Cases reported "Tuberculosis"

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1/608. Lymphocyte transformation test for the evaluation of adverse effects of antituberculous drugs.

    The usefulness of the lymphocyte transformation test (LTT) for the analysis of adverse reactions to antituberculous drugs was evaluated. - The LTT was performed with isoniazid and rifampicin in 15 tuberculosis and 2 MOTT (Mycobacteria other than tuberculosis)-infection patients who suffered drug reactions, in 23 patients without any adverse reactions, in 7 controls previously exposed to antituberculous drugs, and in 14 controls who had never been exposed. 4/15 of the hepatotoxic reactions only showed a positive LTT with rifampicin, 3/15 only with isoniazid, and in 8/15 the LTT was negative. In an anaphylactoid shock reaction the LTT was extremely exaggerated for both rifampicin and isoniazid. In patients without any side effects only one slightly increased LTT due to isoniazid was observed. Two healthy controls with previous contact to these drugs showed a positive LTT for isoniazid, one of those with both rifampicin and isoniazid. The LTT was negative in all control persons without any former contact to antituberculous medications. In most cases hepatotoxicity seems to be a pure toxic reaction without the participation of cellular immune mechanisms. LTT can be useful for identifying the drug responsible for immunological side effects.
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ranking = 1
keywords = tuberculosis
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2/608. Isolated tuberculosis of the pancreas after orthotopic liver transplantation.

    A patient presented with intermittent high fever, upper abdominal pain, and loss of appetite 9 months after an orthotopic liver transplantation. Computed tomography showed a large mass in the pancreas that was confirmed at laparotomy. Pathological examination of the pancreatic biopsy specimen showed several chronic granulomatous lesions with caseating necrosis. Two and one half months after beginning antituberculous treatment, there was an important reduction of the pancreatic mass.
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ranking = 2
keywords = tuberculosis
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3/608. Cat scratch disease diagnosed by polymerase chain reaction in a patient with suspected tuberculous lymphadenitis.

    We present a patient diagnosed as having tuberculous lymphadenitis after lymph node biopsy and referred for tuberculous therapy. On review, because of recent cat exposure, she was tested for cat scratch disease (CSD), but serological tests for bartonella henselae were negative. However, the diagnosis of CSD was confirmed, and tuberculosis excluded, by polymerase chain reaction techniques. This case serves as a reminder that CSD may mimic tuberculosis histologically and that sensitive molecular diagnostic tests are available.
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ranking = 1
keywords = tuberculosis
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4/608. Vascular changes in tuberculous meningoencephalitis.

    Our report refers two cases of tuberculous encephalomeningitis which differ in the course and pathological changes. In case 1 blood vessels showed features of peri, endo-, or panvasculites. In some vessels endothelium proliferation leading to the stenosis or obliteration of the vascular lumen was observed. necrosis was an effect of vessels occlusion. In case 2 many fewer vessel were involved in onflammation process. Vascular changes were also less extensive and were observed more rarely. Tuberculous infection often caused less tissue lesions than vascular changes. Different pathological changes probably depend on the type and virulence of Myobacterium tuberculosis and on the host immune response to the infection.
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ranking = 0.5
keywords = tuberculosis
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5/608. Nested polymerase chain reaction on vaginal smears of tuberculous cervicitis. A case report.

    BACKGROUND: Tuberculous cervicitis (TC) is a rare disease the diagnosis of which is based on the microscopic and/or cultural recognition of mycobacteria. In recent years, the polymerase chain reaction (PCR), especially with double-round amplification ("nested" PCR [nPCR]), has been increasingly used for rapid detection of mycobacteria in clinical samples. CASE: The present case is the first example of tuberculosis diagnosed with the aid of nPCR amplification of mycobacterial dna fragments on smeared and Papanicolaou-stained cytologic material. First detected on vaginal smears, the amplicon IS6110 was subsequently identified also on paraffin-embedded tissue sections. CONCLUSION: The technique described here could also be applied to aspiration cytology smears to give rapid and accurate information on mycobacterial infections.
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ranking = 0.5
keywords = tuberculosis
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6/608. Treatment of osteomyelitis by antibiotic impregnated porous hydroxyapatite block.

    A novel drug delivery system was developed for osteomyelitis using porous hydroxyapatite blocks (HA-b) that were impregnated with antibiotics by a centrifuge method. For the experimental study, a 10 mm3 HA-b was placed in a container, mixed with an antibiotic solution and centrifuged at 1500 rpm for 15 min for the purpose of impregnating antibiotics into the pores. The slow release activity of antibiotic (Arbekacin sulfate [1-N-(S)-4 amino-2-hydroxybutyryl dibekacin]) from the HA-b was tested. An evaluation was made of the slow-releasing capabilities of the ABK from HA-b which was still maintained at 0.5 microgram/ml within 21 exchanges of PBS after 42 days. Consequently, seven patients with osteomyelitis, including one with tuberculosis and two with infected hip arthroplasty, have been treated. On a follow-up study, all of the foci had completely healed by the end of the follow-up period without complications. This new method is simple and can be performed safety as a one-stage operation.
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ranking = 0.5
keywords = tuberculosis
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7/608. Tuberculosis treatment through directly observed therapy in a large multisite methadone maintenance treatment program: addressing the public health needs of a high-risk population.

    The rate of tuberculosis in patients receiving methadone treatment is significantly greater than the general population. The stabilization of former injection drug users occurs within methadone maintenance treatment programs, indicating the suitability of these sites for directly observed therapy (DOT). There are formidable barriers to the success of DOT, some are institutional, others patient-related. Strategies to address these obstacles need to be implemented. The integration of DOT into existing programs required support from the new york State Department of Health, institutional commitment, as well as continued staff and patient education and training.
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ranking = 0.5
keywords = tuberculosis
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8/608. familial mediterranean fever. No role of mycobacterium tuberculosis in ten patients.

    BACKGROUND: Tuberculosis (TB) and familial mediterranean fever (FMF) are two common diseases in our region, turkey. Both share some properties in common: Both cause AA type amyloidosis and have association with some immunological abnormalities. Upon incidentally observing mycobacterium tuberculosis in bone marrow biopsies of three patients with FMF in a previous study, we intended to elucidate this association prospectively. MATERIAL AND methods: In this study, we examined prospectively 10 FMF patients, 5 male and 5 female, with a median duration of 31 years disease activity. All were under colchicine therapy. They had no sign of renal involvement. The bone marrow biopsies of these patients were examined for the presence of M. tuberculosis by polymerase chain reaction (PCR), BACTEC culture and pathological stains. Pathological examination was performed for the existence of granuloma and amyloid deposition by hematoxylin-eosin, Crystal Violet and congo red stains. RESULTS: The examination of all bone marrow specimens by the mentioned methods suggest that mycobacterium tuberculosis has no role in the ethiopathogenesis of FMF. Although the patients had a positive family history of 60% for tuberculosis and in 80% of them with positive tuberculin skin test. CONCLUSIONS: We concluded that although there seemed to be a kind of association between both diseases, this relationship is not via the direct existence of bacteria itself. Considering high family history and skin test positivity, one should look for the presence of autoimmune mechanisms under this suspicious relationship between tuberculosis and FMF. Also, this is the first study examined the state of amyloidosis in the bone marrow at an earlier stage of FMF without overt renal findings.
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ranking = 4.5
keywords = tuberculosis
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9/608. 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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ranking = 1
keywords = tuberculosis
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10/608. cryptococcosis of thoracic vertebra simulating tuberculosis: diagnosis by fine-needle aspiration biopsy cytology--a case report.

    A rare case of cryptococcosis of sixth thoracic vertebra (T6) along with pulmonary involvement in an old diabetic patient is presented. The infection resulted in lytic lesion of T6 vertebra and girdle pain. A computerized tomographic (CT) guided fine-needle aspiration biopsy (FNAB) cytology was performed, which showed encapsulated fungal spores of cryptococcus neoformans with granulomatous reaction, later confirmed by fungal culture.
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ranking = 2
keywords = tuberculosis
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