Complication Of Pulmonary Tuberculosis Research Articles

When Pulmonary Tuberculosis Leads to Pneumothorax: An Unusual Presentation

Spontaneous secondary pneumothorax (SSP) is a rare but serious complication of pulmonary tuberculosis (TB), often resulting from cavitary lung disease. A 38-year-old male presented with pleuritic chest pain and fever, with imaging revealing a left-sided pneumothorax and cavitary lesions. Diagnosis was confirmed via sputum analysis positive for Mycobacterium tuberculosis. The patient was treated with standard anti-TB therapy and a chest drain, leading to clinical improvement. SSP in TB occurs due to ruptured subpleural lesions, requiring prompt management of both pneumothorax and TB. Early diagnosis and integrated treatment are essential, particularly in high-prevalence settings.

‘Destroyed Lung’: A Marker of Sequel of ‘Far Advanced’ Radiological Type of Pulmonary Tuberculosis’

Pulmonary Tuberculosis is caused by bacilli mycobacterium tuberculosis and known to infect human race since the dawn of history and archaeological evidence has traced its association in neolithic times. Tuberculosis is the most common infectious lung disease in India with significant mortality and morbidity. Tuberculosis can cause diverse thoracic presentations ranging from nodules, consolidations& cavitation, mediastinal adenopathy, pleural effusion to diffuse endobronchial disease presenting like bronchial asthma. Due to diverse presentations, diagnosis is many times delayed due to lack of suspicion by treating general physicians and rational treatment not offered in time. In spite of awareness by government organizations and considered as a ‘global health issue of concern’ by the World Health organization, tuberculosis is still considered as a social stigma. Destroyed lung is described in literature and known as a complication of pulmonary tuberculosis. Destroyed lung is defined as combination of pleural and parenchymal lung destruction with cavitation, bronchiectasis, loss of lung volume and mediastinal herniation to diseased side. In this case series, we have reported two cases with history of pulmonary tuberculosis in the past and received adequate anti-tuberculosis treatment. Both were having residual chronic lung disease and symptoms causing significant impact on quality of life with recurrent hospitalization, hospital visits and cost of care. One patient has a history of delayed diagnosis and ATT was started after maximum lung destruction due to a tuberculous process that has already occurred. In this patient tuberculosis was cured but residual lung damage or sequel presenting as destroyed lung. In the second case, tuberculosis was diagnosed in adequate time but the patient has defaulted due to adverse events of ATT and he has taken medications as per his own tolerance. Neither adherence nor compliance was acceptable in the second case and resulted in a partially treated case of pulmonary tuberculosis. Ongoing lung destruction in the second case would be the cause for destroyed lungs in absence of irrational medicines in today’s era of good quality ATT. Destroyed lung is preventable with early diagnosis, prompt evaluation with microscopy and nucleic acid amplification tests and treatment with universally available, acceptable and affordable free ATT as National guidelines. 'Destroyed lung' are having a significant impact on quality of life and health expenditure and are considered as ‘radiological stigma’ of Tuberculosis. Radiological classifications of tuberculosis are less used now, and, it can be justified in grading of disease severity and aggressive treatment planning. Radiological classifications also help in predicting complications such as ‘destroyed lung’ during evolution of advanced pulmonary tuberculosis disease which can be prevented with timely diagnosis and use of rational treatment with good clinical and radiological outcome.

Imaging recommendations and algorithms for pediatric tuberculosis: part 1-thoracic tuberculosis.

Tuberculosis (TB) remains a global health problem and is the second leading cause of death from a single infectious agent, behind the novel coronavirus disease of 2019. Children are amongst the most vulnerable groups affected by TB, and imaging manifestations are different in children when compared to adults. TB primarily involves the lungs and mediastinal lymph nodes. Clinical history, physical examination, laboratory examinations and various medical imaging tools are combined to establish the diagnosis. Even though chest radiography is the accepted initial radiological imaging modality for the evaluation of children with TB, this paper, the first of two parts, aims to discuss the advantages and limitations of the various medical imaging modalities and to provide recommendations on which is most appropriate for the initial diagnosis and assessment of possible complications of pulmonary TB in children. Practical, evidence-based imaging algorithms are also presented.

A case report on recurrent subphrenic abscess with pulmonary tuberculosis

Subphrenic abscess though a common presentation itself encountered in surgical practice due to various cause, a tubercular subphrenic abscess in the absence of coexisting tuberculous abdomen presenting as a complication of pulmonary tuberculosis is extremely rare. Only a very few cases have been reported as an extrapulmonary manifestation of tuberculosis so far. We report a case of isolated sub-diaphragmatic abscess which responded well with anti-tuberculous therapy despite all other interventions.

‘Destroyed lung’ as Post Tuberculosis Sequel: A Preventable Stigma of ‘disease of concern’ of Millennium!

Pulmonary Tuberculosis is caused by bacilli mycobacterium tuberculosis and known to infect human race since the dawn of history and archaeological evidence has traced its association in neolithic times. Tuberculosis is the most common infectious lung diseases in India with significant mortality and morbidity. Tuberculosis can cause diverse thoracic presentations ranging from nodules, consolidations & cavitation, mediastinal adenopathy, pleural effusion to diffuse endobronchial disease presenting like bronchial asthma. Due to diverse presentations, diagnosis is many times delayed due to lack of suspicion by treating general physicians and rational treatment many not offered in time. In spite of awareness by government organizations and considered as ‘global health issue of concern’ by World Health organization, tuberculosis is still considered as social stigma. Destroyed lung is described in literature and known complication of pulmonary tuberculosis. Destroyed lung is defined as combination of pleural and parenchymal lung destruction with cavitation, bronchiectasis, loss of lung volume and mediastinal herniation to diseased side. In this case series, we have reported two cases with history of pulmonary tuberculosis in past and received adequate anti-tuberculosis treatment. Both were having residual chronic lung disease and symptoms causing significant impact on quality of life with recurrent hospitalization, hospital visits and cost of care. One patient has history of delayed diagnosis and ATT was started after maximum lung destruction due to tuberculous process has already occurred. In this patient tuberculosis was cured but residual lung damage or sequel presenting as destroyed lung. In second case, tuberculosis was diagnosed in adequate time but patient has defaulted due to adverse events of ATT and he has taken medications as per his own tolerance. Neither adherence nor compliance was acceptable in second case and resulted into partially treated case of pulmonary tuberculosis. Ongoing lung destruction inn second case would be cause for destroyed lung in absence of irrational medicines in today’s era of good quality ATT. Destroyed lung is preventable with early diagnosis, prompt evaluation with microscopy and nucleic acid amplification tests and treatment with universally available, acceptable and affordable free ATT as National guidelines. Destroyed lung is having significant impact on quality of life and health expenditure and considered as ‘radiological stigma’ of Tuberculosis.

A rare case of rapid development of bullous lung

Tuberculosis, although an ancient disease, affecting humans for millennia; continues to present in atypical ways. Whilst the development of bullous lung disease in patients suffering from Pulmonary Tuberculosis, has been reported, it remains an extremely rare phenomenon. The underlying mechanisms remain unknown, and potential causes have been hypothesized, including the role of Isoniazid as part of antitubercular therapy. We reported one such case of a rapid development of bullous lung as a complication of Pulmonary Tuberculosis.

Isolated epiglottic tuberculosis: presented as severe respiratory distress

<p class="abstract">Tuberculosis is a systemic disease and it can involve any organ of the body. Laryngeal tuberculosis, caused by mycobacterium tuberculosis is quite common in our ENT practice but it is usually a complication of pulmonary tuberculosis, and most patients with laryngeal tuberculosis have coexisting active pulmonary tuberculosis. Most of the times the area of involvement in this secondary laryngeal tuberculosis is posterior part of the larynx. We are reporting a case of isolated primary epiglottic tuberculosis, which is a rare entity, who presented with severe respiratory distress and inspiratory stridor. It was initially suspected and misdiagnosed as a case of laryngeal carcinoma because of common laryngoscopic findings of diffuse edema, deformed laryngeal cartilages and ulcerations in both of these conditions but on further evaluation it was diagnosed as primary epiglottic tuberculosis with no pulmonary involvement. After making the correct diagnosis from histopathological examination, the patient was managed successfully by anti tubercular treatment.</p>

Tuberculous exudative pleuritis in the correspondence to extrapulmonary tuberculosis and the total number of exudative pleurisy

Objective — to discover the correlation between exudative pleurisy of tuberculous genesis and pleural effusions of other genesis and to establish correlation with other forms of extrapulmonary tuberculosis. Materials and methods. The results of surveys of 1382 patients with pleural effusion who were treated at the Lviv Pulmonary Health Centre in 2015—2018 were analyzed. The frequency of exudative pleurisy of tuberculous genesis was assessed, the ratio of pleural effusions of other genesis was determined, the tuberculous pleurisy fraction was estimated in relation to other forms of extrapulmonary tuberculosis, the genesis of exudative pleurisy and ratio between them was evaluated.All patients underwent a general labolatory, radiological and instrumental examinations. Microscopic examination for acid-resistant bacilli of sputum smear, culture media for the detection of Mycobacterium tuberculosis, and molecular genetic testing for test Xpert/MBT/RIFAssay were performed. An ultrasound method was used to detect residual fluid in the pleural cavity after pleural puncture. Thoracoscopy and video thoracoscopy were used for differential diagnosis of pleural effusion.Results and discussion. In 2015, 50 cases of tuberculous pleurisy (TP) were identified, in 2016 — 59, in 2017 — 55, in 2018 — 34 cases of tuberculous pleurisy. Correspondingly, significant stable datas on this nosology were found. The number of cases of exudative pleurisy (EP) as complications of pulmonary tuberculosis (PT) during the indicated years were respectively: 2015 — 61, 2016 — 65, 2017 — 98, 2018 — 120. Thus, a persistently high level of indicators of complicated form of PT — EP, with a tendency to increase, remains. The total number of all pleural effusions (non-exudative pleurisy, oncopleuritis, transudative, etc.) for the specified period was: 2015 — 284, 2016 — 315, in 2017 — 386, in 2018 — 397 cases. A sufficiently stable level of indicators of EP of different genesis for the period from 2016 to 2018 was established — 39.4 %, 2017 — 39.6 %, 2018 — 38.8 %. A high dominant percentage of TP was detected.In the Lviv Pulmonary Health Centrein 2015, extrapulmonary tuberculosis of breathing organs (EPTBO) in the structure of extrapulmonary tuberculosis (EPT) was 54.3 %, and the TP in the structure of extrapulmonary tuberculosis of breathing organs was 98 %. In 2016, EPTBO in the structure of EPT was 57.7 %, and TP in the structure of EPTBO — 78.7 %. In 2017, EPTBO was found in the structure of EPT — 53.4 %. TP was 100 % relative to EPTBO. In 2018, the TP compared to EPTBO was 97.1 %. Thus, there is a consistently high value of the amount of TP in the structure of respiratory tuberculosis.Conclusions. TP is the most common form among EP of different genesis at present. TP is the most common nosology among pathologies of extrapulmonary tuberculosis. TP covers respiratory tuberculosis almost completely, from 78.8 to 98 % Given the dominant indicators of TP, we review it appropriate to consider and present them in reports and analytical forms.

Immediate results of pneumonectomy in the complex treatment of patients with destructive pulmonary tuberculosis

Introduction. Currently, surgical methods in the compre-hensive treatment of patients with pulmonary tuberculosis remain in demand all over the world. Among them, pneu-monectomy is performed in 10.3–21.8% of cases and is of-ten accompanied by various postoperative complications.Objective. Study of the immediate results of pneu-monectomy in the comprehensive treatment of patients with destructive pulmonary tuberculosis.Material and methods. A continuous retrospective study was carried out in 2012 through 2017. Inclusion criteria: pa-tients between 18 and 75 years; diagnosis verified by cul-ture technique; total destructive lesion of one of the lungs; chemotherapy for at least 6 months, taking into account the data on MTB drug sensitivity. Exclusion criteria: pre-sence of a destructive lesion in the contralateral lung. 129 patients were enrolled into the study. Patients’ sex, age, duration of the disease, complications of pulmonary tuber-culosis before surgery, MTB drug sensitivity, bacterial shed-ding, X-ray changes, respiratory function, lung perfusion, comorbidity and degree of activity of a specific process were studied, as well as the characteristics of surgical inter-ventions, intraoperative and postoperative complications. Postoperative complications were assessed in accordance with TM&M classification. Differences between groups were determined using the χ2 test. A p value less than 0.05 was considered to be statistically significant.Results. Complications in the early postoperative period developed in 52 (40.4%) patients; 26 (20.2%) patients had minor complications, 26 (20.2%) major ones. In postope-rative period 1 (0.8%) patient died. Postoperative compli-cations were eliminated in 125 (96.9%) patients. Among bacillary patients, bacterial shredding ceased in 80 (91%). Satisfactory immediate result was achieved in 120 (93%) patients, unsatisfactory, in 9 (7%). In the group of patients with major postoperative complications there were sig-nificantly more patients with a disease duration of more than 36 months, as well as those with HCV infection and MDR/XDR MTB (p<0.05).Conclusion. Pneumonectomy is a highly effective opera-tion in the comprehensive treatment of patients with uni-lateral destructive pulmonary tuberculosis

Insights on the history of tuberculosis: Novalis and the romantic idealization

Tuberculosis affected the world population since ancient times, being known to Hippocratic physicians. It was not completely understood and it was difficult to manage. From the eighteenth century onwards, it became highly devastating with a high sociological impact until Robert Koch (1843–1910) identified the pathogenic agent of tuberculosis, in 1882. His discovery enabled a progressive identification and control of infectious diseases. Novalis, born Georg Philipp Friedrich von Hardenberg (1772–1801), an early German Romantic poet, struck by the suffering and death of his fiancée, Sophie von Kühn (1782–1797), who died of a liver abscess as a complication of pulmonary tuberculosis, is a major founder of the romantic idealizing of the disease which lasted until the control of the endemic. Current medicine tends to identify the condition which struck Novalis as cystic fibrosis. However, his name will always be associated with the white plague, the feared and ethereal disease that killed and inspired young artists and talented poets.

Infantile endobronchial tuberculosis

Endobronchial tuberculosis (TB) is a specific form or complication of pulmonary tuberculosis. We report four infants with endobronchial TB presenting with secondary complications such as obstructive emphysema and atelectasis and their response to appropriate anti-tuberculous therapy (ATT) with steroid treatment. Early diagnosis and prompt treatment before the development of fibrosis is important to prevent complications such as bronchiectasis.

Pulmonary Tuberculosis.

This review on pulmonary tuberculosis includes an introduction that describes how the lung is the portal of entry for the tuberculosis bacilli to enter the body and then spread to the rest of the body. The symptoms and signs of both primary and reactivation tuberculosis are described. Routine laboratory tests are rarely helpful for making the diagnosis of tuberculosis. The differences between the chest X ray in primary and reactivation tuberculosis is also described. The chest computed tomography appearance in primary and reactivation tuberculosis is also described. The criteria for the diagnosis of pulmonary tuberculosis are described, and the differential is discussed. The pulmonary findings of tuberculosis in HIV infection are described and differentiated from those in patients without HIV infection. The occurrence of tuberculosis in the elderly and in those patients on anti-tumor necrosis factor alpha inhibitors is described. Pleural tuberculosis and its diagnosis are described. Efforts to define the activity of tuberculosis and the need for respiratory isolation are discussed. The complications of pulmonary tuberculosis are also described.

Neurotuberculosis immune reconstitution inflammatory syndrome in the setting of HIV infection: A case report and review of literature.

Immune reconstitution inflammatory syndrome (IRIS) is an exaggerated immune response which can occur with various coinfections in human immunodeficiency virus (HIV) infected patients, of which the most commonly implicated in central nervous system (CNS)-IRIS are progressive multifocal leukoencephalopathy (PML), cryptococcosis, and tuberculosis (TB). TB-IRIS is a known complication of pulmonary TB or TB lymphadenitis coinfection in HIV infected patients who are on antituberculosis treatment (ATT) after the initiation of antiretroviral therapy (ART). However, development of IRIS in extrapulmonary TB such as CNS TB is very rare. Our case is that of an isolated CNS-TB-IRIS, presenting as increase in the size and perilesional edema of the ring enhancing lesions in the brain, which was observed in two sequential magnetic resonance imaging done over a period of 2 months in a retropositive patient who presented with clinical deterioration after commencement of ART. As prompt diagnosis was made and specific management aimed at IRIS was started without delay, the patient improved symptomatically.

Mucoid Pseudotumor Complicating a Pneumatocele that Developed as a Complication of Pulmonary Tuberculosis

Mucoid Pseudotumor Complicating a Pneumatocele that Developed as a Complication of Pulmonary Tuberculosis

Diagnostic delay of pulmonary tuberculosis in patients with acute respiratory distress syndrome associated with aspiration pneumonia: Two case reports and a mini-review from Japan.

Diagnosing active tuberculosis in elderly patients presents problems due to nonspecific symptoms and complications such as aspiration pneumonia. The current study presents two cases of pulmonary tuberculosis with bilateral pulmonary infiltrates associated with aspiration pneumonia. The two elderly patients developed acute respiratory distress syndrome as a result of aspiration pneumonia. The diagnoses of pulmonary tuberculosis were delayed in both cases, as the patients were diagnosed with active tuberculosis following discharge from hospital. The sputum test for acid-fast bacillus at the time of administration was smear-negative/culture-positive in these patients. They were treated with isoniazid, rifampicin and ethambutol, and nosocomial transmission of tuberculosis from these patients was not reported. The number of elderly patients with aspiration pneumonia is predicted to increase rapidly, and aspiration pneumonia combined with pulmonary tuberculosis is a major medical and healthcare concern in Japan. The present study concludes that physicians should always consider the complication of pulmonary tuberculosis when treating pneumonia patients, in particular in treating elderly patients with pulmonary infiltrates.

The incidence of asbestos-related diseases about on asbestos enterprises in Qingdao from 1988 to 2014

It can provide statistics reference for the prevention and treatment by analysising the status and characteristics related to the asbestos disease of an asbestos products enterprises from 1988 to 2014. We have collected the data concerning the case of asbestos-related disease between 1988 and 2014, then the data were arranged, collecteted and analyzed using statistical method. The total of patients is 625 (male: 225, female: 400). Diagnosis of asbestosis is 617 cases, Accordingly, stage Ⅰis 500, stage Ⅱis 112 and stage Ⅲ is 5. Average age of morbidity is 64.84±9.87 and working age is 24.45±7.40 years; The patients of lung cancer caused by asbestos are 12 people, and average age of morbidity is 66.25±11.20 years, and the working age is 29.18±7.77years; The patients of mesothelioma are 4 people, average age of morbidity is 49-78 (M=60) and working age is 27years. Asbestosis patients with complications of pleural plaque is 37.44%, complications of pulmonary tuberculosis is 5.19%., and there are 239 patients lose their lives, motality is 38.74%. There is a high incidence of a disease about asbestos related disease in the asbestos products factory, it has close relationship with asbestos exposure time, the dust concentration of workplace and type of work et al. Asbestos related diseases are still the main problem in Qingdao.

A Case Report of Tubercular Constrictive Pericarditis

Diagnosis of Constrictive pericarditis is sometimes become difficult because that requires a high degree of clinical suspicion due to nonspecific sign and symptoms. But in endemic area like our country the presentation of tubercular constrictive pericarditis is common. Here we report a case of 28 year Bangladeshi male with tubercular constrictive pericarditis presenting with progressive exertional dyspnea, ankle edema, puffyness of face, dry nonproductive caugh. After physical examination and investigation, the patient was diagnosed as constrictive pericarditis. Patient was previously diagnosed as a tubercular patient and still now on antitubercular cat-1 chemotherapy. So finally diagnosis becomes tubercular constrictive pericarditis. After improvement of the symptoms with medical treatment, the definitive surgical intervention, pericardiectomy done. Then removed pericardial tissue was sent for histopathological examination and histopathological report confirmed the diagnosis of tubercular pericarditis. This case is a late presentation of extrapulmonary manifestation of pulmonary tuberculosis, which is present as a consequence or, complication of pulmonary tuberculosis. So, early diagnosis and treatment is very much important in this case to prevent late consequence like tubercular constrictive pericarditis.University Heart Journal Vol. 10, No. 1, January 2014; 42-44

Hypertrophic osteoarthropathy as a complication of pulmonary tuberculosis

La pachydermopériostose (PDP) ou ostéoarthropathie hypertrophiante (OAH) primitive est une maladie héréditaire rare.Nous rapportons une observation de PDP chez un jeune homme de 22 ans, issu d'un mariage consanguin. Le tableau associait une arthropathie, un hippocratisme digital, une périostose diffuse et une pachydermie des extrémités et du front. Tout le bilan réalisé à la recherche d'une étiologie est resté négatif. Ainsi le diagnostic de PDP était retenu et le malade était traité par colchicine.Les problèmes diagnostiques que peut poser la PDP, surtout avec les OAH secondaires et les rhumatismes inflammatoires chroniques sont discutés.The pachydermoperiostosis (PDP) or primitive hypertrophic osteoarthropathy (HOA) is a rare hereditary disease.We report a 22-year-old man born to consanguineous marriage who presented presented with PDP. This patient disclosed an arthropathy, a clubbing, a diffuse periostosis, and a pachyderma of the hands, the feet and the forehead. All the examinations that were performed to look for an etiology remained negative. Diagnosis of PDP was considered and the patient treated with colchicine.We discuss the diagnostic issues raised by PDP, especially with the secondary HOA and chronic inflammatory rheumatisms.

Hypertrophic osteoarthropathy as a complication of pulmonary tuberculosis

The patient is a 17-year-old man with a history of pulmonary tuberculosis treated for 6 months with the standard regimen [isoniazid, rifampin, ethambutol, and pyrazinamide for 2 months (intensive phase) followed by isoniazid and rifampin for 4 months (continuation phase)] with complete adherence and whose sputum smears at the end of his treatment were negative for acid-fast bacillus. Six months later, he presented to the emergency room complaining of pain and swelling of the ankles, knees and wrists for four weeks prior to admission with no constitutional (fever, night sweats, fatigue, weight loss) and respiratory symptoms. On physical examination, finger clubbing was evident and confirmed by observation of the Schamroth’s sign (Fig. 1). Chest computer tomography showed cystic bronchiectasis and cavitations in the left lower and upper lobes (Fig. 2). X-rays of wrists and legs showed periosteal reaction along the metacarpals, distal radius, ulna, tibia and fibula (Fig. 3) but not acro-osteolysis of the distal phalanges of the hands and feet. Human immunodeficiency virus antibody test was negative. Pharmacologic therapy with nonsteroidal anti-inflammatory drugs was effective in relieving pain from hypertrophic osteoarthropathy (HOA) during his hospital stay and after 3 months of follow-up.

Pulmonary Thromboembolism: A Rare Complication of Pulmonary Tuberculosis

Pulmonary Thromboembolism: A Rare Complication of Pulmonary Tuberculosis