assess the recovering speed of patients. Recovering speed of the patients receiving preventive measures of nutrition risk is obviously rapid than patients receiving conventional nursing alone,with statistical significance(P<0.05).ConclusionPreventive measures of nutrition risk on vegetarian diet patients with pulmonary tuberculosis could accelerate their recovering speed.%目的:探讨肺结核素食习惯患者实施营养风险防范措施的效果。方法选取我院肺结核素食习惯患者共64例,2010年—2011年32例,实施常规护理;2012年—2014年32例,采取营养风险防范措施。2组患者均在出院后2,3,4,6个月进行回访追踪观察,评价症状改善情况,体重增长,结核菌痰涂片镜检阴转率,学习、生活、持家能力恢复情况等身体恢复指标。结果采取营养风险防范措施的患者身体恢复速度明显高于常规护理组,差异有统计学意义(P<0.05)。结论对肺结核素食习惯患者及时采取营养风险防范措施可加快身体恢复速度。

  7. Impaired pulmonary function after treatment for tuberculosis: the end of the disease?

    Science.gov (United States)

    Chushkin, Mikhail Ivanovich; Ots, Oleg Nikolayevich

    2017-01-01

    To evaluate the prevalence of pulmonary function abnormalities and to investigate the factors affecting lung function in patients treated for pulmonary tuberculosis. A total of 214 consecutive patients (132 men and 82 women; 20-82 years of age), treated for pulmonary tuberculosis and followed at a local dispensary, underwent spirometry and plethysmography at least one year after treatment. Pulmonary impairment was present in 102 (47.7%) of the 214 patients evaluated. The most common functional alteration was obstructive lung disease (seen in 34.6%). Of the 214 patients, 60 (28.0%) showed reduced pulmonary function (FEV1 below the lower limit of normal). Risk factors for reduced pulmonary function were having had culture-positive pulmonary tuberculosis in the past, being over 50 years of age, having recurrent tuberculosis, and having a lower level of education. Nearly half of all tuberculosis patients evolve to impaired pulmonary function. That underscores the need for pulmonary function testing after the end of treatment. Avaliar a prevalência de alterações da função pulmonar e investigar os fatores que afetam a função pulmonar em pacientes tratados para tuberculose pulmonar. Um total de 214 pacientes consecutivos (132 homens e 82 mulheres; 20-82 anos de idade), tratados para tuberculose pulmonar e acompanhados em um dispensário local, foi submetido a espirometria e pletismografia pelo menos um ano após o tratamento. O comprometimento pulmonar estava presente em 102 (47,7%) dos 214 pacientes avaliados. A alteração funcional mais comum foi o distúrbio ventilatório obstrutivo (observado em 34,6%). Dos 214 pacientes, 60 (28,0%) apresentaram função pulmonar reduzida (VEF1 abaixo do limite inferior de normalidade). Os fatores de risco para função pulmonar reduzida foram tuberculose pulmonar com cultura positiva no passado, idade acima de 50 anos, recidiva de tuberculose e menor nível de escolaridade. Quase metade de todos os pacientes com tuberculose

  8. Tuberculosis in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Flávio Jota de Paula

    1987-06-01

    Full Text Available Nine cases of tuberculosis (TB were diagnosed among 800 uremic patients, followed-up during 11 years, a prevalence of 1125%, 2.5 times higher than that in the general population. Six patients (66.7% had lymph node involvement (4 cervical and 2 mediastinal. Three patients (33.3% had pulmonary involvement (2 pleuro-pulmonary and 1 bilateral apical pulmonary. Eight patients were undergoing dialysis and 1 was pre-dialytic. The duration of dialysis ranged from 1 to 60 months. Three patients had previously received immunosuppressive drugs for unsuccessful renal transplantation. Daily fever was present in all but one patient; he was asymptomatic and TB was suspected after routine chest radiography. Biopsy was the diagnostic procedure in 7 patients (77.8%, four by direct cervical lymph node biopsy, 2 by mediastinal, performed by mediastinoscopy and 1 by pleural biopsy. In 2 other patients TB was confirmed by the presence of tubercle bacilli; in sputum (1 patient and in a bronchial flushing specimen (the other patient. Triple therapy was used in all patients (isoniazid and ethambutol in all, plus rifampicin in 8 and streptomycin in 1. One patient had jaundice and another had optical neuritis. Five patients were cured. The other four died during treatment of causes unrelated to TB or its treatment.

  9. 1例疑似肺结核病例的药学监护%Pharmaceutical care on a suspected pulmonary tuberculosis patient

    Institute of Scientific and Technical Information of China (English)

    舒鹤; 王哲; 赵稳华; 张莉

    2015-01-01

    目的:通过参与1例35岁疑似肺结核女性患者的药物治疗实践过程,探讨涂阴肺结核患者的治疗方案及治疗过程中的药学监护重点。方法在本例疑似肺结核患者的诊治过程中,临床药师对抗结核治疗指征进行评估,对四联抗结核治疗方案进行评价,对卡介苗多糖核酸注射液及异烟肼雾化吸入的给药方式查证后进行干预,当患者出现血尿酸水平升高时,参考有关指南给予评估并给出处理意见,并重点对患者用药依从性进行宣传教育。结果临床药师通过认真分析患者病情,查阅相关指南,在药物治疗方面提出了合理化建议,并通过用药教育增加患者抗结核治疗的依从性,使本例疑似肺结核患者的治疗安全、合理。结论临床药师发挥自身专业特长通过协助临床医师及时、有效地制定治疗方案,为患者得到安全、有效的个体化治疗提供专业的药学服务。%Objective To explore the role of pharmaceutical care on smear‐negative tuberculosis patients through the practice partici‐pating in the treatment of a 35‐year‐old female patient with suspected pulmonary tuberculosis .Methods The pharmacists evalua‐ted whether this patient should accept antituberculous therapy ,evaluated the anti‐TB treatment ,suggested stopping improper us‐age of inhaling BCG polysaccharide and nucleic acid injection and isoniazid injection ,and educated the patient for better compli‐ance .During the therapy ,the serum uric acid level was found abnormally elevated .According to relevant guidelines ,pharmacists suggested giving some life intervention without drug treatment .Results Through analyzing patient′s condition ,pharmacists put forward rational suggestions on medical therapy .Patient′s compliance to anti‐TB treatment was increased and satisfactory thera‐peutic efficacy was acquired finally .Conclusion Clinical pharmacists assisted clinician to

  10. 肺结核合并呼吸衰竭患者的集束化治疗%Bundle treatments for patients with pulmonary tuberculosis and respiratory failure

    Institute of Scientific and Technical Information of China (English)

    林艳荣; 韦静

    2015-01-01

    目的 探讨肺结核并呼吸衰竭(呼衰)重症患者集束化治疗的效果.方法 采用前瞻性研究方法,选择2013年1月至2014年12月入住南宁市第四人民医院重症医学科患肺结核合并呼衰需有创机械通气治疗的56例行集束化治疗的患者为观察组,给予有创机械通气,1 h内经验性使用抗菌药物,早期目标性血流动力学支持治疗,纠正脑功能障碍,有效的抗结核治疗,早期建立肠内营养,预防呼吸机相关性肺炎(VAP)等一系列重症治疗护理措施,6 h及12 h逐项完成;以42例2011年1月至2012年12月既往住院采用传统针对性治疗的患者为对照组.比较两组患者治疗后生命体征、血常规、呼吸、肝肾等器官功能变化,急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、预计病死率和序贯器官衰竭评分(SOFA评分)的改善情况、VAP的发生率、治愈好转率、病死率、有创机械通气时间、住重症加强治疗病房(ICU)时间.结果 治疗前除观察组血小板计数(PLT)较对照组偏高外,体温、白细胞计数(WBC)、血糖、总胆红素(TBil)、丙氨酸转氨酶(ALT)、白蛋白(Alb)、胆固醇水平两组治疗前后比较差异均无统计学意义(均P>0.05).治疗后72 h两组心率(HR)、呼吸频率(RR)、APACHEⅡ评分、预计病死率均较治疗前降低,动脉血氧分压(PaO2)、氧合指数均较治疗前升高;对照组治疗前后pH值、PLT、动脉血二氧化碳分压(PaCO2)及SOFA评分比较差异均无统计学意义(均P>0.05);观察组治疗后pH值较治疗前升高,PLT、PaCO2及SOFA评分均较治疗前降低(均P0.05).结论 集束化治疗能有效减少肺结核合并呼衰患者VAP的发生率、提高治愈好转率.%Objective To investigate the therapeutic effect of bundle treatments for critically ill patients with pulmonary tuberculosis and respiratory failure (RF).Methods A prospective study was conducted, including 56 patients with pulmonary

  11. Transcriptional profiles discriminate patients with pulmonary tuberculosis from non-tuberculous individuals depending on the presence of non-insulin diabetes mellitus.

    Science.gov (United States)

    Serrano, Carmen J; Cuevas-Córdoba, Betzaida; Macías-Segura, Noé; González-Curiel, Rosa Angélica; Martínez-Balderas, Víctor Yordani; Enciso-Moreno, Leonor; Small, Peter; Hernández-Pando, Rogelio; Enciso-Moreno, José Antonio

    2016-01-01

    Our objective was to identify transcriptional biomarkers in peripheral blood mononuclear cells (PBMC) that discriminate individuals with latent tuberculosis infection (LTBI) from those with pulmonary tuberculosis (PTB) in subjects with non-insulin-dependent diabetes mellitus (NIDDM) and in individuals without NIDDM. Using gene expression microarrays we identified differentially expressed genes from lungs of mice infected with Mycobacterium tuberculosis (Mtb) or a mutant (ΔsigH) representing a non-inflammatory model. Genes expressed in blood, with inflammatory related functions were evaluated in humans by RT-qPCR. NCF1 and ORM transcripts have the better discriminatory capacity to identify PTB subjects from LTBI and non-infected controls (NICs) independently of the presence of NIDDM. The sequential evaluation of the mRNA levels of NCF1 and ORM as multiple diagnostic tests showed 95% Sensitivity (Se) and 80% Specificity (Sp). In addition, FPR2 promises to be a good biomarker for the PTB detection in subjects with NIDDM (Se=100%; Sp=90%).

  12. Sputum smear-positive pulmonary tuberculosis: Is sputum smear examination required to discontinue airborne precautions?

    Science.gov (United States)

    Argemi, X; Albrecht, M; Hansmann, Y; Jaulhac, B; Koebel, C; Schramm, F

    2015-10-01

    Our aim was to evaluate the criteria required to discontinue airborne precautions for patients presenting with sputum smear-positive pulmonary tuberculosis as the need for sputum smear examinations is still a matter of debate. We conducted a retrospective study in the University Hospitals of Strasbourg (France) from July 2011 to July 2013. Our aim was to describe the results of sputum smear examinations and cultures obtained from treated patients presenting with drug-sensitive pulmonary tuberculosis. We included 97 patients in the study. Nearly half of patients for whom a sputum smear examination was performed had a negative sputum direct examination but a positive culture. According to the literature, those patients are still likely to be contagious. This questions the safety of discontinuing airborne precautions in this situation. We also observed a great disparity in physicians' behaviors. Only half of them waited to get a negative sputum direct examination before discontinuing airborne precautions. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. HIV and parasitic co-infections in tuberculosis patients

    DEFF Research Database (Denmark)

    Range, N.; Magnussen, Pascal; Mugomela, A.

    2007-01-01

    A cross-sectional study was conducted in Mwanza, Tanzania, to determine the burden of HIV and parasitic co-infections among patients who were confirmed or suspected cases of pulmonary tuberculosis (PTB). Of the 655 patients investigated, 532 (81.2%) had been confirmed as PTB cases, by microscopy...

  14. 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。

  15. 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

  16. Application of continuous nursing intervention in pulmonary tuberculosis patients self-management%延续护理干预在肺结核患者自我管理中的应用

    Institute of Scientific and Technical Information of China (English)

    邹喜荣; 尹凤鸣

    2013-01-01

    目的:探讨延续护理干预在肺结核患者自我管理中的应用成效.方法:选取我科2010年10 ~12月出院的肺结核患者120例,在常规出院指导的基础上采用电话、手机短信、网络信息随访进行延续护理干预,干预时间6个月,比较干预前后患者自我管理水平.结果:6个月后随访,患者药物管理、饮食管理、心理和社会适应、症状管理及总分均优于干预前,差异有统计学意义(P<0.01).结论:对肺结核患者出院后实施延续护理干预能提高患者的自我管理水平.%Objective: To investigate the application effect of nursing intervention on the continuation of self management of tuberculosis patients. Methods: 120 pulmonary tuberculosis patients discharged in our department from October to December in 2010, based on conventional discharge guidance on the use of telephone, mobile phone short message, network information follow - up continuing nursing intervention, the intervention time was 6 months, compared before and after the intervention patients self - management level. Results: After 6 months of follow - up, patients with drug management, catering management, psychological and social adaptation, symptom management and total points scored better than before the intervention, the difference was statistically significant (P <0.01). Conclusion; Pulmonary tuberculosis patients after discharge of continuous nursing intervention can improve the patients self management level.

  17. Fifteen-year trend in treatment outcomes among patients with pulmonary smear-positive tuberculosis and its determinants in Arsi Zone, Central Ethiopia.

    Science.gov (United States)

    Hamusse, Shallo D; Demissie, Meaza; Teshome, Dejene; Lindtjørn, Bernt

    2014-12-01

    Background Directly Observed Treatment Short course (DOTS) strategy is aimed at diagnosing 70% of infectious tuberculosis (TB) and curing 85% of it. Arsi Zone of Ethiopia piloted DOTS strategy in 1992. Since then, the trend in treatment outcomes in general and at district-level in particular has not been assessed. The aim of this study was to analyse the trend in TB treatment outcomes and audit district-level treatment outcomes in the 25 districts of Arsi Zone. Design A retrospective cohort study design was employed to audit pulmonary smear-positive (PTB + ) patients registered between 1997 and 2011. Demographic and related data were collected from the TB unit registers between January and March 2013. The 15-year trend in treatment outcomes among PTB+ patients and district-level treatment outcomes was computed. Results From 14,221 evaluated PTB+ cases, 11,888 (83.6%) were successfully treated. The treatment success rate (TSR) varied from 69.3 to 92.5%, defaulter rate from 2.5 to 21.6%, death rate from 1.6 to 11.1%, and failure rate from 0 to 3.6% across the 25 districts of the zone. The trend in TSR increased from 61 to 91% with the increase of population DOTS coverage from 18 to 70%. There was a declining trend in defaulter rate from 29.9 to 2.1% and death rate from 8.8 to 5.4% over 15 years. Patients aged 25-49 years (Adjusted Odd Ratio (AOR), 0.23; 95% CI: 0.21-0.26) and ≥50 years (AOR, 0.43; 95% CI: 0.32-0.59), re-treatment cases (AOR, 0.61; 0.41, 0.67), and TB/HIV co-infection cases (AOR, 0.45; 95% CI: 0.31-0.53) were associated with unsuccessful treatment outcomes. Conclusions DOTS expansion and improving population DOTS coverage in Arsi has led to a significant increase in treatment success and decrease in death and defaulter rates. However, there is a major variation in treatment outcomes across the 25 districts of the zone, so district-specific intervention strategy needs to be considered. The low TSR among re-treatment cases might be due to the high

  18. Clinical application of pulmonary function test in the treatment of pulmonary tuberculosis patients complicat-ed with diabetes mellitus%肺功能检测在肺结核合并糖尿病中的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    张鑫; 李坤玲; 康书慧; 刘士甫; 赵磊; 曹金凤

    2015-01-01

    Objective To investigate the changes of pulmonary function in patients with pulmonary tubercu-losis complicated with diabetes mellitus. Methods The study selected 30 patients with pulmonary tuberculosis com-plicated with type 2 diabetes as the group A, 50 patients with pulmonary tuberculosis only as the group B, and 50 pa-tients with type 2 diabetes mellitus only as the group C. Their lung function was detected and analyzed comparatively. Results The abnormality of lung function was 66. 7% (20/30) in the group A, which was significantly higher than that of the group B (36%) and the group C (11/50) (P<0. 05). The indexes of pulmonary function were better in the group B and C than in the group A (P<0. 05). Conclusion Pulmonary tuberculosis patients complicated with diabetes has poor pulmonary function.%目的:探析肺结核合并糖尿病患者的肺功能改变。方法入选我院2013年7月-2014年7月收治的30例肺结核合并2型糖尿病患者作为观察对象,列为A组,检测肺功能,并与50例肺结核( B组)及50例2型糖尿病( C组)患者的肺功能进行比较,分析其变化。结果 A组肺功能异常发生率66.7%(20/30)显著高于B组36.0%(18/50)和C组22.0%(11/50),差异均具有统计学意义(均P<0.05);B组和C组各项肺功能指标均显著优于A组,差异均具有统计学意义(均P<0.05)。结论肺结核合并糖尿病患者的各项肺功能指标较差。

  19. COPD 合并肺结核患者相关危险因素分析%Analysis of the related risk factors in patients with COPD combined with pulmonary tuberculosis

    Institute of Scientific and Technical Information of China (English)

    邱艳

    2015-01-01

    目的:探讨慢性阻塞性肺部疾病(COPD)合并肺结核患者相关危险因素。方法174例 COPD 合并肺结核患者作为合并组,213例单纯性 COPD 患者作为单纯组,收集两组患者相关临床资料,进行单因素分析和多因素 Logistic 回归分析。结果合并组出现消瘦和低热的比例分别为31.6%和42.5%,均高于单纯组(P <0.05);单因素分析显示,两组患者在年龄、吸烟史、结核接触史、粉尘接触史、咳嗽病史、营养不良史和应急情况方面差异具有统计学意义(P <0.05);多因素 Logistic 回归分析显示,年龄、吸烟史、结核接触史、粉尘接触史和应急情况均是 COPD 合并肺结核患者独立影响因素(P <0.05)。结论年龄、吸烟史、结核接触史、粉尘接触史和应急情况均是 COPD 合并肺结核发生的独立影响因素,应有针对性的采取有效措施,减少该病的发生。%Objective To investigate the related risk factors of patients with COPD combined with pulmonary tuberculosis. Methods 1 74 patients with COPD combined with pulmonary tuberculosis were selected as combined group,and 21 3 patients with COPD as simple group.The clinical data of the two groups were collected.Univariate analysis and multivariate logistic re-gression analysis were used.Results The percentages of weight loss and fever were 31 .6% and 42.5% respectively in com-bined group,which were higher than those in simple group,the differences were statistically significant (P <0.05).Univariate analysis showed,the differences of age,smoking history,history of exposure to tuberculosis,dust exposure history,cough history,history of malnutrition and emergency situations between the two groups were statistically significant (P <0.05 ). Logistic regression analysis showed,age,smoking history,history of exposure to tuberculosis,dust exposure history and e-mergency situations were independent influence factors in

  20. Assessments of serum copper and zinc concentration, and the Cu/Zn ratio determination in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) in Côte d'Ivoire.

    Science.gov (United States)

    Bahi, Gnogbo Alexis; Boyvin, Lydie; Méité, Souleymane; M'Boh, Gervais Melaine; Yeo, Kadjowely; N'Guessan, Kouassi Raymond; Bidié, Alain Dit Philippe; Djaman, Allico Joseph

    2017-04-11

    In Côte d'Ivoire, multidrug-resistant tuberculosis (MDR-TB) is a serious public health problem with a prevalence estimated at 2.5% in 2006. Zinc and copper are essential Trace element needed to strengthen the immune system and also useful in the fight against tuberculosis. The Cu / Zn ratio is a good indicator of oxidative stress. The principal aim of this study was to evaluate the serum concentration of some trace element and determine the Cu / Zn ratio in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) before and after second line treatment of TB. Blood samples were obtained from 100 MDR-TB patients after confirmation of their status through the microscopic and molecular diagnosis of resistance to Isoniazid and Rifampicin by GeneXpert. The concentration level of zinc and copper were determined using flame air / acetylene atomic absorption spectrometer (AAS) Type Varian Spectr AA-20 Victoria, Australlia. A significant decrease in zinc levels (P TB patients compared to controls TB free. During treatment a significant reduction in Cu / Zn ratio (P TB. Therefore the evaluation of the zinc and copper status could represent essential parameters in monitoring of TB second line treatment for better treatment management.

  1. Tuberculosis reinfection in a pregnant cystic fibrosis patient

    Directory of Open Access Journals (Sweden)

    Asween Marco

    2015-01-01

    Full Text Available Cystic Fibrosis (CF is a multisystem disease predominantly affecting the airways and predisposing patients to recurrent infections with various multidrug resistant organisms. Mycobacterium tuberculosis (MTB infection is rarely seen, but considered a potential pathogen in CF patients. We report a 26 year old pregnant CF patient on Ivacaftor who was admitted with symptoms suggestive of tuberculosis. Three years prior to the current admission, she had completed four drug anti- MTB therapy for pulmonary tuberculosis and was considered cured as her sputum cultures after six months of treatment were negative. Genotype analysis revealed the current MTB strain to be different from the strain causing the previous infection. After receiving first line anti-tuberculous regimen for nine months, the patient's condition markedly improved culminating in an uneventful pregnancy and delivery. To our knowledge, this is the only reported case of reinfection tuberculosis in a CF patient.

  2. Contact investigation in households of patients with tuberculosis in Hanoi, Vietnam: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Gregory James Fox

    Full Text Available SETTING: Existing tuberculosis control strategies in Vietnam are based on symptomatic patients attending health services for investigation. This approach has not resulted in substantial reductions in the prevalence of tuberculosis disease, despite the National Tuberculosis Program achieving high treatment completion rates. Alternative approaches are being considered. OBJECTIVE: To determine the feasibility and yield of contact investigation in households of patients with smear positive pulmonary tuberculosis among household members of tuberculosis patients in Hanoi, Vietnam. METHODS: Household contacts of patients with smear positive pulmonary tuberculosis were recruited at four urban and rural District Tuberculosis Units in Hanoi. Clinical and radiological screening was conducted at baseline, six months and 12 months. Sputum microscopy and culture was performed in contacts suspected of having tuberculosis. MIRU-VNTR molecular testing was used to compare the strains of patients and their contacts with disease. RESULTS: Among 545 household contacts of 212 patients, four were diagnosed with tuberculosis at baseline (prevalence 734 cases per 100,000 persons, 95% CI 17-1451 and one was diagnosed with tuberculosis during the subsequent 12 months after initial screening (incidence 180 cases per 100,000 person-years, 95% CI 44-131. Two of these cases were culture positive for M. tuberculosis and both had identical or near-identical MIRU-VNTR strain types. CONCLUSION: Household contacts of patients with potentially infectious forms of tuberculosis have a high prevalence of disease. Household contact investigation is feasible in Vietnam. Further research is required to investigate its effectiveness.

  3. [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.

  4. Tuberculosis screening in patients with HIV

    DEFF Research Database (Denmark)

    Bjerrum, Stephanie Mia Katrine; Bonsu, Frank; Hanson-Nortey, Nii Nortey

    2016-01-01

    BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...

  5. 糖尿病合并肺结核患者相关因素分析%Analysis of the Related Factors for Development of Pulmonary Tuberculosis Among Diabetes Mellitus Patients

    Institute of Scientific and Technical Information of China (English)

    崔艳凤; 陈立波; 张长宁; 桂书彦; 顾建芬; 叶强

    2012-01-01

    Objective:To discuss the related factors for the development of pulmonary tuberculosis among diabetes mellitus patients.Methods:71 patients with type 2 diabetes mellitus(T2DM) were devided into the observation group(87 cases) and the control group(84 cases) depending on whether complicated with pulmonary tuberculosis. And then 13 factors were contrasted between the two groups.Results: There was no significantly difference on family history of diabetes, drinking, and stress events nearly three months between the two groups(P>0.05); but there were significantly differences on duration of diabetes, daily blood glucose control, HbAlc, diet control, complications of diabetes, smoking, history of exposure to tuberculosis, tuberculosis family history, and daily physical exercise between the two groups(P< 0.05); and daily blood glucose control, diet control, complications of diabetes, smoking, history of exposure to tuberculosis, tuberculosis family history, and daily physical exercise between the two groups were all independent risk factors for diabetic patients with tuberculosis.Conclusion:Controlling glycemic and diet strictly, treat the complications of diabetes aggressively, quiting smoking, strengthening publicity and education of the tuberculosis knowledge, adhering to proper physical exercise have important significance for the prevention of diabetic patients with tuberculosis.%目的:探讨糖尿病患者并发肺结核的相关因素,为临床糖尿病患者肺结核的防治提供客观证据.方法:选择2型糖尿病合并肺结核患者87例作为观察组,单纯2型糖尿病患者84例作为对照组,对比两组糖尿病病程、血糖控制情况、近3个月糖化血红蛋白(HbA1c)、糖尿病家族史、饮食情况、糖尿病并发症、饮酒、吸烟、结核病传染源接触史、结核病家族史、近3月来应激事件、日常体育锻炼、体重指数等因素之间的差异.结果:观察组与对照组在糖尿病

  6. Compared study of sputum specimen from patient with pulmonary tuberculosis detected with fluorogenic probes and realteme PCR%肺结核56例痰标本FQ-PCR检测价值分析

    Institute of Scientific and Technical Information of China (English)

    梁颖惠

    2011-01-01

    目的:探讨不同检测方法对肺结核的诊断价值.方法:以实时荧光定量聚合酶链反应法、痰直接涂片找抗酸杆菌法、痰结核杆菌培养法对56 例确诊肺结核患者痰标本检查结果进行比较.结果:荧光定量 PCR法检出结核杆菌阳性率显著高于痰涂片抗酸染色和培养法(P<0.05),其他非肺结核结果阳性率仅为 2.7 %,特异度较高.结论:实时荧光定量聚合酶链反应法对肺结核诊断方面灵敏度及特异度较高,同时反映抗结核治疗过程中痰标本中的结核杆菌的数量变化,对抗结核药物疗效有良好的监控效果.%Objective: To discuss the diagnosis value af different methods on pulmonary tuberculosis. Methods : The sputum specimens obtained from 56 patients with tuberculosis were detected mycobacterium tuberculosis (MTB) with fluorogenic probes and real-time PCR (FQ - PCR) , smear acid-fast and cultureof organism. Results :Thepositive rate of MTB detected with FQ - PCR was higher than that with smear acid-fast and cultureof organism. Thepositive rate of non-tuberculosis was only 2. 7 %. The specificity was higher. Conclusion: The high sensitivity and specificity rare renders a positive FQ -PCR result , which isclinically useful. Furthermore , the variationaf the TB - DNA reflects the variationof the mycobacterium tuberculosis when treatment. It is useful to monitor the curative effect.

  7. "Comparative Study Of The Profiles Of Th1 And Th2 Cytokines In Patients With Sputum Smear- Positive Pulmonary Tuberculosis And PPD–Positive Healthy Persons And Their Changes During Treatment "

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    M. Hajiabdolbaghi

    2006-06-01

    Full Text Available Background and Aim: The better understanding of immunopathologic mechanism of tuberculosis (TB is necessary for the production of new vaccines and adjunctive immunomodulator drugs. Intended to this object, the following study including the measurement of serum concentrations of Th1 (Interferon (IFN-y and interkeukin (IL-2 and Th2 cytokines(IL-4AND IL-10 in patients with sputum smear-positive pulmonary TB and comparisons of them with PPpositive healthy persons, was designed. Materials and Methods: The HIV-negative patients that had sputum smear-positive pulmonary TB as defined WHO criteria and hospitalized in the infectious diseases ward of Imam Khomeini hospital or referred to health care centers in the south of Tehran, were included in the study. The PPD-positive healthy persons who were close contacts with pulmonary TB patients, were considered as control group. Results: In this research 34 active pulmonary TB patients (including17men and 17 womanand 23 healthy persons with PPD skin test results  or = 10mm (including 12men and 11 woman were studied. The mean ages of the patients and the healthy persons were 73 and 41 years and 74 and 27 years, respectively. The mean serum IFN-Y concentration was significantly higher in TB patients but the mean serum IL-2 IL-4and IL-10 concentrations were significantly higher in healthy persons. The com parison of the mean serum levels of these cytokines before and during treatment (about 2 months after starting treatment showed that the amounts of IFN-y and IL4 were increased and the amounts of IL2 and IL-10 were decreased but only the changes of IL-10 were statistically significant. There were no effect on the cytokine changes before and during treatment by age and gender of the patients. Conclusion: The results of the study of serum Th1 and Th2 cytokines in pulmonary TB patients were different in comparison with the results of the studies of peripheral blood mononuclear cells (PBMCs stimulated with

  8. Rhodococcus equi isolation from sputum of patients with suspected tuberculosis

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    Paulo da Silva

    2010-03-01

    Full Text Available Rhodococcus equi has emerged as an opportunistic pathogen associated with pulmonary, invasive or systemic infections in immunocompromised patients. We report the identification of 51 R. equi isolates found in sputum samples of 546 individuals suspected to have pulmonary tuberculosis in two Public Health Hospital Units in Brazil. The epidemiology of R. equi infection as well as the phenotypic identification and drug susceptibility profile of isolates are described in this paper.

  9. Extra-Pulmonary Tuberculosis and Its Surgical Treatment.

    Science.gov (United States)

    Fry, Donald E

    2016-08-01

    Tuberculous infection has declined in the United States but remains a major infectious disease with morbidity and death for millions of people. Although the primary therapy is drugs, complications of the disease require surgical interventions. The published literature on tuberculosis was reviewed to provide a current understanding of the medical treatment of the disease and to define those areas where surgical intervention continues to be necessary. Multi-drug therapy for tuberculosis has become the standard and has reduced the complications of the disease necessitating surgical intervention. However, multi-drug resistance and extensively drug-resistant tuberculosis continue to be major problems and require effective initial therapy with surveillance to define resistant infections. The roles of surgery in tuberculosis are in establishing the diagnosis in extra-pulmonary infection and in the management of complications of disseminated disease. Tuberculosis remains an occupational risk for surgeons and surgical personnel. Tuberculosis is still a global problem, mandating recognition and treatment. Surgeons should have an understanding of the diverse presentation and complications of the disease.

  10. Retrospective Analysis of the Data of Elderly Patients with Diabetes Compli-cated by Pulmonary Tuberculosis%老年糖尿病合并肺结核患者病例资料的回顾报道分析

    Institute of Scientific and Technical Information of China (English)

    张瑾

    2015-01-01

    Objective To retrospectively analyze the data of elderly patients with diabetes complicated by pulmonary tuber-culosis so as to provide reference for clinical diagnosis and treatment of the disease. Methods A retrospective analysis was conducted on the clinical data of two hundred patients admitted from January 2013 to January 2015, of them, 100 elderly patients with diabetes complicated by pulmonary tuberculosis were set as the study group, and other 100 patients with pul-monary tuberculosis were set as the control group. And the treatment, focus features and clinical manifestations of the two groups were analyzed. Results The observation group had much higher incidence of hemoptysis, expectoration, cough and fever than the control group (P<0.05). The incidence of sputum turning negative, lesions absorption rate, cavity closure rate in the observation group was obviously lower than that in the control group, respectively (P<0.05). CT or X-ray examination showed that there was significant difference in the range of tuberculosis lesions between the two groups. Most of the tuber-culosis lesions in the observation group infringed 2-3 lung fields. The incidence of porosis in the observation group was much higher than that in the control group(P<0.05). The observation group failed the treatment was mainly due to poor con-trol of blood glucose, while the control group due to adverse drug reactions. Conclusion The chest lesions and clinical symptoms were severe in elderly patients with diabetes and pulmonary tuberculosis. In order to ensure the therapeutic ef-fect, early screening needs to be done well and the blood glucose should be controlled and monitored during the anti-tuber-culosis treatment.%目的 回顾分析老年糖尿病合并肺结核患者病例资料, 为临床诊断与治疗提供参考依据. 方法 回顾分析从2013年1月—2015年1月收治的100例老年糖尿病合并肺结核患者(研究组)临床资料,并选取同期100例单纯肺结核患者

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

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    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.

  12. Recurrent erythema nodosum and pulmonary lymph node tuberculosis in a patient treated for psoriatic arthritis and psoriasis with TNF inhibitors

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    Piotr Parcheta

    2014-10-01

    Full Text Available Introduction. Psoriasis is a chronic inflammatory disease affecting approximately 2% of the population. Biologic agents are the new treatment options for patients with moderate to severe plaque psoriasis who have failed traditional systemic therapies. The therapy with tumor necrosis factor antagonists significantly increases the risk of reactivation of latent tuberculosis; therefore, screening is important before the introduction of biological treatment. Objective. Presentation of diagnostic difficulties in establishing an etiological factor of recurrent erythema nodosum in a 46-year-old woman treated with anti-TNF-α agents (etanercept and adalimumab for plaque psoriasis and psoriatic arthritis. Case report. We present a case of a 46-year-old woman, treated with etanercept and adalimumab for plaque psoriasis and psoriatic arthritis. Despite prophylactic antituberculosis treatment before introduction of biological therapy, the patient developed erythema nodosum most likely caused by lymph node tuberculosis. Conclusions . The development of erythema nodosum, especially the recurrent form, in a patient with a positive tuberculin skin test and negative IGRA test treated with anti-TNF should always prompt increased vigilance and exclusion of active tuberculosis, which may develop even in patients who have undergone prophylactic antituberculosis treatment.

  13. Effects of a food supplement rich in arginine in patients with smear positive pulmonary tuberculosis--a randomised trial

    DEFF Research Database (Denmark)

    Schön, T; Idh, J; Westman, A

    2011-01-01

    Gondar, Ethiopia (n = 180) were randomized to a food supplementation rich in arginine (peanuts, equivalent to 1 g of arginine/day) or with a low arginine content (wheat crackers, locally called daboqolo) during four weeks. The primary outcome was cure rate according to the WHO classification.......39) or secondary outcomes. In the subgroup analysis according to HIV status, peanut supplemented HIV+/TB patients showed increased cure rate (83.8% (31/37) vs 53.1% (17/32), p

  14. Delays in the diagnosis of pulmonary tuberculosis in Coahuila, Mexico.

    Science.gov (United States)

    Salinas, J; Calvillo, S; Caylà, J; Nedel, F B; Martín, M; Navarro, A

    2012-09-01

    To determine diagnostic delay in pulmonary tuberculosis (PTB) cases and analyse associated factors. New PTB cases were studied in Coahuila, Northern Mexico, between 2008 and 2009. We obtained census data and data on residential address, symptoms and diagnosis from the national patient database; sociodemographic variables were obtained during home visits. Bivariate analyses used the Kaplan-Meier method; multivariate analysis consisted of modelling survival. We studied 458 subjects (median age 48 years), who were predominantly males (56.1%); the median years of schooling was 6.0 years, 83.4% were urban residents, 50.3% were unemployed, and 87.7% suffered from food poverty. The median delay between the onset of symptoms and the first medical consultation was 53.5 days. Lack of formal education (P = 0.050) and living ≥5 km from a health unit (P = 0.034) were associated with longer delays and consequently with severe symptoms (cough ≥2 weeks, P = 0.001; chest pain, P = 0.032; malnutrition, P = 0.003). Mean health system delay (between first consultation and smear test result) was 18.5 days, and was significantly longer when the first consultation was with a private physician (P < 0.001) and when patient age was ≥46 years (P = 0.001). In Coahuila, lack of formal education, living ≥5 km from a health unit, first consultation with a private physician, and being aged ≥46 years contributed to delays in PTB diagnosis.

  15. Community-acquired Tsukamurella pneumonia in a young immunocompetent adult: a case misdiagnosed as pulmonary tuberculosis and literature review.

    Science.gov (United States)

    Yang, LiKun; Cao, Yan; Dan, Zijun; Wang, Zhongyuan; Wang, Xinjing

    2017-08-01

    This report describes a case of Tsukamurella pneumonia in a 24-year-old immunocompetent woman. The patient was diagnosed as having pulmonary tuberculosis and was treated for nearly 9 months. The correct diagnosis was suspected only when the results of mycobacteria nucleic acid amplification tests on cultural colonies were negative. Tsukamurella was identified from the patient's sputum and bronchoalveolar lavage fluid by using 16S rRNA sequence analysis. Here, the clinical presentation, diagnosis, and treatment strategies of Tsukamurella pneumonia are discussed, along with a literature review. Tsukamurella pneumonia may be highly underdiagnosed owing to its similarity with pulmonary tuberculosis and the habitual thinking of doctors in countries with a high tuberculosis burden. Tsukamurella should be carefully considered in the etiology of tuberculosis-like lung diseases.

  16. 宿主免疫功能低下并发肺结核CT表现特征%CT Features of Pulmonary Tuberculosis Complicated by Low Immune Function Patients

    Institute of Scientific and Technical Information of China (English)

    余红胜; 沈又利; 刘孟磊; 段潘峰

    2016-01-01

    objective: To analyze CT features of pulmonary tuberculosis complicated by low immunefunction patients. Methods:38 cases of confirmed CT images of pulmonary tuberculosis in immunocompromised patients were collected, anglicizing from the lesion types, distribution, size, configurations of focus, property and lymphatic pathological changes, etc. Results:the most of CT images of pulmonary tuberculosis in immunocompromised patients caught infiltrative pulmonary tuberculosis, the lesions distributed widely, the consolidation (38/38, 100%), nodules (21/38, 55%), cavitations (16/38, 42.1%), lymphatic pathological changes (11/38, 28.9%) were typical manifestation, which accompanied emphysema, hardening and calcified fibrous bands, the stenosis and dilatation of bronchus and pleural changes, etc. Conclusion: the CT images of pulmonary tuberculosis complicated by low immune function patients are complex and changeable, the features of which include that the pathogenic location and CT symptom are both atypical, the extent of disease is wide, the multi-character focus coexist and spread easily, the lung is damaged seriously and the prognosis is poor. CT diagnosis with medical history and clinical material attach positive significance to clear diagnosis.%目的:研究宿主免疫功能低下并发肺结核的CT影像表现特征.方法:搜集38例免疫功能低下并发肺结核患者的临床及CT影像资料,从病变类型、分布、大小、形态、性质以及淋巴结改变等方面进行分析.结果:免疫功能低下并发肺结核患者的CT影像表现以浸润型肺结核为主,病变广泛分布,主要表现为实变阴影(38/38,100%)、多发性结节(21/38,55%)、空洞(16/38,42.1%)、淋巴结改变(11/38,28.9%),多伴有肺气肿、纤维条索硬化、钙化、支气管狭窄或扩张、胸膜改变等征象.结论:宿主免疫功能低下并发肺结核的CT影像学表现复杂多样、多变,发病部位及CT征象均不典型;病变范围广,

  17. Increasing pathomorphism of pulmonary tuberculosis: an observational study of slow clinical, microbiological and imaging response of lung tuberculosis to specific treatment. Which role for linezolid?

    Directory of Open Access Journals (Sweden)

    Roberto Manfredi

    Full Text Available During recent years, a progressive emerging of tuberculosis occurred, related to the overall increased age of general population, primary and secondary (iatrogenic immunodeficiencies, the availability of invasive procedures, surgical interventions and intensive care supports, bone marrow and solid organ transplantation, and especially the recent immigration flows of people often coming from areas endemic for tuberculosis, and living with evident social-economical disadvantages, and with a reduced access to health care facilities. Since January 2006, at our reference centre we followed 81 consecutive cases of pulmonary tuberculosis, with 65 of them which remained evaluable for the absence of extrapulmonary complications, and a continuative and effective clinical and therapeutic follow-up. The majority of episodes of evaluable pulmonary tuberculosis (49 cases out of 65: 75,4% occurred in patients who immigrated from developing countries. In two patients multiresistant (MDR Mycobacterium tuberculosis strains were found, while two more subjects (both immigrated from Eastern Europe suffered from a disease due to extremely resistant (XDR M. tuberculosis strains. Although enforcing all possible measures to increase patients' adherence to treatment (empowerment, delivery of oral drugs under direct control, use of i.v. formulation whenever possible, over 72% of evaluable patients had a very slow clinical, microbiological, and imaging ameliorement (1-6 months, with persistance of sputum and/or bronchoalveolar lavage (BAL fluid positive for M.tuberculosis microscopy and/or culture for over 1-4 months (mean 9.2±3.2 weeks, during an apparently adequate treatment. When excluding patients suffering from XDR and MDR tuberculosis, in four subjects we observed that off-label linezolid adjunct together with at least three drugs with residual activity against tuberculosis, led to a significantly more rapid clinical-radiological improvement and negative

  18. Environmental Factors Related to Pulmonary Tuberculosis in HIV-Infected Patients in the Combined Antiretroviral Therapy (cART) Era

    Science.gov (United States)

    Álvaro-Meca, Alejandro; Díaz, Asuncion; de Miguel Díez, Javier; Resino, Rosa

    2016-01-01

    The aim of our study was to evaluate the seasonal variations and whether short-term exposure to environmental risk factors, such as climate and air pollution, is associated with PTB-related hospital admissions in human immunodeficiency virus (HIV)-infected patients in Spain during the era of combined antiretroviral therapy (cART). A retrospective study was carried out using data from the Minimum Basic Data Set (MBDS) and the State Meteorological Agency (AEMET) of Spain. The primary outcome variable was hospital admissions with PTB diagnosis. The environmental risk factors evaluated were season, temperature, humidity, NO2, SO2, O3, PM10, and CO. Overall, HIV-infected patients had a lower frequency of PTB-related hospital admissions in summer (22.8%) and autumn (22.4%), but higher values in winter (26.6%) and spring (28.2%). Using a Bayesian temporal model, PTB-related hospital admissions were less frequent in summer-autumn and more abundant in winter-spring during the first years of follow-up. During the later years of follow-up, the seasonal trends continued resulting in the lowest values in autumn and the highest in spring. When considering short-term exposure to environmental risk factors, lower temperatures at 1 week (odds ratio (OR) = 1.03; p = 0.008), 1.5 weeks (OR = 1.03; p<0.001), 2 weeks (OR = 1.04; p<0.001), and 3 weeks (OR = 1.03; p<0.001) prior to PTB admission. In addition, higher concentration of NO2 at the time of admission were significantly associated with higher likelihoods of PTB-related hospital admission in HIV-infected patients when 1.5 weeks (OR = 1.1; p = 0.044) and 2 weeks (OR = 1.21; p<0.001) were used as controls. Finally, higher concentration of SO2 at 1.5 weeks prior to PTB admission was significantly associated with a higher likelihood of PTB-related hospital admissions (OR = 0.92; p = 0.029). In conclusion, our data suggest an apparent seasonal variation in hospital admissions of HIV-infected patients with a PTB diagnosis (summer

  19. 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.

  20. 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.

  1. [Severe pulmonary tuberculosis in the ICU, diagnosis and treatment].

    Science.gov (United States)

    Phelippeau, M; Petureau, F

    2015-10-01

    Pulmonary tuberculosis can rarely lead to acute respiratory distress syndrome and anti-tuberculous therapy initiation depends on this difficult diagnosis in ICU. A 50-year-old man presented a septic shock and acute respiratory distress syndrome with bilateral infiltrates mainly in the upper lobes on chest radiography. Diagnosis of pulmonary tuberculosis was made 10days after admission on examination of cavitary and diffuse infiltrates on a second CT scan, in addition to presence of acid-fast bacilli on smear examination of bronchial aspirates. Amikacin, with four first-line anti-tuberculous drugs, was started in the case of a resistant strain and seriousness of the illness. After 14weeks, he left on rifampicin and isoniazid treatment. There are no specific recommendations concerning pulmonary tuberculosis in ICU but a delay in initiation of anti-tuberculous therapy is a factor of poor prognosis. Using a second-line anti-tuberculous drug, like amikacin or/and fluoroquinolones, within initial treatment may accelerate improvement of sepsis and immediately treat resistant strains, when genomic methods for detection of resistance are not available in routine. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Comparison of treatment outcomes of new smear-positive pulmonary tuberculosis patients by HIV and antiretroviral status in a TB/HIV clinic, Malawi.

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    Hannock Tweya

    Full Text Available BACKGROUND: Smear-positive pulmonary TB is the most infectious form of TB. Previous studies on the effect of HIV and antiretroviral therapy on TB treatment outcomes among these highly infectious patients demonstrated conflicting results, reducing understanding of important issues. METHODS: All adult smear-positive pulmonary TB patients diagnosed between 2008 and 2010 in Malawi's largest public, integrated TB/HIV clinic were included in the study to assess treatment outcomes by HIV and antiretroviral therapy status using logistic regression. RESULTS: Of 2,361 new smear-positive pulmonary TB patients, 86% had successful treatment outcome (were cured or completed treatment, 5% died, 6% were lost to follow-up, 1% failed treatment, and 2% transferred-out. Overall HIV prevalence was 56%. After adjusting for gender, age and TB registration year, treatment success was higher among HIV-negative than HIV-positive patients (adjusted odds ratio 1.49; 95% CI: 1.14-1.94. Of 1,275 HIV-infected pulmonary TB patients, 492 (38% received antiretroviral therapy during the study. Pulmonary TB patients on antiretroviral therapy were more likely to have successful treatment outcomes than those not on ART (adjusted odds ratio : 1.83; 95% CI: 1.29-2.60. CONCLUSION: HIV co-infection was associated with poor TB treatment outcomes. Despite high HIV prevalence and the integrated TB/HIV setting, only a minority of patients started antiretroviral therapy. Intensified patient education and provider training on the benefits of antiretroviral therapy could increase antiretroviral therapy uptake and improve TB treatment success among these most infectious patients.

  3. Psychometric testing of the short version of the world health organization quality of life (WHOQOL-BREF questionnaire among pulmonary tuberculosis patients in Taiwan

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    Chung Wei-Sheng

    2012-08-01

    Full Text Available Abstract Background Studies on the effects of tuberculosis on a patient’s quality of life (QOL are scant. The objective of this study was to evaluate the psychometric properties of the Taiwan short version of the World Health Organization Quality of Life (WHOQOL-BREF questionnaire using patients with tuberculosis in Taiwan and healthy referents. Methods The Taiwanese short version of the WHOQOL-BREF was administered to patients with tuberculosis undergoing treatment and healthy referents from March 2007 to July 2007. Patients with tuberculosis (n = 140 and healthy referents (n = 130, matched by age, sex, and ethnicity, agreed to an interview. All participants lived in eastern Taiwan. Reliability assessments included internal consistency, whereas validity assessments included construct validity, convergent validity, and discriminant validity. Results More than half of these patients and referents were men (70.7% and 66.2%, respectively, and their average ages were 50.1 and 47.9 years, respectively. Approximately 60% of patients and referents were aboriginal Taiwanese (60.7% and 61.1%, respectively. The proportion with low socioeconomic status was greater for these patients. The internal consistency reliability coefficients were .92 and .93 for the patients and healthy referents, respectively. Exploratory factor analysis on the healthy referents displayed a 4-domain model, which was compatible with the original WHOQOL-BREF 4-domain model. However, for the TB patient group, after deleting 3 items, both exploratory and confirmatory factor analysis revealed a 6-domain model. Conclusion Psychometric evaluation of the Taiwan short version of the WHOQOL-BREF indicates that it has adequate reliability for use in research with TB patients in Taiwan. However, the factor structure generated from this TB patient sample differed from the WHO’s original 4-factor model, which raised a validity concern to apply the Taiwan short version of the WHOQOL

  4. Radiografia torácica e bacteriologia na fase inicial de tratamento de 800 pacientes masculinos com tuberculose pulmonar Chest X-ray and bacteriology in the initial phase of treatment of 800 male patients with pulmonary tuberculosis

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    Sefa Levent Ozsahin

    2011-06-01

    Full Text Available OBJETIVO: Avaliar radiografias de tórax de pacientes com tuberculose pulmonar e determinar se a extensão das lesões radiográficas correlaciona-se com os parâmetros bacteriológicos. MÉTODOS: Neste estudo descritivo e retrospectivo; foram avaliadas radiografias de tórax, baciloscopias para BAAR e culturas de escarro para Mycobacterium tuberculosis no momento basal e durante os dois primeiros meses de tratamento. A amostra foi composta por 800 pacientes masculinos internados entre 1995 até o presente em um hospital com 250 leitos no noroeste da Turquia. RESULTADOS: A VHS média inicial foi de 58 ± 37 mm/h. Inicialmente, a baciloscopia e as culturas de escarro tiveram resultado positivo em 83,8% e em 89,5% dos pacientes, respectivamente. Após o primeiro mês do tratamento, a proporção de culturas positivas foi maior nos pacientes com doença cavitária do que naqueles sem doença cavitária (53,7% vs. 37,7%; p 0.05 para todos, mas houve correlação positiva com VHS (r = 0,23, p OBJECTIVE: To evaluate chest X-rays of patients with pulmonary tuberculosis and to determine whether the extent of radiographic lesions correlates with bacteriological parameters. METHODS: In this retrospective, descriptive study, we evaluated chest X-rays, as well as AFB detection by smear microscopy and culture for Mycobacterium tuberculosis, initially and during the first two months of treatment, in 800 male patients hospitalized between 1995 and the present at a 250-bed hospital in northwestern Turkey. RESULTS: The initial mean ESR was 58 ± 37 mm/h. Initial sputum smears and cultures were positive in 83.8% and 89.5% of the patients, respectively. After the first month of treatment, the proportion of patients with positive sputum culture was higher among those with cavitary tuberculosis than among those with non-cavitary tuberculosis (53.7% vs. 37.7%, p 0.05 for all but was positively correlated with the ESR (r = 0.23, p < 0.001. During the first and second

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

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    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

  6. Drug Resistance in Patients with Pulmonary Tuberculosis at Different Ages in Huizhou City%惠州市不同年龄段肺结核患者耐药情况分析

    Institute of Scientific and Technical Information of China (English)

    许爱东; 李静; 徐志强; 黄国楼

    2014-01-01

    Objective To analysis the drug resistance in patients with pulmonary tuberculosis at different ages in Huizhou city,to provide references for diagnosis and treatment of drug resistant tuberculosis. Methods From 2010 to 2013,1 484 pulmonary tuberculosis patients were randomly chosen in the Tuberculosis Institute of Huizhou,and then divided into 18-35 years old group of 356 cases,36-59 years old group of 612 cases,≥60 years old group of 516 cases. The drug resistant rate of first-line anti-tuberculosis drugs and multi-drugs resistant rate of 3 groups were retrospectively analyzed. Results INH and SM resistant rates of 18-35 years old group were higher than those of 36-59 years old group,INH,RFP,SM,EMB resistant rates and total drug resistant rate were higher than those of ≥60 years old group(P﹤0. 05);the RFP resistant rate in 36-59 years old group was higher than that of ≥60 years old group ( P﹤0. 05 ) . The multi-drugs resistant rate of 18 -35 year old group was higher than that of 36-59 years old group,3 drugs resistant rate,4 drugs resistant rate and multi-drugs resistant rate were higher than those of≥60 years old group(P﹤0. 05). Conclusion There is a big difference of drug resistance in patients with pulmonary tuberculosis at different ages in Huizhou city,while young patients are easy to get acquired drug resistance,for which is necessary to take individual measures to prevent and control.%目的:分析惠州市不同年龄段肺结核患者耐药情况,为耐药肺结核的诊断与治疗提供参考依据。方法抽取2010-2013年惠州市结核病防治研究所结核科收治的肺结核患者1484例,按照年龄分为18~35岁组356例,36~59岁组612例,≥60岁组516例。回顾性分析3组患者一线抗结核药物耐药情况及耐多药情况。结果18~35岁组患者异烟肼( INH)和链霉素( SM)耐药率均高于36~59岁组,INH、利福平( RFP)、SM、乙胺丁醇( EMB)耐药

  7. Smoking prolongs the infectivity of patients with tuberculosis.

    LENUS (Irish Health Repository)

    Siddiqui, U A

    2010-10-01

    We sought to establish if smokers on anti-tuberculosis treatment are more likely to have a prolonged period of infectivity, compared to non-smoking tuberculosis patients, in a low tuberculosis prevalence country. We conducted a cross-sectional, retrospective study in Ireland that recruited 53 microbiologically confirmed cases of pulmonary tuberculosis (PTB). The age-sex adjusted odds ratios (AOR) suggest that the infectivity status of PTB on treatment was four times more likely to be prolonged beyond 6-8 weeks, if the cases had a smoking history (AOR: 4.42; 95% CI: 1.23; 15.9). Smoking was associated with delayed sputum smear conversion in PTB patients on treatment.

  8. Risk Factors of Pulmonary Smear Positive Tuberculosis Incidence in Dili District Timor Leste 2014

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    Jacinta dos Santos Guterres

    2015-04-01

    Full Text Available Background and objectives: According to the WHO, the pulmonary tuberculosis (TB in Timor-Leste is estimated to have the highest mortality rate in the region which is 45 per 100,000 populations. The aim of this study was to determine the risk factors for pulmonary tuberculosis in the Dili District. Methods: The study design was a case-control. Cases were patients with positive BTA pulmonary tuberculosis, and controls were non TB patients registered at two TB clinics (Motael and Bairro-Pite and the three public health centers (Comoro, Formosa and Becora in Dili, July 2013 - February 2014. Numbers of samples were 138 people consisting of 46 cases and 92 controls (1:2. Risk factors studied were smoking habits, contact with patients, nutritional status, family income, population density, sun lighting, ventilation and the use of firewood for cooking. Data were collected through interviews, observation and measurement. Bivariate analysis was performed to determine the similarity between cases and controls and to calculate the crude OR. Multivariate analysis with logistic regression was performed to determine adjusted risk factors that contribute to the increasing TB patients. Results: There were no significant differences between cases and control groups in age, gender, education and occupation (p>0.05. Bivariate analysis showed that the risk factors of pulmonary tuberculosis were the contact with patients (OR=2.809; 95%CI:1.337-5.900, nutritional status (OR=2.380; 95%CI:1.096-5.169, the sun lighting (OR=8.090; 95%CI:3.468-18.872 and ventilation (OR=6.141; 95%CI:2.709-13.924. Multivariate analysis showed that the significant risk factors were the contact with patients (OR=3.428; 95%CI:1.455-8.075 and exposure to sunlight (OR=4.601; 95% CI:1.336-15.845. Conclusion: The contact with patients and the exposure to sunlight were the risk factors for pulmonary TB of positive BTA at the Dili District of Timor Leste. Keywords: Risk factors for tuberculosis, the

  9. 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.

  10. OPPORTUNITIES TO DIAGNOSE ACTIVE TUBERCULOSIS IN THE PATIENTS WITH CLINICALLY CURED RESPIRATORY TUBERCULOSIS

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    G. S. Balasanyants

    2017-01-01

    Full Text Available Goal of the study: to evaluate the test with tuberculous recombinant allergen (TRA in the patients with effective treatment course due to tuberculosis, to investigate the impact of clinical, epidemiological and social factors on persistence of active tuberculosis.Materials and methods. Patients were divided into 2 groups basing on time period after completion of the main treatment course. Group I – 32 patients (up to 6 months, group II – 63 patients (more than 6 months.Results of the study. Results of TRA tests in Group I remained positive in 34.4% of patients and in Group II - 23.8%. The average size of the induration in Group I made 10 mm(95% CI 6.5-13.3, in Group II – 13 mm (95% CI 8.4-19.7 Patients from Group I had positive results of TRA test more often in case of initial infiltrate form of pulmonary tuberculosis and bacillary excretion. In patients from Group II the positive TRA results correlated with presence of concurrent conditions and exposure to a tuberculosis case in the past. Positive results were confidently more often observed in lonely patients in both groups. TRA test can be a valuable tool to evaluate the risk of tuberculosis relapse after completion of the main treatment course. 

  11. The prevalence and factors associated for anti-tuberculosis treatment non-adherence among pulmonary tuberculosis patients in public health care facilities in South Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Woimo, Tadele Teshome; Yimer, Wondwossen Kassahun; Bati, Temesgen; Gesesew, Hailay Abrha

    2017-03-20

    Evidence exists pointing out how non-adherence to treatment remains a major hurdle to efficient tuberculosis control in developing countries. Many tuberculosis (Tb) patients do not complete their six-month course of anti-tuberculosis medications and are not aware of the importance of sputum re-examinations, thereby putting themselves at risk of developing multidrug-resistant and extensively drug-resistant forms of tuberculosis and relapse. However, there is a dearth of publications about non-adherence towards anti-Tb medication in these settings. We assessed the prevalence of and associated factors for anti-Tb treatment non-adherence in public health care facilities of South Ethiopia. This was a cross-sectional survey using both quantitative and qualitative methods. The quantitative study was conducted among 261 Tb patients from 17 health centers and one general hospital. The qualitative aspect included an in-depth interview of 14 key informants. For quantitative data, the analysis of descriptive statistics, bivariate and multiple logistic regression was carried out, while thematic framework analysis was applied for the qualitative data. The prevalence of non-adherence towards anti-Tb treatment was 24.5%. Multiple logistic regression analysis demonstrated that poor knowledge towards tuberculosis and its treatment (AOR = 4.6, 95%CI: 1.4-15.6), cost of medication other than Tb (AOR = 4.7, 95%CI: 1.7-13.4), having of health information at every visit (AOR = 3, 95% CI: 1.1-8.4) and distance of DOTS center from individual home (AOR = 5.7, 95%CI: 1.9-16.8) showed statistically significant association with non-adherence towards anti- tuberculosis treatment. Qualitative study also revealed that distance, lack of awareness about importance of treatment completion and cost of transportation were the major barriers for adherence. A quarter of Tb patients interrupted their treatment due to knowledge, availability and accessibility of DOTS service. We recommend

  12. 外周血CD14+单核细胞微RNA在结核分枝杆菌潜伏感染和肺结核中的差异表达%Differential expression of microRNA profiles in peripheral blood CD14+ monocytes between latent tuberculosis infection and pulmonary tuberculosis patients

    Institute of Scientific and Technical Information of China (English)

    林巧; 钟红剑; 邹容容; 刘腊香; 郑军; 张国良; 陈心春; 周伯平; 唐瑛

    2015-01-01

    pulmonary tuberculosis patients.Methods Thirty-one patients with pulmonary tuberculosis and 31 patients with LTBI were enrolled from Shenzhen Bao' an Chronic Diseases Prevent and Treatment Hospital and Shenzhen Third People' s Hospital during June 2013 and February 2014.Differentially expressed miRNAs were detected by using a miRNA chip in 6 pulmonary tuberculosis patients and 6 LTBI patients (male 3,female 3),and TaqMan qPCR test was performed to verify the differentially expressed miRNAs in two groups (25 for each).Receiver operating characteristic (ROC) curve was used to evaluate the differentially expressed miRNAs in diagnosis of pulmonary tuberculosis.Target genes of differentially expressed miRNAs were forecasted using miRFocus database,and GO term and KEGG pathway annotation were performed.Results There were 40 differentially expressed miRNAs in CD14 + monocytes between LTBI and pulmonary tuberculosis patients,among which 4 had > 2-fold up-regulation and 36 had > 2-fold down-regulation in pulmonary tuberculosis patients.All differentially expressed miRNAs could be divided into two clusters.TaqMan qPCR test showed that the expression of miR-378 (up-regulated miRNA) in pulmonary tuberculosis patients was 4.17 ± 0.25,which was significantly higher than that in LTBI patients (2.31 ± 0.24,t =5.25,P < 0.01) ; the expression of miR-483-5p (down-regulated miRNA) in pulmonary tuberculosis patients was 1.7l ± 0.16,which was significantly lower than that in LTBI patients (2.97 ± 0.15,t =5.45,P < 0.01).ROC curve analysis showed that the sensitivities and specificities of miR-378 and miR-483-5p in the diagnosis of pulmonary tuberculosis were 0.76,0.72 and 0.84,0.76,respectively.Bioinformatic analysis showed that the target genes of miR-378 and miR-483-5p mainly involved in cell proliferation,apoptosis,antigen presentation and signal transduction.Conclusion There are significant differences in miRNA profiles in CD14 + monocytes between LTBI and pulmonary tuberculosis

  13. 某医院传染科老年肺结核患者孤独感的原因分析%The Causes of Loneliness in Elderly Patients with Pulmonary Tuberculosis by Environmental Stress of Infectious Diseases Ward

    Institute of Scientific and Technical Information of China (English)

    邬梅珍; 杨敏; 康明芬

    2011-01-01

    [目的]分析老年肺结核患者在传染科病房特定环境下所产生的压力因素,进一步探讨导致状态孤独感心理体验的原因,并提出对策.[方法]采用质性研究的方法对37名老年肺结核患者进行深入访谈、现场记录,并进行资料整理,提炼主题.[结果]传染科老年肺结核患者产生状态孤独感的环境压力因素来自三方面.(1)自然环境压力:有个人空间的改变、物理居住环境的改变、方位空间的隔离;(2)社会环境压力:有社会支持不足、经济条件不富裕、家属对疾病认知偏差;(3)个体因素压力:有特定的人格特点和行为方式、患者对疾病认知程度.[结论]护理人员应正确认识老年肺结核患者在特定环境所产生的压力而导致的孤独感心理,为患者提供有效的应对援助.提供舒适的物理环境、适宜的个人空间、正确对待空间隔离,提高社会支持及利用度、指导应用正确的减压策略.%[Objective] To identify the stress factors in elderly patients with pulmonary tuberculosis patients in specific circumstances of infectious diseases ward, to further explore the causes of psychological experience of loneliness and to propose relative solutions. [ Methods ] Using qualitative research methods, 37 cases of elderly patients with pulmonary tuberculosis patients were interviewed with field recording and followed by data consolidation. [ Results ] Infectious diseases ward elderly patients with pulmonary tuberculosis patients undertake environmental stressors were identified from 1) natural stressors: personal space changes and living environment space isolation; 2)socio-environmental stressors: lack of social support, poor economic conditions and, cognitive biases for their illness from family members; 3) individual factors: specific personality/behavior andpersonal cognition of disease. [ Conclusion ] The loneliness of elderly patients with pulmonary tuberculosis patients under

  14. Analysis of the cure of chronic diseases in patients with pulmonary tuberculosis and related lifestyle%治愈肺结核患者慢性病患病及相关生活方式分析

    Institute of Scientific and Technical Information of China (English)

    张德坤; 缪昌东; 张洵

    2015-01-01

    Objective to understand the past cure pulmonary tuberculosis patients with chronic non communicable diseases, the prevalence of physical condition and lifestyle related issues, as the guidance of pulmonary tuberculosis patients after healing, provide a reasonable way of life and provide the basis to improve the quality of life;Methods by Taizhou city“basic public health service information system”extraction over the age of 18 previous cure pulmonary tuberculosis personnel related data analysis;Results a total of 2014 residents information system management of tuberculosis in 923 residents, many residents over 55 years old, which combined with diabetes patients was 93, the prevalence rate of 10.08%diabetes combined with hypertension, are 329, the prevalence rate of hypertension was 35.64%, population of BMI index was 22.03 ± 2.63kg/m2, weight of 89 patients people, lean rate 9.64%, overweight rate is 18.85%, obesity rate was 2.06%, the smoking rate was 22.64%, the drinking rate 26.32%, never to participate in physical exercise rate 77.25%;Conclusion among tuberculosis patients in body mass index was significantly lower than that of ordinary people, should pay attention to poor nutritional status, TB patients more promptly corrected;at the same time TB patients excessive focus on diet, nutrient intake imbalance caused by excessive, will cause some nutrition related chronic diseases, should pay more attention to the prevention of nutrition related chronic diseases, improve their life style.%目的:为了解既往治愈肺结核病人慢性非传染疾病患病情况、体质状况以及生活方式相关问题,为指导肺结核患者愈后提供合理的生活方式改善生活质量提供依据;方法通过泰州市《基本公共卫生服务信息系统》提取18岁以上既往治愈肺结核病人员相关资料进行分析;结果2014年居民信息系统共管理结核居民923人,以55岁以上居民较多,其中合并有糖尿病病人为93人

  15. 糖尿病合并肺结核应用胰岛素泵强化治疗的护理%Nursing of Diabetic Patients with Pulmonary Tuberculosis by Intensive Treatment of Insulin Pump

    Institute of Scientific and Technical Information of China (English)

    黎英豪

    2014-01-01

    Objective To explore the clinical effect and nursing of diabetic patients with pulmonary tuberculosis by intensive treatment of insulin pump. Methods 36 cases of diabetic patients with pulmonary tuberculosis received intensive treatment of insulin pump, nursing of pump implantation, psychological and diet. The fasting blood glucose, postprandial 2 h blood glucose before and after treatment and sputum negative conversion were compared. Results Compared with pre-treatment, the fasting blood glucose, postprandial 2 h blood glucose and sputum negative conversion after treatment were statistically significantly different (P <0.01). Conclusions Insulin pump has better hypoglycemic effect in intensive treatment of diabetic patients with pulmonary tuberculosis. Pump implantation nursing, psychological nursing and diet nursing are keys to guarantee the efficacy.%目的:探讨胰岛素泵强化治疗糖尿病合并肺结核患者的临床效果及其护理。方法对36例糖尿病合并肺结核患者进行胰岛素泵强化治疗,以及置泵、心理、饮食护理,比较治疗前后空腹血糖、餐后2h血糖以及痰菌转阴情况。结果36例糖尿病合并肺结核患者应用胰岛素泵强化治疗和护理后空腹血糖、餐后2h血糖以及痰菌转阴与治疗前比较,差异具有显著统计学意义(P<0.01)。结论糖尿病合并肺结核应用胰岛素泵强化治疗降糖效果良好,做好置泵、心理、饮食护理是保障疗效的关键。

  16. Tonsillar tuberculosis, with primary pulmonary focus: A Case Report

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    Juan Antonio Lugo Machado

    2015-09-01

    Full Text Available Tuberculosis is an infectious disease that affects various organs and tissues, with greater tropism for lung disease, gastrointestinal and central nervous system tissue and even bone. However isolated cases of affection to other structures have been reported, just like this patient who came with symptoms in the tonsils and subsequently, lung involvement became apparent. The tonsillar infection in this case was considered a secondary tuberculosis with primary focus in the lungs.

  17. [Skin tuberculin test (STT) for screening tuberculosis in contacts of tuberculosis patients].

    Science.gov (United States)

    Toure, N O; Dia, Y; Diatta, A; Ndiaye, E H M; Thiam, K; Niang, A; Fall, N; Kane, M; Mbae, F; Cisse, A; Hane, A A

    2006-01-01

    Many studies have underlined the theorical and practical role of Skin Tuberculin Test (STT) as an important tool for the diagnosis and for the screening of tuberculosis in the population. This prospective study evaluated STT in 51 smear positive tuberculosis patients and 108 contacts tuberculosis patients apparently in a good health condition. Twenty seven patients have disappeared before the end of the study and 7 patients were excluded for non suitable results. So we analysed only 73 cases. The mean age was 34 years, with extreme of 1 and 77 years. There were 33 male and 40 female patients for a sex-ratio of 0,8. BCG vaccination scar was found in 64% of patients. We calculated the Body-Mass-Index and we found a proteinocaloric malnutrition (BMISTT induration was 12,3mm with extremes of 7 and 20mm. Considering a STT STT and 69 (95%) a positive STT. 13 of these 69 patients had a STT > 15mm. The age group of the 10 to 50 years had more positive STT. Meanwhile, according to the sexe and to the nutritional status, there was no statistical difference. All patients with a negative STT received BCG vaccination after 2 months of follow-up. Those with STT>15mm were examinated and had a chest X-ray the day of their enrolment, at the second month and at the sixth month and we didn't find any evolutive tuberculosis. According to these results, we can conclude that STT is not an important test for the screening of pulmonary tuberculosis in contact patients. Clinical examination, chest X-ray and sputum smear remain very important for the diagnosis. Despite these results, STT remain the only validated technic between the different tuberculin tests. Its interest was twofold: the research of an acquired immunity against tuberculosis after BCG immunisation and it is clinical test for the diagnosis of tuberculosis in children.

  18. Humoral response to low molecular weight antigens of Mycobacterium tuberculosis by tuberculosis patients and contacts

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    Beck S.T.

    2005-01-01

    Full Text Available Much effort has been devoted to the identification of immunologically important antigens of Mycobacterium tuberculosis and to the combination of target antigens to which antibodies from serum of tuberculous patients could react specifically. We searched for IgG antibodies specific for antigens of 45 to 6 kDa obtained after sonication of the well-characterized wild M. tuberculosis strain in order to detect differences in the antibody response to low molecular weight antigens from M. tuberculosis between patients with pulmonary tuberculosis and contacts. Specific IgG antibodies for these antigens were detected by Western blot analysis of 153 serum samples collected from 51 patients with confirmed pulmonary tuberculosis. Three samples were collected from each patient: before therapy, and after 2 and 6 months of treatment. We also analyzed 25 samples obtained from contacts, as well as 30 samples from healthy individuals with known tuberculin status, 50 samples from patients with other lung diseases and 200 samples from healthy blood donors. The positive predictive value for associated IgG reactivity against the 6-kDa and 16-kDa antigens, 6 and 38 kDa, and 16 and 38 kDa was 100% since simultaneous reactivity for these antigens was absent in healthy individuals and individuals with other lung diseases. This association was observed in 67% of the patients, but in only 8% of the contacts. The humoral response against antigens of 16 and 6 kDa seems to be important for the detection of latent tuberculosis since the associated reactivity to these antigens is mainly present in individuals with active disease.

  19. 肺结核患者应对方式和社会支持的研究%Investigation on coping styles and social support of pulmonary tuberculosis patients

    Institute of Scientific and Technical Information of China (English)

    资青兰; 何志青; 胡贵方; 唐惠红; 龚芳

    2013-01-01

    Objective To investigate the coping styles and social support of pulmonary tuberculosis patients,and to compare the coping styles and social support of different demographic characteristics.Methods A total of 250 cases of new sputum smear positive pulmonary tuberculosis patients were selected continuously in accordance with the registration order.They were investigated with Trait Coping Style Questionnaire and Social Support Rating Scale.Results About 80.04% of the patients showed a moderate or low level of positive coping style and 26.40% showed a high level of negative coping style.The percent of high level subjective support was 27.20%,and the percents of low level objective support and usage degree of support were 90.80% and 100.00%,while the total score of high level social support was 4.00%.Marriage and gender were found to be the influencing factors.Conclusion Pulmonary tuberculosis patient stend to choose negative coping styles and show a low level of social support.The unmarried or divorced patients are the low level social support groups.It is suggested to take actions to reduce the patients'emotional stress,avoide negative coping style and enhance social support,especially for those unmarried or divorced,to promote the control of pulmonary tuberculosis.%目的 调查肺结核患者的应对方式和社会支持水平,并比较不同人口学特征肺结核患者的应对方式、社会支持状况.方法 按确诊登记顺序连续抽取250例新发痰涂片阳性的肺结核患者,选用特质应对方式问卷和社会支持评定量表进行问卷调查.结果 80.40%的肺结核患者积极应对方式得分处于中低水平,26.40%的患者消极应对方式得分处于高水平;肺结核患者高水平的主观支持占27.20%,低水平的客观支持、支持利用度分别占90.80%、100.00%,而患者高水平的社会支持总分仅占4.00%;婚姻状况和性别是主要影响因素.结论 肺结核患者多采用消

  20. Clinical analysis of 73 childish patients with pulmonary tuberculosis.%儿童肺结核病73例临床分析

    Institute of Scientific and Technical Information of China (English)

    江红; 文立; 熊志刚

    2011-01-01

    Objective To raise the cognition of puhmonary tuberculosis in children. Methods The clinical data of 73 childish patients with tuberculosis admitted in this department during 1998 ~2010 were retrospectively analyzed. Results Children infected with tubrculosis usually have no specific clinical symptoms, they were always misdiagnosed as upper respiratory tract infection or pneumonia in 37 cases of this series,the nisdiagnosis rate reached 50.7% , and the average duration for delayed diagnosis was 15 d. The cure rate of 2HRZS/4HR therapy was 90.9%. Conclusion The information about history of illness, chest X - ray examination, bacteriological examination of sputum and PPD intraderml test are important for diagnosing tuberculosis in children. Pay more attention to the characteristics of childish tuberculosis and comprehensive analysis of various clinical data can raise the rate for accurate diagnosis. The efficacy of short - term course of chemotherapy in treatment of childish tuberculosis is good.%目的 提高对儿童肺结核的认识.方法 回顾性分析1998~2010年收治的73例儿童肺结核病例.结果 儿童肺结核临床症状无特异性,误诊为上呼吸道感染、肺炎37例,误诊率50.7%,延误时间平均15 d.采用短程化疗方案(2HRZS/4HR)治疗,治愈率为90.9%.结论 胸部X线表现,痰细菌学检查,结核菌素试验对儿童肺结核的诊断有重要意义.重视儿童肺结核的特点,综合分析各种临床资料才能提高诊断率.儿童肺结核短程化疗方案效果良好.

  1. 优质护理对肺结核并咯血患者疗效的影响%Effects of High Quality Nursing on the Patients with Pulmonary Tuberculosis Complicated by Hemoptysis

    Institute of Scientific and Technical Information of China (English)

    孙玉姝

    2015-01-01

    Objective To study and analyze the clinical effect of high quality nursing on patients with pulmonary tuberculosis and hemoptysis. Methods 106 cases with pulmonary tuberculosis and hemoptysis visited and treated in our hospital from January 2013 to December 2014 were selected and randomly divided into the control group and the study group in accordance with the computer sampling method. 53 cases in the control group received conventional nursing service, and 53 cases in the study group received high quality nursing service. Results The incidence of massive hemoptysis, asphyxia and transferring to the ICU in the study group was much lower than that in the control group, respectively, the difference had statistical significance, P<0.05. The duration of hemoptysis and length of stay in the study group was obviously shorter than that in the control group, respectively, the difference had statistical significance, P<0.05. Conclusion For patients with pulmonary tuberculosis complicated by hemoptysis, high quality nursing intervention can effectively improve the symptoms of hemoptysis and enhance the clinical curative effect obviously.%目的:研究分析优质护理应用于肺结核并咯血的临床效果。方法整群选择2013年1月-2014年12月期间在该院就诊治疗的106例肺结核并咯血患者,应用计算机取样法进行随机性分组,一组53例患者接受常规护理作为试验的对照组;一组53例患者接受优质护理服务作为试验的研究组。结果研究组患者发生大咯血、窒息以及转ICU的概率均显著低于对照组,差异有统计学意义(P<0.05)。研究组患者咯血持续时间、住院时间均显著小于对照组,差异有统计学意义(P<0.05)。结论对肺结核并咯血患者开展优质护理干预,能有效改善咯血症状,促进临床疗效的明显提高。

  2. 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.

  3. [Isoniazid content of lungs in patients with pulmonary tuberculosis depending on the method of its administration as part of a comprehensive preoperative preparation].

    Science.gov (United States)

    Strelis, A K; Blinov, V Iu; Gubina, N A

    1992-01-01

    Isoniazid concentration in the resected areas of a lung was studied in 47 patients with tuberculosis. It has been proved that galvanization of the chest against the background of intermittent intravenous chemotherapy allows to create a high concentration of the preparation in the damaged part of a lung situated at the interelectrode space. Isoniazid content in the wall of the caverna and paracavernous tissues in patients after the direct current influencing was (5.3 +/- 1.0) and (15.2 +/- 1.2) mukg/g. These indices were significantly higher than in patients, who sustained enteral, or intravenous drip administration of the preparation 3 times a week. Intravenous intermittent chemotherapy in combination with galvanization is indicated at the time of preoperative preparation of the patients.

  4. 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

  5. 235例肺外结核性创面患者流行病学调查%Epidemiological investigation of 235 patients with extra-pulmonary tuberculosis wounds

    Institute of Scientific and Technical Information of China (English)

    常娜; 贾赤宇; 刘真; 张亚洁; 李文婷; 田甜

    2015-01-01

    目的 初步探讨肺外结核性创面流行病学特点和规律,为临床研究提供可靠数据.方法 对笔者单位2010年1月-2012年12月收治的肺外结核性创面患者的性别、年龄、民族、家庭背景、卡介苗接种情况、原发病灶、外伤史这几项资料进行回顾性分析,总结其规律及特点. 结果 5 863例肺外结核病患者中,235例出现结核性创面,占4.0%.其中男139例、女96例,男女之比为1.4∶1.0.年龄1~87(37±18)岁,其中大于15岁且小于或等于30岁青壮年患者构成比最大(100例,42.6%).多数患者为汉族;仅有11例患者为少数民族,占4.7%.患者中163例来自农村,占69.4%;72例来自城镇,占30.6%.卡介苗接种率为13.6%(32例).原发病灶中,以周围淋巴结结核为主,共112例,占47.7%,其中又以颈部淋巴结结核为主(99例,88.4%).21例(男19例、女2例)患者近期有车祸等外伤史. 结论 结核性创面有一定的发病率,并非罕见,以农村地区青壮年人群多发,患者的卡介苗接种率较低,颈部淋巴结结核为主要原发病灶.%Objective To investigate the epidemiological characteristics and patterns of extra-pulmonary tuberculosis wounds in order to provide reliable data for further clinical research.Methods Records of patients with extra-pulmonary tuberculosis wounds hospitalized from January 2010 to December 2012 were retrospectively analyzed,including gender,age,nationality,family background,Bacille CalmetteGuerin (BCG) vaccination,primary lesion,and history of injury.Results Tuberculosis wounds were found in 235 patients among 5 863 patients with extra-pulmonary tuberculosis,accounting for 4.0%.Among the patients with tuberculosis wounds,there were 139 male and 96 female,and the ratio of male to female was 1.4∶ 1.0.The age of patients ranged from 1 to 87 (37 ± 18) years old,and the highest incidence occurred in patients older than 15 and younger than or equal to 30 years old (100 cases

  6. ICOS, SLAM and PD-1 expression and regulation on T lymphocytes reflect the immune dysregulation in patients with HIV-related illness with pulmonary tuberculosis

    Science.gov (United States)

    Jurado, Javier Oscar; Pasquinelli, Virginia; Alvarez, Ivana Belén; Martínez, Gustavo Javier; Laufer, Natalia; Sued, Omar; Cahn, Pedro; Musella, Rosa María; Abbate, Eduardo; Salomón, Horacio; Quiroga, María Florencia

    2012-01-01

    Background Tuberculosis (TB) continues to be the most frequent cause of illness and death from an infectious agent globally, and its interaction with HIV is having devastating effects. To investigate how HIV alters the immune response to Mycobacterium tuberculosis (Mtb), we assessed basal and Mtb-induced proliferation, cytokine production, and expression of signalling lymphocytic activation molecule (SLAM), inducible costimulator (ICOS) and programmed death-1 (PD-1) on T lymphocytes from HIV-positive individuals coinfected with TB, HIV-positive subjects, TB patients and healthy donors (HD). Findings HIV-TB patients showed increased ICOS, SLAM and PD-1 basal levels on T lymphocytes, whereas HIV-positive individuals displayed elevated levels of SLAM and PD-1, TB patients high levels of SLAM, and HD low levels of the three proteins. Mtb-stimulation enhanced ICOS expression in the four groups, but only TB and HD increased SLAM and PD-1 levels. Conclusions These data show the immune deregulation that takes place during the immune response against TB in different study populations. PMID:22713261

  7. ICOS, SLAM and PD-1 expression and regulation on T lymphocytes reflect the immune dysregulation in patients with HIV-related illness with pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Horacio Salomón

    2012-06-01

    Full Text Available Background: Tuberculosis (TB continues to be the most frequent cause of illness and death from an infectious agent globally, and its interaction with HIV is having devastating effects. To investigate how HIV alters the immune response to Mycobacterium tuberculosis (Mtb, we assessed basal and Mtb-induced proliferation, cytokine production, and expression of signalling lymphocytic activation molecule (SLAM, inducible costimulator (ICOS and programmed death-1 (PD-1 on T lymphocytes from HIV-positive individuals coinfected with TB, HIV-positive subjects, TB patients and healthy donors (HD. Findings: HIV-TB patients showed increased ICOS, SLAM and PD-1 basal levels on T lymphocytes, whereas HIV-positive individuals displayed elevated levels of SLAM and PD-1, TB patients high levels of SLAM, and HD low levels of the three proteins. Mtb-stimulation enhanced ICOS expression in the four groups, but only TB and HD increased SLAM and PD-1 levels. Conclusions: These data show the immune deregulation that takes place during the immune response against TB in different study populations.

  8. 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

  9. 湖南长沙市结核分枝杆菌耐药情况分析%Drug resistance analysis on Mycobacterium tuberculosis in patients with pulmonary tuberculosis in Changsha area

    Institute of Scientific and Technical Information of China (English)

    潘建华; 罗丹; 石国民; 彭雪峰; 向延根

    2016-01-01

    Objective To investigate the current situation of Mycobacterium tuberculosis drug resistance in Changsha area. Methods A total of 6198 Mycobacterium tuberculosis strains were identified in Changsha Central Hospital from 2011 to 2015 and the sensitivity of Mycobacterium tuberculosis strains to 7 kinds of anti-tuberculosis drugs was performed. Results The top 5 of the drug resistance rates of 6198 strains of Mycobacterium tuberculosis complex group were INH(14. 18% ),RFP(13. 57% ),SM(12. 31% ),EMB(3. 87)and OFLX(2. 60). The o-verall rate of resistance to anti-TB drugs was 20. 56% . MDR rate was 9. 31%. PDR rate was 4. 52% and XDR rate was 0. 45% . The detection rate of drug resistant tuberculosis of male was higher than female in all age groups except the female under 20 years old in 2012. The resistance in retreated patients was higher than in initial patients. Con-clusion The prevalence of drug resistance of Mycobacterium tuberculosis in our hospital is lower than that of the fifth national tuberculosis epidemiological survey,but MDR rate is higher than the national level. Therefore,its drug re-sistance situation is still grim.%目的:了解长沙地区结核分枝杆菌耐药情况。方法分析本院2012年1月-2015年10月分离的6198株结核分枝杆菌对7种抗结核药物的耐药情况。结果6198株结核分枝杆菌复合群菌株耐药率顺位前5位依次为 INH(14.18%)、RFP(13.57%)、SM(12.31%)、EMB(3.87)、OFLX(2.60);总耐药率为20.56%,耐多药占9.31%,多耐药占4.52%,广泛耐药占0.45%;除2012年20岁以下年龄组女性耐药结核菌的检出率略高于男性外,其余年份各年龄组男性均高于女性;复治患者的耐药率(24.76%)高于初治患者(19.49%),两者差异有统计学意义(χ2=176.21,P <0.001);结论本院结核分枝杆菌耐药率总体低于全国第五次结核病流行病学调查结果,但耐多药率高于全国水平,耐药状况仍然严峻。

  10. 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

  11. Comparison of sensitivity of QuantiFERON-TB gold test and tuberculin skin test in active pulmonary tuberculosis.

    Science.gov (United States)

    Khalil, Kanwal Fatima; Ambreen, Asma; Butt, Tariq

    2013-09-01

    To compare the sensitivity of tuberculin skin test (TST) and quantiFERON-TB gold test (QFT-G) in active pulmonary tuberculosis. Analytical study. Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi, from July 2011 to January 2012. QuantiFERON-TB gold test (QFT-G) was evaluated and compared it with tuberculin skin test (TST) in 50 cases of active pulmonary tuberculosis, in whom tuberculous infection was suspected on clinical, radiological and microbiological grounds. Sensitivity was determined against postive growth for Mycobacterium tuberculosis. Out of 50 cases, 43 were females and 7 were males. The mean age was 41.84 ± 19.03 years. Sensitivity of QFT-G was 80% while that of TST was 28%. QFT-G has much higher sensitivity than TST for active pulmonary tuberculosis. It is unaffected by prior BCG administration and prior exposure to atypical mycobacteria. A positive QFT-G result can be an adjunct to diagnosis in patients having clinical and radiological data compatible with pulmonary tuberculosis.

  12. [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

    Actinomycosis is a chronic suppurative infection, produced by anaerobic Gram-positive bacteria or microaerobic Actinomyces species. It is rare in children and adolescents and it is more common in immunocompromised. Mycobacterium tuberculosis collaborates on the development of the disease. Pulmonary involvement appears as a picture of chronic condensation that does not improve with conventional antibiotic treatment. Classic complications affecting the thoracic wall with drainage in «sulfur granule» and fistulization are described less frequently nowadays. The diagnosis is a real challenge and it is set by using the isolation of species of Actinomyces. The treatment of choice for all clinical forms of the disease is the prolonged use of antibiotics. to present a pediatric case of comorbidity between tuberculosis and actinomycosis and to highlight the importance of diagnostic suspicion of actinomycosis in the presence of all chronic suppurative processes. Sociedad Argentina de Pediatría.

  13. 含莫西沙星强化期抗结核方案用于初治肺结核的效果评价%Therapeutic effect of the regimen containing Moxifloxacin in intensive phase for pulmonary tuberculosis patients

    Institute of Scientific and Technical Information of China (English)

    贾维

    2011-01-01

    Objective To explore the effect and safety of the regimen containing Moxifloxacin in intensive phase for pulmonary tuberculosis patients. Methods 88 cases with initial tuberculosis(each group of 44 cases) were studied in comparison in the same period. The treatment group contained isoniazid, rifampicin and moxifloxacin of antituberculosis regime and the control group contained isoniazid,rifampicin and pyrazineamide. Results After 2 months intensive phase anti-tubercular treatment ,the sputum negative conversion rates was 95.0% and control's was 94.4%(P > 0.05); the absorb rate of lesions: the treatment group 77.3 % and the control group 79.5%; the liver damage rate: the treatment group and control group was 68.2% ,34.1% respectively(P < 0.05). Conclusion Anti-tuberculosis intensive phase regimes containing moxifloxacin for tuberculosis treatment was safe and effective in initial treatment of pulmonary tuberculose.%目的 探讨强化期含莫西沙星用于初治肺结核的有效性和安全性.方法 对88例初治肺结核进行了同期对照配对研究(每组44例).其中治疗组为含莫西沙星(异烟肼、利福平、莫西沙星)的抗结核方案,对照组为异烟肼、利福平、吡嗪酰胺的治疗方案.结果 抗结核治疗2个月,治疗组与对照组痰菌阴转率(95.0%与94.4%)、病灶吸收好转率(77.3%与79.5%)差异均无统计学意义(均P>0.05));肝损率治疗组34.1%,对照组68.2%,差异有统计学意义(P<0.05).结论 含莫西沙星的强化期联合抗结核方案用于初治肺结核的治疗安全有效.

  14. 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.

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

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    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.

  16. Broncoscopia no diagnóstico de tuberculose pulmonar em pacientes com baciloscopia de escarro negativa Bronchoscopy for the diagnosis of pulmonary tuberculosis in patients with negative sputum smear microscopy results

    Directory of Open Access Journals (Sweden)

    Márcia Jacomelli

    2012-04-01

    Full Text Available OBJETIVO: Avaliar a acurácia diagnóstica da broncoscopia em pacientes com suspeita clínica ou radiológica de tuberculose, com baciloscopia negativa ou incapazes de produzir escarro. MÉTODOS: Estudo transversal prospectivo de 286 pacientes com suspeita clínica/radiológica de tuberculose pulmonar e submetidos à broncoscopia - LBA e biópsia transbrônquica (BTB. As amostras de LBA foram testadas por pesquisas diretas e culturas de BAAR e de fungos, e as de BTB por exame histopatológico. RESULTADOS: Dos 286 pacientes estudados, a broncoscopia contribuiu para o diagnóstico em 225 (79%: tuberculose pulmonar em 127 (44%; inflamações crônicas inespecíficas em 51 (18%; pneumocistose, infecções fúngicas ou nocardiose em 20 (7%; bronquiolite obliterante com pneumonia em organização, alveolites ou pneumoconioses em 14 (5%; neoplasias pulmonares ou metastáticas em 7 (2%; e micobacterioses não tuberculosas em 6 (2%. Para o diagnóstico de tuberculose, o LBA mostrou sensibilidade e especificidade de 60% e 100% respectivamente, havendo um aumento importante da sensibilidade quando associado à biópsia (84% e à baciloscopia após a broncoscopia (94%. Complicações controláveis decorrentes do procedimento ocorreram em 5,6% dos casos. CONCLUSÕES: A broncoscopia representa um método diagnóstico confiável para pacientes com tuberculose pulmonar, apresentando baixos índices de complicações. A associação de biópsia transbrônquica ao lavado broncoalveolar elevou a sensibilidade diagnóstica do método e permitiu o diagnóstico diferencial com outras doenças.OBJECTIVE: To evaluate the diagnostic accuracy of bronchoscopy in patients with clinical or radiological suspicion of tuberculosis who were unable to produce sputum or with negative sputum smear microscopy results. METHODS: A prospective cross-sectional study involving 286 patients under clinical or radiological suspicion of having pulmonary tuberculosis and submitted to

  17. [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.

  18. 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

  19. Pulmonary thromboembolism in AIDS patient with chronic venous insufficiency, pulmonary tuberculosis and breast cancer: a case report and pathophysiology review Tromboembolismo pulmonar em uma paciente com AIDS com insuficiência venosa profunda, tuberculose pulmonar e câncer de mama: relato de um caso e revisão da fisiopatologia

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    Juan José Cortez-Escalante

    2006-04-01

    Full Text Available Recent literature reports thrombotic episodes occurring in patients with HIV infection associated with other abnormalities including neoplasms and infections predisposing to a hypercoagulable state. We report a 47-year-old woman who developed pulmonary thromboembolism in association with HIV infection, pulmonary tuberculosis and breast cancer. She was treated with rifampin, isoniazid, pyrazinamide; heparin, phenprocoumon, zidovudine, lamivudine and efavirenz. Acid fast bacilli were visualized in a sputum smear and three months after, Mycobacterium tuberculosis was isolated from lymph node biopsy during a episode of immune reconstitution. The isolated mycobacteria showed sensitivity to all first-line drugs. HIV infection, breast cancer and pulmonary tuberculosis have several mechanisms that induce hypercoagulable state and can lead to thromboembolic complications. Pulmonary thromboembolism in this patient was a diagnostic challenge because of all the other severe diseases that she experienced at the same time.Publicações recentes relatam episódios trombóticos em pacientes infectados pelo HIV associados a outras condições que incluem neoplasias e infecções que predispõem para um estado de hipercoagulabilidade. Relata-se o caso de uma paciente de 47 anos portadora do HIV que desenvolveu tromboembolismo pulmonar, tuberculose pulmonar e câncer de mama. Foi tratada com rifampicina, isoniazida, pirazinamida, heparina, femprocumona, zidovudina, lamivudina e efavirenz. Bacilos ácido-álcool-resistentes foram observados no exame de escarro e três meses depois foi isolado o Mycobacterium tuberculosis da biópsia de linfonodo durante um episódio de reconstituição imune. A micobactéria isolada demonstrou sensibilidade a todas as drogas anti-tuberculosas de primeira linha. A infecção pelo HIV, o câncer de mama e a tuberculose pulmonar possuem vários mecanismos que induzem um estado de hipercoagulabilidade e que podem produzir complica

  20. 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。

  1. Clinical characteristics of patients with pulmonary tuberculosis complicated by lung cancer research and living conditions%肺结核并发肺癌患者的临床特征及生存状况研究

    Institute of Scientific and Technical Information of China (English)

    唐洪翠

    2015-01-01

    目的:探讨肺结核并发肺癌患者的临床特征及生存状况。方法该院2009年6月至2014年6月收治的80例肺结核并发肺癌患者,分析首次病发症状、肿瘤特征、影像学特点和生存状况。结果首次病发症状:咳嗽36例(45.00%)、咯痰咯血22例(27.50%)、胸闷25例(31.00%)、胸背部疼痛18例(22.50%)、发热22例(27.50%)。C T和病理学检查:单侧肺部肿瘤87.50%,周围型肿瘤65.00%,中后期肿瘤40.00%,腺癌30.00%。肿瘤直径范围:2.2~10.1 cm ,平均直径5.1 cm。病灶部位:合并空洞影15例(18.75%),结节团块组织密度影35例(43.75%),右上肺突变影5例(6.25%),右中叶肺不张5例(6.25%),上肺突变影4例(5.00%),双肺弥散结节影8例(10.00%),肿瘤与结合病灶部位同侧38例(47.50%),不同侧30例(37.50%),双侧结核病灶11例(13.75%)。随访调查:女性、年龄小于55岁、无吸烟史、肿瘤直径小于5.1 cm、中央型位置、Ⅰ期、稳定性肺结核、肿瘤与结核不同侧和手术治疗的患者的累积生存5年时间的比例较高(P<0.05)。肺结核并发肺癌患者的1年累积生存率为66.70%,3年45.00%,5年30.00%。结论女性、年龄小于55岁、无吸烟史、肿瘤直径小于5.1 cm、中央型位置、Ⅰ期、稳定性肺结核、肿瘤与结核不同侧和手术治疗的患者的生存时间较长。%Objective To explore the clinical characteristics and survival of patients with pulmonary tuberculo‐sis complicated by lung cancer .Methods 80 cases of pulmonary tuberculosis complicated by lung cancer patients were selected in our hospital from June 2009 to June 2014 as the object of study ,initial symptoms of the disease , tumor characteristics ,imaging characteristics and survival were statistical analyzed in 80 patients .Results In

  2. Prevalence and genetic characterisation of HTLV-1 and 2 dual infections in patients with pulmonary tuberculosis in Central-West Brazil

    Directory of Open Access Journals (Sweden)

    Aline Garcia Kozlowski

    2014-02-01

    Full Text Available Human T-cell lymphotropic virus (HTLV may impact the clinical course of tuberculosis (TB. Both infections are highly endemic in Brazil. The aim of this study was to assess the prevalence of HTLV-1/2 in TB patients in Central-West Brazil and to perform a genetic characterisation of the respective isolates. Of the 402 patients, six (1.49% were positive for anti-HTLV and five (1.24%; 95% confidence interval: 0.46-3.05 were infected with HTLV-1/2. Genetic characterisation demonstrated that the four HTLV-1 isolates belonged to the Transcontinental subgroup A of the Cosmopolitan subtype a and that the HTLV-2 isolate belonged to subtype a (HTLV-2a/c. The prevalence of HTLV infection observed in this study is higher than that observed in local blood donors and the HTLV-1 and 2 subtypes identified are consistent with those circulating in Brazil.

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

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    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

  4. 救助精神病患者感染肺结核的原因及护理对策%Relief Mental Cause of Infection in Patients with Pulmonary Tuberculosis and Nursing Countermeasures

    Institute of Scientific and Technical Information of China (English)

    王雪荣

    2013-01-01

    目的:探讨救助精神病患者合并肺结核的原因,提出护理对策。方法:对我院2012年12月-2013年1月集中发现救助精神病患者合并肺结核的病例资料进行回顾性分析。结果:患者长期住院,机体抵抗力下降,常规入院检查漏诊率高,临床症状不典型,住院环境条件受限、消毒隔离措施不力等,是肺结核感染和复发的主要原因。经过全程抗结核药物治疗和采取有效的护理措施,37例患者已获临床痊愈,不再有传染性,也没有新增病例。结论:要把好入院辅助检查关,通过加强消毒隔离、服药管理、饮食护理、吸烟管理、病情观察、环境、痰液、物品消毒处理、提高医护人员防治结核病的意识等措施,有效控制了院感的再发生。%Objective: to study the relief cause of psychosis patients complicated with pulmonary tuberculosis, made nursing strategies. Method: our hospital found relief with mental il ness in the December 2012-January 2013 set retrospective analysis of pulmonary tuberculosis case information. Results: patients with long-term hospitalization, decline in body resistance, General admission verify that high rate of missed diagnosis, clinical symptoms are not typical, restricted hospital environment conditions, inadequate disinfection and isolation measures, is a major cause and recurrence of tuberculosis infection. Through the whole course of anti-TB drug therapy and nursing measures to take ef ective, 37 patients had clinical cure, is no longer infectious, and no new cases. Conclusion: to be admit ed to secondary checks good close, through the strengthening of disinfection and isolation, medication management, catering management, observation, environmental care, smoking, sputum, disinfection processing, raising TB awareness measures such as medical and nursing staf , ef ective sense of control.

  5. Nutritional risk screening in pulmonary tuberculosis patients complicated with pulmonary infection%应用NRS2002方法对肺结核合并肺部感染患者的营养风险筛查和分析

    Institute of Scientific and Technical Information of China (English)

    卢春丽; 谭守勇; 江涛; 许蕴怡

    2014-01-01

    目的:研究肺结核合并肺部感染患者的营养风险、营养不足发生率,并与单纯肺结核患者进行比较。方法采用NRS2002营养风险筛查方法,随机选择2012年4月~10月新入院肺结核患者200例,在入院2天内和住院2周时进行营养风险筛查初查和复查,并按是否合并肺部感染,分为研究组(90例)和对照组(110例),比较两组营养不足、营养风险的发生率,进行统计分析。营养不足判定标准为体重指数BMI0.05。结论肺结核合并肺部感染住院患者的营养风险和营养不足发生率较高,应推广和使用NRS2002营养风险筛查方法,作为临床实施营养支持的参考依据。%Objective To study the incidence of malnutrition and nutrition risk in pulmonary tuberculosis patients complicated with pulmonary infection. Methods Totally 200 adult tuberculosis patients were enrolled in this study. All patients were divided into two groups according to pulmonary infection. The nutrition risks were screened in two days after admission and then two weeks later by Nutrition Risk Screening 2002 (NRS2002). Body mass index (BMI) lower than 18. 5 kg/m2 and serum albumin (sALB) lower than 30g/L were regarded as undernutrition. Re-sults 82% patients were judged at the risk of malnutrition and 43. 5% patients with malnutrition. The incidence of nutrition risk in the research group (88. 9%) was higher than that in the control group (76. 4%) (P0. 05). Conclusion Tuberculosis patients complicated with pulmonary infection have high nutritional risk or undernutrition. NRS2002 should be promoted in the nutrition assessment.

  6. 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......, to secreted mycobacterial antigens is suggestive of an early stage of infection by M. tuberculosis, which could in time result in overt disease or containment of the infection. This possibility is currently being investigated by follow-up studies of the household contacts....

  7. 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......, to secreted mycobacterial antigens is suggestive of an early stage of infection by M. tuberculosis, which could in time result in overt disease or containment of the infection. This possibility is currently being investigated by follow-up studies of the household contacts....

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

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    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.

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

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    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

  10. IMMUNOTHERAPY IN TREATMENT OF PULMONARY TUBERCULOSIS IN ADOLESCENTS

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    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.

  11. Tuberculosis screening in patients with HIV

    DEFF Research Database (Denmark)

    Bjerrum, Stephanie; Bonsu, Frank; Hanson-Nortey, Nii Nortey;

    2016-01-01

    BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...... May and October 2014, before and after a performance feedback intervention in August 2014. The outcomes of interest were overall tuberculosis suspicion rate during consultations and provider adherence to the International Standards for Tuberculosis Care and the World Health Organizations' guidelines...

  12. Pulmonary disease in patients with human immunodeficiency virus infection

    DEFF Research Database (Denmark)

    Lundgren, J D; Orholm, Marianne; Lundgren, B

    1989-01-01

    Pulmonary disease is the most important cause of morbidity and mortality in patients infected with human immunodeficiency virus (HIV). All parts of the hospital system are expected to be involved in the diagnosis and treatment of HIV infected patients in the coming years. Many different processes...... cause pulmonary disease alone or in combination. Bilateral interstitial infiltrates are the most frequent chest x-ray abnormality and are most frequently caused by infection with Pneumocystis carinii. Cytomegalovirus, Mycobacterium tuberculosis, nonspecific interstitial pneumonitis and pulmonary Kaposi...

  13. DERMATOGLYPHICS STUDY OF TUBERCULOSIS PATIENTS AND ITS CORRELATION WITH NORMAL PERSONS IN SOUTHERN (HADOTI REGION, RAJASTHAN

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    Manisha

    2016-04-01

    Full Text Available BACKGROUND Dermatoglyphics is a scientific study of epidermal ridges and their configuration on palmar and sole region. Dermatoglyphics had proved its importance in medicolegal, anthropological and in clinical fields. Abnormal dermatoglyphic pattern has been in many non-chromosomal genetic disorder and other diseases whose aetiology may be influenced directly or indirectly by genetic disorder. The tuberculosis is partly genetic and partly environmental. The genetic contribution is one of the causes of pulmonary tuberculosis. Tuberculosis caused by mycobacterium tuberculosis. So an attempt has been made to study Dermatoglyphic patterns in pulmonary tuberculosis patients and to compare them with normal individuals. AIMS AND OBJECTIVES To compare the dermatoglyphics patterns of pulmonary tuberculosis patients with normal individuals, both qualitative and quantitative. MATERIAL AND METHODS Dermatoglyphics prints of total 100 (Male 67 and Female 33 pulmonary tuberculosis patients (Sputum Positive and 100 normal individuals (Male 66, Female 34 from July 2013 to June 2014 were studied qualitatively and quantitatively: Dermatoglyphic printing was done by using older and fairly good “Indian Ink Method.” (Cummins and Midlo, 1961. RESULTS TFRC of pulmonary tuberculosis significantly high (140.77+39.63 as compared to TFRC of normal (115.02+39.63 and has high % of whorl and low % of loops as compared to normal. P value is significant in whorl and loops and TFRC. CONCLUSION Racial and genetic factors play important roles in deciding the qualitative and quantitative patterns of dermatoglyphics. Genetic contribution is one of the causes of pulmonary tuberculosis. Further quantitative study is needed to confirm the findings of present study.

  14. 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.)

  15. Evaluation of enzyme-linked immunospot assay detecting Mycobacterium tuberculosis specific T cell responses in patients with pulmonary tuberculosis%酶联免疫斑点法检测肺结核患者特异性结核抗原多肽T细胞的应答

    Institute of Scientific and Technical Information of China (English)

    饶英; 陈嘉臻; 朱静; 张文宏; 莫凌; 钟敏; 孟成艳; 张西燕; 虞胜镭; 陈刚; 王莹; 王菲菲

    2008-01-01

    Objective To evaluate the application of a new enzyme-linked immunospot assay (ELSIPOT)based on Mycobacterium tuberculosis-sepeific T cells detection in the diagnosis of active pulmonary tuberculosis in China.Methods Using the ELlSPOT assay.T cells specific for early secreted antigenic target 6-kDa protein(ESAT-6)and culture filtrate protein 10(CFP-10)in the peripheral blood from 76 active pulmonary tuberculosis patients were measured.Thirty healthy people were recruited as healthy controls,which had no tuberculosis contacting history and were normal for chest X ray examination as well as negative for tuberculosis skin test(TST).The data were analyzed using Chi-square test and Mann-Whitney test.Results The positive rate of ELISPOT was 71.0%(54/76)and 6.7%(2/30)in the patients with active pulmonarytuberculosis and healthy controls respectively.Furthermore,the positive rate was as high as 87.5% in patients with antituberculosis treatment course less than 1 month,and decreased to 74.1% and 52.0% in the patients with the treatment course varying from 1 to 6 months and more than 6 months respectively(X2=35.63,P=0.000).In the patients with treatment course less than 1 month,the sensitivity,specificity,positive predictive value and negative predictive value of ELISPOT were 87.5 oA,93.3 oA,91.3% and 90.3%,respectively.Conclusion ELISPOT assay is a sensitive assay for detecting tuberculosis infection,especially in the patients with anti-tuberculosis treatment course less than 1 month.%目的 评价我国酶联免疫斑点法(ELISPOT)用于诊断肺结核患者的应用价值.方法 结核特异性ELISPOT法检测76例诊断明确的肺结核患者外周血单核细胞.同时选择30例无结核接触史、胸部X线片无异常且PPI)皮试阴性的成年人作为对照.数据采用卡方检验和非参数Mann-Whitney检验.结果 76例患者总体阳性率为71.0%,健康对照组阳性率为6.7%.按照患者抗结核疗程分为治疗1个月内、治疗6个月内、治疗6

  16. Elevated serum CA 19-9 levels in patients with pulmonary nontuberculous mycobacterial disease

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    Ji Young Hong

    2016-02-01

    Full Text Available Abstract Increased serum CA 19-9 levels in patients with nonmalignant diseases have been investigated in previous reports. This study evaluates the clinical significance of serum CA 19-9 elevation in pulmonary nontuberculous mycobacterial disease and pulmonary tuberculosis. The median CA 19-9 level was higher in patients with pulmonary nontuberculous mycobacterial disease than in patients with pulmonary tuberculosis (pulmonary nontuberculous mycobacterial disease: 13.80, tuberculosis: 5.85, p < 0.001. A multivariate logistic regression analysis performed in this study showed that Mycobacterium abscessus (OR 9.97, 95% CI: 1.58, 62.80; p = 0.014 and active phase of pulmonary nontuberculous mycobacterial disease (OR 12.18, 95% CI: 1.07, 138.36, p = 0.044 were found to be risk factors for serum CA 19-9 elevation in pulmonary nontuberculous mycobacterial disease. The serum CA 19-9 levels showed a tendency to decrease during successful treatment of pulmonary nontuberculous mycobacterial disease but not in pulmonary tuberculosis. These findings suggest that CA 19-9 may be a useful marker for monitoring therapeutic responses in pulmonary nontuberculous mycobacterial disease, although it is not pulmonary nontuberculous mycobacterial disease-specific marker.

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

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    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

  18. 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 ...

  19. a retrospective study of pulmonary tuberculosis (ptb)

    African Journals Online (AJOL)

    DR. AMINU

    PREVALENCE AMONGST PATIENTS ATTENDING INFECTIOUS DISEASES. HOSPITAL (IDH) IN KANO, ... there is need for stepping up TB awareness, treatment and control program. Key words: .... increased the spread of TB in both the developing and developed world. ... gastroenteritis, cholera, TB, e.t.c.. Target Groups ...

  20. Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study

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    Kritski Afrânio

    2006-02-01

    Full Text Available Abstract Background Smear negative pulmonary tuberculosis (SNPT accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. Methods The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs and chest X-rays were used for constructing logistic regression and classification and regression tree models. From the logistic regression, we generated a clinical and radiological prediction score. The area under the receiver operator characteristic curve, sensitivity, and specificity were used to evaluate the model's performance in both generation and validation samples. Results It was possible to generate predictive models for SNPT with sensitivity ranging from 64% to 71% and specificity ranging from 58% to 76%. Conclusion The results suggest that those models might be useful as screening tools for estimating the risk of SNPT, optimizing the utilization of more expensive tests, and avoiding costs of unnecessary anti-tuberculosis treatment. Those models might be cost-effective tools in a health care network with hierarchical distribution of scarce resources.

  1. A registry-based cohort study of pulmonary tuberculosis treatment outcomes in Istanbul, Turkey.

    Science.gov (United States)

    Babalik, Aylin; Kilicaslan, Zeki; Caner, S Sevkan; Gungor, Gokay; Ortakoylu, M Gonenc; Gencer, Serap; McCurdy, Stephen A

    2013-01-01

    The aim of this study is to evaluate the treatment outcomes and identify factors associated with adverse tuberculosis treatment outcomes for bacteriologically confirmed pulmonary tuberculosis. Treatment outcomes of pulmonary tuberculosis were evaluated retrospectively among 11,186 smear- and/or culture-positive patients treated between 2006 and 2009 in Istanbul, Turkey. Adverse treatment outcomes were identified in 1,010 (9.0%) patients including death (1.8%), treatment default (6.1%), and treatment failure (1.1%). Factors associated with adverse treatment outcomes included being born abroad (odds ratios [OR], 5.38; 95% confidence intervals [CI], 3.67-7.91), history of tuberculosis treatment (OR, 3.77; 95% CI, 3.26-4.36), age > 65 years (OR, 2.79; 95% CI, 2.21-3.53), and male gender (OR, 1.91; 95% CI, 1.59-2.27). Death was most strongly associated with age > 65 years (OR, 45.1; 95% CI, 27.0-75.6), followed by treatment default with history of interrupted treatment (OR, 11.6; 95% CI, 8.94-15.1), and treatment failure with prior history of treatment failure (OR, 17.1; 95% CI, 6.97-41.6). Multidrug resistance was strongly associated with adverse treatment outcomes (OR, 10.8; 95% CI, 8.02-14.6). Age > 65 years, male sex, being born abroad, and history of treatment failure were found to be risk factors for adverse treatment outcomes. Hence, patients with any of these characteristics should be carefully monitored and treated aggressively.

  2. Incidence of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and impact on patient outcome.

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    Maryline Bonnet

    Full Text Available OBJECTIVES AND DESIGN: We used data from a randomized trial of HIV-tuberculosis co-infected patients in Mozambique to determine the incidence and predictors of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (IRIS occurring within 12 weeks of starting antiretroviral therapy, and to evaluate its association with patient outcome at 48 weeks. METHODS: HIV-tuberculosis co-infected and antiretroviral therapy-naïve adults with less than 250 CD4/mm3 were randomized to a nevirapine or efavirenz-based antiretroviral therapy initiated 4 to 6 weeks after starting tuberculosis treatment, and were then followed for 48 weeks. Tuberculosis cases were diagnosed using WHO guidelines, and tuberculosis-IRIS by case definitions of the International Network for the Study of HIV-associated IRIS. RESULTS: The 573 HIV-tuberculosis co-infected patients who initiated antiretroviral therapy had a median CD4 count of 92 cells/mm(3 and HIV-1 RNA of 5.6 log10 copies/mL. Mortality at week 48 was 6.1% (35/573. Fifty-three (9.2% patients presented a tuberculosis-IRIS within 12 weeks of starting antiretroviral therapy. Being female and having a low CD4 count, high HIV-1 RNA load, low body mass index and smear-positive pulmonary tuberculosis were independently associated with tuberculosis-IRIS. After adjustment for baseline body mass index, CD4 count and hemoglobin, occurrence of tuberculosis-IRIS was independently associated with 48-week mortality (aOR 2.72 95%CI 1.14-6.54. Immunological and HIV-1 virological responses and tuberculosis treatment outcomes were not different between patients with and without tuberculosis-IRIS. CONCLUSION: In this large prospective cohort, tuberculosis-IRIS occurrence within 12 weeks of starting antiretroviral therapy was independently associated with the mortality of HIV-tuberculosis co-infected patients at 48 weeks post antiretroviral therapy initiation.

  3. Periodontitis in patients with focal tuberculosis

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    Alexandrova Е.А.

    2010-12-01

    Full Text Available The research goal is to investigate the mechanisms of formation and peculiarities of periodontitis in patients with focal tuberculosis. Patients with periodontitis and focal tuberculosis are proved to develop local inflammatory reaction with increased infection and activation of proinflammatory cytokines in parodontal pockets fluid. The main risk factor of frequent and durable recurrence of parodontal pathology in case of focal tuberculosis was the development of pathologic process as a cause of disbalance of lipid peroxidation and antioxidant system, endotoxicosis syndrome

  4. Can follow-up examination of tuberculosis patients be simplified? A study in Chhattisgarh, India.

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    Debashish Kundu

    Full Text Available BACKGROUND: Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely. OBJECTIVES: To assess the incremental yield of the second sputum sample in the follow-up of tuberculosis patients under the Revised National Tuberculosis Control Programme (RNTCP in Chhattisgarh, India. METHODOLOGY: A record review of tuberculosis (TB patients registered in 2009 using a structured proforma from two sources, Tuberculosis and Laboratory Register, was undertaken in the six districts of Chhattisgarh, India. RESULTS: In smear positive cases, of 10,048 follow-up examinations, 45 (0.5% were found to be smear positive only on the second sputum when the result of the first sample was negative. In smear negative pulmonary and extra pulmonary TB patients, of 6,206 follow-up smear examinations, 11(0.2% were found to be smear positive. CONCLUSIONS: The incremental yield of a second smear examination was very low, indicating that examination of one sputum sample is enough during follow-up among TB patients. There is insufficient yield to support sputum smear microscopy for monitoring smear negative pulmonary TB and extra pulmonary TB patients. These results indicate that the follow-up smear microscopy can be substantially simplified with favourable resource implications.

  5. Estimated rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a -four-drug fixed-dose combination regimen at a tertiary health care facility in the city of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Silva, Vangie Dias da; Mello, Fernanda Carvalho de Queiroz; Figueiredo, Sonia Catarina de Abreu

    2017-01-01

    To estimate the rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four-drug fixed-dose combination (FDC) regimen, as well as to evaluate possible associated factors. This was a retrospective observational study involving 208 patients with a confirmed diagnosis of pulmonary tuberculosis enrolled in the Hospital Tuberculosis Control Program at the Institute for Thoracic Diseases, located in the city of Rio de Janeiro, Brazil. Between January of 2007 and October of 2010, the patients were treated with the rifampin-isoniazid-pyrazinamide (RHZ) regimen, whereas, between November of 2010 and June of 2013, the patients were treated with the rifampin-isoniazid-pyrazinamide-ethambutol FDC (RHZE/FDC) regimen. Data regarding tuberculosis recurrence and mortality in the patients studied were retrieved from the Brazilian Case Registry Database and the Brazilian Mortality Database, respectively. The follow-up period comprised two years after treatment completion. The rates of cure, treatment abandonment, and death were 90.4%, 4.8%, and 4.8%, respectively. There were 7 cases of recurrence during the follow-up period. No significant differences in the recurrence rate were found between the RHZ and RHZE/FDC regimen groups (p = 0.13). We identified no factors associated with the occurrence of recurrence; nor were there any statistically significant differences between the treatment groups regarding adverse effects or rates of cure, treatment abandonment, or death. The adoption of the RHZE/FDC regimen produced no statistically significant differences in the rates of recurrence, cure, or treatment abandonment; nor did it have any effect on the occurrence of adverse effects, in comparison with the use of the RHZ regimen. Estimar as taxas de recidiva, cura e abandono de tratamento em pacientes com tuberculose pulmonar tratados com o esquema de dose fixa combinada (DFC) de quatro drogas e avaliar possíveis fatores associados

  6. Presentation of tuberculosis in TB-HIV co-infection patients and the treatment outcome with directly observed short course therapy

    Institute of Scientific and Technical Information of China (English)

    Sameer Singhal; Prem Jaiswa

    2011-01-01

    Objective:To investigate different presentations of tuberculosis in HIV positive patients and their treatment outcome with directly observed short course therapy (DOTS). Methods: All patients having tuberculosis-HIV (TB-HIV) co-infection were taken. Different manifestations of tuberculosis in HIV positive patients were analyzed. Outcome of the treatment was observed in 14 patients. The rest of the patients were either transferred to other districts or still continuing their DOTS therapy according to the revised national tuberculosis control programme (RNTCP). Results:A total of 901 patients were diagnosed as tuberculosis. Out of these, 227 had positive pulmonary tuberculosis smear, 212 had negative smear and 462 had extra pulmonary tuberculosis. A total of 65 patients suffered from TB-HIV co-infection (7%). Result showed that the incidence of TB-HIV coinfection was the highest in productive age group of 16-45 years old (75%). Treatment completion rate was only 57%and the rate was higher in extra pulmonary tuberculosis patients (83%). Out of 4 sputum positive cases, 3 were declared cured (75%). Conclusions:TB-HIV co-infection in wardha (Cental India) is around 7%. Pattern of tuberculosis in HIV positive patient is the same as in HIV negative patient. Pattern of extra-pulmonary tuberculosis in HIV positive patients is mainly in form of tubercular lymphadenitis and pleural effusion. DOTS is the best modality of treatment of tuberculosis.

  7. 苏州市相城区2011~2015年流动人口肺结核病患者流行病学特征及就诊治疗率分析%Epidemiological Characteristics and Treatment Rate of Pulmonary Tuberculosis Patients in Xiangcheng District City of Suzhou During 2011~2015

    Institute of Scientific and Technical Information of China (English)

    李金元

    2016-01-01

    Objective To investigate the epidemiological characteristics, diagnosis and treatment of pulmonary tuberculosis patients in Xiangcheng District city of Suzhou during 2011 to 2015, to provide reference for the prevention and treatment of pulmonary tuberculosis of lfoating population in Xiangcheng District of Suzhou city.MethodsStatistical analysis on the data of diagnosis and treatment of tuberculosis patients registered in Suzhou tuberculosis management information system in 2011 to 2015.Results Pulmonary tuberculosis patients in the majority of the population, aged 19 to 45 years old, the number of Han nationality is more, mainly to the occupation of migrant workers. Pulmonary tuberculosis patients in floating population were mainly due to illness.Conclusion Xiangcheng District in Suzhou City, the lfoating population of tuberculosis patients with young men, mainly in male migrant workers, patients with poor awareness of active treatment and treatment compliance is poor. We should strengthen TB prevention and control in the area of lfoating population manhood male workers.%目的:探讨苏州市相城区2011~2015年流动人口肺结核病患者流行病学特征及诊治情况,为苏州市相城区流动人口肺结核病的防治工作提供参考依据。方法对2011~2015年苏州市结核病管理信息系统登记的流动人口结核病患者的诊治资料进行统计分析。结果流动人口肺结核病患者以男性居多,年龄集中在19~45岁,汉族人数较多,职业主要以民工为主。流动人口肺结核病患者来源以因病就诊为主要来源。结论苏州市相城区流动人口肺结核病患者以青壮年男性民工为主,患者的主动就诊意识和治疗依从性较差,应加强该区域流动人口中青壮年男性民工的肺结核病防控工作。

  8. 糖尿病合并肺结核患者结核分枝杆菌L型感染的研究%Study of Diabetes Patients with Pulmonary Tuberculosis Mycobacterium Tuberculosis L Infection

    Institute of Scientific and Technical Information of China (English)

    邵蔚; 姚莉

    2012-01-01

      Objective To investigate the infection caused by Mycobacterium tuberculosis L-forms and its’ drug resistance in cases of diabetes mellitus complicated with pulmonary tuberculosis and evaluate its clinical significance. Methods Select 128 cases of newly diagnosed tuberculosis patients admitted to General Hospital of Huainan Oriental Hospital from January 2009 to December 2011. Among them, 60 cases of patients with diabetes and tuberculosis (study group), simply smear-positive tuberculosis (diabetes) in 68 patients (control group). Patients were sputum Mycobacterium tuberculosis bacteria type and L-type culture, smear microscopy and culture, identification, while the L-type culture identified by PCR, and isolated from the L-type strain Reply the sexual experiments .Results Study group of 60 cases of diabetes in patients with pulmonary tuberculosis, Mycobacterium tuberculosis, bacterial type culture was positive in 13 cases (21.67%), L-type culture was positive in 28 cases (46.70%), the difference between the two is extremely significant (χ2=7.86,P6.5%L-positive detection rate of 86.10%;bothsignificant difference between (χ2= 8.76, P6.5%L型阳性检出率为86.10%;两者之间差异显著(χ2=8.76, P<0.05).经PCR鉴定,28例L型培养阳性物中,23例呈阳性反应,5例呈阴性反应.对照组68例单纯性肺结核患者中,细菌型培养阳性38例(55.89%),L型培养阳性4例(5.89%),PCR鉴定均呈阳性反应.结论 糖尿病患者合并肺结核后结核分枝杆菌L型的感染率较高;其中血糖控制不佳的患者结核分枝杆菌L型的感染率比血糖控制较好的患者感染率高.大多数结核分枝杆菌L型具有回复为细菌型而导致结核病的内源性复发的

  9. Pulmonary tuberculosis presenting as post-operative fever of unknown origin.

    Science.gov (United States)

    Bogue, Patrick; Bolland, Mhairi; How, Peter; Benziger, Harrison

    2017-01-06

    Post-operative fever is common following emergency surgery. Investigation and management of post-operative fever can be challenging when a clear source of sepsis is not evident or the underlying source of infection is not recognised. We herein report a case of secondary pulmonary tuberculosis presenting as post-operative fever following emergency laparotomy for a perforated duodenal ulcer. This case of tuberculosis was diagnosed on day 41 post-operatively and prior inconclusive results meant that we relied mainly on re-visiting history and examination in order to identify 3 targeted investigations: plain chest X-ray, sputum sample and blood test. Accordingly, the co-management of this complex patient achieved a good outcome. 2017 BMJ Publishing Group Ltd.

  10. Home care guide of silicosis complicated with pulmonary tuberculosis in elderly patients%矽肺并发肺结核老年患者的居家护理指导

    Institute of Scientific and Technical Information of China (English)

    任惠英; 高明静; 王小娟

    2016-01-01

    目的:探讨矽肺并发肺结核老年患者的居家护理方法。方法选择2013年1月~2015年1月本院收治的矽肺合并肺结核患者80例,按照随机数字表法分为两组,各40例,观察组实施居家护理干预,对照组实施常规护理,比较两组焦虑和抑郁评分情况、干预前后患者生活质量评分情况以及两组近1年总住院时间,次数及生存情况。结果干预后观察组 HAMD 及 HAMA 评分低于对照组(P <0.05),干预后观察组生活质量评分显著优于对照组(P <0.05),观察组1年总住院时间短于对照组(P <0.05),生存例数显著多于对照组(P <0.05)。结论针对矽肺合并肺结核患者实施有效的护理干预,能显著降低患者焦虑抑郁心理,提高患者生活质量,延长患者生存时间。%Objective To explore the methods of home care of silicosis complicated with pulmonary tuberculosis in elderly patients. Methods 80 cases of patients with silicosis complicated with pulmonary tuberculosis cured in our hospital from January 2013 to January 2015 were randomly divided into two groups with 40 cases in each 40. Patients in observation group were implemented with home care, and patients in control group were implemented with routine care. Anxiety and depression scores with life quality score before and after the intervention and survival times were compared. Results The HAMD and HAMA scores in the observation group were lower than those in control group (P< 0.05). The life quality scores in the observation group were better than that in control group (P < 0.05). The one-year hospital stay time in the observation group was shorter than that in control group (P < 0.05). The survived rate in the observation group was more than that in control group (P < 0.05). Conclusion The implementation of effective nursing intervention for patients with silicosis complicated with pulmonary tuberculosis can reduce anxiety and depression

  11. Radiological features of pulmonary tuberculosis in human immunodeficiency virus-infected patients: correlation with the blood CD4 cell count; Patrones radiologicos de la tuberculosis pulmonar en pacientes con infeccion VIH: correlacion con el indice de linfocitos CD4 en sangre

    Energy Technology Data Exchange (ETDEWEB)

    Isusi, M.; Eguidazu, J.; Oleaga, L.; Grande, D. [Hospital de Basurto. Bilbao (Spain)

    2000-07-01

    To describe the radiological features of pulmonary tuberculosis (TB) in patients infected with human immunodeficiency virus (HIV) and its correlation with the blood CD4 cell count. We present 44 HIV+patients, 24 with CD4 cell counts of less than 200 cells/mm''3 (group A) and 20 in whom the CD4 counts surpassed this level (group B). We also assessed the chest x-ray images to determine whether or not there was any correlation with the blood CD4 cell counts. Fisher's exact test was used for the statistical study of the differences in the radiological findings in the two groups. The incidence of atypical features was significantly greater in the patients with CD4 cell counts of less than 200 cells/mm''3 (group A) than in those with CD4 counts of over 200 cells/mm''3 (group B). Among HIV+patients, those with a more intact immune status were more likely to present lung x-ray images typical of post-primary TB, with cavitary lesions in upper lobes. The group of patients in whom the immune deficiency was more marked showed a greater incidence of atypical pulmonary findings, more characteristics of primary TB. (Author)

  12. 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.

  13. 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

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

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    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.

  15. [Treatment of tuberculosis in patients with comorbidities].

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    Abe, Masahiro; Fujita, Akira

    2013-12-01

    Early detection and appropriate treatment are the keys to tuberculosis control. In particular, providing appropriate treatment for tuberculosis in patients with HIV infection, rheumatoid arthritis (RA), chronic hepatic disease, or renal failure necessitating hemodialysis, and taking appropriate measures against adverse reactions to antituberculosis drugs are issues of critical importance. This mini-symposium, four experts explained the current status of "treatment of tuberculosis in patients with comorbidities" and proposed measures to address these problems. Dr. Aoki talked about "HIV infection complicated by tuberculosis." To the next, Dr. Yoshinaga gave a talk on "treatment of tuberculosis in RA patients receiving biological agents. Further, Dr. Sasaki lectured on "tuberculosis in patients with hepatic disease/impairment". Lastly, Dr. Takamori gave a lecture on "tuberculosis in patients with renal disease and those on hemodialysis. Tuberculosis patients often have some underlying diseases, and adverse reactions caused by antituberculosis drugs, such as hepatic and renal impairments, are matters of concern. I believe that this mini-symposium has provided useful information for physicians engaged in tuberculosis treatment and for many other healthcare professionals as well.

  16. Coexistence of leprosy and pulmonary tuberculosis: An uncommon entity

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    Ajay Kumar Verma

    2015-01-01

    Full Text Available The association of two of the oldest diseases of mankind, leprosy and tuberculosis (TB has been uncommonly reported in the literature. Herein, we report a known case of leprosy subsequently associated with sputum positive TB complicated by a type-II lepra reaction. There is a need for screening of patients for TB in patients diagnosed with leprosy to prevent the accidental misuse of an important drug, rifampicin to prevent the possibility of drug-resistant TB.

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

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    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

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

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    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.

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

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    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.

  20. Mycobacterium tuberculosis infection in a HIV-positive patient

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    Maria Theresa Montales

    2015-01-01

    Full Text Available Mycobacterium tuberculosis (MTB and human immunodeficiency virus (HIV coinfection remains a global public health challenge. We report a 40 year old African American male who is a known HIV-positive patient, non-compliant with his antiretrovirals and developed pulmonary tuberculosis. His chief complaints were chronic cough, fever, night sweats and undocumented weight loss. He had a prior positive T-SPOT-TB test; however, chest radiograph and sputum smear examination revealed normal results. PCR-based GeneXPERT MTB/RIF assay was ordered and confirmed MTB infection. The sputum cultures grew MTB and sensitivities showed susceptibility to all primary anti-tuberculosis medications. A delay in diagnosis and initiation of MTB therapy, in the setting of HIV or AIDS, may result in rapid disease progression and worse clinical outcome.

  1. Elevated serum CA 19-9 levels in patients with pulmonary nontuberculous mycobacterial disease.

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    Hong, Ji Young; Jang, Sun Hee; Kim, Song Yee; Chung, Kyung Soo; Song, Joo Han; Park, Moo Suk; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Kang, Young Ae

    2016-01-01

    Increased serum CA 19-9 levels in patients with nonmalignant diseases have been investigated in previous reports. This study evaluates the clinical significance of serum CA 19-9 elevation in pulmonary nontuberculous mycobacterial disease and pulmonary tuberculosis. The median CA 19-9 level was higher in patients with pulmonary nontuberculous mycobacterial disease than in patients with pulmonary tuberculosis (pulmonary nontuberculous mycobacterial disease: 13.80, tuberculosis: 5.85, pdisease (OR 12.18, 95% CI: 1.07, 138.36, p=0.044) were found to be risk factors for serum CA 19-9 elevation in pulmonary nontuberculous mycobacterial disease. The serum CA 19-9 levels showed a tendency to decrease during successful treatment of pulmonary nontuberculous mycobacterial disease but not in pulmonary tuberculosis. These findings suggest that CA 19-9 may be a useful marker for monitoring therapeutic responses in pulmonary nontuberculous mycobacterial disease, although it is not pulmonary nontuberculous mycobacterial disease-specific marker.

  2. STUDY OF POLYSOMNO G RAPHY IN CURE POST - TUBERCULOSIS PATIENTS

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    Bhise Dhondiba

    2015-08-01

    Full Text Available Patients with obstructive sleep apnea (OSA have various Comorbidities like cardiovascular, cerebrovascular diseases and metabolic disorders. There is an association between pulmonary hypertension and obstructive sleep apnea. Obstructive sleep apnea is associated with nocturnal arterial oxygen desaturation. During apnea the increa sed vagal tone induces hypoxia and by mechanical effects of o