History Of Tuberculosis Infection Research Articles

Preventive therapy for iatrogenic active tuberculosis in systemic lupus erythematosus patients

To explore the efficacy and safety of preventive therapy for iatrogenic active tuberculosis (TB) induced by glucocorticoid. During 2007-2011, a total of 203 systemic lupus erythematosus (SLE) patients with high-risk active TB, such as a history of TB infection, TB family member and strong positive purified protein derivative (PPD) skin test or hypoalbuminemia and hyperglycemia were enrolled. They were randomly divided into three groups based on whether or not anti-TB treatment was offered at the beginning of glucocorticoid treatment for SLE: simple glucocorticoid group (n = 70); glucocorticoid plus rimifon group (n = 67); glucocorticoid plus rimifon plus ethambutol group (n = 66). Anti-TB treatment was offered at least 12 months for the preventive anti-TB group. And follow-ups were conducted every 2-3 months for 2 year to observe the efficacy and side effects of anti-TB drugs. During this period, anyone with fever and/or cough consulted a physician immediately. No active TB occurred in anti-TB treatment group. And 8 patients (11.43%) had active TB in simple glucocorticoid group, including hematogenous disseminated TB (n = 1), pulmonary TB (n = 3), bone TB (n = 1), tuberculous meningitis (n = 1) and undefined focus TB infection (n = 2). And 6/8 cases had active TB within 6 months after using glucocorticoids. According to the study protocol, any case of active TB shall receive 3-4 combined anti-TB drugs for 1 year. The TB conditions of 7/8 patients were better controlled by anti-TB treatment.One patient died of tuberculous meningitis after lost follow-up. Two patients had mild temporary numbness in finger tap of both hands. And 3 patients on double anti-TB drugs showed a mild elevation of liver enzymes. For high-risk population of active TB, glucocorticoid therapy plus 1 or 2 preventive anti-TB treatment drugs may prevent its occurrence. And there is no serious adverse reaction during preventive anti-TB treatment.

Automatic screening for tuberculosis in chest radiographs: a survey.

Tuberculosis (TB) is a major global health threat. An estimated one-third of the world's population has a history of TB infection, and millions of new infections are occurring every year. The advent of new powerful hardware and software techniques has triggered attempts to develop computer-aided diagnostic systems for TB detection in support of inexpensive mass screening in developing countries. In this paper, we describe the medical background of TB detection in chest X-rays and present a survey of the recent approaches using computer-aided detection. After a thorough research of the computer science literature for such systems or related methods, we were able to identify 16 papers, including our own, written between 1996 and early 2013. These papers show that TB screening is a challenging task and an open research problem. We report on the progress to date and describe experimental screening systems that have been developed.

Bacteriological and molecular detection of Mycobacterium bovis in cattle with inconclusive results to intradermal tuberculin tests

A dairy herd (77 cows) from Rio de Janeiro, Brazil, with a history of tuberculosis infection was tested by a comparative cervical test (CCT). Seventeen cows were reactive and seven were inconclusive (swelling ≥ 2.0 mm and ≤ 3.9 mm, respectively). All of these 24 cows were slaughtered and necropsied ; samples from lungs and lymph nodes were collected for multiplex polymerase chain reaction (PCR) and culturing. Infection was confirmed in 23/24 (95.8%) of the slaughtered animals (five by culturing, four by PCR, and 14 by both tests). All cows with inconclusive results at CCT were confirmed as infected. Although slaughter of inconclusive reactor cows is not mandatory in many countries, our study provided evidence to support the slaughter of these cows, at least during an outbreak.

Autopsy Cases of Miliary Tuberculosis: Clinicopathologic Features Including Background Factors

To assist physicians, especially young physicians, in identifying tuberculosis (TB) infection before the terminal stage, we analyzed 7 cases of numerous tuberculous granulomas in multiple organs and compared clinical and autopsy findings between cases. Patients ranged in age from 41 to 86 years at the time of death. The main chief complaint was fever of unknown origin (3 of 7 cases [43%]). The main underlying conditions were liver cirrhosis (2 of 7 cases [29%]) and chronic renal failure (2 of 7 cases [29%]). Two patients (29%) had been given methylprednisolone pulse therapy for various lung disorders. Active TB was not diagnosed before autopsy in 4 of 7 (57%) patients. Calcified lesions indicative of old TB were present in 4 of 7 (57%) patients. Thus, miliary tuberculosis may represent a re-emergence of latent TB infection in these cases. Various histologic features of nonreactive exudative inflammation were seen, along with granulomas containing Langhans giant cells with or without caseous necrosis in hypervascular organs, such as the lung, liver, and bone marrow. Physicians should be mindful of the possibility of miliary TB when older patients with hepatorenal disease and a history of TB infection have undergone immunosuppressive treatment. Active tuberculous infection can depend on the presence of an underlying disease and immunocompromise.

Not all Colonic Masses in the Elderly are Malignancy; A Case of Ileocecal Tuberculosis in the Absence of Gastrointestinal or Pulmonary Symptoms

Purpose: With our increasing immunocompromised and elderly population, infections considered isolated to underdeveloped countries, such as tuberculosis (TB), continue to have a presence in the United States. An 81 year old male presenting for annual physical examination was noted with a twenty-five to thirty pound weight loss over one year's time and complained of mildly progressive fatigue and poor appetite. At the time of examination he denied other specific complaints. A CAT scan of his abdomen and pelvis revealed a colonic mass with extension into the region of the ileocecal valve. No regional or retroperitoneal adenopathy was noted. Subsequent colonoscopy revealed an ulcerated semi-circumferential mass in the cecum (Figure 1). He had no history of prior colonoscopy and the mass was assumed to represent a malignant process. Biopsies however showed necrotizing granulomatous tissue without evidence of malignant cells. Special staining showed positivity for acid fast bacillus and sputum was found to be growing Mycobacterium tuberculosis. He was immediately started on 4 drug antituberculosis therapy. Within 6 months of treatment, he had regained his lost weight and appetite and was back to his baseline level of activity. Classically, TB involves the pulmonary system with the gastrointestinal system being the sixth most frequent site of extrapulmonary involvement. Intestinal tuberculosis remains a diagnostic challenge, especially in the absence of pulmonary symptoms, with past attempts at diagnostic criteria applying only to situations of high clinical suspicion. Common presentations of intestinal TB include symptoms such as abdominal pain, fever, diarrhea, and a palpable abdominal mass. Our patient presented with atypical symptoms of intestinal TB and was without classic pulmonary symptoms or history of TB infection or exposure. This case reiterates that in today's medicine not all colonic masses in the elderly population can be assumed malignant.Figure 1: Ulcerated semi-circumferential mass which was found to represent a tuberculosis infection at the ileocecal valve.

Periorbital Tuberculosis in a Young Man: A Case Report

Background: Tuberculosis is an endemic disease in developing countries which may involve various organs. Soft tissue involvement including periorbital tissues is very rare, and often this involvement is accompanied by the involvement of other body organs such as lungs. Most of the patients suffering from periorbital infections have underlying diseases and diagnosis of these infections without concomitant involvement of other parts of body is often complex. Case presentation: In this paper, a periorbital tuberculous infection is described. A 17-year-old male with chronic periorbital mass underwent surgical and medical treatment and the mass recurred. Culture and microscopic studies of the specimen showed mycobacterium tuberculosis. The patient was treated for a periorbital tuberculous infection for a 6-month period with antituberculous regimen and was cured. Conclusion: Periorbital tuberculous infection may occur in the absence of underlying factors or active tuberculosis in the rest of the body organs or a history of tuberculosis infection.

Absence of Relationships Between Tuberculin Responses and Development of Adult Asthma With Rhinitis and Atopy

To investigate the relationship between tuberculin skin responses and the development of adult asthma, rhinitis, and atopy. Two hundred fourteen patients with mild-to-moderate asthma accompanied with rhinitis and 220 normal volunteers underwent a medical history, chest radiography, allergen skin-prick testing (SPT), bovine Mycobacterium tuberculosis vaccine (BCG) scar identification, purified protein derivative (PPD) tuberculin skin testing, serum-total and serum-specific IgE measurements, and bronchial provocation (provocative dose of histamine causing a 20% fall in FEV(1) [PD(20)]). Thirty-one normal volunteers (14.1%) and 168 asthma-rhinitis subjects (78.5%) had one or more positive skin test results (p < 0.0001). Neither the presence of a BCG scar nor a history of BCG vaccination had a significant effect on atopy in either group. The rate of PPD positivity had no statistical difference between atopy and nonatopy in both groups. In multivariate logistic regression analysis, the odds ratio for tuberculin reactivity was not related to the level of serum-total IgE nor to the level of serum-specific IgE to Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF), skin response to DP and DF, and PD(20). Overall, no significant correlations were found between tuberculin skin reactivity and log serum-total IgE or PD(20). There is no relationship between history of tuberculosis infection, tuberculin responses, and development of adult bronchial asthma, allergic rhinitis, and atopy. Our study suggests that the protection provided by intradermal BCG vaccination in infants to prevent atopic diseases may be limited in early childhood, when a substantial memory of cellular immune modulation still exists.

Absence of Relationship between History of Tuberculosis Infection, Skin Tuberculin Responses and Development of Adult Bronchial Asthma, Allergic Rhinitis and Atopy

Absence of Relationship between History of Tuberculosis Infection, Skin Tuberculin Responses and Development of Adult Bronchial Asthma, Allergic Rhinitis and Atopy

Quoi de neuf en allergologie pédiatrique en 2000 ?Revue de la littérature internationale dˈoctobre 1999 à octobre 2000

The relation between maternal and childhood atopy may result from an increased intrauterine Th2 environment and high levels of Th2 cytokines in the milk of atopic mothers. The value of in vitro tests for early prediction of atopy is low, but high levels of eosinophil-derived proteins in nasal secretions of neonates may predict respiratory allergy. The prevalence of respiratory allergy has decreased in children living in rural areas, especially on farms. This may be related to exposure to mycobacterias, but the development of allergic conditions is independent of tuberculin reactivity and history of tuberculosis infection; however, the prevalence of asthma is decreased in young adults infected by Mycobacterium tuberculosis during childhood. High levels of eosinophils in the blood of children with bronchiolitis predict the development of persistent wheezing and asthma. Inhaled, oral and intravenous corticosteroids do not prevent relapses of bronchiolitis and persistent wheezing, but early hyposensitization has long-term beneficial effects on asthmatic symptoms. Results of prick-tests and specific IgE determinations are correlated with the severity of food allergy, and several studies confirm the diagnostic value of patch-tests with foods in children with atopic dermatitis associated with food allergy. Interesting cases of unexpected food allergies are reported (carob-induced anaphylaxis, and exercise-induced anaphylaxis to snails). Finally, children with spina bifida demonstrate a progressive sensitization to latex, in spite of a latex-free environment after the first surgical procedure(s), and the gelatin included in vaccines is highly immunogenic and allergenic.

Mycobacterium tuberculosis Infection in Pregnant and Nonpregnant Women Infected With HIV in the Women and Infants Transmission Study

Prevalence of Mycobacterium tuberculosis (TB) infection and anergy were evaluated in a cohort of pregnant and nonpregnant women infected with the human immunodeficiency virus who were enrolled in a prospective natural history study (the Women and Infants Transmission Study) conducted in New York, NY; Boston and Worcester, Mass; Chicago, Ill; and San Juan, Puerto Rico. One hundred eighty-three women (65 pregnant, 118 nonpregnant) were evaluated for TB. The TB history and risk factors were assessed by interview and medical record review. Intradermal skin testing with tuberculin, mumps, and tetanus antigens and CD4+ lymphocyte count were performed. Overall prevalence of TB infection or disease by documented medical history and/or a tuberculin skin test induration of 5 mm or more was 14% (26 of 183). History of TB infection or disease was documented in 11% of the women who were interviewed. Tuberculin and anergy skin test results were evaluable for 124 women; 6% (seven of 124) had tuberculin skin test induration of 5 mm or more, including 11% (five of 46) of the pregnant women who were tested. Induration between 2 and 5 mm was observed in four more women, three of whom were pregnant. Anergy was observed in 42% (52 of 124); prevalence of anergy was higher in nonpregnant women (38 [49%] of 78) than in pregnant women (14 [30%] of 46). While anergy was more common in women with a CD4+ cell count of 0.5 x 10(9)/L or less, 27% of those with a CD4+ cell count of more than 0.5 x 10(9)/L were also anergic. These data support current Public Health Service recommendations for tuberculin skin testing in persons infected with the human immunodeficiency virus, and emphasize that evaluation should include pregnant as well as nonpregnant women. The prevalence of anergy does not appear increased in pregnancy in women infected with the human immunodeficiency virus. Health care providers should include tuberculin and anergy skin testing as part of the standard prenatal care for women infected with the human immunodeficiency virus.