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PubMed2004

[New approaches to formation of registration group of individuals followed up by antituberculosis institutions in Uzbekistan].

The paper presents the results of a three-year (2000-2002) follow-up of the movement of dispensary contingents registered in tuberculosis facilities in order to develop new dispensary groups. The dispensary groups of patients with active forms of tuberculosis have been ascertained to accumulate a great number of patients with its inactive forms due to the untimely of their transfer to the inactive groups in terms of effective treatment and the clinical forms of tuberculosis. New dispensary grouping will more definitely regulate the transfer of patients from active to inactive groups and strike from the list of dispensary patients. The proposed new grouping excludes registration Groups 0, II, and VII. If required, the persons struck from Groups III and VB and those followed up as Groups 0 and VII patients will be transferred to adult and pediatric polyclinics and followed up in recurrent tuberculosis risk groups.

Adolescent↗
PubMed2004

[The phenotypes of haptoglobin and the level of acute-phasic proteins in the sera of children with local form of intrathoracic tuberculosis].

Seventy-seven children aged 4-12 years who had local forms of primary intrathoracic tuberculosis were examined. On admission to and discharge from hospital, haptoglobin (Hp) was phenotyped and the content of Hp was measured, and the activity of alpha1-antitrypsin (alpha1-AT) was determined. In all ill children, the distribution of Hp phenotypes did not differ from the normal level, but all patients with tuberculous pleurisy were found to be carriers of Hp1 gene (among them the phenotype Hp 2-2 was absent and the minor variant of Hp 1-1 was detectable in half the cases). In patients of this group, alpha1-AT acted as a typical acute phase reagent and remained moderately increased by the termination of treatment in the vast majority of the examinees. On the contrary, on admission the content of Hp was to be decreased. Its increase was natural only in patients with tuberculous pleurisy. The level of Hp was associated with its phenotype. Carriers of Hp1-1 had elevated levels of Hp in the overwhelming majority of cases whereas those of Hp 2-2 had its decreased levels. It is concluded that in children with primary tuberculosis, the serum level of Hp may not be used as an indicator of the activity of the process. Possible causes and the values of decreased levels of circulating Hp in children with primary tuberculosis are discussed in the paper.

Acute-Phase Proteins↗
PubMed2004

[Overview of the HIV/tuberculosis coinfection in Bogotá, Colombia, 2001].

The magnitude and characteristics of the co-infection of TB-AIDS was evaluated in cases reported in Bogotá, 2001. A cross sectional study was carried out using the epidemiological registry of TBC-AIDS cases from the Health Secretariat of Bogotá. Only TB cases with a positive HIV test were included in. Of 950 TB cases reported in Bogotá, 113 (11.9%) were indicated to have TB and HIV positive tests; epidemiological information was recovered from 103 of them. Most cases were male (male:female ratio was 12:1); 38.8% were between ages 25 to 34; 40.8% of cases belonged to the contributive regime; 82% were new cases. Of the 105 cases, 62% were classified with the pulmonary form of TB and 30% with extra pulmonary disease. In the last group, the most frequent form was lymph node tuberculosis. Diagnostic criteria were recorded for only 55 patients; however, 78% were confirmed with microscopic smears. Procedural data were available for 29 patients in the first phase of treatments; 86.2% had received therapy recommended by the Ministry of Health. The failures of TB control programs indicated by statistical data, do not reflect patient's activities that may be contributing to greater infection risk. Additional monitoring may be necessary to fortify the current TB control program.

Adolescent↗
PubMedDate not supplied

Lingual ulcer as the only sign of recurrent mycobacterial infection in an HIV/AIDS-infected patient.

The report describes an HIV/AIDS patient seen at a referral center in Mexico City, in whom a mycobacterial infection in the oral mucosa, probably tuberculosis (TB) was identified. The purpose is to describe the clinical and histological findings in an HIV-infected patient, who after being treated successfully for tuberculous lymphangitis 4 years ago, presented with a lingual ulcer as the only suggestive sign of recurrence of mycobacterial infection, probably M. tuberculosis. A 39-year-old man seen in the HIV clinic of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" in Mexico City since 1991 for HIV infection. In 1999 the patient developed tuberculous lymphangitis; he was managed with a 4-drug regimen for 12 months, with improvement of local and systemic symptoms. In May of 2003, the patient presented a painful superficial lingual ulcer, 0.7 cm in diameter, well circumscribed, crateriform with slightly elevated, irregular and indurated borders, of 4 months duration. The histopathological examination showed chronic granulomatous inflammation with giant multinucleated cells, suggestive of mycobacterial infection, and recurrence of TB was considered. Rifampin, isoniazide, pyrazinamide, ethambutol and streptomycin were administered. The lingual lesion improved with partial healing at the first week and total remission at 45 days after the beginning of the antituberculous treatment. In June, 2003, the patient began highly active antiretroviral therapy (HAART) that included two NRTIs and one NNRTI. At 7 months of follow-up, the patient remains free of lingual lesions. The particularity of the present case is that the lingual ulcer was the only sign of infection by mycobacteria, suggestive of TB, in an HIV/AIDS patient that probably represented a recurrence of a previous episode.

Adult↗
PubMedDate not supplied

[Diagnostic features of tuberculosis in extra-pulmonary locations].

Bacteriological examination of patients with extralung tuberculosis is carried out, namely: tuberculosis of urino-genital organs, cerebral membranes and central nervous system, bones and joints, and also of peripheral lymphatic knots. Strains isolated under these diseases were examined for medical sensitivity to antibacterial drugs (ABD), their biochemical characteristics were studied. It was ascertained, that the strains of mycobacteria of tuberculosis (MBT), isolated under tuberculosis of cerebral membranes and central nervous system, tuberculosis of urino-genital organs, tuberculosis of bones and joints are characterized by the expressed high resistance to two-three antibacterial drugs of the first series.

Humans↗
PubMed1992

[X-ray findings in pulmonary tuberculosis in children and its complications].

Pulmonary tuberculosis is still a common disease in children, especially those of immigrant families. Prevention and diagnosis rest on the plain chest film which should remain the first step of the work-up. Apart from cerebromeningeal complication, CT scan is also useful for evaluating chest lesions including mediastinal lymphadenopathies and lung parenchyma involvement. CT scan combined with endoscopy ensures detection of complications including bronchogenic dissemination. With a few cases as illustrations, the role of roentgenographic investigations in the management of pediatric tuberculosis is outlined.

Adolescent↗
PubMed2006

Tuberculosis treatment default among Brazilian children.

OBJECTIVES: To study the prevalence and time of tuberculosis (TB) treatment default among children and to compare defaulters with those who completed treatment. METHODS: Retrospective cohort study at the Hospital Municipal Jesus, Rio de Janeiro, Brazil, among TB patients aged <15 years followed from 1998 to 2002. The group that completed treatment was compared with those that defaulted. RESULTS: The records of 248 patients were studied. The default rate was 24.2% and was more frequent in the first 2 months of treatment (43.3%) and among those aged <1 year (42.4%). The following variables were associated with default: previous default (relative risk [RR] 1.99, 95%CI 1.12-3.54, P = 0.035), father not living with the child (RR 1.85, 95%CI 1.06-3.21, P = 0.030) and father using illicit drugs (RR 2.93, 95%CI 1.44-5.97, P = 0.002). CONCLUSIONS: Health professionals responsible for treating children with TB should pay special attention to children aged <1 year, those with a history of previous default, and those whose father is absent or an illicit drug user.

Adolescent↗
PubMed2006

[Transient worsening of chest radiograph and development of lymphadenopathy during chemotherapy for miliary tuberculosis].

A-37-year old woman was referred to our hospital because of bilateral pulmonary micronodular shadows on chest X-ray. Prednisolone was reported to be administered for her coughs and dyspnea more than a month, but was discontinued recently. Under the diagnosis as miliary tuberculosis, we started to treat her with the combined use of pyrazinamide, isoniazid, rifampicin, and ethambutol. Then her symptoms subsided gradually. Two months later, however, high fever developed, followed by exacerbation of the radiographic shadows, and marked cervical and mediastinal lymphadenopathy. We considered them so-called paradoxical worsening, and continued the antituberculosis therapy unchanged. Those clinical manifestations began to subside about 4 months after the initiation of the treatment. Paradoxical worsening has been described as a relatively rare manifestation, and seem to be attributable to prompt recovery of the immunity to mycobacterial antigens after the use of antituberculous therapy. We considered that, in this case, disseminated tuberculosis and firstly administered steroid that might suppress immune function, and discontinuation of steroid therapy followed by the bactericidal antituberculous chemotherapy were associated with the development of the paradoxical reactions, by analogy with immune reconstitution syndrome frequently reported in HIV-related tuberculosis patients.

Adult↗
PubMed1999

Extra-pulmonary tuberculosis in patients with fever of unknown origin: clinical features and diagnosis.

One hundred twenty-nine patients with extra-pulmonary tuberculosis admitted at the Abbassia Fever Hospital, NAMRU-3 during a seven year period (1991 to 1997) are described. Tuberculous peritonitis was diagnosed in 35 patients, tuberculous lymphadenitis in 32, intestinal tuberculosis in 19, genito-urinary tuberculosis in 14, skeletal tuberculosis in 13, disseminated miliary tuberculosis in 11, and splenic tuberculosis in 5 patients. The clinical picture included fever, and weight loss accompanied by anaemia and an elevated erythrocyte sedimentation rate in all patients.

Adolescent↗