tuberculosis

摘要： BACKGROUND Osteoarticular tuberculosis(OATB) is a severe form of extrapulmonary TB, which causes notable morbidity and warrants a high index of suspicion for prompt management. The diagnosis of OATB poses a challenge, because of the difficulty of collecting the samples and, secondarily, the paucibacillary nature of lesion, which gives poor sensitivity and reproducibility, with long turnaround time of routine/conventional laboratory tests and the requirement for invasive procedures and expertise. The Xpert MTB/RIF assay has been approved by the World Health Organization as a rapid diagnostic tool for diagnosing pulmonary and extrapulmonary TB.AIM To emphasize the diagnostic efficiency of gene Xpert for OATB in suspected patients in a tertiary care hospital of Eastern India.METHODS This retrospective study was conducted in the Department of Microbiology and Orthopaedics by analyzing the data of the gene Xpert assay over a 3-year duration from January 2018 to February 2021. Demographic and clinical data were recorded. The diagnostic efficiency of gene Xpert was evaluated against the composite reference standard(CRS).RESULTS A total of 37 cases fell into positive, probable, and possible categories of osteoarticular TB out of 112 patients included in the study by CRS;gene Xpert result was positive in 35 out of the 37 different CRS categorized cases. Of the 112 cases, culture was put in 40 cases, and, of these cultures, 5 cases showed the growth of MTB. Of these, 4 cases were included in the 35 cases diagnosed by gene Xpert.Smear microscopy was positive in 6 out of 37 CRS categorized cases. When compared with CRS, the sensitivity of gene Xpert assay, culture, and smear was found to be 94.6%, 13.5%, and 16.2%, respectively, while specificity in all the three types of tests was 100%. When kappa statistics were applied, the percentage of agreement gene Xpert, culture, and microscopy with CRS was found to be 95%, 20%, and 22.6%, respectively. Follow-up of the gene Xpert positive patients after getting anti-tubercular treatment revealed improved conditions.CONCLUSION Gene Xpert could detect 31 extra cases with a low and very low mycobacterial load that were missed by the routine culture methods. Hence, more samples should be processed for molecular diagnostic methods like gene Xpert along with other conventional methods for the validation of the molecular test prospectively for the timely diagnosis of osteoarticular TB.

摘要： Cardiovascular manifestations and electrocardiographic abnormalities have been reported among some prevalent infections in tropical regions,which lead to a great amount of morbidity and mortality.The major infectious diseases include chikungunya,dengue fever,H1N1 influenza,and coronavirus disease-19(COVID-19)in the viral category,leptospirosis,salmonellosis,scrub typhus and tuberculosis in the bacterial category,and malaria in the protozoan parasite category.All these infirmities constitute a foremost infection burden worldwide and have been linked to the various cardiac rhythm aberrancies.So we aimed to identify and compile different studies on these infections and associated acute electrocardiographic(ECG)changes.The search was made in online international libraries like PubMed,Google Scholar,and EMBASE,and 38 most relevant articles,including original research,systematic reviews,and unique case reports were selected.All of them were evaluated thoroughly and information regarding ECG was collected.Myocarditis is the predominant underlying pathology for rhythm disturbance and can be affected either due to the direct pathogenic effect or the abnormal immune system activation.ECG variabilities in some infections like chikungunya,scrub typhus,and leptospirosis are associated with longer hospital stay and poor outcome.Tropical infective diseases are associated with prominent acute cardiac rhythm abnormalities due to myocarditis,which can be identified preliminarily by ECG changes.

摘要： Background: Tuberculosis was the deadliest infectious agent before covid-19;1.5 million deaths in 2020. Despite, a variety, of easy and cheap diagnostic tools, detection rates still fall below 90%;diagnosis delays are long exceeding 30 days in many continents. This study aimed to determine risk factors for pulmonary TB diagnosis delays in Mali. Methods: A cross-sectional study was conducted in Bamako to include pulmonary TB patients at treatment initiation centers. Verbal consent was obtained before the interview. Demographics, clinical, treatment cost, and patient, medical, and diagnostic delays were computed using SPSS 25.0 considering a significance level p Results: In total 266 patients were included, 80.8% were male, mean age was 40.5 ± 12 years, primary education level was 50.4%, treatment cost before diagnosis was 100 - 200 thousand CFA in 65.4%, smokers were 42.1%, median patient, medical and total diagnostic delays were 58, 57 and 114 days respectively. Education level below university, social reasons, and non-request of health workers were identified as independent risk factors for diagnostic delay > 100 days in Mali. Conclusion: Diagnostic delay is relatively very long in Mali, there is an urgent need for identification and action to shorten the delays to limit the transmission chain and avoid disabling pulmonary sequels.

摘要： Tuberculosis infections is a serious illness and can be life threatening for patients with hematologic malignancies. We are reporting the observations of two children aged 7 and 5 years undergoing anticancer treatment for hematological malignancies. The symptoms were, in the first case, cough, purulent sputum and signs of tuberculosis impregnation, for the second case, cervical adenopathies (PDA) with inflammatory signs. The evolution under antituberculosis treatment was favorable for both patients, with a 5-year follow-up for the first patient and one year for the second case. The tuberculosis did not affect chemotherapy. The goal of our work is to specify the etio-pathogenic mechanisms, the clinical, therapeutic and evolutionary particularities of this rare association.

摘要： BACKGROUND Hemophagocytic lymphohistiocytosis(HLH)is a rare disorder with rapid progression and high mortality.HLH occurs mostly due to infection,malignant tumors,and immune disorders.Among infections that cause HLH,viral infections,especially Epstein-Barr virus infections,are common,whereas tuberculosis is rare.Tuberculosis-associated HLH has a wide range of serological and clinical manifestations that are similar to those of systemic lupus erythematosus(SLE).CASE SUMMARY This study describes a case of tuberculosis-associated HLH misdiagnosed as SLE because of antinuclear antibody(ANA),Smith(Sm)antibody and lupus anticoagulant positivity;leukopenia;thrombocytopenia;pleural effusion;decreased C3,quantitatively increased 24 h urinary protein and fever.The patient was initially treated with glucocorticoids,which resulted in peripheral blood cytopenia and symptom recurrence.Then,caseating granulomas and hemophagocytosis were observed in her bone marrow.She was successfully treated with conventional category 1 antituberculous drugs.In addition,we reviewed the literature on tuberculosis-associated HLH documented in Pub Med,including all full-text articles published in English from December 2009 to December 2019,and summarized the key points,including the epidemiology,clinical manifestations,diagnosis,and treatment of tuberculosis-associated HLH and the differences of the present case from previous reports.CONCLUSION Tuberculosis should be considered in patients with fever or respiratory symptoms.Antituberculous drugs are important for treating tuberculosisassociated HLH.

摘要： Tuberculosis(TB)remains a major public health threat;approximately 10 million new TB cases are recorded worldwide,and more than 1.2 million deaths were caused by TB in 2019[1].The diagnostic delay presents a major obstacle to the control of the TB epidemic.

摘要： Nontuberculous mycobacteria(NTM)are opportunistic pathogens of environmental origin that can cause human infections in a wide variety of tissues[1].Lung involvement is the most common manifestation of NTM infection[1].The symptoms and radiographic signs are similar to those of patients with pulmonary tuberculosis(TB)who are infected with Mycobacterium tuberculosis complex(MTBC)[1].Most NTM species are naturally resistant to first-line anti-TB drugs and have different resistance profiles,thus misdiagnosis leads to inappropriate treatment and increases the risk of poor prognosis for patients with an NTM infection,and even wider spread through person-to-person contact[2].

摘要： Introduction: Tuberculosis and sickle cell disease are one of the main global health priorities particularly in Africa. We aimed to determine the epidemiological, diagnostic and therapeutic aspects of tuberculosis in children and adolescents with sickle cell disease. Patients and methods: Patients aged 0 - 20 years with sickle cell anemia presented with tuberculosis at the Centre Hospitalier National d’Enfants Albert Royer (CHNEAR), Dakar, Senegal were included in the study. Medical history, risk factors, clinical, bacteriological, and outcome data was collected. Data was analyzed using the SPSS software, version 16. Results: A total of 25 cases of tuberculosis were documented from January 1st, 1991 to December 31st, 2019 (hospital prevalence: 0.97%). Mean age was 12.5 years. The sex ratio was 1.5 (15 girls and 10 boys). Pulmonary tuberculosis in 14 cases was the most frequent followed by lymph nodes in 7 cases involvement and Pott’s disease in 4 cases. In 5 patients Tb was multifocal. Mean duration of treatment was 8.27 months (6 to 12 months). Outcome was good on antituberculosis treatment. None patient died. Conclusion: Children and adolescents with sickle cell disease can be infected with Mycobacterium tuberculosis. Pulmonary tuberculosis, lymph nodes and bone involvement are the most frequent localizations. Outcome is good on antituberculosis treatment.

摘要： The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma, and the number of axillary lymph nodes metastasizing changes the stage. Since tuberculosis also produces lymph node enlargement, this can mimic or complicate the staging of a malignant disease. Dual organ pathology can lead to interpretation difficulties and inappropriate treatment of tuberculosis as well as breast carcinoma. Additionally, fine needle aspiration cytology (FNAC) of such cases can be misleading if only one of the diseases is detected. We report two cases of infiltrating carcinoma of the nonspecific type of the breast in two women aged 35 and 55 where tuberculosis was found in the axillary lymph nodes in addition to metastases. As the present case led to the fortuitous discovery of tuberculosis with tumor metastasis, it reinforces the possibility of a coexisting lesion in the minds of pathologists, especially in areas endemic to tuberculosis.

摘要： Rationale:Genitourinary tuberculosis can develop during the disease course of disseminated disease and the distinctive histological finding is epithelioid granuloma with or without caseation and accompanied Langhans-type giant cells.Barely,the lesion is only restricted to kidney involving both glomerular and extraglomerular compartment.Association with immune complex-mediated glomerulonephritis has been sparsely reported in the literature.Patient concern:A 42-year-old non-diabetic,non-hypertensive male presented with generalized body swelling and frothing of urine for 3 months.Diagnosis:Membranous nephropathy with tuberculous interstitial nephritis.Intervention:Anti-tuberculous therapy for extrapulmonary tuberculosis was administered along with low dose corticosteroid.Outcomes:Reduction of proteinuria was achieved at one month follow-up visit.Lessons:Tuberculosis should be considered as a potentially treatable cause of secondary membranous nephropathy as pharmacotherapy greatly helps improve the outcome.

摘要： 本发明一种抗结核分枝杆菌(Mycobacterium tuberculosis)及其感染的药物及其应用，属于制药领域，其特征在于，所述药物的全部或部分活性成分为细菌素如大肠菌素E1、Ia、Ib、A、B、N或其水性孔道结构域及其肽链羧基端连接的抗体模拟物多肽构成的重组多肽。该药物对多重耐药结核杆菌能产生高效杀菌作用，对致死性耐药结核菌株感染的猕猴进行治愈。