Pulmonary Tuberculosis

2016 ◽  
Author(s):  
Bhakti Hansoti
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Blood Test ◽  
Clinical Specimen ◽  
X Ray ◽  
Retrosternal Pain ◽  
Night Sweats ◽  
Chest X Ray ◽  
Latent Tb ◽  
Latent Tb Infection

Mycobacterium tuberculosis (TB) is most commonly known for its manifestations in the lungs; symptoms include fever and chest pain (retrosternal pain and/or dull intracapsular pain). In the reactivation stage of TB, typical symptoms may include cough, weight loss, fatigue, fever, night sweats, chest pain, dyspnea, and/or hemoptysis. Symptoms may remain undiagnosed for several years. Poverty, HIV, and drug resistance are major contributors to the resurging global TB epidemic. Two kinds of tests are used to detect TB: the tuberculin skin test or a TB blood test. These tests only tell you if a person has been infected with the bacteria. The do not differentiate between latent TB infection and active TB. This distinction clinically suspected when the clinical picture of active TB matches with initial investigations (such as acid-fast bacilli stains, chest x-ray, or CT) and is definitively confirmed by the growth of M. tuberculosis in a clinical specimen.

scholarly journals Differences and similarities between the symptoms and clinical signs in patients with pulmonary tuberculosis and pneumonia

2019 ◽  
Vol 76 (2) ◽  
pp. 192-201
Author(s):  
Sonja Smiljic ◽  
Blagica Radovic ◽  
Aleksandra Ilic ◽  
Goran Trajkovic ◽  
Sladjana Savic ◽  
...  
Keyword(s):  
Weight Loss ◽  
Chest Pain ◽  
Pulmonary Tuberculosis ◽  
Rural Areas ◽  
Clinical Signs ◽  
Developed Countries ◽  
X Ray ◽  
Increased Risk ◽  
Night Sweats ◽  
Chest X Ray

Background/Aim. Tuberculosis in the second decade of the 21st century is an infectious disease with the highest mortality rate. In addition, in developed countries, pneumonia is the major couse of morbidity and mortality in adults. The aim of our study was to point out the differences and similarities between symptoms, laboratory parameters and clinical indicators in patients with pulmonary tuberculosis (PTB) and patients with pneumonia in the general population and in people belonging to the high risk groups for developing tuberculosis. Methods. This prospective study included patients with PTB (n = 70) and pneumonia (n = 75) treated at the Pulmonology Department of Clinical Hospital Center in Kosovska Mitrovica. Results. PTB was more frequent in men, 30?39 years of age (OR; 6:08), mainly from rural areas (p = 0.001), and with lower levels of education (p = 0.031). Pneumonia was more frequent in women older than 60 years of age (p = 0.0012). Night sweats (p = 0.001) and weight loss (p = 0.062) were significantly more frequent in patients with PTB, while chest pain (p = 0.001) and high temperature (p = 0.036) were more common in patients with pneumonia. X-ray changes in patients with PTB were located in the upper fields (p = 0.001), or appeared to be bilateral (p = 0.004). The strongest predictor associated with an increased risk of night sweats was diagnosed PTB (OR = 30.0). The chest pain was a predictor of pneumonia, unilateral changes (OR = 4.65) in the lower lung fields (OR = 0.08). Conclusion. Night sweats, weight loss and chest X-ray abnormalities in upper fields were significant indicators of PTB. Chest pain, fever and chest X-ray abnormalities in lower fields were significant indicators of pneumonia.

scholarly journals 806. 2013–2015 Nationwide Tuberculosis Contact Investigation in Childcare Centers and Schools in Korea

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S289-S289
Author(s):  
Woosuck Suh ◽  
Jong-Hyun Kim ◽  
Ji Hyen Hwang ◽  
Sodam Lee ◽  
Kang-Hee Lee ◽  
...  
Keyword(s):  
School Setting ◽  
Age Groups ◽  
Disease Status ◽  
Childcare Centers ◽  
X Ray ◽  
Contact Investigation ◽  
Chest X Ray ◽  
Latent Tb ◽  
The Republic ◽  
Latent Tb Infection

Abstract Background The Republic of Korea has the highest incidence rate of tuberculosis (TB) among members of the OECD, reported as 78.8/100,000 population in 2016. In response, a state-run intensive contact investigation for TB is being conducted. More effective TB control requires an epidemiologic emphasis on the diagnosis and treatment of latent TB infections in children and adolescents, compared with other age groups. Here we present an analysis of data from the childcare center and school contact investigation by the Korea Centers for Disease Control and Prevention (CDC) in 2013–2015. Methods Data collected from index patients included age, sex, occupation, disease status, results of AFB smear/culture, and chest x-ray. Data collected from contacts included age, sex, results of serial tuberculin skin test (TST), and chest x-ray. Congregate settings included childcare centers, kindergartens, elementary and secondary schools, and age groups were stratified as follows: 0–4 years, 5–12 years, and 13–18 years. TSTs were considered positive if induration ≥10 mm on the first test (TST1) or demonstrated an increase ≥6 mm over the induration of TST1 on repeat testing after 8 weeks (TST2). Results Of the 197,801 subjects with data collected, 173,998 were eligible and included in our analysis. TST1 results were available for 159,346 (91.6%) and when results were positive, induration was 10–14 mm in 7.6% and ≥15 mm in 1.5%. TST2 results were available for 119,797 (82.7%) of the 144,904 with negative TST1, and conversion rate was 9.0%. Altogether considering TST1 and TST2, 17.3% contacts had latent TB infections. Positive rates of TST significantly decreased with age: 20.3% in 0–4 years, 18.8% in 5–12 years, 17.1% in 13–18 years. Conclusion In this 3-year school-setting contact investigation, 17.3% contacts were diagnosed with latent TB infection, as demonstrated by TST reactions. Positive rates of TST significantly but mildly decreased with age. Disclosures All authors: No reported disclosures.

scholarly journals Increased mRNA Expression of Key Cytokines Among Suspected Cases of Pneumocystis Jirovecii Infection

2020 ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokines mRNA expression among suspected P. jirovecii infection.Methods: This was a cross-sectional analytic study undertaken in Aseer region, Saudi Arabia. A 100 suspected PCP cases and a 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by the immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results: Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to control. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrates, patchy infiltrates, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p<0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with the weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p<0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed with cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4 and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4 and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negatives cases. Conclusion: Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Increased mRNA expression of key cytokines among suspected cases of Pneumocystis jirovecii infection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokine mRNA expression among suspected P. jirovecii infection. Methods This was a cross-sectional analytical study undertaken in Aseer region, Saudi Arabia. One hundred suspected PCP cases and 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to controls. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrate, patchy infiltrate, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p< 0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p< 0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed in cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4, and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4, and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negative cases. Conclusion Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Increased mRNA expression of key cytokines among suspected cases of Pneumocystis jirovecii infection

2021 ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokine mRNA expression among suspected P. jirovecii infection.Methods: This was a cross-sectional analytical study undertaken in Aseer region, Saudi Arabia. 100 suspected PCP cases and 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results: Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to controls. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrate, patchy infiltrate, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p<0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p<0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed in cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4, and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4, and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negative cases. Conclusion: Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Pulmonary Tuberculosis Screening in Patients with Diabetes Mellitus

2019 ◽  
Vol 26 (2) ◽  
pp. 159-168
Author(s):  
Adela-Gabriela Firănescu ◽  
Maria Moța
Keyword(s):  
Diabetes Mellitus ◽  
Pulmonary Tuberculosis ◽  
X Ray ◽  
Type 2 Dm ◽  
Chest X Ray ◽  
Latent Tb ◽  
Latent Tb Infection ◽  
Type 1 Dm

Abstract Background and aims: Diabetes mellitus (DM) is a risk factor for pulmonary tuberculosis (TB), increasing the risk of progression of latent tuberculosis infection (LTBI) to active TB threefold, threatening the TB control, especially in developing countries. The aim of this study was to assess active and latent TB infection frequency in patients with DM. Material and methods: There were enrolled in this study 503 adult DM patients. Active TB screening was performed through anamnestic data, clinical examination and chest X-ray and latent TB infection screening was evaluated using the tuberculin skin tests (TST). Results: A number of 63 (12.5%) patients had type 1 DM and 440 (87.5%) had type 2 DM. Personal history of TB was present in 21 (4.2%) subjects, 5 (8.1%) with type 1 DM and 16 (3.6%) with type 2 DM. The TST was positive in 258 (51.5%) patients and 54 (10.7%) presented cough for more than two weeks at the time of examination. The chest X-ray revealed suggestive lesions for active TB in 4 (1%) subjects and lesions of inactive TB in 90 (22.4%) subjects. Conclusions: TB screening must receive proper attention in patients with DM, being essential for diagnosis in those with nonspecific symptoms.

scholarly journals Increased mRNA expression of key cytokines among suspected cases of Pneumocystis jirovecii infection

2020 ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokines mRNA expression among suspected P. jirovecii infection.Methods: This was a cross-sectional analytic study undertaken in Aseer region, Saudi Arabia. A 100 suspected PCP cases and a 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by the immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results: Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to control. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrates, patchy infiltrates, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p<0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with the weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p<0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed with cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4 and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4 and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negatives cases. Conclusion: Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Prevalence of latent tuberculosis infection and feasibility of TB preventive therapy among Thai prisoners: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sivaporn Gatechompol ◽  
Weerakit Harnpariphan ◽  
Ruamthip Supanan ◽  
Gompol Suwanpimolkul ◽  
Jiratchaya Sophonphan ◽  
...  
Keyword(s):  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Preventive Therapy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ltbi Prevalence ◽  
History Of ◽  
Chest X Ray ◽  
Latent Tb ◽  
Latent Tb Infection

Abstract Background Prisons are considered as major reservoirs for tuberculosis. Preventive therapy for latent TB infection (LTBI) is an adjunctive strategy to control TB. However, LTBI data in Thai prisoners is limited. This study assessed the prevalence of LTBI and feasibility of isoniazid preventive therapy (IPT). Methods A cross-sectional study was conducted among prisoners in Klong Prem Central Prison, Bangkok. Participants were screened for active TB by questionnaire and chest X-ray. LTBI was evaluated by Tuberculin skin test (TST) and QuantiFERON-TB Gold Plus (QFTP) among subgroup. Participants with positive TST or QFTP were considered to have LTBI. Participants with LTBI were offered IPT. Results From August 2018–November 2019, 1002 participants were analyzed. All participants were male with a median age of 38 (IQR 32–50) years. LTBI identified by either TST/QFTP was present in 466 (46.5%) participants. TST was positive in 359 (36%) participants. In the subgroup of 294 participants who had both TST and QFTP results, 181/294 (61.6%) tested positive by QFTP. Agreement between TST and QFTP was 55.1% (Kappa = 0.17). The risk factors associated with LTBI were previous incarceration (aOR 1.53, 95%CI, 1.16–2.01, p = 0.002), history of prior active TB (aOR 3.02, 95%CI, 1.74–5.24, p < 0.001) and duration of incarceration ≥10 years (aOR 1.86, 95%CI, 1.24–2.79, p = 0.003). Majority of LTBI participants (82%) agreed to take IPT. Three hundred and 56 (93%) participants completed treatment whereas 27 (7%) participants discontinued IPT due to the side effects of INH. Conclusion This is the first study to evaluate the prevalence of LTBI and feasibility of IPT among Thai prisoners. LTBI prevalence in male prisoners in Thailand is high. LTBI screening and treatment should be implemented together with other preventive components.

Suggests More Tests for Chest Pain Diagnosis

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 143-144
Author(s):  
Michael F. Elmore ◽  
Glen A. Lehman
Keyword(s):  
Chest Pain ◽  
Physical Examination ◽  
Pediatric Patients ◽  
Laboratory Studies ◽  
Psychiatric Interview ◽  
X Ray ◽  
Pain Diagnosis ◽  
Chest X Ray ◽  
Pain Characteristics ◽  
Diagnostic Work

Driscoll et al. (Pediatrics 57:648, May 1976) reported a series of 43 patients with chest pain evaluated by history and physical examination, psychiatric interview, screening laboratory studies, ECG, and chest x-ray film. No organic cause was identified in 45% of patients, and various psychiatric aspects of the pain were discussed. The history obtained from pediatric patients is often suboptimal, and specific pain characteristics and associations cannot be defined. We therefore propose that more vigorous diagnostic work-ups are necessary before chest pain can be classed as "idiopathic."

scholarly journals Pneumomediastinum in Blunt Chest Trauma: A Case Report and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gregory Mansella ◽  
Roland Bingisser ◽  
Christian H. Nickel
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Common Mechanism ◽  
Cervical Trauma ◽  
X Ray ◽  
Retrosternal Pain ◽  
Chest X Ray ◽  
Bedside Diagnosis

Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to blunt chest trauma after jumping from a bridge into a river. He complained of persistent retrosternal pain with exacerbation during deep inspiration. Physical examination showed only a slight tenderness of the sternum and the extended Focused Assessment with Sonography for Trauma (e-FAST) was normal. Pneumomediastinum was suspected by chest X-ray and confirmed by computed tomography, which showed a lung contusion as probable cause of the pneumomediastinum due to the “Mackling effect.” Sonographic findings consistent with pneumomediastinum, like the “air gap” sign, are helpful for quick bedside diagnosis, but the diagnostic criteria are not yet as well established as for pneumothorax. This present case shows that despite minimal findings in physical examination and a normal e-FAST a pneumomediastinum is still possible in a patient with chest pain after blunt chest trauma. Therefore, pneumomediastinum should always be considered to prevent missing major aerodigestive injuries, which can be associated with a high mortality rate.

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