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[Two cases of extrapulmonary tuberculosis causing differential diagnostic problems].

The decrease of tuberculotic diseases was continuous in the past years. This statement relates to pulmonalis as well as to extrapulmonalis tbc. The authors want to call attention to the possibility of the varied and more rarely appearing extrapulmonalis manifestation. In the first of their cases the burst of spondylitis tbc, and in the other one the very rare spleen tbc--which was made probably clinicum and later by the US abdomen examination--caused differential diagnostic problem.

Abscess↗

[Urogenital tuberculosis. Apropos of 40 cases].

The authors report a series of 40 cases of genitourinary tuberculosis diagnosed and treated in the department of urology "B" of Avicenne hospital over a 7-year period. The objective of this study is to define the various diagnostic and therapeutic aspects of this disease. The patients were predominantly males (62.5%) with a mean age of 40 years. 25% of cases reported a history of extra-urinary tuberculosis. The very polymorphous clinical presentation is dominated by signs of cystitis (45%). Intravenous urography is frequently suggestive of the diagnosis based on the appearance and multiplicity of the lesions. The radiological lesions most frequently encountered were silent kidney (19 cases) and small tuberculous bladder (11 cases). The definitive diagnosis was established by pathological examination in 38 cases (biopsies, operative specimens, prostatic resection chips) and/or by demonstration of AFB in 2 cases (urine, pus). Tuberculostatic treatment was administered to all patients, either alone (5 cases) or, more usually, in combination with surgical and/or endo-urological treatment (35 cases), reflecting the magnitude and severity of the destructive and scar lesions.

Adolescent↗

[Changes in the content and composition of phospholipids in various portions of the spinal cord in patients with tuberculosis of the spine].

Content and composition of phospholipids in various sections of the spinal marrow were investigated in patients with spinal tuberculosis. In the patients with tuberculous spondylitis, changes in the content of phospholipids in the spinal marrow were observed which were especially pronounced in the injured areas. The changes varied in different patients: in some patients, the content of the lipids was changed insignificantly while in the others it was markedly lowered (5-6-fold). Investigation of the phospholipid composition revealed in some patients decreased relative contents of the phosphatidyl ethanolamine plasmogenic form characteristic of myelin. It was suggested that the spinal marrow cells had undergone destruction in the injured areas.

Humans↗

[A case of cervical and mediastinal lymph nodes tuberculosis, tuberculous pleurisy, spinal caries and cold abscess in the anterior chest wall].

A 61-year-old woman with schizophrenia that had been treated in a psychiatric hospital was admitted to our hospital because of subileus and back pain. Though subileus was improved, she had a sudden attack of fever 7 days later and developed right pleural effusion, a cold abscess in the anterior chest wall and swelling of a thumb-sized right cervical lymph node which broke through the skin. We made a diagnosis of cervical and mediastinal lymph nodes tuberculosis, tuberculous pleurisy, spinal caries and cold abscess in the anterior chest wall due to the biopsy findings of the specimen taken from the cervical lymph node, examination of pleural effusion, chest CT, bacteriological examination of the cold abscess and spinal MRI. We started chemotherapy with the antituberculous drugs (HRSZ) and symptoms except back pain improved. She complained of paresis of the both lower extremities, which completely paralyzed 8 months later in spite of continued chemotherapy. Thereafter her paralysis was gradually improved and she was able to walk by herself after 12 months chemotherapy.

Abscess↗