Clinical Presentation of Pulmonary Tuberculosis in under 10s and Differences in AIDS-Related Cases: A Cohort Study of 115 Patients

1997 ◽  
Vol 27 (3) ◽  
pp. 139-142 ◽  
Author(s):  
J E Garay
Keyword(s):  
Pulmonary Tuberculosis ◽  
Hiv Infection ◽  
Gastric Lavage ◽  
Lower Lobe ◽  
Failure To Thrive ◽  
Warning Signs ◽  
Mantoux Test ◽  
Important Diagnostic Tool ◽  
Chronic Fever ◽  
Hiv Negative

One hundred and fifteen cases of pulmonary tuberculosis (PTB) in children under 10 were reviewed, including a case—control retrospective study between HIV positive (+ ve) and HIV negative (–ve) children. Overall, respiratory symptoms not responding to acute respiratory infection (ARI) protocol and >10% weight loss or failure to thrive during 3 months were the main presenting symptons, but chronic fever alone is also common in HIV infected children with PTB. Hylar enlargement is the most frequent radiologic pattern, although lobar infiltrates are common when HIV infection coexists. Gastric lavage culture was an important diagnostic tool but Mantoux test, gastric lavage direct smear and erythrocyte sedimentation rate (ESR) levels, were not helpful in diagnosing PTB. Our findings suggest that when HIV infection is suspected or confirmed, chronic fever and lower lobe infiltrates should also be considered as PTB warning signs.

scholarly journals Radiographic features of pulmonary tuberculosis in patients infected by HIV: is there an objective indicator of co-infection?

2001 ◽  
Vol 34 (4) ◽  
pp. 369-372 ◽  
Author(s):  
Maria de Fátima Militão de Albuquerque ◽  
Silvio Cavalcanti de Albuquerque ◽  
Antonio Roberto Leite Campelo ◽  
Marta Cruz ◽  
Wayner V. de Souza ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Hiv Infection ◽  
Radiological Finding ◽  
Tuberculin Test ◽  
University Hospital ◽  
Local Health ◽  
Appropriate Treatment ◽  
Immunodeficiency Virus ◽  
The University ◽  
Hiv Negative

This study aimed to compare the radiographic characteristics of patients with pulmonary tuberculosis (TB) and human immunodeficiency virus (HIV) infection with those of HIV-negative patients. In all, 275 TB patients attending the outpatients clinics at the University Hospital/UFPE, were studied from January 1997 to March 1999. Thirty nine (14.2%) of them were HIV+, with a higher frequency of males in this group (p=0.044). Seventy-five percent of the HIV+ patients and 19% of the HIV- had a negative tuberculin test (PPD) (p < 0.001). The proportion of positive sputum smears in the two groups was similar. The radiological finding most strongly associated with co-infection was absence of cavitation (p < 0.001). It may therefore be concluded that the lack of cavitation in patients with pulmonary TB may be considered a useful indicator of the need to investigate HIV infection. This approach could contribute to increasing the effectiveness of local health services, by offering appropriate treatment to co-infected patients.

scholarly journals Tuberculin diagnostics in pulmonary tuberculosis combined with HIV-infection

2012 ◽  
Vol 93 (4) ◽  
pp. 576-579
Author(s):  
E A Borodulina ◽  
N O Lebedeva ◽  
L V Povalyaeva ◽  
I IL Tsygancov ◽  
B E Borodulin
Keyword(s):  
Pulmonary Tuberculosis ◽  
Hiv Infection ◽  
Skin Prick Test ◽  
Screening Method ◽  
Risk Groups ◽  
Main Group ◽  
Mantoux Test ◽  
Intradermal Test ◽  
Control Group ◽  
Prick Test

Aim. To evaluate the sensitivity to tuberculin in patients with infiltrative pulmonary tuberculosis in combination with an infection, caused by the human immunodeficiency virus (HIV), using various different tests. Methods. Examined were patients with infiltrative pulmonary tuberculosis with HIV infection (134 patients, the main group) and without HIV infection (100 patients, control group). Tuberculin diagnostics included an intradermal Mantoux test with 2 tuberculin units, the skin prick test with a 100% solution of PPD-L and the intradermal test «Diaskintest». Results. In the main group, a positive reaction to the Mantoux test with 2 tuberculin units was reported significantly less frequently (56.0%) than in the comparison group (89.0%), the diagnostic value of the test decreased with a decrease in the number of CD4+ lymphocytes. The prick test was characterized by a complete correlation with the results of the Mantoux test, although having a number of advantages. The sensitivity of the «Diaskintest» in the main group was 48.3%, and in the control group - 84.6%, at the same time the sensitivity of the «Diaskintest» decreased to 17% in cases of pronounced immunodeficiency. Conclusion. The skin prick test can be used as a screening method for early detection of tuberculosis in HIV-infected individuals with CD4+ lymphocyte count of 300 cells in 1 ml or more with the aim of forming risk groups, followed by screening for tuberculosis.

scholarly journals Correlation between clinical and radiological presentation of pulmonary tuberculosis in children

2014 ◽  
Vol 42 (1) ◽  
pp. 21-24 ◽  
Author(s):  
T Karim ◽  
MSA Quarashi ◽  
MA Rahman
Keyword(s):  
Pulmonary Tuberculosis ◽  
Gastric Lavage ◽  
Lateral View ◽  
Mantoux Test ◽  
Night Sweats ◽  
Chest X Ray ◽  
Criteria For Diagnosis ◽  
Medical University ◽  
Tuberculosis In Children ◽  
Posterior Anterior

Pulmonary tuberculosis may be easily confused with other chest diseases during its initial presentation. This study was carried out to identify presenting clinical and laboratory features that differentiate pulmonary tuberculosis from other diseases and to correlate clinical features and radiological findings. This study was conducted in department of pediatrics and Radiology in Bangabandhu Sheikh Mujib Medical University and Dhaka Shihsu Hospital from July 2005 to June 2006. A total fifty Children below 18 were included in the study after being clinically diagnosed as pulmonary tuberculosis. These patients were subjected to detailed history and, clinical examination. Each patient was evaluated by blood CBC, ESR, Mantoux test, Chest X-ray posterior anterior/lateral view, BCG test and gastric lavage. Statistical analysis was performed by SPSS 8 computer program. Fever, cough, weight loss, night sweats and raised ESR were the most common findings in PTB children. No correlation was found between clinical and laboratory parameters in establishing a confident diagnosis of the disease. The study highlights the importance of further research to pinpoint stronger and more reliable criteria for diagnosis. DOI: http://dx.doi.org/10.3329/bmj.v42i1.18974 Bangladesh Med J. 2013 Jan; 42 (1): 21-24

scholarly journals Identification of tuberculosis in patients of pulmonology department, including patients with HIV infection

2021 ◽  
Vol 6 (2) ◽  
pp. 60-65
Author(s):  
Irina I. Dubrovskaya ◽  
Lyudmila A. Zenkova ◽  
Natalya V. Bagisheva ◽  
Anna V. Mordyk ◽  
Andrei Yu. Lobastov ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Clinical Laboratory ◽  
Full Range ◽  
Study Groups ◽  
Mantoux Test ◽  
Hiv Status ◽  
One Step ◽  
Group 2 ◽  
Hiv Negative ◽  
Group 1

Objectives to define the possibilities of diagnosing tuberculosis in patients of pulmonology hospital, including patients with HIV infection. Material and methods. During this retrospective one-step study, we analyzed 103 medical records of patients in pulmonology departments who had received a full range of laboratory and instrumental examinations, including the Mantoux test and the test with a recombinant tuberculosis allergen (Diaskintest). The patients were divided into two groups depending on their HIV status: Group 1 included 78 HIV-negative patients, Group 2 consisted of 25 HIV-positive patients. Results. A microscopy of sputum and bronchial lavage did not reveal acid-resistant mycobacteria in all patients. PCR test for M. tb DNA was positive in three patients in Group 1 (33.3 13.9% of the total number of examined patients) and in one patient in Group 2 (25.0 13.9%) (2 = 0.01; p = 0.931). According to the results of immunodiagnostics, a positive normergic reaction to the Mantoux test was observed in 24 patients in Group 1 and in 7 patients in Group 2 (30.8 5.2% and 28.9 9.0% respectively), 2 = 0.04; p = 0.846. The reaction for recombinant tuberculosis allergen (Diaskintest) was positive in 9 patients in Group 1 (11.5 3.6%) and in 5 patients in Group 2 (20.0 8.0%), 2 = 0.85; p = 0.358. Based on clinical, laboratory, instrumental and immunological examinations by a TB doctor, in total 12 patients (11.7%) were diagnosed with tuberculosis. These patients were distributed among the study groups as follows: 9 people (11.5 3.6%) in Group 1 and 3 people (12.0 6.5%) in Group 2 (2 = 0.0; p = 0.956). Conclusion. The inclusion of the Mantoux test and the reaction for recombinant tuberculosis allergen (Diaskintest) in the set of diagnostic tests for patients of the pulmonology department of the general hospital simplified the differential diagnosis of tuberculosis and pneumonia, both for a pulmonologist and a TB specialist.

Dependence of hitting the eye from immunological indicators in patients with pulmonary tuberculosis and HIV infection

2018 ◽  
pp. 13-16
Author(s):  
I.N. Voronova ◽  
◽  
V.M. Hokkanen ◽  
S.I. Sanaeva ◽  
M.V. Zhemkova ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Hiv Infection

Prevalence of ocular diseases in patients with pulmonary tuberculosis and HIV infection

2016 ◽  
Vol 64 (6) ◽  
pp. 29-31
Author(s):  
A. Zborovskaia ◽  
◽  
N. Konovalova ◽  
T. Pyl’kevich ◽  
A. Dorokhova ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Hiv Infection ◽  
Ocular Diseases

scholarly journals Misdiagnosis of chronic pulmonary aspergillosis as pulmonary tuberculosis at a tertiary care center in Uganda: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Richard Kwizera ◽  
Andrew Katende ◽  
Felix Bongomin ◽  
Lydia Nakiyingi ◽  
Bruce J. Kirenga
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Diagnostic Criteria ◽  
Tertiary Care ◽  
Chest Imaging ◽  
Resource Limited Settings ◽  
Pulmonary Aspergillosis ◽  
Resource Limited ◽  
Chronic Pulmonary Aspergillosis ◽  
Hiv Negative

Abstract Background Diagnosis of chronic pulmonary aspergillosis (CPA) is based on a combination of clinical symptomatology, compatible chest imaging findings, evidence of Aspergillus infection and exclusion of alternative diagnosis, all occurring for more than 3 months. Recently, a rapid, highly sensitive and specific point-of-care lateral flow device (LFD) has been introduced for the detection of Aspergillus-specific immunoglobulin (Ig)G, especially in resource-limited settings where CPA is underdiagnosed and often misdiagnosed as smear-negative pulmonary tuberculosis (PTB). Therefore, in our setting, where tuberculosis (TB) is endemic, exclusion of PTB is an important first step to the diagnosis of CPA. We used the recently published CPA diagnostic criteria for resource-limited settings to identify patients with CPA in our center. Case presentation Three Ugandan women (45/human immunodeficiency virus (HIV) negative, 53/HIV infected and 18/HIV negative), with a longstanding history of cough, chest pain, weight loss and constitutional symptoms, were clinically and radiologically diagnosed with PTB and empirically treated with an anti-tuberculous regimen despite negative microbiological tests. Repeat sputum Mycobacteria GeneXpert assays were negative for all three patients. On further evaluation, all three patients met the CPA diagnostic criteria with demonstrable thick-walled cavities and fungal balls (aspergilomas) on chest imaging and positive Aspergillus-specific IgG/IgM antibody tests. After CPA diagnosis, anti-TB drugs were safely discontinued for all patients, and they were initiated on capsules of itraconazole 200 mg twice daily with good treatment outcomes. Conclusions The availability of simple clinical diagnostic criteria for CPA and a LFD have the potential to reduce misdiagnosis of CPA and in turn improve treatment outcomes in resource-limited settings.

scholarly journals COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK

2021 ◽  
pp. sextrans-2020-054768
Author(s):  
Iain Hyndman ◽  
Diarmuid Nugent ◽  
Gary George Whitlock ◽  
Alan McOwan ◽  
Nicolò Girometti
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Sexual Activity ◽  
Sexual Behaviour ◽  
Well Being ◽  
Categorical Variables ◽  
Cross Sectional ◽  
The Impact ◽  
Mental Well Being ◽  
Hiv Negative

ObjectivesThe COVID-19 pandemic and its related restrictions have affected attendance to and delivery of UK sexual healthcare services (SHS). We surveyed the impact on sexual behaviour of men having sex with men (MSM) to inform future SHS provision.MethodsWe conducted a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk of HIV infection who attended 56 Dean Street, a sexual health and HIV clinic. The survey was conducted over a 7-day period in August 2020. Data on sociodemographic characteristics, sexual behaviour and related mental well-being experienced during lockdown (defined as 23 March–30 June 2020) were extracted. Categorical and non-categorical variables were compared according to HIV pre-exposure prophylaxis (PrEP) use.Results814 MSM completed the questionnaire: 75% were PrEP users; 76% reported they have been sexually active, of which 76% reported sex outside their household. 75% reported fewer partners than prior to lockdown. Isolation/loneliness (48%) and anxiety/stress (27%) triggered sexual activity, and 73% had discussed COVID-19 transmission risks with their sexual partners. While 46% reported no change to emotions ordinarily experienced following sex, 20% reported guilt for breaching COVID-19 restrictions. 76% implemented one or more changes to their sexual behaviour, while 58% applied one or more steps to reduce COVID-19 transmission during sex. 36% accessed SHS and 30% reported difficulties in accessing testing/treatment. Of those who accessed SHS, 28% reported an STI diagnosis. PrEP users reported higher partner number, engagement in ‘chemsex’ and use of SHS than non-PrEP users.ConclusionsCOVID-19 restrictions had a considerable impact on sexual behaviour and mental well-being in our survey respondents. High rates of sexual activity and STI diagnoses were reported during lockdown. Changes to SHS provision for MSM must respond to high rates of psychological and STI-related morbidity and the challenges faced by this population in accessing services.

Clinical outcomes of syphilis in HIV-negative and HIV-positive MSM: occurrence of repeat syphilis episodes and non-treponemal serology responses

2021 ◽  
pp. sextrans-2020-054887
Author(s):  
Silvia Achia Nieuwenburg ◽  
Ricardo Jamie Sprenger ◽  
Maarten Franciscus Schim van der Loeff ◽  
Henry John Christiaan de Vries
Keyword(s):  
Hiv Infection ◽  
Controlled Trial ◽  
Clinical Manifestations ◽  
Response To Treatment ◽  
Disease Stage ◽  
Hiv Positive ◽  
Sexual Risk Behaviour ◽  
Serological Response ◽  
History Of ◽  
Hiv Negative

ObjectivesHIV-positive men who have sex with men (MSM) may be at a higher risk of repeat syphilis, have different clinical manifestations and have a different serological response to treatment compared with HIV-negative MSM. The objective of this study was to assess whether HIV-negative and HIV-positive MSM with infectious syphilis (primary, secondary or early latent) differed in history of previous syphilis episodes, disease stage and non-treponemal titre of initial and repeat episodes, and the titre response 6 and 12 months after treatment. Furthermore, determinants associated with an inadequate titre response after treatment were explored.MethodsThis retrospective analysis used data of five longitudinal studies (four cohorts; one randomised controlled trial) conducted at the STI clinic in Amsterdam, the Netherlands. Participants were tested for syphilis and completed questionnaires on sexual risk behaviour every 3–6 months. We included data of participants with ≥1 syphilis diagnosis in 2014–2019. Pearson’s χ² test was used to compare HIV-negative and HIV-positive MSM in occurrence of previous syphilis episodes, disease stage of initial and repeat syphilis episode and non-treponemal titre treatment responses.ResultsWe included 355 participants with total 459 syphilis episodes. HIV-positive MSM were more likely to have a history of previous syphilis episodes compared with HIV-negative MSM (68/90 (75.6%) vs 96/265 (36.2%); p<0.001). Moreover, HIV-positive MSM with repeat syphilis were less often diagnosed with primary syphilis (7/73 (9.6%) vs 36/126 (28.6%)) and more often diagnosed with secondary syphilis (16/73 (21.9%) vs 17/126 (13.5%)) and early latent syphilis (50/73 (68.5%) vs 73/126 (57.9%)) (p=0.005). While not significantly different at 12 months, HIV-negative MSM were more likely to have an adequate titre response after 6 months compared with HIV-positive MSM (138/143 (96.5%) vs 66/74 (89.2%); p=0.032).ConclusionsIn repeat syphilis, HIV infection is associated with advanced syphilis stages and with higher non-treponemal titres. HIV infection affects the serological outcome after treatment, as an adequate titre response was observed earlier in HIV-negative MSM.

Abstract WP426: Subarachnoid Hemorrhage in patients infected with Human Immunodeficiency Virus

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Haralabos Zacharatos ◽  
Malik M Adil ◽  
Ameer E Hassan ◽  
Sarwat I Gilani ◽  
Adnan I Qureshi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Subarachnoid Hemorrhage ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Hiv Infection ◽  
The United States ◽  
Hiv Positive ◽  
Published Data ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Background: There is limited data regarding the unique attributes of ischemic stroke among patients infected with human immunodeficiency virus (HIV). There is no published data regarding the occurrence and outcomes of subarachnoid hemorrhage (SAH) among HIV infected persons. Methods: The largest all-payer Nationwide Inpatient Sample (NIS 2002-2010) data was used to identify and analyze all patients presenting with the primary diagnosis of SAH in the United States. Among this cohort, we identified the patients who were not HIV positive and those who were HIV positive. Patient demographics, medical co-morbidities, in-hospital complications, in-hospital procedures, and discharge disposition were compared between the two groups. The association between HIV infection and outcomes was evaluated in multivariate analysis after adjusting for potential confounders. Results: Of the 351,491 patients admitted with SAH, 1367 (0.39%) were infected with HIV. HIV infected patients were younger, mean age [±SD] of 45 ±14.2 years versus those who were not 58±19 years, (p<0.0001). The rate of blood transfusion [27,286 (7.8%) versus 245.6 (18%), p=0.0003], mechanical ventilation [51,199 (14.6%) versus 316.1(23.1%), p=0.008], and sepsis [14,644 (4.2%) versus 236.1 (17.3%), p<0.0001] was significantly higher among HIV infected patients. After adjusting for age, gender, hypertension, coagulopathy, atrial fibrillation, renal failure, and dyslipidemia, HIV negative patients had a significantly higher rate of discharge to home (odds ratio [OR] 1.9, 95% CI: 1.4-2.6, p<0.0001) and lower in-patient mortality (OR 0.4, 95% CI: 0.3-0.5, p<0.001). Further adjustment for blood transfusion and sepsis reduced the odds of discharge to home for the HIV negative patients, from 1.9 to 1.7 but did not affect in-hospital mortality. Conclusion: The in-hospital mortality in HIV infected patients with SAH is higher despite these patients being younger than non-HIV infected patients. We believe that this study provides a nationwide perspective which may have some important implications for early recognition and diagnosis of HIV-infection in SAH patients.

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