Cases reported "Tuberculosis"

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1/61. Rapid identification of mycobacterium bovis BCG by the detection of the RD1 deletion using a multiplex PCR technique.

    The bcg vaccine strain cannot, with confidence, be differentiated from other members of the mycobacterium tuberculosis complex on phenotypic tests alone. Isolates from clinical sites not associated with vaccination may be confused with M. tuberculosis. A characteristic of BCG strains is the deletion of the genomic region RD1; detection of this forms the basis of a multiplex polymerase chain reaction (PCR) assay to distinguish BCG strains. In this study, 28 M. tuberculosis complex strains were analysed by the PCR assay. A dna sequence displaying the characteristic deletion was detected in all eleven of the BCG strains tested and was not found in representatives of other members of the complex, including M. bovis. Thus, the assay affords a rapid, simple and effective method for the discrimination of the bcg vaccine strain from other members of the M. tuberculosis complex.
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ranking = 1
keywords = complex
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2/61. Isolated endobronchial atypical mycobacterium in a child: a case report and review of the literature.

    Isolated endobronchial lesions caused by Mycobacterium avium are rare, especially in the pediatric population. We share the case of a 10-month-old boy who, after 1 week of cough and low-grade fever, had a radiographic examination showing endobronchial obstruction. At bronchoscopy, a granuloma of the left bronchus intermedius was found. Histopathologic examination revealed necrotizing granulomatous inflammation. Kinyoun Acid Fast stain revealed acid fast bacilli. Cultures were positive for M. avium. Current treatment options and controversies are presented. The roles of antibiotics and steroids in preventing progressive disease are discussed. The need for serial bronchoscopy and the potential benefits of surgical resection are discussed. Isolated endobronchial M. avium infection remains a rare and challenging problem. The paucity of clinical experience, and variation in patient presentation, obligates a high index of suspicion, and frequent follow-up with bronchoscopic examination and pulmonary assessment, for the child diagnosed with isolated endobronchial atypical mycobacterial infection.
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ranking = 62268.572590194
keywords = mycobacterium, avium
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3/61. Severe disseminated BCG infection in an 8-year-old girl.

    An 8-year-old girl died of sepsis due to staphylococcal infection one year and 8 months after Bacille Calmette-Guerin (BCG) revaccination. Two months after the vaccination in accordance with the school health program, she was hospitalized with a high fever, skin rash over the face and lower limbs, and leukopenia. Her clinical and laboratory pictures were not compatible with those of any established type of immunodeficiency. The polymerase chain reaction (PCR) test for M. tuberculosis complex was positive for bone marrow, pleural fluid, and peripheral blood. The strain recovered from a mycobacterial culture of the blood was identical to the BCG strains with which the patient was vaccinated, based on restriction fragment length polymorphism (RFLP) and a pulse-field gel electrophoresis (PFGE) analyses of dna. She developed finally a lung abscess due to staphylococcal septicemia, which was the direct cause of her death.
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ranking = 0.25
keywords = complex
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4/61. Fatal sepsis due to mycobacterium tuberculosis after allogeneic bone marrow transplantation.

    mycobacterium tuberculosis is a serious, but rare infectious complication after allogeneic bone marrow transplantation. We describe a case of fatal sepsis due to mycobacterium tuberculosis after allogeneic bone marrow transplantation for philadelphia chromosome-positive ALL. The diagnosis was made after BAL. Although broad-spectrum antituberculous therapy was started immediately after diagnosis, blood cultures became positive for mycobacterium tuberculosis. The patient developed severe pyrexias and finally died of multi-organ failure. Rapid progression of mycobacterial infection should be considered in patients post BMT with unexplained fever, particularly in patients from endemic areas.
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ranking = 62156.881602607
keywords = mycobacterium
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5/61. Two cases of long lasting bacteremia due to mycobacterium avium complex despite new macrolides-containing regimens in patients with acquired immunodeficiency syndrome.

    The prognosis of mycobacterium avium complex (MAC) infection has been improved by new macrolides-containing regimens and the use of highly active antiretroviral therapy (HAART) in the treatment of acquired immunodeficiency syndrome (AIDS). We report on two AIDS cases with long lasting bacteremia due to MAC under this regimen. Both patients experienced problems due to side effects from the anti-MAC regimen and from an immune-reconstitution syndrome related to HAART. MAC infection persisted despite treatment, however, no anti-MAC drug-resistant isolates emerged throughout the clinical course in either case. These cases demonstrate that therapy for disseminated MAC infection is sometimes difficult even with HAART and macrolides-containing regimens.
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ranking = 187.40164597737
keywords = avium, complex
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6/61. Cutaneous complications of BCG vaccination in infants with immune disorders: two cases and a review of the literature.

    Two infants, one with a T-cell-signaling defect resulting in a primary immunodeficiency syndrome and the other with severe combined immunodeficiency (SCID), are described. Both infants developed cutaneous infections secondary to their bacillus Calmette-Guerin (BCG) vaccinations. Both patients were from countries where BCG is routinely administered in infancy. The infant with the T-cell-signaling defect developed a disseminated infection involving the skin, while the infant with SCID developed a localized cutaneous infection at the site of his BCG immunization. These two cases resemble other reported cases of cutaneous BCG infection following routine vaccination in immunocompromised patients. mycobacterium bovis infection should be considered in patients with cutaneous eruptions who have received BCG vaccination, especially those who are immunocompromised.
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ranking = 86.880654342151
keywords = bacillus
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7/61. Pharyngeal tuberculosis.

    PURPOSE: To increase awareness of tuberculosis (TB) as an important differential diagnosis of lesions in the pharynx and discuss its presentation. patients AND methods: The study included nine patients (2 males and 7 females); each with a diagnosis of primary pharyngeal tuberculosis (PTB). Of these, 3 had nasopharyngeal TB, 5 had tonsillar TB, and 1 had hypopharyngeal TB. The diagnostic criteria were either positive culture, positive smear, or histopathologic features of caseating granuloma consistent with TB in the biopsy specimen and a response to treatment. RESULTS: All patients had primary infection. The main presenting symptom in all nasopharyngeal TB was neck mass, whereas tonsillar TB patients presented with sore throats or discomfort. Dysphagia was the presenting symptom in hypopharyngeal TB. Six patients (3 with nasopharyngeal TB and 3 with tonsillar TB) had cervical adenopathy. The smear for acid-fast bacillus was positive in 4 patients (44.4%); culture was positive in 2 patients (22.2%). Histopathologic features of caseating granuloma, consistent with TB, were positive in all patients who received antituberculous medications. CONCLUSION: Otolaryngologists should consider pharyngeal TB as one of the differential diagnosis of lesions of the pharynx especially in those countries where TB is endemic.
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ranking = 86.880654342151
keywords = bacillus
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8/61. Cytologic features of disseminated bacillus Calmette-Guerin (BCG) infection.

    Disseminated bacillus Calmette-Guerin (BCG) infection is an unusual complication of immunization against mycobacterium tuberculosis with the bacillus Calmette-Guerin. We report on 4 such cases in which the diagnosis was suspected at the fine-needle aspiration biopsy (FNAB) procedure. Participants were 4 males (mean age, 21.5 mo; range, 8-36 mo) in good general condition, in whom epidemiology data favoring tuberculosis and presence of pulmonary tuberculosis were lacking. Cases 1 and 2 presented with a deep-seated subcutaneous nodule located near the left mamilla and lower aspect of the left scapula, respectively, resulting from lymph node involvement by BCG. Cases 3 and 4 presented as an osteolytic lesion of the ninth right rib and right iliac bone, respectively. FNAB findings showed poorly to moderately cellular smears. Epithelioid histiocytes in a granuloma pattern with occasional multinucleated Langerhans-type giant cells, lymphocytes, and polymorphonuclear leukocytes in a finely granular background with necrotic debris were found in all cases. The presence of isolated calcified spherules interspersed among the cells was found to be a useful finding for diagnosis. When dealing with disseminated BCG infections, clinical and cytological pictures must be evaluated as a whole in order to arrive at an accurate diagnosis.
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ranking = 521.2839260529
keywords = bacillus
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9/61. Unilateral bronchiectasis and esophageal dysmotility in congenital adult tracheoesophageal fistula.

    Tracheoesophageal fistulas (TEF) in adults are most commonly neoplastic, and very rarely congenital in nature. We report a 45-year-old Hispanic male with TEF and initial presentation of minimal hemoptysis. The patient had radiographic evidence of unilateral upper lobe (RUL) bronchiectasis, massive esophageal dilatation, and dysmotility. However, there was no evidence of esophageal malignancy, achalasia, or Chagas' disease. bronchoscopy revealed a large TEF in the posterior wall of trachea, which was not visualized on esophagram or esophagoscopy. bronchoalveolar lavage (BAL) cultures grew mycobacterium avium complex (MAC). Our report illustrates that idiopathic, or congenital, TEF can be associated with esophageal dysmotility, adulthood bronchiectasis, and atypical mycobacterial superinfection.
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ranking = 37.480329195474
keywords = avium, complex
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10/61. Disseminated BCG infection in a patient with severe combined immunodeficiency.

    Disseminated mycobacterial infection after bacillus Calmette-Guerin (BCG) vaccination is a very rare disorder, occurring mostly in patients with immunologic deficiency. We report a case of disseminated BCG infection in a 16-month-old girl with severe combined immunodeficiency. Plain radiographs showed multiple osteolytic lesions in the femora, tibiae, humerus, and phalanges. Abdominal sonography and CT scanning revealed multiple nodules in the spleen, and portocaval lymphadenopathy.
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ranking = 86.880654342151
keywords = bacillus
(Clic here for more details about this article)
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