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PubMed1991

Extrapulmonary tuberculosis--a simple diagnosis? A retrospective study at Dar es Salaam, Tanzania.

Data from the national tuberculosis programme show that extrapulmonary tuberculosis is increasing rapidly in Tanzania, most likely caused by the human immunodeficiency virus (HIV) epidemic. Retrospective data from 271 patients admitted to Muhimbili Medical Centre (MMC), Dar es Salaam between January 1, 1987 and December 31, 1988 with the diagnosis of extrapulmonary tuberculosis reveal that in only 18% of the cases a bacteriological or histological confirmation of the diagnosis had been made. This figure is only 3% when the tuberculous lymphadenitis cases are excluded. The most common diagnosis was tuberculous pleuritis (119 cases), followed by tuberculous lymphadenitis (67 cases), tuberculosis of the spine (47 cases), tuberculous pericarditis (16 cases) and others. The mean clinical features are presented. In 79 patients the HIV ELISA test was performed, of which 52% were positive. There is an urgent need for improving the diagnosis of extrapulmonary tuberculosis requiring prospective studies.

Adult↗
PubMed1991

[AIDS and tuberculosis].

From Jan. 1, 1989, through July, 1, 1991, 193 patients with HIV infection were treated at the Department of Acquired Immunodeficiency, Infectious diseases Hospital in Warsaw. Tuberculosis was diagnosed in 11 (5.7%) cases; in three cases diagnosis was first established post mortem. In eight cases tuberculosis was diagnosed clinically and confirm by microbiologic or histologic examinations. Antituberculous chemotherapy was successful in five cases (early results). All 11 patients had other concomitant infections or neoplasms. Six of 11 patients died, of them 3 with misdiagnosis of tuberculosis prior to death. The problem of HIV infection and tuberculosis and its impact on epidemiology of tuberculosis is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Clinical course of infiltrative tuberculosis in adolescents].

The course of infiltrative tuberculosis making up 53.2% in the pattern of clinical forms was investigated in 64 adolescents. Infiltrative tuberculosis morbidity among the girls is 3 times higher. The main detection method is represented by a planned roentgenofluorographic examination, since in the region in question infiltrative tuberculosis tends to have limited symptoms in 56.2% of the adolescents, including 30.5% of them even with disseminated process. In 60.9% of the cases, infiltrative tuberculosis is observed to have a decomposition phase which is 4.5 times more frequently traced in patients living in contact with a bacillary ++carrier . In 8% of the patients, infiltrative tuberculosis was complicated by hemoptysis. Infiltrative tuberculosis in 32.8% of the adolescents manifests itself in a pulmonary form of primary tuberculosis. Due to a complex treatment hemodynamic indices are normalized by the end of the first month in addition to the removal of the intoxication signs by the third month. Cavity closure was achieved in 71.8% of the patients. Despite the given therapy, transformation into the destructive forms of tuberculosis took place.

Adolescent↗
PubMed1991

[Status of the bronchi in adolescents and young patients with tuberculosis of the respiratory organs].

A comparative analysis is presented of the results of bronchoscopy carried out in 1976-1980 in 406 adolescents and young subjects with different forms of pulmonary tuberculosis and in 115 patients of the same age groups who were examined in 1987-1989. The last decade was marked by the incidence decrease of tuberculosis of bronchi in patients with tuberculosis of respiratory organs from 27.8 to 17.4% and by more benign course. At the same time, the incidence of nonspecific endobronchitis significantly increased (by 3 times). Among the causes of development and growth of the incidence of nonspecific endobronchitis in pulmonary tuberculosis patients the main role is assigned to the deterioration of ecological situation, occupational factors and bad habits. It is considered that nonspecific endobronchitis is not the consequence of pulmonary tuberculosis but are independent diseases having a negative influence on the course of pulmonary tuberculosis.

Adolescent↗
PubMedDate not supplied

[Active-evolutive pulmonary tuberculosis with negative tuberculin reaction].

In a lot of 452 patients with various forms of tuberculosis, in various locations, the authors have investigated the efficiency of tests currently employed in detecting tuberculin sensitivity (intradermoreaction to PPD, the test to sensitines and the Ustvedt test), in relation with several immunologic tests performed in vitro (index of lymphoblastogenesis to PPD and/or phytohaemagglutinin, leucocyte migration inhibition test, and the rosette test). It was noted that the two groups of investigations give similar results when tuberculin reactions are positive and intense. Under the conventionally admitted threshold of tuberculinic allergy the test of blastic transformation of lymphocytes, and especially the leucocyte migration inhibition tests are still positive and may be considered as a valuable means for measuring infra-tuberculinic allergy, as well as for the diagnosis of latent tuberculous infections.

Adolescent↗
PubMed1991

[A case of tuberculous mesenteric lymphadenitis detected by abdominal symptom after 4 months' antituberculous chemotherapy against pulmonary tuberculosis].

We reported a case of tuberculous mesenteric lymphadenitis. A twenty three year old man was admitted to our hospital with pulmonary tuberculosis on May, 1988. Chest X ray findings improved after 4 months' antituberculous chemotherapy, but he complained of right lower abdominal pain and a mass with tenderness. Barium series of gastro-intestinal tract showed evidence of extrinsic compression on the intestine. Abdominal CT showed rim enhancement and a multiloculated appearance, and the ultrasonography showed a hypoechoic mass. But we did not make a definite preoperative diagnosis, therefore exploratory operation was done. An abscess with caseous granuloma was found in the mesenteric lymphnodes removed at laparotomy.

Abdominal Pain↗
PubMed1991

[The usefulness of systematic follow-up of tuberculosis for the diagnosis of relapse in French Polynesia between 1971 and 1984].

Standard chemotherapy for one year was proposed for the treatment of tuberculous patients in French Polynesia between 1971 and 1978, and for nine months with the addition of pyrazinamide from 1979 to 1984. After treatment, the patients were followed up systematically for a period of 5 years. The aim of this study was to evaluate the value of the follow up measures to detect relapses. Of 1,065 patients treated between 1971 and 1984 at the centre for the control of tuberculosis 35 (3%) presented with a relapse, of whom 30 were confirmed either by bacteriological examination or histological examination. The level of relapse seen was not linked to age, sex, nor type of treatment received (one year or nine months). However, the level of relapse in non compliant patients to the initial treatment (7%) was significantly greater than those observed in patients who were totally compliant (2%) (p less than 0.0001). Of the 35 relapses 9 (26%) were discovered during routine follow up visits, of whom 8 were detected during the first year. The median delay separating apparent recovery from relapse was 8 months. 28 patients (80%) presented with symptoms suggestive of a relapse. Over 5 years 5773 consultations were carried out, which meant 642 consultations to detect one relapse. The authors suggest that in French Polynesia a systematic follow up limited to one year after apparent cure should be adequate.

Adult↗
PubMedDate not supplied

[The clinico-radiological aspects of tuberculosis in infants and young children].

The primary pulmonary tuberculosis in the infant and small child is a reality we have to consider. Although the success in the antituberculosis struggle is evident and real in Romania, the contamination risk as this age is present and may lead to very severe forms. The bacteriologic investigation is the only way of establishing a certain diagnosis. But, since in the infant and the small child the etiologic agent is isolated only in 50% of cases, the clinical criteria with the test at tuberculin, radiologic examination, anamnestic data and epidemiologic inquiry increase considerably in importance. The study presents clinical-radiological observations on 6 cases of primary pulmonary tuberculosis in children under 3 years old.

Child, Preschool↗