Active Pulmonary Tuberculosis Infection Research Articles

TB in the ED: Consequences of Delayed Recognition Active Pulmonary Tuberculosis Infection in the Emergency Department Waiting Room

TB in the ED: Consequences of Delayed Recognition Active Pulmonary Tuberculosis Infection in the Emergency Department Waiting Room

Rates of latent and active tuberculosis in BGC vaccinated, immunosuppressed Crohn's disease patients form Bulgaria before and during anti-tumor necrosis factor therapy.

Although the use of anti-tumor necrosis factor-alpha (anti-TNF-α) agents is highly effective in achieving and maintaining remission in patients with moderate-to-severe IBD, they place the patient at increased risk of developing opportunistic infections, including new cases of tuberculosis infection (TBI) and/or reactivation of latent tuberculosis infection (LTBI). Our study aims to determine the incidence of TBI [active tuberculosis (ATBI) and LTBI] among patients with Crohn's disease (CD) receiving anti-TNF-α therapy. We performed a retrospective analysis of consecutive CD patients undergoing anti-TNF-α (infliximab, adalimumab) treatment for a minimum of 6 months, in the period between June 2010 and December 2019, followed-up at a reference IBD center. All patients were HIV negative, and BCG vaccinated. In all patients, ATBI was excluded and all were tested for LTBI prior to initiating a biological treatment. Before starting the biological treatment, we established LTBI in 11/109 (10.1%): 8/11 (72.7%) patients were TST positive, 2/11 (18.2%) were IGRA positive and TST negative, 1/11 (9.1%) were both IGRA and TST positive. In patients undergoing biological therapy with previous negative screening test for tuberculosis, a total of 16/74 (21.6%) patients were newly diagnosed with LTBI. The median induration (not erythema) diameter of TST is 8 (IQR 5-17) mm. Active pulmonary tuberculosis infection, developed in 3/74 (4.1%) patients. One patient developed ATBI on the background of chemoprophylaxis with INH for LTBI. Specialists should thoroughly analyse all patient clinical data, chest X-ray results, epidemiological and BCG status, as well as perform a LTBI screening before initiating immunosuppressive and/or biological treatment. IBD patients have a higher risk of developing TBI in the first 12 months.

Psoriasis in Patients with Type 2 Diabetes is Associated with Low Incidence of Active Pulmonary Tuberculosis Infection: A Nationwide Propensity Score-Matched Population Cohort Study

Psoriasis in Patients with Type 2 Diabetes is Associated with Low Incidence of Active Pulmonary Tuberculosis Infection: A Nationwide Propensity Score-Matched Population Cohort Study

Previous pulmonary tuberculosis enhances the risk of lung cancer: systematic reviews and meta-analysis

Purpose The possible association between history of pulmonary tuberculosis (TB) and lung cancer (LC) has attracted researchers’ attention for several decades. This systematic review and meta-analysis aim to assess the association between previous pulmonary TB infection and LC risk. Methods A Systematic and comprehensive search was performed in the following databases: PubMed, Embase, clinical key, Web of Science and Google Scholar, in articles and abstracts published from 1987 to 2021. Thirty-two articles (involving 50,290 cases and 846,666 controls) met the inconclusive criteria. The Comprehensive Meta-Analysis version 2.2 software was used for this meta-analysis. Results The result of this meta-analysis demonstrates that pre-existing active pulmonary TB increases the risk of LC (RR = 2.170, 95% confidence interval [CI] 1.833–2.569, p < .001, I 2 = 91.234%). The results showed that the risk of the history of active pulmonary TB infection in adenocarcinoma was 2.605 (95% CI 1.706–3.979, p < .001, I 2 = 55.583%), in small-cell carcinoma was 2.118 (95% CI 1.544–2.905, p < .001, I 2 = 0.0%), in squamous-cell carcinoma, was 3.570 (95% CI 2.661 − 4.791, p < .001, I 2 = 42.695%) and 2.746 (95% CI 2.300–3.279, p < .001, I 2 = 41.686%) for other histological types of LCs. According to these results, a history of active pulmonary TB increases the risk of LC. Conclusions This study emphasizes the importance of LC screening in pulmonary TB patients even after the infection is treated. With the increased chances of LC in a patient who had a history of active pulmonary TB, there could be a need for a further follow-up period after pulmonary TB recovery.

Optic disc swelling in a patient with tuberculous meningitis: a diagnostic challenge

We discuss the diagnostic challenge in an adult patient presented with purely ocular symptoms diagnosed with tuberculous meningitis (TBM). A 38-year-old woman presented with bilateral painless blurring of vision. There...

Genome-wide expression for diagnosis of pulmonary tuberculosis: a multicohort analysis

Active pulmonary tuberculosis is difficult to diagnose and treatment response is difficult to effectively monitor. A WHO consensus statement has called for new non-sputum diagnostics. The aim of this study was to use an integrated multicohort analysis of samples from publically available datasets to derive a diagnostic gene set in the peripheral blood of patients with active tuberculosis. We searched two public gene expression microarray repositories and retained datasets that examined clinical cohorts of active pulmonary tuberculosis infection in whole blood. We compared gene expression in patients with either latent tuberculosis or other diseases versus patients with active tuberculosis using our validated multicohort analysis framework. Three datasets were used as discovery datasets and meta-analytical methods were used to assess gene effects in these cohorts. We then validated the diagnostic capacity of the three gene set in the remaining 11 datasets. A total of 14 datasets containing 2572 samples from 10 countries from both adult and paediatric patients were included in the analysis. Of these, three datasets (N=1023) were used to discover a set of three genes (GBP5, DUSP3, and KLF2) that are highly diagnostic for active tuberculosis. We validated the diagnostic power of the three gene set to separate active tuberculosis from healthy controls (global area under the ROC curve (AUC) 0·90 [95% CI 0·85-0·95]), latent tuberculosis (0·88 [0·84-0·92]), and other diseases (0·84 [0·80-0·95]) in eight independent datasets composed of both children and adults from ten countries. Expression of the three-gene set was not confounded by HIV infection status, bacterial drug resistance, or BCG vaccination. Furthermore, in four additional cohorts, we showed that the tuberculosis score declined during treatment of patients with active tuberculosis. Overall, our integrated multicohort analysis yielded a three-gene set in whole blood that is robustly diagnostic for active tuberculosis, that was validated in multiple independent cohorts, and that has potential clinical application for diagnosis and monitoring treatment response. Prospective laboratory validation will be required before it can be used in a clinical setting. National Institute of Allergy and Infectious Diseases, National Library of Medicine, the Stanford Child Health Research Institute, the Society for University Surgeons, and the Bill and Melinda Gates Foundation.

Densely calcified tuberculous constrictive pericarditis with concurrent active pulmonary tuberculosis infection

Though pulmonary tuberculosis is a common chronic infection in the developing countries like Nepal, the incidence of tubercular constrictive pericarditis is very low. Here we report a patient of active pulmonary tuberculosis with sputum positive for acid fast bacilli along with densely calcified constrictive pericarditis which has been reported as a very rare presentation in the literature.DOI: http://dx.doi.org/10.3126/jcmsn.v10i2.12955 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2); 41-43

Proteomic analysis of sputum in patients with active pulmonary tuberculosis

The protein composition of sputum most faithfully reflects the state of the lungs. The aim of this study was to determine whether relative qualitative and quantitative differences in protein expression of sputum could be related to active pulmonary tuberculosis. Sputum samples were collected from 65 patients with active pulmonary tuberculosis and 38 healthy controls. Comprehensive proteomic approaches were used to profile the proteome changes of host sputum in response to Mycobacterium tuberculosis infection using two-dimensional electrophoresis in combination with matrix-assisted laser desorption ionization time-of-flight/time-of-flight mass spectrometry. Mascot software was used to identify proteins from protein databases. Enzyme-linked immunosorbent assay was used to confirm the proteomic results. A total of 62 differentially expressed proteins were identified, among which, 15 proteins were up-regulated and 47 proteins were down-regulated in the tuberculosis sputum compared with the controls. Bacterial protein UqhC was the most increased protein, whereas serum albumin was the most decreased protein in the tuberculosis sputum compared with the controls. The enzyme-linked immunosorbent assay analysis was consistent with proteomic data. Bioinformatics analysis suggested that multiple host cell pathways were involved in the tuberculosis infection processes, including acute phase response, signal transduction, cytoskeleton structure, immune response and so on. In all, for the first time, our results revealed that a number of proteins were differentially expressed during active pulmonary tuberculosis infection. These data will provide valuable clues for further investigation of tuberculosis pathogenesis and biomarkers for detection of active pulmonary tuberculosis infection.

Adenosine Deaminase Level as an Indicator for Differentiating Between Active Pulmonary Tuberculosis Infection and Other Pulmonary Infections

Background: In spite of recent advents, and novel improvements in the diagnosis and treatment of pulmonary tuberculosis (TB), definitive diagnosis of pulmonary TB in children is problematic. Therefore, measurement of the serum level of adenosine deaminase (ADA) was later introduced as a helpful marker for the diagnosis of TB. Objectives: The purpose of this study was to determine the usefulness of the ADA testin the diagnosis of pulmonary TB, and compare enzyme activity between patients with pulmonary TB and those with other pulmonary infections. The sampling strategy was randomized, and the design of study was case-control diagnostic descriptive, we used IBM SPSS V-16.0.2 software for analyzing our data. Patients and Methods: This study was performed at the National Research Institute of Tuberculosis and Lung Diseases (NRITLD) in Tehran, IR Iran. In all, 49 children, divided into 3 groups, were examined. Of these, 22 had pulmonary TB, 17 had other pulmonary infections, and the remaining 10 children were normal and were assigned to the control group. Results: Serum ADA levels were higher in the pulmonary TB patients than in the control group (P < 0.05), however, these levels did not differ significantly between TB patients and patients with other pulmonary infections (P = 0.391). Our evaluation revealed that ADA level in TB patients with a positive smear of gastric washing were higher than those in patients with a negative smear (P = 0.006). Conclusions: Similar to the other studies, this study showed higher serum ADA level in pulmonary TB patients than in normal individuals. However, ADA was not found to be a suitable marker for differentiating between pulmonary TB and other pulmonary infections.

Adenosine Deaminase Level as an Indicator for Differentiating Between Active Pulmonary Tuberculosis Infection and Other Pulmonary Infections

Background: In spite of recent advents, and novel improvements in the diagnosis and treatment of pulmonary tuberculosis (TB), definitive diagnosis of pulmonary TB in children is problematic. Therefore, measurement of the serum level of adenosine deaminase (ADA) was later introduced as a helpful marker for the diagnosis of TB. Objectives: The purpose of this study was to determine the usefulness of the ADA testin the diagnosis of pulmonary TB, and compare enzyme activity between patients with pulmonary TB and those with other pulmonary infections. The sampling strategy was randomized, and the design of study was case-control diagnostic descriptive, we used IBM SPSS V-16.0.2 software for analyzing our data. Patients and Methods: This study was performed at the National Research Institute of Tuberculosis and Lung Diseases (NRITLD) in Tehran, IR Iran. In all, 49 children, divided into 3 groups, were examined. Of these, 22 had pulmonary TB, 17 had other pulmonary infections, and the remaining 10 children were normal and were assigned to the control group. Results: Serum ADA levels were higher in the pulmonary TB patients than in the control group (P < 0.05), however, these levels did not differ significantly between TB patients and patients with other pulmonary infections (P = 0.391). Our evaluation revealed that ADA level in TB patients with a positive smear of gastric washing were higher than those in patients with a negative smear (P = 0.006). Conclusions: Similar to the other studies, this study showed higher serum ADA level in pulmonary TB patients than in normal individuals. However, ADA was not found to be a suitable marker for differentiating between pulmonary TB and other pulmonary infections.

Circulating MicroRNAs in Patients with Active Pulmonary Tuberculosis

Emerging evidence shows that microRNAs (miRNAs) play an important role in pathogen-host interactions. Circulating miRNAs have been repeatedly and stably detected in blood and hold promise to serve as molecular markers for diverse physiological and pathological conditions. To date, the relationship between circulating miRNAs and active pulmonary tuberculosis (TB) has not been reported. Using microarray-based expression profiling followed by real-time quantitative PCR validation, the levels of circulating miRNAs were compared between patients with active pulmonary tuberculosis and matched healthy controls. The receiver operating characteristic curve was used to evaluate the diagnostic effect of selected miRNA. Bioinformatic analysis was used to explore the potential roles of these circulating miRNAs in active pulmonary tuberculosis infection. Among 92 miRNAs significantly detected, 59 miRNAs were downregulated and 33 miRNAs were upregulated in the TB serum compared to their levels in the control serum. Interestingly, only two differentially expressed miRNAs were increased not only in the serum but also in the sputum of patients with active pulmonary tuberculosis compared to the levels for the healthy controls. Upregulated miR-29a could discriminate TB patients from healthy controls with reasonable sensitivity and specificity. A number of significantly enriched pathways regulated by these circulating miRNAs were predicted, and most of them were involved in acute-phase response, inflammatory response, and the regulation of the cytoskeleton. In all, for the first time our results revealed that a number of miRNAs were differentially expressed during active pulmonary tuberculosis infection, and circulating miR-29a has great potential to serve as a marker for the detection of active pulmonary tuberculosis infection.