Skin Tuberculin Test Research Articles

A case report: Reactivation of tubercular infection presenting as bilateral frosted branch angiitis

: Frosted branch angiitis is a rare form of angiitis having multifactorial associations. Tubercular retinitis is a common association with frosted branch angiitis. Aim of this study is to show that frosted branch angiitis can be the only presenting symptom of reactivated tubercular infection.: A female patient presented with severe diminution of vision in both eyes and bilateral severe form of retinal vasculitis. She had a positive skin tuberculin test. Radiological investigation (HRCT Chest) revealed an old healed infection in the form of fibrotic streaks. She had previous history of Tuberculosis 17 years back and she didn’t complete the ATT course at that time.: Reactivation of Tubercular infection can present as frost branch angiitis. Prompt diagnosis and effective management helps in preventing as well as reversing the loss of vision.

Study of infection levels of Mycobacterium Tuberculosis in a city of Nasiriyah – Iraq

Tuberculosis happened because of bacteria M. tuberculosis it is complex and one of the world's leading causes of death. Mycobacterium TB is thought to have infected one-third of the world's population. The study of tuberculosis was conducted at a city of southern Iraq for 6-year (from 2014 to 2019). Patients of TB who were clinically identified at the chest clinics of the medical center for Mycobacterium TB diagnosis is based on isolating the tuberculosis germ from the patient's sputum culture, also X-rays or CT scans or PCR are important tools in supporting the diagnosis. In addition, a skin tuberculin test is performed, as a positive result supports the diagnosis of active tuberculosis but does not prove it. The number of isolates tested 3360 was 630 in 2014, 646 in 2015, 585 in 2016, 610 in 2017, 474 in 2018, and 415 in 2019. The current research was carried out from September 2020 to May 2021 in medical center in south of Iraq. Age, sex, educational status, residence, and marital status, history of previous contact with active TB patients, incarceration, and nutritional status were all utilized as variables in smear positive tuberculosis and pervious treatment for tuberculosis. Results of our survey study included samples from different people that suspect infected by M. tuberculosis .Out of them 2628 were with M. tuberculosis positive and 732 with negative. The important increase in the number of cases observed in the medical center in year (2014, 2015, 2017) apparent increase in infection resulted from an increase in detection rate or increased search for the condition, examination was performed on people men/ women ( child or adult ) whose clinical change deviated in any way from the normal, and that patients with mild signs had previously been overlooked, but in 2016 2018, 2019, there is appear decrease in number of tuberculosis , this is rented to health care or devices health care-associated infection, like those associated with vital signs or may be early diagnosis to tuberculosis and last it is caused by using antibiotic with high activity. The research aims to know and study the causes of the increase in tuberculosis and the age groups that can be infected.

Aptamer-Based Diagnostic Systems for the Rapid Screening of TB at the Point-of-Care.

The transmission of Tuberculosis (TB) is very rapid and the burden it places on health care systems is felt globally. The effective management and prevention of this disease requires that it is detected early. Current TB diagnostic approaches, such as the culture, sputum smear, skin tuberculin, and molecular tests are time-consuming, and some are unaffordable for low-income countries. Rapid tests for disease biomarker detection are mostly based on immunological assays that use antibodies which are costly to produce, have low sensitivity and stability. Aptamers can replace antibodies in these diagnostic tests for the development of new rapid tests that are more cost effective; more stable at high temperatures and therefore have a better shelf life; do not have batch-to-batch variations, and thus more consistently bind to a specific target with similar or higher specificity and selectivity and are therefore more reliable. Advancements in TB research, in particular the application of proteomics to identify TB specific biomarkers, led to the identification of a number of biomarker proteins, that can be used to develop aptamer-based diagnostic assays able to screen individuals at the point-of-care (POC) more efficiently in resource-limited settings.

Bilateral Adrenal Adenomas Attributed to Extrapulmonary Mycobacterium Tuberculosis

Introduction: Adrenal infections are rare, with the Mycobacterium tuberculosis (MTB) being the most common causative agent in the developing world. MTB usually spreads to the adrenal glands hematogenously where it may be clinically manifested years after systemic infection. Here, we present a case of bilateral adrenal MTB infection associated with MTB peritonitis. Case Presentation: A 46-year-old male, from Ecuador, without significant medical history and no medical follow-up presented to the emergency room with a two-week history of abdominal pain, nausea, diarrhea, and significant weight loss. He denied fever, cough, or night sweats. No smoking, alcohol, or illicit drug use. He works as a construction worker without a history of sick contacts. Vital signs were stable, with abdominal distension and fluid shifting dullness on exam. Blood work revealed leucocyte count of 5.58K (4-11K), INR 1.2 (0.9–1.1), Sodium 132 mEq/L (136–145 mEq/L) with albumin 3.3 mg/dL (3.5–5.2 mg/dL), total bilirubin level, 1.3 mg/dL (0–1.2 mg/dL), and AST and alkaline phosphatase levels, 73 U/L (0–40 U/L) and 186 U/L (40–129 U/L) respectively. Computerized tomography (CT) of the abdomen showed large ascites, omental nodularity, calcified gall bladder, bilateral adrenal nodules, and multiple abdominal lymphadenopathies. Chest CT revealed right apical reticulonodular densities. A diagnostic paracentesis revealed an exudative effusion with serum ascites albumin gradient of 0.7, and negative acid fast bacilli (AFB) and adenosine deaminase enzyme. Ascitic cellular analysis was negative for malignant cells. AFB blood and sputum cultures were negative, though Quantiferon gold test was positive and a skin tuberculin test was 13x13mm. Tumor markers CA19-9, CEA, and alpha-fetoprotein came back negative. Additionally, serum aldosterone, plasma metanephrines, DHEA-S, AM Testosterone, ACTH, and morning cortisol levels were normal. The patient had a negative 1-mg dexamethasone suppression test. Positron emission tomography (PET) scan showed a hypermetabolic left adrenal mass (4.9x3.2 cm) and nodular peritoneum with no fluorodeoxyglucose (FDG) uptake in the enlarged abdominal lymph nodes. Peritoneal biopsy analysis revealed non-caseating granuloma positive for MTB. The adrenal biopsy was not performed given the extensive intra-abdominal disease. The patient was started on anti-MTB treatment (Isoniazid, rifampicin, pyrazinamide, and ethambutol) with significant clinical improvement and a slight decrease in the adrenal masses following abdominal imaging. Conclusion: Extrapulmonary MTB should be part of a differential diagnosis for bilateral adrenal masses. Adrenal glands could be infected by a variety of pathogenic microorganisms either by direct contact or hematogenous dissemination. A high index of suspicion is required for the diagnosis of MTB in patients with atypical presentation.

Potential efficiency of conventional and advanced approaches used to detect Mycobacterium bovis in cattle

The present study was aimed to assess the prevalence and efficiency of techniques for the diagnosis of bovine tuberculosis (bTB) including enzyme-linked immunosorbent assay (ELISA), Gamma interferon assay (IFN-γ) and polymerase chain reaction (PCR) in comparison to skin tuberculin test and culture technique. A total of 2600 cross-breed dairy cattle in Menoufia and Daqahlia governorates were tested by the single intradermal tuberculin test where the disease prevalence was 1.8%. Serum and whole blood samples were collected from positive tuberculin reactors for ELISA and IFN-γ assay, respectively. After slaughtering of positive tuberculin reactors, the post-mortem examination was carried out and tissue samples were collected for the bacteriological examination and PCR. The percentage of visible lesions of tuberculin reactors was 78.7%, while non-visible lesions were 21.27%. Culture technique revealed that the percentage of bTB was 63.8%. The ELISA and IFN-γ assay using short-term culture filtrate (ST-CF) prepared antigen revealed higher sensitivity (72.3% and 82.9%) than the bovine purified protein derivative (PPD-B) antigen. Although prepared ST-CF antigen has great efficiency and eligibility for the diagnosis of bTB, PCR appeared to have a higher sensitivity (85.1%) than other diagnostic methods when dealing with post-mortem samples. Gamma interferon assay using ST-CF antigen is recommended for antemortem diagnosis of bTB in cattle.

CD14-159C/T polymorphism in the development of delayed skin hypersensitivity to tuberculin.

The skin tuberculin test (TST), an example of a delayed-type hypersensitivity (DTH) reaction, is based on measuring the extent of skin induration to mycobacterial tuberculin (PPD). Little is known about the genetic basis of TST reactivity, widely used for diagnosing TB infection. The study investigated the relationship of the single base change polymorphic variants in CD14 gene (CD14(-159C/T)) with the development of DTH to PPD in BCG-vaccinated Polish Caucasian individuals. We found persistent lack of TST reactivity in about 40% of healthy subjects despite receiving more than one dose of BCG. The TST size was negatively correlated with the number of BCG inoculations. The distribution of C/T genotype was significantly more frequent among TST-negative compared with TST-positive individuals. The concentration of serum sCD14 was positively associated with mCD14 expression, but not with the TST status or CD14(-159C/T) polymorphism. A significant increase in mCD14 expression and serum sCD14 levels was found in TB group. We hypothesize that CD14(-159C/T) polymorphic variants might be one of genetic components in the response to attenuated M. bovis BCG bacilli.

Latent Tuberculosis in Health Care Workers Exposed to Active Tuberculosis in a Tertiary Care Hospital in Oman.

Data on the prevalence of tuberculosis (TB) in healthcare workers (HCW) in Oman and the Arabian Gulf is scarce. The aim of this study was to estimate the prevalence of latent tuberculosis (LTB) among HCW exposed to active TB in one of the tertiary care hospitals in Muscat. Exposed HCW were screened for LTB from January to June 2012 using skin tuberculin and serum interferon tests. Candidates were followed-up for a total of nine months. Descriptive statistics were used to summarize the data. A total of 371 exposed HCW were involved in the study. The incidence of LTB in exposed HCW was 33.2% (n = 123). Almost 54% (66/123) of the HCW started treatment and only 42.4% (28/66) completed the full nine-month treatment course. The high prevalence of LTBI in exposed HCW merits further evaluation of the screening and treatment programs in the country. Future countrywide studies are warranted to provide more precise statistics on the prevalence and management of this public health issue.

Features Immunodiagnostic Local Forms of Tuberculosis in Children

The 100 children with local forms of tuberculosis (LFT) were examinated used by the method of continuous sampling. The results of the LFT immunodiagnostic with the Diaskintest (DST) in the children were evaluated. Diaskintest were started applying in Samara one of the first from Russia. The confirmation of the tuberculosis in children with LFT was done in 99% of cases by the positive skin tuberculin tests and in 84% by Diaskintest positive. It is shown that Diaskintest can not be taken as an absolute diagnostic criteria for the diagnosis of the tuberculosis. Were noted that the FGA stimulated IFN-γγ production level were significantly reduced (1,7 times), the DST stimulated IFN-γγ production level were elevated more than 18 pg/ml in the children with negative skin Diaskintest. This observation shows that the issues in the fields of tuberculosis immunodiagnostic require further investigations.

DIAGNOSIS OF TUBERCULOUS ASCITIES;

Diagnosing Tuberculous ascites is a challenge. Polymerase chain reaction (PCR) and adenosine deaminase activity(ADA) have come up as promising modalities to aid diagnosis of tuberculosis in body fluids. Objective: To find and compare theusefulness of ADA and PCR in ascitic fluid in diagnosis of peritoneal tuberculosis. Study Design: A cross-sectional study. Place of Study:Medical Unit-I, Ghulam Mohammad Mahar Medical College Hospital, Sukkur. Duration of Study: From January 2010 to July 2011.Methods: Fifty five patients of exudative ascites, were diagnosed as peritoneal tuberculosis by following criteria- clinical suspicion, PPD(Skin Tuberculin test) positive, suggestive bacteriological and/or imaging findings and ascitic fluid showing lymphocytosis withdecreased glucose and SAAG (Serum- Ascites albumin gradient) of <1.1 gm/ dL. PCR and ADA were performed in the ascitic fluid andpositivity rates determined and compared. Results: Out of 55 study subjects, 50 patients (90.9%) were PCR positive and 48 (87.3%)were ADA positive; both were equiefficacious (p=0.54). High agreement between PCR and ADA tests was noted. Conclusions: ADA andPCR are comparable as diagnostic modality for tuberculous peritonitis, however ADA scores over PCR because of easy availability, lowcost, less infrastructure requirement and less-time consuming.

Screening of recombinant proteins as antigens in indirect ELISA for diagnosis of bovine tuberculosis

Bovine tuberculosis is an important infectious disease caused by Mycobacterium bovis, which is responsible for considerable economic losses. This disease constitutes a serious public health problem. Control programs in most countries, including Brazil, are based on the identification and slaughter of infected animals, as defined by the skin tuberculin test, which has its constraints. In the present study, the recombinant proteins CFP-10, ESAT-6, Mb0143, MPB83, PE5, PE13, TB10.4, TB15.3 and a chimera of ESAT-6/MPB70/MPB83 (fusion protein) were tested as ELISA antigens for the diagnosis of bovine tuberculosis. The proteins were produced in Escherichia coli, purified and tested in ELISAs with sera from 126 cattle having tested negative in the comparative intradermal tuberculin test (CITT) and 107 sera from cattle having tested positive in the CITT. Also, 236 sera from two BTB-free beef cattle herds were tested. Among the proteins tested, only the ESAT-6/MPB70/MPB83 chimera demonstrated satisfactory agreement with the CITT (kappa index: 0.688), reflecting in 83.2% sensitivity and 86.5% specificity. The ELISA absorbances of the cattle sera from BTB-free herds showed similar levels to those of CITT positive cattle, probably as the result of successive skin tuberculinizations to define the BTB-free status of the herds. However, the ELISA with the ESAT-6/MPB70/MPB83 chimera was useful to discriminate BTB positive and negative cattle in herds prior to the tuberculin skin test.

Mycobacterium pinnipedii in a captive Southern sea lion (Otaria flavescens): a case report

Mycobacterium pinnipedii causes tuberculosis in free-living and captive pinniped species throughout the world. We report on the isolation of this M. tuberculosis complex (MTC) member from an imported male Southern sea lion (Otaria flavescens) in a zoo in the Czech Republic. Nodular granulomatous lesions were found in the lungs, pleura and mesenteric lymph nodes of this animal and M. pinnipedii was isolated from lung, mesenteric and submandibular lymph nodes. Identification of the isolates was confirmed using two independent molecular methods. Direct IS6110 PCR amplification confirmed the presence of an MTC member in these samples. Faecal and oral swabs from three living female sea lions were examined using direct IS6110 PCR and were all found to be negative. Twelve environmental samples were examined using direct microscopy after Ziehl-Neelsen staining and culture methods along with direct IS6110 PCR examination, all yielding negative results. Seven people that came into close contact with the infected animal were examined using a skin tuberculin test and chest x-ray, revealing no evidence of infection by a MTC member.

Tuberculosis genital. Diagnóstico diferencial con cáncer de ovario

In women with an adnexal mass, ascites and elevated serum markers, ovarian carcinoma must be excluded. However, several other entities, including genital tuberculosis, may produce similar symptoms. A 38-year-old woman with no personal or familial history of interest presented with abdominal pain, ascites, constitutional syndrome, high fever and elevated Ca125 and Ca15.3 levels. Computed tomography revealed severe septated ascites and an adnexal mass. A skin tuberculin test was negative for tuberculosis.At exploratory laparotomy, miliary spread over abdominal organs was observed, with adhesions and partial pelvic block. Intraoperative biopsy was negative for malignancy but a double adnexectomy was performed and adhesions were released. Postoperative histologic examination revealed typical features of genital tuberculosis.

Our experiences with diagnosis of latent tuberculosis in patients before the initiation of anti-TNF treatment with QuantiFERON-TB Gold test

Objective Recently, the possibility of anti-TNF treatment was introduced into clinical praxis in Slovakia (2001 – Infliximab, 2003 – Etanercept and 2005 – Adalimumab). One of the most serious and redoubtable side effects of anti-TNF treatment is the development of latent tuberculosis (TBC). Subjects with latent TBC have positive skin tuberculin test and in their organisms, there are vital TBC bacteria which are inactive (“hibernating status”). After immunosuppression of various origins, it comes to the activation of these bacteria and these persons become contagious. Latent form of tuberculosis is curable. QuantiFERON-TB Gold Test presents the break in the diagnosis of latent tuberculosis on the basis of quantification of interferon-gamma produced by T-lymphocytes after stimulation with mycobacterial proteins. Since 1 st April 2007, this test was according to the Methodic Letter of Main expert for Pneumology and Phtiseology in Slovakia incorporated into the standard algorithms for screening of latent TBC before the initiation of anti-TNF treatment. Aim Examination of the patients with QuantiFERON-TB Gold Test before the initiation or in continuance of anti-TNF treatment. Methods We enrolled all the 106 patients before the initiation of anti-TNF treatment (indicated after 1 st April 2007) and 73 other patients with already initiated anti-TNF treatment. Nowadays there are approximately 500 patients with rheumatoid arthritis, psoriatic arthritis and ancylosing spondylitis treated with anti-TNF medication. Results In patients with planned anti-TNF treatment (all from 1 st April 2007) we observed in 70% negative, 9% positive and 6% questionable results. In 15% we are still waiting for the final result of the test. In the group of patients with already initiated anti-TNF treatment we noted in 93% negative, 4% positive (3 subjects) and 3% questionable results. In the patients we verified reactivation of the latent tuberculosis during anti-TNF treatment. Conclusion All the patients with negative test results initiated anti-TNF therapy. Those with positive results were firstly treated according to the protocol for the prophylactic anti-tuberculosis therapy during 6 months and after 2 months of therapy after consensus with pneumologist-phtiseologist we could start anti-TNF therapy. Patients with questionable test results (immunosuppressed) underwent after one month re-testing. Surprisingly, we found the lower frequency of questionable results in the group of already treated patients (3%) in comparison with those with planned anti-TNF treatment (6%). Test is suitable for the identification of highly risk persons, for the detection of hidden form of tuberculosis, decreased the risk of false negative results and prevents the development of active diseases. It allows to eliminate the mistakes in the interpretation of skin tuberculin test, economically execute desired number of the samples, accelerate the establishment of the diagnosis and consecutively specifically initiate adequate therapy. It is necessary to consider also the risk of false positive results of this test.

Tuberculose primaire de la glande parotide

Objectives To report on a case of primary tuberculosis of the parotid gland in a 13-year-old child, and to stress the corresponding diagnostic pitfalls. Case report A 13-year-old child presented with an isolated mass of the right parotid area. Radiological findings were in favour of a cystic lesion. Skin tuberculin test was positive. Bacteriological and histopathological examinations were realized after spontaneous fistulization of the mass, and allowed the diagnosis of tuberculosis of the parotid gland. Evolution was favourable under antituberculous chemotherapy. Discussion Localization of tuberculosis in salivary glands is rare. Diagnosis is difficult because there are no specific clinical, radiological or biological signs of the disease. Only bacteriological and histopathological findings can confirm the diagnosis. Fine needle aspiration cytology is very helpful, and permits to avoid abusive surgery. Treatment is based on antituberculous drugs and allows usually a favourable evolution.

Anorectal Tuberculosis Mimicking Crohnʼs Disease

Case Presentation: A 31 year old man with a diagnosis of therapy-refractory perianal Crohn's disease was referred for further management. His symptoms of hematochezia and perianal pain started one year prior to his referral. The Crohn's disease diagnosis was established post biopsy of the terminal ileum and the colon. Initial therapy included mesalamine, prednisone, metronidazole and ciprofloxacin with no response. Physical examination revealed perianal tenderness with nodularity and ulceration with no evidence of fistulas. Chest X-Ray and CT identified bilateral upper lobe nodular opacities. A skin tuberculin test (PPD) was placed and was 18mm in diameter at 72 hours. Biopsies of the perianal lesions were repeated and microscopic examination showed chronic inflammation with necrotizing granulomas. Stains for acid-fast bacilli were positive. A bronchial alveolar lavage was performed and was negative, but a lung wedge biopsy positive for necrotizing granulomas. Cultures of the all biopsy material grew Mycobacterium tuberculosis complex. The patient was started on Rifampin, Isoniazid, Pyrazinamide, Ethambutol therapy and treatment for Crohn's disease was discontinued. His clinical symptoms subsequently improved markedly. Discussion: Of all patients with TB infection, 5% will have involvement of their gastrointestinal tract. TB infection of the gastrointestinal system is the 6th most common cause of extra-pulmonary involvement. Tuberculosis can involve any part of the GI tract. The most common site being the terminal ileum and cecum. Perianal TB is extremely rare, accounting for less than 1 percent of cases. TB and Crohn's disease can be indistinguishable clinically and endoscopically. Biopsies from the colon in TB can reveal large confluent granulomas with central necrosis and Langhan's giant cells. Stains for AFB and cultures from the biopsies may be positive but polymerase chain reaction (PCR) of the biopsy has higher sensitivity and specificity (75% and 100%, respectively) for detecting TB. Treatment for GI TB includes Rifampin, Isoniazid, Pyrazinamide, and Ethambutol (RIPE). Current recommendations for the treatment of extra-pulmonary TB are 12–24 months of RIPE therapy. Differentiating TB from Crohn's disease can be very difficult. However, establishing the correct diagnosis is critical prior to subjecting the patient to immunosuppressive medications for Crohn's disease.

A clinical study on the etiology of parapneumonic effusion in children

Purpose:This study was designed to document the etiologies and the characteristics of parapneumonic effusion in children. Methods:During a 17-year period from 1987 to 2004, parapneumonic effusion was confirmed in 86 children at Gyeongsang National University Hospital. The clinical records of these children were reviewed and radiological findings and laboratory data, especially results of thoracentesis, were analyzed retrospectively. Results:M. pneumoniae(34 subjects) was the most common pathogen at all over age, especially above 1-years-old. There were diagnosed with clinical characteristics and serologic tests. The 2nd most common pathogen revealed non tuberculous bacteria(14 subjects). A species of bacteria at no tuberculous bacteria revealed S. aureus(5), S. pneumoniae(3), P. aeroginosa(3), other staphylococcus (2), and K. pneumoniae(1). There were confirmed with sputum culture or pleural fluid culture or blood culture. S. aureus was most common pathogen in infants. The 3rd common pathogen was M. tuberculosis(7). There were confirmed with skin tuberculin tests and AFB stains. Another that was classified as a non bacteria was adenovirus(2). Complications of parapneumonic effusion such as pleural thickness occurred on M. tuberculosis(1). Non tuberculous bacteria, especially S. aureus revealed a serious predominance of polymorphocyte at pleural fluid, and lowest pleural pH and glucose, and highest pleural protein and LDH. Tuberculosis revealed high pleural protein and LDH. Conclusion:Age and chemistries of pleural fluid might be helpful in differentiating various etiologies of parapneumonic effusion. If there were suspicious of tuberculosis and non-tuberculous bacteria, more aggressive approaches were needed to prevent complication.

Impact of Circulating TGF-β and IL-10 on T Cell Cytokines in Patients with Asthma and Tuberculosis

Regulatory T cells, which stimulate or inhibit the effector functions of distinct T cell subsets, are critical in the control of the immune response. We investigated the effect of TGF-β and IL-10 on T cell subsets according to the Th1/Th2 immune status. Sixty-two patients with asthma and 38 patients with pulmonary tuberculosis were included. Allergy skin tests, tuberculin tests, and chest radiography were performed. The levels of circulating IL-4, IFN-γ, TGF-β1, and IL-10 were measured using ELISA. The level of TGF-β1 was higher in patients with asthma than in those with tuberculosis, but the IL-10 levels were the same between the asthma and tuberculosis groups. Atopy was unrelated to the tuberculin response. The IFN-γ level was correlated with the IL-10 level, and the level of IL-4 was unrelated to the IL-10 or TGF-β1 level. The level of IL-10 was higher in the negative tuberculin reactors than in the positive tuberculin reactors among patients with asthma, and TGF-β1 was higher in the positive tuberculin reactors than in the negative tuberculin reactors among patients with tuberculosis. These results demonstrate that the regulatory effects of circulating TGF-β and IL-10 on T cell cytokines may be different between Th2-type asthma and Th1 tuberculosis.

Bifocal Tuberculosis Highlighted by Obstetric Combined Spinal–Epidural Analgesia

Bifocal Tuberculosis Highlighted by Obstetric Combined Spinal–Epidural Analgesia

Screening for tuberculosis in an east London HIV clinic.

A prospective study was carried out to assess the value of routine skin tuberculin testing and chest radiography in HIV seropositive patients, attending the Genitourinary Medicine (GUM) clinic between July 1991-May 1992. 144 consecutive HIV seropositive patients had tuberculin Tine tests and chest radiographs performed. Ten patients were treated for active tuberculosis (TB) on the basis of abnormal radiography with or without strongly positive (Grade 3/4) skin tuberculin tests. A further 10 patients received prophylaxis on the basis of abnormal chest radiography consistent with previous tuberculous infection or strongly positive tuberculin tests. Active or previous tuberculous infection was found in the UK born Caucasian homosexual population as well as in injecting drug users and patients who were born in areas of high TB prevalence. Screening for TB in HIV seropositive patients is important both for detecting asymptomatic tuberculous infection and for recognizing patients at risk for reactivation of latent TB. We showed a high pick-up rate with 20 out of 144 patients having treatment as a result of screening.

A Case of Pulmonary Tuberculosis Presenting with a Choroidal Tuberculoma

A 17-year-old woman was referred because of a choroidal mass, with marked decrease in vision, in her left eye. Her medical history was negative. However, preliminary examination revealed a positive skin tuberculin test (PPD) and a chest x-ray picture of pulmonary tuberculosis. Bronchoscopy documented the diagnosis. Findings of other systemic investigations were negative. Fluorescein angiographic findings were compatible with the clinical diagnosis of a choroidal tuberculoma. A regimen of antituberculous medications was started, and both the choroidal and the pulmonary lesions gradually subsided. To our knowledge this is the first reported case of nonmiliary tuberculosis that presented solely with a choroidal lesion.