Cases reported "Tuberculosis"

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1/51. Transcontinental spread of multidrug-resistant mycobacterium bovis.

    Globally, the proportion of all cases of tuberculosis (TB) caused by drug-resistant strains is increasing. We report the case of a Canadian citizen who acquired a highly drug-resistant strain of mycobacterium bovis while visiting a relative with AIDS-related tuberculosis in spain. The origin of the strain was traced using spoligotyping, a polymerase chain reaction (PCR)-based fingerprint technology, and the European dna database. The level of primary drug resistance-all five first-line drugs and 19 of 21 second-line drugs-in this case was unprecedented in canada. Isolation of this strain from a Canadian citizen represents the first report of its appearance in this hemisphere. The infection was contained and combined medical-surgical treatment delivered.
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keywords = bovis
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2/51. 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 = bovis
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3/51. Nosocomial transmission of mycobacterium bovis bacille Calmette-Guerin to children receiving cancer therapy and to their health care providers.

    A previous report of nosocomial infection due to mycobacterium bovis bacille Calmette-Guerin (BCG) implicated contamination of chemotherapy solutions reconstituted under the same biosafety hood as bcg vaccine used for bladder cancer therapy. We report 3 similar BCG infections in children and describe evidence of respiratory transmission to health care workers (HCWs) from 1 patient. These children were receiving chemotherapy for leukemia when they presented with active tuberculosis. Each isolate was identified biochemically and by both gas-liquid chromatography and major polymorphic tandem repeat-polymerase chain reaction. Pulsed-field gel electrophoresis showed that 2 isolates were identical strains and identical to the Tice and Connaught strains licensed in the united states for bladder chemotherapy. The third isolate differed by a single fragment after DraI restriction. One patient with heavily positive sputum exposed numerous HCWs. Of 41 HCWs, 2 (5%) converted their purified protein derivatives (PPD) skin test. These data underscore the risk of nosocomial BCG transmission by contamination of chemotherapy solutions and demonstrate the potential for transmission to HCWs from patients with active pulmonary disease.
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ranking = 1
keywords = bovis
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4/51. Disseminated bacille Calmette-Guerin infection in an infant with a novel deletion in the interferon-gamma receptor gene.

    Six weeks after receiving BCG vaccination, a Canadian aboriginal infant presented with suspected sepsis, lymphadenopathy and hepatosplenomegaly. Lymph node biopsy revealed macrophages filled with acid-fast bacilli. mycobacterium bovis was cultured from tissue specimens and there was evidence of concomitant cytomegalovirus disease. The infant died of disseminated BCG infection. A novel deletion at nucleotide 165 in the interferon-gamma receptor (IFN-gammaR1) was identified. The incidence of this mutation in the aboriginal population and the impact on the heterozygous state are unknown.
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ranking = 0.2
keywords = bovis
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5/51. 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 = 5.1880035925152
keywords = mycobacterium
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6/51. 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 = 5.1880035925152
keywords = mycobacterium
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7/51. 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 = 0.66411244422898
keywords = bacillus, bovis
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8/51. 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 = 0.46411244422898
keywords = bacillus
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9/51. 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 = 2.7846746653739
keywords = bacillus
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10/51. 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 = 0.46411244422898
keywords = bacillus
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