Reactivation Of Pulmonary Tuberculosis Research Articles

COVID-19 and Pulmonary Tuberculosis, Between Coinfection and Reactivation from Latent Tuberculosis Patient: A Systematic Review

Introduction: Globally, cases of pulmonary tuberculosis (PTB) are rising by 4%, while new cases have declined in many nations, most notably by 14% in Indonesia. During the COVID-19 pandemic, the number of undiagnosed and untreated PTB patients could rise and infect more people. In particular, CD8+ lymphocytes were decreased in COVID-19. Perhaps this is the cause of the rise in cases, but there is no data to show it. Aim: Determine current data about the PTB with COVID-19 coinfection and possible reactivation of PTB after COVID-19 infection in LTB patient.
 Methods: This systematic review is based on PRISMA statements using Pubmed, EBSCOHost, Science Direct and Cochrane from December 2019 to July 2022. Inclusion and exclusion criteria were set to select studies that included. We analyze risk of bias of all included studies with JBI critical appraisal tools.
 Results: This study had 107,425 patients in total from 20 studies. All studies were deemed to have low overall author bias risks. A critical component of PTB defense is CD8+. By reducing lymphocytes, COVID-19 can encourage the growth of PTB, which might therefore result in coinfection or the reactivation of existing PTB.
 Conclusion: COVID-19 possibly increase case of PTB in form of co-infection or reactivation of PTB in LTB patients. This needs special attention for patients that have infected by COVID-19 to followed up for risk developing PTB.

A clinical profile of sputum positive pulmonary tuberculosis among elderly patients

The Pulmonary Tuberculosis has been known to mankind to cause increased morbidity and mortality especially in elderly. There is delay in diagnosis of pulmonary tuberculosis which led to increased mortality. Hence, this study looks into the pattern of presentations of the pulmonary tuberculosis and the radiological features that these patients demonstrate, which may help in early diagnosis and effective management.A cross-sectional, descriptive study was conducted on seventy patients above 60 years of age, who attended the outpatient department or those who were admitted in the geriatric ward of BLDE DU, Shri B. M. Patil Medical College, Hospital and Research Centre with symptoms suggestive of pulmonary tuberculosis over a period of twenty-four months irrespective of sex. The patients who tested sputum positive by ZN Stain for Mycobacterium Tuberculosis irrespective of primary diagnosis, defaulters and reactivation of pulmonary tuberculosis were included in the study group. In our study male predominance was seen with 48% of elderly in age group of 60-65 years. Majority (67%) of patients had typical features like fever, cough, evening rise of temperature while 32% had atypical symptoms like decreased appetite, increased thirst, weight loss and breathlessness. The common comorbid was Hypertension (10%). The most common radiological feature was miliary mottling (21%), while there was 11% mortality reported.This study being carried on elderly with sputum positive have given insight on the various pattern of clinical presentations and radiological features in elderly. Importance of sputum examination cannot be undermined in elderly and high degree of suspicion will help reach the diagnosis.

The Bidirectional Relationship between Pulmonary Tuberculosis and Lung Cancer.

Lung cancer and pulmonary tuberculosis are two significant public health problems that continue to take millions of lives each year. They may have similar symptoms and, in some cases, are diagnosed simultaneously or may have a causal relationship. In tuberculosis disease, the chronic inflammation, different produced molecules, genomic changes, and fibrosis are believed to be important factors that may promote carcinogenesis. As a reverse reaction, the development of carcinogenesis and the treatment may induce the reactivation of latent tuberculosis infection. Moreover, the recently used checkpoint inhibitors are a debatable subject since they help treat lung cancer but may lead to the reactivation of pulmonary tuberculosis and checkpoint-induced pneumonitis. Pulmonary rehabilitation is an effective intervention in post-tuberculosis patients and lung cancer patients and should be recommended to improve outcomes in these pathologies.

Incidence and Predictors of Pulmonary Tuberculosis among Children Who Received Antiretroviral Therapy (ART), Northwest Ethiopia: A Multicenter Historical Cohorts Study 2009-2019.

The human immune deficiency virus (HIV) is the strongest risk factor for endogenous reactivation of pulmonary tuberculosis (PTB) through target reduction of CD4, T-lymphocytes, and cellular immune function. Almost one-third of deaths among people living with HIV are attributed to tuberculosis. Despite this evidence, in Ethiopia, information is scarce and meager regarding PTB incidence after ART initiated for seropositive children. Methods. Facility-based multicenter historical cohort was conducted among 721 seropositive children after initiating ART from January 1, 2009, to December 31, 2019. Data from the records of children were extracted using a standardized checklist. The collected data were entered using Epi-Data version 4.2 and exported to STATA (SE) R-14 version statistical soft wares for further analysis. Bivariable and multivariable Cox regression analyses were conducted to identify predictors of PTB incidence. Results. Seven hundred twenty-one (N = 721) seropositive children were included with a mean (±SD) age of 118.4 ± 38.24 months. During the follow-up periods, 63 (15.2%) participants developed new cases of TB; majority (61/63, 96.8%) of them were PTB. The overall incidence rate and the median (±IQR) time of PTB reported were determined as 5.86 per 100 child years (95% CI: 4.58, 7.5) and 17.8 (±11) months, respectively. At baseline, children being severely stunted (AHR = 2.9 : 95% CI, 1.2–7.8, P=0.03), with Hgb ≤10 mg/dl (AHR = 4.0; 95% CI, 2.1–8.1, P=0.001), and not given isoniazid and cotrimoxazole preventive therapy (AHR = 2.4; 95% CI: 1.2; 5.1, P=0.001) (AHR = 2.5; 95% CI, 1.4–4.7, P=0.021) were significantly associated with PTB incidence. Conclusion. A high incidence rate of PTB was observed in our study as compared with the previous finding in Ethiopia. Cases at baseline not taking IPT and CPT, being severely stunted, and having low hemoglobin (≤10 mg/dl) levels were found to be at higher risk of developing PTB.

Case Report: Pulmonary Tuberculosis Reactivation in Patients with Human Immunodeficiency Virus: A Case Report

We present one case of co-infection with Mycobacterium tuberculosis (MTB) in a patient with Human Immunodeficiency Virus (HIV). It`s a case of a 27-year-old woman admitted at the Clinical Hospital of Infectious Disease and Pneumology ”Dr. Victor Babeș” Timișoara. The patient was known to be HIV-positive since 2019 and developed pulmonary tuberculosis during the therapy. The patient was non-compliant at antiretroviral therapy and developed pulmonary tuberculosis first time in December 2020. One year later, the same patient was admitted in the hospital with pulmonary manifestations and a reactivation of pulmonary tuberculosis was once again confirmed.

A study on the outcome of pulse therapy in vesicobullous disorders at a tertiary care centre in Chidambaram, Tamilnadu

Introduction: With the advent of pulse therapy and adjuvant immunosuppressive drugs, the outcome and prognosis of vesicobullous disorders have been improved to a greater extent. Different regimen protocol has been tried and this descriptive study was carried out to assess the outcome of various pulse therapy regimens in vesicobullous disorder at our centre. Methods: A total of 26 vesicobullous patients were enrolled for the study. Diagnosis was made clinically and confirmed by histopathology. They received treatment with Dexamethasone-Cyclophosphamide pulse (DCP) or Dexamethasone -Azathioprine pulse (DAP) or Dexamethasone pulse (DP) therapy and were followed up for clinical remission and side effects of therapy. Results: There was a total of 26 patients comprising 69.23% females and 30.77% males and 50% were between the age group of 40-50 years. Pemphigus vulgaris was the commonest clinical type seen in 69.23%.DCP was given for 22(84.62%) patients, dexamethasone pulse in 3(11.54%) and DAP in one (3.85%). In DCP group 77.27% of patients were in Phase I and 22.73% achieved clinical remission. One patient was refractory to DCP and required rituximab infusion. Weakness, headache, vomiting and weight gain were the commonest side effects encountered in our study. Avascular necrosis of femur and reactivation of pulmonary tuberculosis were the major side effects noticed in one patient each. Conclusion: DCP therapy prove to be an excellent therapeutic regimen in case of vesicobullous disorders to attain faster recovery sparing the adverse effect of corticosteroids. DAP can be an useful therapeutic option in patients who were unmarried or in reproductive age group. Keywords: Pemphigus vulgaris, Dexamethasone-cyclophosphamide pulse. Dexamethasone-azathioprine pulse, Dexamethasone pulse

Pulmonary Tuberculosis Reactivation and CNS Involvement Following Treatment of Myelofibrosis with Ruxolitinib: Case Report and Review of the Literature of Incidence in Myeloproliferative Neoplasms

Pulmonary Tuberculosis Reactivation and CNS Involvement Following Treatment of Myelofibrosis with Ruxolitinib: Case Report and Review of the Literature of Incidence in Myeloproliferative Neoplasms

Pulmonary tuberculosis and peptic ulcer disease association in geriatric patients

The geriatric population is predisposed to the development of pulmonary tuberculosis (PT), both by endogenous and exogenous factors. Regarding for peptic ulcer disease (PUD) in this same age group, the clinical manifestations are related to the loss of weight and to the depreciation of the general state; a situation that provokes reactivation of PT, causing a more severe clinical picture, not only due to the association of the two pathologies, but also by the age group itself. In this case report, we present a 97-year-old woman with an unexpected association of pulmonary tuberculosis and DUP.

A severe Case of Hypercalcemia due to Pulmonary Tuberculosis Reactivation

A severe Case of Hypercalcemia due to Pulmonary Tuberculosis Reactivation

Diabetes mellitus: an important risk factor for reactivation of tuberculosis.

SummaryDiabetes mellitus was identified as a risk factor for developing tuberculosis (TB) infection, and relapse after therapy. The risk of acquiring TB is described as comparable to that of HIV population. The fact that diabetics are 3× times more prone to develop pulmonary TB than nondiabetics cannot be overlooked. With DM recognized as global epidemic, and TB affecting one-third of the world population, physicians must remain vigilant. We present a 45-year-old woman born in Dominican Republic (DR), with 10-year history of T2DM treated with metformin, arrived to our Urgency Room complaining of dry cough for the past 3months. Interview unveiled unintentional 15lbs weight loss, night sweats, occasional unquantified fever, and general malaise but denied bloody sputum. She traveled to DR 2years before, with no known ill exposure. Physical examination showed a thin body habitus, otherwise well appearing woman with stable vital signs, presenting solely right middle lung field ronchi. LDH, ESR, hsCRP and Hg A1C were elevated. Imaging revealed a right middle lobe cavitation. Sputum for AFB disclosed active pulmonary TB. Our case portrays that the consideration of TB as differential diagnosis in diabetics should be exercised with the same strength, as it is undertaken during the evaluation of HIV patients with lung cavitation. Inability to recognize TB will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace.Learning pointsDiabetes mellitus should be considered an important risk factor for the reactivation of pulmonary tuberculosis.High clinical suspicious should be taken into consideration as radiological findings for pulmonary tuberculosis in patients with diabetes mellitus may be atypical, involving middle and lower lobes.Inability to recognize pulmonary tuberculosis will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace.

Reactivation of pulmonary tuberculosis during treatment with triple therapy for hepatitis C

Reactivation of pulmonary tuberculosis during treatment with triple therapy for hepatitis C

Reactivation of Pulmonary Tuberculosis following Treatment of Myelofibrosis with Ruxolitinib.

Ruxolitinib is widely in use for treatment of myeloproliferative disorders. It causes inhibition of the Janus kinase (JAK) signal transducer and activation of transcription (STAT) pathway, which plays a key role in the underlying pathophysiology of myeloproliferative diseases. We describe a case of reactivation pulmonary tuberculosis in a retired physician while on treatment with ruxolitinib. We also review the literature on opportunistic infections following use of ruxolitinib. Our case highlights the importance of screening for latent tuberculosis in patients from highly endemic areas prior to start of therapy with ruxolitinib.

Reactivation of pulmonary tuberculosis during cancer treatment

Reactivation of Mycobacterium tuberculosis can occur in patients with latent tuberculosis (TB) with risk factors including chronic disease (i.e., malignancy). We herein describe the case of an immigrant from Hong Kong with lung cancer and no known TB disease who presents with reactivation of TB in the setting of chemotherapy and radiation therapy.

A hypothesis for reactivation of pulmonary tuberculosis: How thoracic wall shape affects the epidemiology of tuberculosis.

This study was aimed at determining the cause for the high incidence of tuberculosis (TB) reactivation occurring in males with a low body mass index (BMI). Current thinking about pulmonary TB describes infection in the lung apex resulting in cavitation after reactivation. A different hypothesis is put forward for TB infection, suggesting that this occurs in subclinical apical cavities caused by increased pleural stress due to a low BMI body habitus. A finite element analysis (FEA) model of a lung was constructed including indentations for the first rib guided by paramedian sagittal CT reconstructions, and simulations were conducted with varying antero-posterior (AP) diameters to mimic chests with a different thoracic index (ratio of AP to the transverse chest diameters). A Pubmed search was conducted about gender and thoracic index, and the effects of BMI on TB. FEA modeling revealed a tenfold increase in stress levels at the lung apex in low BMI chests, and a four-fold increase with a low thoracic index, r(2) = 0.9748 P < 0.001. Low thoracic index was related to BMI, P = 0.001. The mean thoracic index was statistically significantly lower in males, P = 0.001, and increased with age in both genders. This article is the first to suggest a possible mechanism linking pulmonary TB reactivation to low BMI due to the flattened thoracic wall shape of young male adults. The low thoracic index in young males may promote TB reactivation due to tissue destruction in the lung apex from high pleural stress levels.

Persistent sle activity related to untreated reactivation of pulmonary tuberculosis

SLE patients are at risk of tuberculosis (TB) infection due to both secondary immunosuppression and intrinsic defects in innate immunity. On the other hand infection can also perpetuate the development of an autoimmunity [1,2].

Late onset Warfarin induced skin necrosis in human immunodeficiency virus infected patient with pulmonary tuberculosis

The incidence of Warfarin-induced skin necrosis (WISN) is very low 0.01-0.10%. The majority of the WISN cases appear between day 3 and 6 of onset of Warfarin therapy. The cases of late onset WISN are rarely seen. We report a case of late onset WISN in a young human immunodeficiency virus positive female patient with thrombotic pulmonary embolism and reactivation of pulmonary tuberculosis.

Preliminary Short-Term Experience of Early Steroid Withdrawal after Liver Transplantation

Purpose: Long-term steroid therapy after liver transplantation (LT) can cause diabetes mellitus, hypertension, hyperlipidemia, osteopenia, susceptibility to infection. To avoid many adverse effects of steroid, modified steroid protocols are studied. Methods: Among 46 transplants of 44 adult patients who received LT from December 2007 to September 2011, 39 recipients were reviewed. We devided recipients into three groups according to steroid therapy period: (1) ≥ 6 months (group A) (2) 1 - < 6 months (group B) (3) 2 weeks (group C). Acute rejection (AR) that was proved by liver biopsy and serious complications were investigated. Intravenous methylprednisolone 500mg was given for operative day and postoperative day (POD) 1 and then tapered. On POD 6, we changed methylprednisolone to prednisolone and discontinued on POD 15. Results: In group A (n=12), the mean period of steroid therapy was 8.8 months (range: 6.3-13.7). In this group, 4 AR, 4 posttransplant diabetes mellitus (PTDM), 1 invasive pulmonary aspergillosis (IPA), 1 avascular necrosis (AVN) of hip joint, 1 pneumonia, 1 intraabdominal abscess and 1 varicella zoster developed. IPA and AVN developed in patients treated with intensive immunosuppression due to AR. The patient who suffered from intraabdominal abscess was died of systemic infection at 6 months after operation. In group B (n=12), the mean period of steroid therapy was 3.2 months (range: 1.1 - 5.3). In this group, 1 AR, 1 PTDM, 2 pneumonia and 1 varicella zoster developed. Among them, one patient who was diagnosed pneumonia was died at 5 months after LT. In group C (n=15), 1 AR, 1 PTDM, 1 reactivation of pulmonary tuberculosis, 1 intraabdominal abscess and 1 varicella zoster developed. Among them, one patient who was diagnosed intraabdominal abscess was died at 5 months due to arterial bleeding. The mean follow-up period between groups was 34 (A), 23.7 (B), 9.2 (C) months, respectively. Conclusion: Even though we need further follow-up, discontinuation of steroid within 2 weeks can be comparable to the long-term therapy regarding AR with the benefit of reduced complication rate.

Pulmonary Tuberculosis Mimicking Metastasis in a Patient With Osteosarcoma

Pulmonary metastasis even at diagnosis or during treatment is an important problem in osteosarcoma treatment and treatment modality varies in patients with metastasis. Metastasectomy and aggressive induction chemotherapy are the 2 most well-known treatment options. However, reactivation of pulmonary tuberculosis can be a problem in developing countries, where the prevalence of tuberculosis is high. Here, we described a patient with osteosarcoma with pulmonary tuberculosis reactivation mimicking metastasis.

Tuberculosis Screening before Anti–Hepatitis C Virus Therapy in Prisons

Tuberculosis Screening before Anti–Hepatitis C Virus Therapy in Prisons

Reactivation of tuberculosis in hepatocellular carcinoma treated with transcatheter arterial chemoembolization: A report of 3 cases

Pulmonary tuberculosis is an opportunistic infection that can be reactivated in immunocompromised conditions, for example, in malignancy or after liver transplantation. Hepatocellular carcinoma (HCC) has a high mortality rate because it is frequently diagnosed at an advanced stage. Although surgical resection is the established curative measure for HCC, it is only feasible for early-stage HCC. Transcatheter arterial chemoembolization (TACE) is the most common treatment modality for patients with unresectable HCC. However, repeated TACE sessions and, occasionally, the tumor itself can further impair the reserve hepatic function and immunity. We report 3 recent cases of HCC with reactivation of pulmonary tuberculosis after TACE.