Case of melioidosis misdiagnosed as pulmonary tuberculosis

2021 ◽  
Vol 14 (5) ◽  
pp. e242499
Author(s):  
Chitra Veluthat ◽  
Kavitha Venkatnarayan ◽  
Priyadarshini Padaki ◽  
Uma Maheswari Krishnaswamy
Keyword(s):  
Pulmonary Tuberculosis ◽  
Burkholderia Pseudomallei ◽  
Male Student ◽  
Response To Therapy ◽  
Morbidity And Mortality ◽  
Antitubercular Treatment ◽  
Microbiological Confirmation

Melioidosis is an endemic infection caused by Burkholderia pseudomallei predominantly reported in the coastal parts of India. A 19-year-old male student with no comorbidities presented with features suggestive of pneumonia. He was initiated on antitubercular treatment empirically elsewhere. However, due to lack of response to therapy diagnosis was revisited. Microbiological investigations were unyielding initially. Despite antitubercular treatment, he presented with complications of pneumonia and was diagnosed to have melioidosis. He was initiated on appropriate antibiotics for the intensive and eradication phase. Obtaining microbiological confirmation is of utmost importance to prevent misdiagnosis and undue morbidity and mortality due to these uncommon infections.

scholarly journals A rare case of pleural effusion due to Acinetobacter junii in a known patient of pulmonary tuberculosis

2018 ◽  
Vol 6 (2) ◽  
pp. 726
Author(s):  
Mousumi Kilikdar ◽  
Nitin A. Ambhore ◽  
Divya S. Shekokar ◽  
Rajesh P. Karyakarte
Keyword(s):  
Pleural Effusion ◽  
Pulmonary Tuberculosis ◽  
Rare Case ◽  
Blood Stream ◽  
Paediatric Oncology ◽  
Tuberculosis Patient ◽  
Blood Stream Infections ◽  
Acinetobacter Junii ◽  
Antitubercular Treatment ◽  
Heterogenous Group

The genus Acinetobacter comprises a heterogenous group of bacterias that are mostly pandrug resistant and implicated in variety of nosocomial infections. Acinetobacter junii is a rare human pathogen and is mainly associated with blood stream infections in paediatric oncology patients. We report a rare case of pleural effusion caused by A. junii in a known pulmonary tuberculosis patient who was on cat-1 antitubercular treatment.

Clinical Features, Diagnosis, and Treatment of Tuberculosis in Infants

PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. 1-7
Author(s):  
Jesus G. Vallejo ◽  
Lydia T. Ong ◽  
Jeffrey R. Starke
Keyword(s):  
United States ◽  
Pulmonary Tuberculosis ◽  
Skin Testing ◽  
Extrapulmonary Tuberculosis ◽  
The United States ◽  
Response To Therapy ◽  
Tuberculin Skin Testing ◽  
Gastric Aspirate ◽  
Directly Observed Therapy ◽  
Contact Investigation

Objective. Despite the recent resurgence of tuberculosis among children in the United States, no series of infants <1 year of age with tuberculosis has been reported in the last 20 years. This study was undertaken to describe the epidemiology, clinical, and radiographic manifestations, and response to therapy in infants <1 year of age with tuberculous disease. Methods. The medical records were reviewed for all infants age 12 months or less with a diagnosis of tuberculosis and cared for at the Children's Tuberculosis Clinic at Ben Taub General Hospital in Houston, Texas between January 1, 1985 and June 30, 1992. Results. Of the 47 infants identified, 51% were female. The median age at diagnosis was 8 months (range 3.5 to 12 months). Fifty-one percent of the infants were African-American and over one-third were Hispanic. All patients were born in the United States. Diagnosis resulted from the examination of an ill infant in 79% of cases, a case contact investigation of an adult suspected of having tuberculosis in 19%, and routine tuberculin skin testing in 2%. An adult with infectious tuberculosis who had contact with the infant was identified in 68% of cases. Intrathoracic disease alone was present in 70% of cases. Fourteen (30%) infants had extrapulmonary tuberculosis (11 central nervous system disease, 2 disseminated disease, and 1 cervical adenitis). Gastric aspirate cultures yielded Mycobacterium tuberculosis from 75% of the infants with isolated intrathoracic disease. Forty-five infants successfully completed therapy and only one death was directly related to tuberculosis. Forty-eight percent of the infants with pulmonary tuberculosis were treated with a 6-month regimen consisting of isoniazid and rifampin supplemented during the first 2 months by pyrazinamide. Eighteen infants received some twice weekly directly observed therapy mainly due to documented or suspected nonadherence. Treatment was well-tolerated; one patient (2%) developed hepatotoxicity due to isoniazid. No infant had a relapse or recurrence of disease in 6 months to 7 years follow-up for a median of 3 years (range, 6 months to 7 years). Conclusion. Most infants with tuberculosis are symptomatic at the time of diagnosis, and bacteriologic confirmation was obtained in 70% of cases. A contact investigation of the household should be initiated immediately when an infant is suspected of having tuberculosis because valuable information needed to establish the diagnosis and guide therapy in the infant may be obtained. Intensive 6-month and twice weekly directly observed therapy appear to be well-tolerated and effective for the treatment of pulmonary tuberculosis in infants.

scholarly journals Trends in sputum smear conversion among smear-positive pulmo-nary tuberculosis patients

2015 ◽  
Vol 4 (1) ◽  
pp. 24-33
Author(s):  
SEK Acquah ◽  
L Quaye ◽  
W Walana ◽  
EK Vicar ◽  
YN Osei ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Significant Proportion ◽  
Response To Therapy ◽  
Sputum Smear ◽  
Patient Response ◽  
Important Indicator ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Conversion Rates

Sputum smear conversion during pulmonary tuberculosis treatment is an important indicator of patient response to therapy and as such determines the direction of TB patient care. This retro-spective review assessed the trends in sputum smear evaluation and conversion rates among follow up pulmonary tuberculosis patients presenting to the Tamale Teaching Hospital from January 2004 to December 2012. A total of 8,238 sputum smear cases comprising of 6,892 (83.7%) diagnoses and 1,346 (16.3%) follow-up cases were recorded. The 1,346 follow-up cases comprised of 57.8% (778/1346) males and 42.2% (568/1346) females. The percentage proportion of follow up cases that had their month of follow up, residential addresses, ages and smear results reported are 93.8% (1262/1346), 95.2% (1281/1346), 98.2% (1322/1346) and 97.8% (1309/1346) respectively. The cumula-tive median age was 43years (IQR: 30 to 55years) with the minimum and maximum ages being 14 and 80 years recorded in 2008 and 2012 respectively. Thirty eight percent (511/1,346) of follow-up cases were from the intensive phase (month 2) evaluation period. One hundred and eleven (111) of the follow up cases were smear positive representing a cumulative positivity rate of 8.5% (111/1309). This comprised of 75(67.6 %) males and 36(32.4%) females. Generally males were observed to be significantly more likely to delay smear conversion during treatment (OR = 1.560; p = 0.035, 95% CI=1.032- 2.359) compared to females. The ages of the positive cases ranged from 14 to 75 years with a median age of 45.5 years. The intensive phase (month 2) positivity rate was 8.1% (63/776) representing a conversion rate of 91.9%. Significant proportion (15.4%) of males were smear posi-tive and were more likely to remain positive after two months of therapy compared to their female counterparts (OR = 2, p = 0.02, CI = 0.098 – 1.299). Periodic surveillance of regional sputum smear late/non conversion among PTB patients on treatment would be useful in supporting Tb manage-ment in Ghana.Keywords: Mycobacterium tuberculosis, follow up, microscopy, acid fast bacilli, Ghana

Pulmonary tuberculosis: could tumor markers CA 15-3 and CA 125 be useful for diagnosis and evaluation of response to therapy?

2017 ◽  
Vol 27 (1) ◽  
pp. 107-114
Author(s):  
Ehsan Rizk ◽  
Ehab Badran Rakha ◽  
Azema Abd El-Rahman ◽  
Walaa Othman Elshabrawy ◽  
Niveen Saudy
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tumor Markers ◽  
Response To Therapy ◽  
Ca 125

scholarly journals A Trial of the Effect of Micronutrient Supplementation on Treatment Outcome, T Cell Counts, Morbidity, and Mortality in Adults with Pulmonary Tuberculosis

2008 ◽  
Vol 197 (11) ◽  
pp. 1499-1505 ◽  
Author(s):  
Eduardo Villamor ◽  
Ferdinand Mugusi ◽  
Willy Urassa ◽  
Ronald J. Bosch ◽  
Elmar Saathoff ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
T Cell ◽  
Pulmonary Tuberculosis ◽  
Morbidity And Mortality ◽  
Micronutrient Supplementation ◽  
Cell Counts
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