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At least 1,153 records · Page 64Linked to original sources
PubMed1995

Tuberculosis: diagnosis and treatment of resurgent disease.

PURPOSE: The incidence of tuberculosis is, once again, on the rise in this country after many years of decline. As advances in the therapeutic management of tuberculosis occur, oral and maxillofacial surgeons should be aware of the current treatment modalities. This article provides a comprehensive review of tuberculosis, because it is likely that we will be seeing more patients with this disease in our practices.

Antitubercular Agents↗
PubMed1994

Intramedullary spinal tuberculomas during treatment of tuberculous meningitis.

A case of multiple intramedullary spinal tuberculomas developing paradoxically during effective treatment of tuberculous meningitis is described. Serial MR imagings with Gd-DTPA enhancement studies showed initial homogeneous enhanced lesion representing myelitis or the early tuberculoma stage, which evolved to show ring enhancement with hypointense center later. Their appearance was similar to those described in brain tuberculoma. Gd-DTPA enhancement MR imaging is more sensitive than MR imaging without enhancement in demonstrating the lesions of tuberculoma and arachnoiditis. Antituberculous medication was effective with marked clinical improvement.

Adult↗
PubMed1992

Human tuberculosis due to Mycobacterium bovis: report of 10 cases.

During the period 1986-1990, 10 cases of human disease caused by Mycobacterium bovis were diagnosed in our hospital. The incidence, in relation to the cases of disease from Mycobacterium tuberculosis diagnosed in the same period, was 0.9%. The patients had an average age of 32 years (range 5-68 years). Pulmonary disease was observed in 5 patients (50%), lymphadenitis in 2, pleural effusion in 2 and peritoneal in 1. The most significant of the epidemiological features was that 2 patients were veterinary students. There was 1 death from ovarian neoplasia with abdominal dissemination. The other cases responded favourably to treatment with standard chemotherapy of 6-12 months achieving cure, without relapse, of all the patients.

Adolescent↗
PubMed1993

[Tuberculosis morbidity between 1982 and 1990 in Algiers].

Information on notified tuberculosis cases collected by the Algerian Ministry of Health and Social Affairs (Ministère de la Santé et des Affaires Sociales Algérien) from 1982-1990 show that 13,916 cases were notified in 1982 and 10,864 in 1990, of which 67%-71% were cases of pulmonary tuberculosis (TP) and 25-29% cases of extrapulmonary tuberculosis (TEP). New cases of smear-positive TP represented 49-55.4% of all cases and the majority of TP (69-79% depending on the year). These forms particularly affected men aged between 20 and 39 and both men and women over the age of 60. The annual incidence of tuberculosis of all forms fell by 40.3% in 9 years, from 72 cases per 100,000 in 1982 to 43 cases in 1990. Similarly, the annual incidence of smear-positive TP fell from 32 per 100,000 to 22 cases (a decline of 37%), and mainly affected the age group 20-39 years. Lymphadenitis remained the most common TEP (a total of 32% in 1990), the fall in incidence of which was similar to that of TP, although slightly less marked. Whilst a firm diagnosis of new TP cases is provided mainly by direct smear examination, TEP are unfortunately rarely confirmed. The HIV pandemic, which has hardly touched Algeria as yet, does not for the moment play a significant role in tuberculosis morbidity in the community.

Adolescent↗
PubMed1994

Tuberculous pericardial effusion associated with HIV infection: a sign of disseminated disease.

OBJECTIVE: To determine whether tuberculous pericardial effusion is associated with HIV infection. DESIGN: Retrospective cohort study. SETTING: Harare, Zimbabwe. SUBJECTS: 61 consecutive patients presenting with tuberculous pericarditis over an 18 month period. RESULTS: Tuberculous pericarditis was significantly associated with HIV seropositivity (odds ratio [OR] 2.46, 95% confidence interval [CI] 1.4-4.3, P = 0.001). The combination of tuberculous pericarditis and tuberculosis at another clinically obvious site (disseminated disease) was more common than pericarditis alone, and was significantly associated with HIV seropositivity (OR 6.1, CI 1.5-25, P = 0.007). Patients with disseminated disease were usually in CDC stage IV prior to the diagnosis of their tuberculosis.

Adult↗
PubMed2004

Computed tomography features of acute pulmonary tuberculosis.

The purpose of this study was to demonstrate the computed tomography (CT) features of pulmonary tuberculosis in patients with acute clinical manifestations. The emergent CT images of 46 non-AIDS patients with acute clinical presentations of pulmonary tuberculosis (TB) were analyzed. The distribution and characterization of the pulmonary and pleural lesions were specifically focused. Multifocal airspace consolidation in multiple lobes was most commonly seen on the CT in 32 of 46 patients (70%), followed by cavitary pulmonary nodular shadows (50%). Other CT manifestations included pleural effusion (40%), TB empyema (20%), and lymphadenopathy (11%). On followup, 12 patients (26%) developed acute respiratory failure. Patients presenting with multifocal pulmonary consolidation, with or without cavitations, on CT should undergo early pulmonary TB workup. These findings could help early detection for pulmonary TB.

Acute Disease↗
PubMed2006

Rare presentation of Mycobacterium avium-intracellulare infection.

Mycobacterium avium-intracellulare causes clinical disease mainly in immunocompromised patients with long-standing pulmonary disease, the symptoms of which are identical to those of pulmonary tuberculosis. In patients with AIDS the infection is typically disseminated. Extrapulmonary infection by M. avium-intracellulare is seen in children aged 1-5 years as cervicofacial lymphadenitis. Other extrapulmonary sites are less common and include musculoskeletal, maxillary sinus, mastoid, breast, small bowel, genitourinary tract and cornea. Such infection of the hard palate is rare. We present an unusual case of infection of the palate by M. avium-intracellulare in a 53-year-old diabetic man. To our knowledge, this infection presenting as a palatal lump in a patient without HIV or pre-existing lung disease has not been previously reported.

Diagnosis, Differential↗
PubMed2006

Tumor of the conus medullaris treated with antituberculous therapy.

This case report concerns a 21-year-old man developing left leg paresis. Evaluation with magnetic resonance imaging (MRI) showed an intramedullary tumor in the conus region. He was planned for surgery but preoperative investigation indicated he had tuberculosis and the tumor was presumed to be a tuberculoma. Antituberculous therapy was started and the patient improved neurologically. The patient was followed clinically and with consecutive MRI during 2 years and the last MRI showed that the lesion had disappeared completely. Intramedullary tuberculomas are rare but important differential diagnosis in patients with spinal cord mass lesions. The role of medical and surgical treatment of intramedullary tuberculomas is discussed.

Antitubercular Agents↗
PubMed2005

Abdominal tuberculosis: imaging features.

LEARNING OBJECTIVES: Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis.

Diagnosis, Differential↗
PubMed2006

Tuberculosis in children: an update.

TB is a common and serious global infection that is spread exclusively from person to person. The initial infection in most healthy people leads to LTBI 95% of the time, but untreated individuals have a 5% to 10% lifetime risk for reactivating their infection to develop highly infectious cavitary pulmonary TB or extrapulmonary disease. Following primary infection progressive disease is more likely to develop in children younger than 5 years old or those who are immunocompromised, particularly those with HIV infection. The diagnosis of TB in most of the world depends on the presence of a clinical illness typical for TB in concert with radiographic changes, the presence of AFB in sputum, or a positive TST. Newer methods of in vitro stimulation of T lymphocytes from TB-infected people to produce interferon may be more accurate than a TST but have yet to be well studied in children. Treatment of children with LTBI is generally 9 months of daily isoniazid unless the child has been in contact with an adult with known isoniazid-resistant TB. For active TB, children generally are treated for 6 months with an initial 2 months of isoniazid, rifampin, and pyrazinamide. Where exposure to an isoniazid-resistant strain is likely, ethambutol is added. After 2 months, pyrazinamide is discontinued unless the patient has been confirmed to have been infected with a resistant strain of M. tuberculosis. BCG, rarely used in the United States, is still considered important to prevent meningitis and miliary disease in very young children in areas of the world with a high prevalence of TB.

Child↗
PubMed1995

Update: abdominal tuberculosis--unusual findings on CT.

To update our knowledge of abdominal tuberculosis as manifested on computed tomography (CT), we reviewed the CT scans of 12 patients with proven abdominal tuberculosis. The nature, range and extent of abdominal involvement was determined. The CT findings were compared to those reported in the literature. The aetiologic agent was Mycobacterium tuberculosis in all patients. One patient had an increased risk because of AIDS. In nine patients, tuberculosis was limited to the abdomen, and three patients had previously unknown thoracic tuberculous disease. Characteristic features in our patients included low density ascites and uncommon patterns of adenopathy. Findings reported to be typical in abdominal tuberculosis were present in only five of our 12 patients. Unusual findings in our patients included solitary and multiple pelvic, adrenal, splenic and hepatic lesions. In six of 12 patients, those findings mimicked malignancy. We conclude that knowledge and early recognition of these unusual manifestations of abdominal tuberculosis should help to optimize clinical management of the disease and avoid misdiagnosis.

Abdominal Pain↗
PubMed1981

Tuberculous aortoarteritis.

Tuberculous aortoarteritis is a distinct entity. Despite the still wide prevalence of active tuberculosis in developing countries, tuberculous aortoarteritis appears to be rare. The vessel is often involved by a direct extension of the disease from adjacent tuberculous tissue. Occasionally it may result from blood-borne seedlings from an active distant focus. True and false aneurysms are the common manifestations. Stenosing and/or constricting types of lesions and perivascular fibrosis have been encountered by us. The probable pathogenesis is discussed with illustrative cases.

Adolescent↗
PubMed1997

Radiological features of pulmonary tuberculosis in 963 HIV-infected adults at three Central African Hospitals.

Tuberculosis is one of the most important infectious complications in human immunodeficiency virus (HIV)-infected individuals in sub-Saharan Africa. In this radiological study, we detail the chest radiographic findings of Zairean and Zambian adults with a diagnosis of AIDS and tuberculosis as seen at three Central African Hospitals. Between 1992 and 1995, consecutive chest radiographs of 963 HIV-infected adults aged between 16 years and 56 years with microbiologically confirmed tuberculosis (TB) were reviewed: (1) 362 adults from Sendwe General Hospital, Lubumbashi, Zaire, (2) 175 from Mama Yemo Hospital, Kinshasa, Zaire, and (3) 426 adults from The University Teaching Hospital (UTH), Lusaka, Zambia. During the same period consecutive chest radiographs from 1000 age-matched HIV-negative adults with tuberculosis were collected for comparative purposes. Comparison of the two groups showed that the HIV-infected group of patients with tuberculosis had a significantly higher proportion of lymphadenopathy (26% vs 13%; P = 0.001), pleural effusions (16% vs 6.8%; P = 0.001), miliary shadowing (9.8% vs 5%; P = 0.001), an interstitial pattern (12% vs 7%; P = 0.01) and consolidation (10% vs 3%; P = 0.001). There was significantly less cavitation (33% vs 78%; P = 0.001) and atelectasis (12% vs 24%; P = 0.001) seen in the HIV-positive group compared to the HIV-negative group of patients. These patterns of radiographic changes were consistently seen across all three hospital sites. The radiographic appearances in HIV-infected individuals with TB is discussed.

AIDS-Related Opportunistic Infections↗