scholarly journals Supraclavicular Scrofuloderma: A Diagnostic Challenge without Apparent Clinical Manifestations of Tuberculosis

2021 ◽  
pp. 356-359
Author(s):  
Yusuke Yoshioka ◽  
Takeshi Namiki ◽  
Tsukasa Ugajin ◽  
Keiko Miura ◽  
Hiroo Yokozeki
Keyword(s):  
Computed Tomography ◽  
Pulmonary Tuberculosis ◽  
Jugular Vein ◽  
Clinical Manifestations ◽  
Diagnostic Challenge ◽  
Cutaneous Manifestations ◽  
X Ray ◽  
High Density Area ◽  
Chest X Ray ◽  
The Common

Scrofuloderma is one of the cutaneous manifestations of tuberculosis and usually occurs when underlying tuberculosis such as lymphadenitis directly involves the skin. However, the diagnosis of scrofuloderma without other apparent clinical manifestations of tuberculosis is sometimes challenging. A 27-year-old male from Bangladesh presented with a dome-shaped tumor on his right clavicle. MRI showed a high-density area that expanded from the lymph nodes between the internal jugular vein and the common carotid artery into the tumor on his right clavicle. Bacterial examinations of cultures from the tumor detected <i>Mycobacterium tuberculosis</i>. Further examinations for pulmonary tuberculosis including chest X-ray and computed tomography did not detect any lesions suggestive of pulmonary tuberculosis. From those examinations, the diagnosis of scrofuloderma was made. We emphasize the importance of recognizing a variety of clinical manifestations of tuberculosis including scrofuloderma due to the recent increase of immigrants from developing countries.

scholarly journals Diagnostic Strategies for Recurrent Cervical Cancer: A Cohort Study

2020 ◽  
Vol 10 ◽  
Author(s):  
Xiaopei Chao ◽  
Junning Fan ◽  
Xiaochen Song ◽  
Yan You ◽  
Huanwen Wu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Cancer ◽  
Clinical Manifestations ◽  
Primary Treatment ◽  
Diagnostic Methods ◽  
Survival Outcomes ◽  
Recurrent Cervical Cancer ◽  
X Ray ◽  
Diagnostic Strategies ◽  
Chest X Ray

ObjectiveThe effectiveness of various strategies for the post-treatment monitoring of cervical cancer is unclear. This pilot study was conducted to explore recurrence patterns in and diagnostic strategies for patients with uterine cervical cancer who were meticulously followed using a customized monitoring plan.MethodsThe epidemiological and clinical data of patients with recurrent cervical cancer treated from March 2012 to April 2018 at a tertiary teaching hospital were retrospectively collected. The diagnostic methods and their reliability were compared across patients with various clinicopathological characteristics and were associated with survival outcomes.ResultsTwo hundred sixty-four patients with recurrent cervical cancer were included in the study, among which recurrence occurred in the first three years after the last primary treatment in 214 patients (81.06%). Half of the recurrence events (50.76%) occurred only within the pelvic cavity, and most lesions (78.41%) were multiple in nature. Among all recurrent cases, approximately half were diagnosed based on clinical manifestations (n=117, 44.32%), followed by imaging examinations (n=76, 28.79%), serum tumor markers (n=34, 12.88%), physical examinations (n=33, 12.50%) and cervical cytology with or without high-risk human papillomavirus (hrHPV) testing (n=4, 1.52%). The reliability of the diagnostic methods was affected by the stage (p&lt;0.001), primary treatment regimen (p=0.001), disease-free survival (p=0.022), recurrence site (p=0.002) and number of recurrence sites (p=0.001). Primary imaging methods (sonography and chest X-ray) were not inferior to secondary imaging methods (computed tomography, magnetic resonance imaging and positron emission tomography-computed tomography) in the detection of recurrence. The chest X-ray examination only detected three cases (1.14%) of recurrence. Patients assessed with various diagnostic strategies had similar progression-free and overall survival outcomes.ConclusionsA meticulous evaluation of clinical manifestations might allow recurrence to be discovered in a timely manner in most patients with cervical cancer. Specific diagnostic methods for revealing recurrence were not associated with the survival outcomes.

scholarly journals High resolution computed tomography and chest x-ray findings in patient with pulmonary tuberculosis

2019 ◽  
Vol 9 (4) ◽  
pp. 32-34
Author(s):  
Chiranjibi Pant ◽  
Anusmriti Pal ◽  
Manoj Kumar Yadav ◽  
Bishow Kumar Shrestha
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Pulmonary Tuberculosis ◽  
Public Health Problem ◽  
Tuberculosis Patient ◽  
Major Public Health Problem ◽  
Radiological Findings ◽  
High Resolution Computed Tomography ◽  
X Ray ◽  
Chest X Ray

Background: Pulmonary Tuberculosis (PTB) is a major public health problem in Nepal. Diag­nosis of pulmonary tuberculosis is done by bacteriological confirmation of respiratory speci­men however Negative smear needs clinical and radiological evaluation for the diagnosis in suspected patient. This study focuses on radiological findings in both Pulmonary bacterio­logically confirmed (PBC) and pulmonary clinically diagnosed (PCD) Tuberculosis. Methods: This observational study was conducted at Chitwan Medical College between Feb 2019 to July 2019. 45 Patient diagnosed with PTB were enrolled. Chest X-ray (CXR) and High Resolution Computed Tomography (HRCT) chest reports were analysed for the presence of findings that suggest active infection like cavity, consolidation, tree in bud, etc in PBC and PCD. Results: A total of 45 PTB patients with mean age: 54.60 ± 19 years were included. 53.3 % were PBC and 46.7 % were PCD tuberculosis, CXR findings in PBC and PCD tuberculosis was nodular infiltrate 45.8% versus 2.4%, consolidation 45% versus 42.9%, cavity 8.3% versus 14.3% respectively however 12.5% PBC tuberculosis patient had a normal chest x-ray. HRCT chest in PBC and PCD showed cavity in 45.8% versus 23%, tree in bud 25% versus 52.4%, con­solidation 62.5 versus 57.1%, ground glass opacity 29.2% versus 23.8% respectively and none of the HRCT chest was normal. In comparison to the CXR, HRCT chest shows more cavitary lesions in PBC and tree in bud was more common in PCD. Conclusions: This study has found that radiological findings suggestive of active PTB was more obvious in HRCT than CXR. Presence of cavity, lobar consolidation and tree in bud lesion in HRCT chest were more frequently observed in both PBC and PCD Tuberculosis.

scholarly journals Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş
Keyword(s):  
Computed Tomography ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Scoring System ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
X Ray ◽  
Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

scholarly journals A simple, valid, numerical score for grading chest x-ray severity in adult smear-positive pulmonary tuberculosis

Thorax ◽  
2010 ◽  
Vol 65 (10) ◽  
pp. 863-869 ◽  
Author(s):  
A. P. Ralph ◽  
M. Ardian ◽  
A. Wiguna ◽  
G. P. Maguire ◽  
N. G. Becker ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
X Ray ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Chest X Ray

HIV-TUBERCULOSIS: A STUDY OF CHEST X-RAY PATTERNS IN RELATION TO CD4 COUNT

2021 ◽  
pp. 10-12
Author(s):  
Abdhesh Kumar ◽  
Naveen Kumar ◽  
Kumar Sourav
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Hospital ◽  
Hiv Positive ◽  
Who Guidelines ◽  
X Ray ◽  
Ciency Virus ◽  
Chest X Ray ◽  
Radiological Patterns ◽  
High Index Of Suspicion ◽  
Ray Patterns

Background: Fight against human immunodeciency virus (HIV) is incomplete without addressing problems associated with difcult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. Aim: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. Materials and Methods: Prospective cohort study was conducted in a tertiary hospital in J.L.N.M.C.H Bhagalpur from april 2019 to january 2021 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. Results: 27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33%) among CD4 less than 200 as compared to CD4 more than 200 (14%). Inltration (39%) followed by consolidation (30%), cavity (11%), and lymphadenopathy (9%) seen with CD4 less than 200. Inltration (37.5%) followed by cavity (25%) and miliary (25%) with CD4 above 200. Bilateral (68.5%) and mid and lower zones or all zone involvement more commonly seen. Conclusion: In patients with CD4 lower than 200 noncavitory inltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement was higher than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIVpositive patients.

scholarly journals S77 Pre-treatment Chest X-ray Severity And Its Relation To Bacterial Burden In Pulmonary Tuberculosis

Thorax ◽  
2014 ◽  
Vol 69 (Suppl 2) ◽  
pp. A43-A43
Author(s):  
S. Murthy ◽  
F. Chatterjee ◽  
P. Phillips ◽  
S. Murray ◽  
T. McHugh ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bacterial Burden ◽  
X Ray ◽  
Chest X Ray ◽  
Pre Treatment

Differential diagnosis of hemoptysis

2021 ◽  
pp. 47-55
Author(s):  
Petr Arkadievich Ilyin
Keyword(s):  
Infectious Disease ◽  
Computed Tomography ◽  
Lung Cancer ◽  
Differential Diagnosis ◽  
Correct Interpretation ◽  
Diagnostic Investigation ◽  
Detailed History ◽  
X Ray ◽  
Chest X Ray ◽  
Upper Gastrointestinal

Blood expectoration or hemoptysis is the coughing up of sputum with blood from the larynx, bronchi or lungs. Hemoptysis is most often caused by diseases of the respiratory tract and lungs — bronchitis or pneumonia, as well as lung cancer, aspergilloma, tuberculosis, bronchiectasis, pulmonary embolism, etc. In the diagnostic investigation of the cause of hemoptysis, it is important to take a detailed history (in the case of an epidemiological history, a laboratory analysis of the secreted sputum for the detection of the causative agent of an infectious disease is necessary), to make the correct interpretation of the patient’s complaints and an assessment of the nature of the sputum (differential diagnosis with bleeding from the upper gastrointestinal tract). A chest X-ray is performed and, then, if indicated, computed tomography, bronchoscopy, and other studies are made. The article presents an algorithm for differential diagnostic investigation of hemoptysis in a patient

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