Cases reported "Tuberculosis, Lymph Node"

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11/24. Immune reconstitution syndrome due to bacillus Calmette-Guerin after initiation of antiretroviral therapy in children with hiv infection.

    The immune reconstitution syndrome caused by bacillus Calmette-Guerin (BCG) was found in 4 hiv-infected children who were immunized with BCG at birth. The localized, suppurative, BCG-related complications developed within 10 weeks after initiation of antiretroviral therapy. The incidence rate was 2.7 cases per 100 persons (95% confidence interval, 0.7-6.7). patients responded well to treatment with isoniazid and rifampicin.
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ranking = 1
keywords = bacillus
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12/24. A case of tuberculous pyomyositis that caused a recurrent soft tissue lesion localized at the forearm.

    We present the case of a 20-year-old male who had a non-traumatic soft tissue lesion (4 x 3 cm) with recurrent discharge at his right posteromedial antebrachial muscles; the patient underwent surgery twice, and antibiotic therapy was administered, but no cure was achieved with these treatments. The patient underwent surgery at our medical center. There was no history of pulmonary, gastrointestinal, or genitourinary tuberculosis (TB). Due to suspected pulmonary, genitourinary, and gastrointestinal TB, radiography and computed tomography scans were performed, and these studies disclosed no evidence of a primary origin. The erythrocyte sedimentation rate and the results of purified protein derivate testing were normal. We also detected submandibular lymphadenopathy (LAP) (2 x 3 cm) localized at a submandibular site in our patient 4 months after his first visit to our clinic. Smears were stained with Ehrlich Ziehl Neelsen (EZN) stain and culture were grown for mycobacterium tuberculosis complex (MTC); the samples used for these assays had been obtained by incisional biopsy of the forearm lesion and by aspiration of the submandibular lymph node, and they were found to be MTC-positive. Then, a culture for MTC, derived from an induced sputum sample, was found to be positive, despite the negative results obtained with a sputum smear subjected to EZN staining. According to these results, the primary focus of the tuberculous pyomyositis and the submandibular LAP was the lungs. The lesion and submandibular LAP were both treated successfully by the administration of antituberculous chemotherapy.
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ranking = 0.0034302603463813
keywords = complex
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13/24. polymerase chain reaction to identify mycobacterium tuberculosis in patients with tuberculous lymphadenopathy.

    Tuberculous lymphadenopathy is often diagnosed and treated on clinical and cytopathological grounds as mycobacterium tuberculosis remains undetected in tissue specimens from such patients. At times, lymph nodes are known to respond sluggishly to and reappear during antitubercular therapy. We report a polymerase chain reaction-based approach to confirm the presence of M. tuberculosis in 4 such patients.
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ranking = 282.13080059036
keywords = mycobacterium
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14/24. Case report of lymph nodal, hepatic and splenic tuberculosis in an hiv-positive patient.

    We describe a case of a male patient, 38 years old, hiv-positive (most recent CD4 count about 259/mm(3)), with abdominal pain, nausea, vomiting, anorexia, weight loss, and vespertine high fever with chills. His hemogram showed normocytic and normochromic anemia, with a high erythrocyte sedimentation rate (ESR) and gross granulations in the neutrophils. transaminases were normal. bone marrow biopsy evidenced a chronic disease anemia pattern and a lack of infectious agents. Abdominal ultrasound examination showed a normal-size spleen, which exhibited heterogeneous parenchyma and multiple small hypoechoic images, together with small ascites, peripancreatic and para-aortic lymphadenopathy. These findings were confirmed by abdominal CT. The liver was normal in size, but had a hyperechoic image, which was not visualized on CT. Histopathological analysis of one of the multiple abdominal lymph nodes obtained by laparoscopic biopsy exhibited a chronic granulomatous inflammatory process, with caseous necrosis. Tissue sections were positive for BAAR (acid-alcohol-resistant bacillus), and the cultures were positive for mycobacterium tuberculosis. Anti-tuberculosis treatment was begun, and the patient evolved with improvement of his general state, fever remission and weight gain. Splenic tuberculosis is a rare disease, occurring predominantly in patients in late stages of AIDS and/or disseminated tuberculosis. It is a difficult diagnosis, since there are no specific findings. Hence, complementary examinations, such as abdominal ultrasound/ CT, or fine needle aspiration, are usually necessary for investigation and differential diagnosis. Often, lesion regression after anti-tuberculosis regimens can be seen, and splenectomy is restricted to complicated or refractory disease.
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ranking = 0.2
keywords = bacillus
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15/24. Cutaneous vasculitis associated with tuberculosis and its treatment.

    Two patients with pulmonary tuberculosis developed cutaneous vasculitis after antituberculosis treatment and a patient with tuberculous lymphadenitis developed vasculitis at presentation before drug therapy. The cutaneous vasculitis probably represented immunological reactions to tubercle bacilli and/or rifampicin with antibodies and immune complex formation.
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ranking = 0.0034302603463813
keywords = complex
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16/24. Cervicofacial mycobacterial infections presenting as major salivary gland disease.

    mycobacterium tuberculosis and atypical mycobacterium are well-known causes of cervical lymphadenopathy, most often presenting without symptoms of systemic infection. These organisms may also directly involve the parenchyma of the major salivary glands and their periglandular or intraglandular nodes. The diagnosis of mycobacterial infections of the major salivary glands, compared to cervical lymph nodes, is equally--if not more--difficult to make. The differential must include the same spectrum of inflammatory and neoplastic diseases as well as lesions unique to the salivary glands. Selected cases are presented and discussed to show that principles established for the treatment of cervical mycobacterial infections must also be applied to major salivary gland infections. In particular, cutaneous fistulas may result from incisional biopsy or incision and drainage of the involved gland. Partial parotidectomy or submaxillary gland excision may be required, followed by multidrug, antituberculous chemotherapy for one to two years. Culturing of the organisms is extremely difficult, and the diagnosis of either mycobacterium tuberculosis or atypical mycobacterial infection must be based on a combination of history and clinical examination, skin testing, histopathology, acid-fast stains, culture, and response to surgery and antituberculous chemotherapy.
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ranking = 141.06540029518
keywords = mycobacterium
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17/24. Practical use of polymerase chain reaction for the diagnosis of steroid induced tuberculous lymphadenitis.

    Tuberculous lymphadenitis that had developed after treatment with systemic prednisolone was diagnosed using the polymerase chain reaction (PCR) combined with dot-blot hybridization. Although the patient had no history of tuberculosis or suggestive radiological findings, a dna fragment specific for mycobacterium tuberculosis complex strains was amplified from a paraffin-embedded biopsy specimen of a cervical swelling, which was compatible with tuberculous lymphadenitis on haematoxylin-eosin (HE) and Ziehl-Neelsen staining. This report demonstrates the practical use of PCR for diagnosis of extra-pulmonary tuberculosis in a case difficult to diagnose conventionally.
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ranking = 0.0034302603463813
keywords = complex
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18/24. Identification of mycobacterium tuberculosis dna in five different types of cutaneous lesions by the polymerase chain reaction.

    BACKGROUND AND DESIGN: A spectrum of skin lesions are believed to be secondary to the presence of mycobacterium tuberculosis. Demonstration of M tuberculosis directly or in culture in some of these eruptions can be difficult. We used the polymerase chain reaction and a primer/probe set specifically for M tuberculosis complex dna to evaluate five types of skin lesions clinically considered to represent infection by, or reaction to, M tuberculosis. OBSERVATIONS: mycobacterium tuberculosis dna was demonstrated in paraffin-embedded sections of these five cases, representing a variety of clinical and histologic patterns. In two cases, M tuberculosis could not be demonstrated by routine cultural methods. CONCLUSION: dna diagnostic methods such as the polymerase chain reaction can be used to rapidly identify cutaneous lesions produced by M tuberculosis.
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ranking = 0.0034302603463813
keywords = complex
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19/24. Tuberculous lymphadenitis presenting with cutaneous leucocytoclastic vasculitis.

    Cutaneous leucocytoclastic vasculitis is an inflammatory vascular disorder due to deposition of immune complexes in dermal vessels. A direct or indirect role of infectious agents in the pathogenesis of such vasculitis has been postulated. We describe a patient with cervical lymphadenitis due to mycobacterium tuberculosis infection who developed cutaneous vasculitis. The vasculitis resolved with standard antituberculous therapy. The association between leucocytoclastic vasculitis and tuberculous infection has only rarely been reported. Tuberculous infection may present in a number of different clinical forms depending in part on variations in the number and virulence of the bacilli, route of infection, presence or absence of an internal tuberculous focus, age and specific immunity of the host. Although the association between infection and vasculitis is well known, mycobacterium tuberculosis as a causative agent of cutaneous leucocytoclastic vasculitis is uncommon.
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ranking = 0.0034302603463813
keywords = complex
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20/24. Cervical lymphadenitis in children: the role of mycobacterium avium-intracellulare.

    Non-tuberculous mycobacteria are the most frequent cause of mycobacterial cervical lymphadenitis in children. Although uncommon, the incidence in recent years has shown a marked increase. Its early differentiation from tuberculous mycobacterial lymphadenitis is essential as the treatment of choice is early surgical excision rather than antituberculous chemotherapy. Three such cases are reported with emphasis on the differential diagnosis and management.
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ranking = 2.3529289912174
keywords = avium
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