Diagnosis Of Primary Tuberculosis Research Articles

Primary oro-pharyngeal tuberculosis mimicking as malignancy

Primary oropharyngeal tuberculosis is a rare entity and accounts for 0.05-5% of all cases of tuberculosis cases. We report here a case of 20-year-old female with primary oropharyngeal tuberculosis. The patient initially presented with an ulcer-proliferative growth on the right tonsil. Subsequently, after a delay of 6 months due to noncompliance of the advice given, she presented with extensive involvement of the oropharynx. The diagnosis of primary tuberculosis was made after histopathological examination and cytological examination for exclusion of acid-fast bacilli in the sputum and bronchoalveolar lavage fluid as well. In endemic region young patients presenting with ulcer-proliferative growth on oropharynx, a high degree of suspicion for tuberculosis should be made. Early diagnosis and prompt treatment with anti-tubercular drugs results in a good treatment outcome with complete resolution of symptoms and signs.

Primary tuberculosis of the appendix in a young male patient: Report of a case

A 23-year-old man without a history of tuberculosis presented with right lower abdominal pain and a fever. An increased inflammatory response was found, and abdominal computed tomography showed a diffuse enlargement and wall thickening in the appendix. An ileocecal abscess and perforating appendicitis were suspected. Therefore, an emergency operation was performed. The surgery revealed a diffuse enlargement with adhesion to the retroperitoneum, which was suspected to be a neoplastic lesion of the appendix, thus an ileocecal resection including the appendix was performed. A histopathological examination revealed a number of epithelioid granulomas having Langerhans giant cells with caseous necrosis in the appendix, in addition to many granulomas without caseous necrosis in the regional lymph nodes. No tubercle bacilli were detected by Ziehl-Neelsen staining. Further examination revealed no tubercular lesions in other organs, thus leading to the diagnosis of primary tuberculosis of the appendix. This is an extremely rare disease reported in Japan.

Diagnosis of Primary Tuberculosis in Children by Amplification and Detection of Mycobacterial DNA

Standard microbiologic techniques were compared with a rapid diagnostic method based on the amplification by polymerase chain reaction (PCR) of a fragment of the IS6110 insertion element (present in multiple copies in the Mycobacterium tuberculosis genome) for the detection of M. tuberculosis in specimens obtained from children diagnosed as having primary tuberculosis on clinical grounds. Two (n = 7) or three (n = 15) gastric aspirates were obtained from the 22 children with primary tuberculosis. All specimens were negative for mycobacteria by acid-fast staining and culture. When DNA was purified from the clinical specimens and aliquots of each sample were amplified in duplicate, 15 of 59 (25%) specimens gave at least one positive result. Increasing beyond two the number of times that samples were tested did not appreciably improve sensitivity. Testing multiple samples from the same individual increased the diagnostic yield. Thus, when three different samples from the same subject were tested two times each, two or more positive results were obtained from 9 of 15 children with primary tuberculosis but 0 of 17 control subjects. Samples from children with symptoms, recent contact with patients with active tuberculosis, vesicular tuberculin responses, or abnormal chest radiographs were more frequently positive than those from patients whose only manifestation of tuberculosis was a positive (but not vesicular) tuberculin response. Thus, M. tuberculosis DNA can be detected by PCR in gastric aspirates of many children with primary tuberculosis, despite that specimens from these patients are negative by culture. Multiple samples must be tested to optimize the diagnostic yield.

Simple Primary Tuberculosis in an Elderly Woman

The diagnosis of primary tuberculous infection was made in a 78-year-old woman. The chest roentgenographic findings were remarkably similar to those often seen in children and adolescents with primary infection. Like the majority of adults with this entity, the patient was asymptomatic; the diagnosis was suspected epidemiologically and was confirmed by culture of M. tuberculosis from the sputum. As the incidence of new tuberculosis cases declines, the diagnosis of primary tuberculosis in the adult may be made more frequently.

Acute Poisoning from Overdose of Isoniazid

The use of isonicotinic acid hydrazide in human tuberculosis was first reported by Selikoff et al. in 1952. 1 Today, isonicotinic acid hydrazide (isoniazid) is used widely as an effective antituberculous drug. It would seem inevitable that its accidental ingestion should occur. Yet search of the English literature reveals only 2 previous reports of acute poisoning in infants due to isoniazid. 2-3 Report of Cases Case1.— History. —A 25-month-old Mexican boy had been receiving isoniazid and para-amino-salicylic acid since June 25, 1959, when a diagnosis of primary tuberculosis had been made. Around noon on March 19, 1960, the mother put the patient in his crib, gave him his bottle and went outside to hang up the wash. Some isoniazid tablets were left on a dresser near the crib. Apparently by pulling the dresser scarf, the patient reached the tablets and ate approximately 18 (100 mg.) tablets. The mother, returning