Tuberculosis in HIV Seropositive Individuals—A Retrospective Analysis

1992 ◽  
Vol 3 (1) ◽  
pp. 38-41 ◽  
Author(s):  
D R Tomlinson ◽  
F Moss ◽  
M McCarty ◽  
D Mitchell ◽  
J Main ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Pulmonary Infection ◽  
Clinical Suspicion ◽  
Hiv Positive ◽  
Mycobacterium Tuberculosis Infection ◽  
Wide Range ◽  
Extra Pulmonary ◽  
Aids Diagnosis ◽  
Culture Positive ◽  
Hiv Seropositive

A retrospective analysis of all culture-positive cases of Mycobacterium tuberculosis infection in HIV positive individuals, over a 5 year period, revealed 18 cases, drawn from a population of approximately 1500. The prevalence of culture proven M. tuberculosis over the 5 year period was therefore 1.2% and was strongly associated with either a concomitant, or a subsequent, AIDS diagnosis. Sixty-one per cent had pulmonary tuberculosis, 17% had both extra-pulmonary and pulmonary infection and 22% had extra-pulmonary infection alone. Although a wide range of radiological abnormalities was seen, segmental consolidation was the commonest, occurring in 57% of cases. Only 55% of the specimens were positive on initial stains for M. tuberculosis, with a mean duration of 4 weeks to become culture positive, emphasizing that early diagnosis rests on clinical suspicion.

scholarly journals Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037913
Author(s):  
Mala George ◽  
Geert-Jan Dinant ◽  
Efrem Kentiba ◽  
Teklu Teshome ◽  
Abinet Teshome ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Clinical Suspicion ◽  
Secondary Outcome ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative ◽  
Culture Positive ◽  
Culture Negative

ObjectivesTo evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests.DesignA cross-sectional study.SettingTwo public referral hospitals in Tigray, Ethiopia.ParticipantsA total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study.Primary and secondary outcome measuresA total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done.ResultsThe strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB.ConclusionsOur finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases.

Analysis of high yielding maize production - a study based on a commercial crop

2008 ◽  
Vol 48 (3) ◽  
pp. 296 ◽  
Author(s):  
C. J. Birch ◽  
G. McLean ◽  
A. Sawers
Keyword(s):  
Retrospective Analysis ◽  
Environmental Conditions ◽  
Sowing Date ◽  
Plant Population ◽  
Higher Plant ◽  
Maize Crop ◽  
Wide Range ◽  
Commercial Crop ◽  
Reduced Temperature

This paper reports on the use of APSIM – Maize for retrospective analysis of performance of a high input, high yielding maize crop and analysis of predicted performance of maize grown with high inputs over the long-term (>100 years) for specified scenarios of environmental conditions (temperature and radiation) and agronomic inputs (sowing date, plant population, nitrogen fertiliser and irrigation) at Boort, Victoria, Australia. It uses a high yielding (17 400 kg/ha dry grain, 20 500 kg/ha at 15% water) commercial crop grown in 2004–05 as the basis of the study. Yield for the agronomic and environmental conditions of 2004–05 was predicted accurately, giving confidence that the model could be used for the detailed analyses undertaken. The analysis showed that the yield achieved was close to that possible with the conditions and agronomic inputs of 2004–05. Sowing dates during 21 September to 26 October had little effect on predicted yield, except when combined with reduced temperature. Single year and long-term analyses concluded that a higher plant population (11 plants/m2) is needed to optimise yield, but that slightly lower N and irrigation inputs are appropriate for the plant population used commercially (8.4 plants/m2). Also, compared with changes in agronomic inputs increases in temperature and/or radiation had relatively minor effects, except that reduced temperature reduces predicted yield substantially. This study provides an approach for the use of models for both retrospective analysis of crop performance and assessment of long-term variability of crop yield under a wide range of agronomic and environmental conditions.

scholarly journals The Role of QuantiFERON-TB Gold Plus in Mycobacterium Tuberculosis Detection in a Severe HIV Immunocompromised Patient—Case Report

Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1523
Author(s):  
Florentina Dumitrescu ◽  
Cătălina-Gabriela Pisoschi ◽  
Vlad Pădureanu ◽  
Andreea Cristina Stoian ◽  
Livia Dragonu ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Immunocompromised Patient ◽  
Symptomatic Treatment ◽  
Pneumocystis Pneumonia ◽  
Hiv Positive ◽  
Patient Case ◽  
Mycobacterium Tuberculosis Infection ◽  
Antituberculosis Therapy ◽  
Antituberculosis Treatment

Tuberculosis (TB) is an important opportunistic infection in HIV-positive people. We are reporting a case of a 31-year-old HIV-infected patient who was hospitalized in July 2021 for dyspnea, cough with mucopurulent sputum and asthenia. He was confirmed to have Serratia liquefaciens pneumonia and acute respiratory failure. The evolution was unfavorable despite the antibiotic, pathogenic and symptomatic treatment. Because the patient had severe immunosuppression (CD4 count = 37 cell/mm3), we used QuantiFERON-TB Gold Plus for the detection of the Mycobacterium tuberculosis infection. The antituberculosis therapy was initiated, which resulted in a significant improvement of the general condition and the patient was discharged with the recommendation to continue antiretroviral therapy, antituberculosis treatment and Trimethoprim/Sulfamethoxazole—single tablet daily for the prophylaxis of Pneumocystis pneumonia.

scholarly journals Retrospective analysis of post-mortem findings in domestic ducks and geese from non-commercial flocks in Sweden, 2011–2020

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Désirée Seger Jansson ◽  
Faruk Otman ◽  
Elisabeth Bagge ◽  
Ylva Lindgren ◽  
Pernille Engelsen Etterlin ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Viral Infections ◽  
Muscovy Duck ◽  
Post Mortem ◽  
National Veterinary Institute ◽  
Domestic Ducks ◽  
Yeast Infection ◽  
Wide Range ◽  
Causes Of Mortality ◽  
Muscovy Ducks

Abstract Background Small poultry flock ownership has become a popular hobby in Europe and North America in recent years but there is a general lack of information regarding bird health and welfare. This retrospective analysis of routine post-mortem cases of non-commercial anseriform poultry aimed at providing information on causes of mortality mostly in relation to mortality events. For this purpose, birds that were submitted for routine post-mortem diagnostics to the National Veterinary Institute (SVA) in Sweden in 2011–2020 were retrospectively reviewed to determine main causes of mortality. Results Records from 79 necropsy submissions involving 120 birds (domestic ducks n = 41, Muscovy ducks n = 45, hybrid ducks n = 2 and domestic geese n = 32) were retrieved and analysed. Most submissions (72.2%) represented flock disease events and unexpected mortality was the most common cause of submission (70.9% of submissions). Twenty-two submissions (27.8%) were referred by veterinarians. There was a wide range of diagnoses of infectious and noninfectious aetiologies. Infectious causes of mortality included parasitic (19.2%), bacterial (13.3%), fungal (10.0%) and viral infections (3.3%) (at bird level of all 120 birds). Some of these infections such as duck virus enteritis (DVE), highly pathogenic influenza (HPAI H5N8) in Muscovy ducks and leucocytozoonosis (Leucocytozoon sp.) in all three species were most likely acquired from contact with wild free-living waterfowl. Generalised yeast infection (Muscovy duck disease) was diagnosed in Muscovy ducks and in a Muscovy duck/domestic duck hybrid. Other diseases were related to generalised noninfectious causes (27.5% of all birds) including diseases such as kidney disease, amyloidosis, cardiac dilatation, reproductive diseases and idiopathic inflammatory conditions. Nutritional or management-related diseases were diagnosed in 14.2% of all birds including rickets and gastrointestinal impaction/obstruction. Congenital/developmental, neoplastic, toxic and traumatic causes of mortality were rare. Conclusions The information obtained in this study can be used to identify and evaluate risks and help owners and veterinarians to prevent disease and provide adequate veterinary care for non-commercial anseriform poultry.

scholarly journals Prenatal Human Immunodeficiency Virus Testing and Patient Management by Obstetricians in a High Seroprevalence Community

1994 ◽  
Vol 2 (1) ◽  
pp. 25-29
Author(s):  
William R. Robinson ◽  
Michael Fleischer
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Management Strategies ◽  
Prenatal Testing ◽  
Human Immunodeficiency Virus Testing ◽  
Hiv Positive ◽  
High Seroprevalence ◽  
Immunodeficiency Virus ◽  
Hiv Seropositive ◽  
Virus Testing

Objective: In order to determine the practice habits of obstetricians concerning frequency of prenatal human immunodeficiency virus (HIV) testing and management strategies for HIV-seropositive obstetric patients, we conducted a telephone survey of practicing obstetricians over a 3-month period.Methods: In the New Orleans metropolitan area, 71/104 (68%) obstetricians participated and completed the survey.Results: Of these obstetricians, 43/71 (60.6%) test all new obstetric patients for HIV; 64/71 (84.5%) routinely ask the patients about risk factors for infection; and 28/71 (39.4%) have actually cared for an HIV-positive patient in their practice. Those obstetricians who routinely tested for HIV were more likely to have personally managed an infected patient and more likely to ask about risk factors. The number of obstetricians who would manage infected patients without consultative assistance was 8/71 (11%).Conclusions: We concluded that obstetricians in this community have largely accepted routinely offered prenatal testing and risk assessment, but they have assumed a relatively small role in risk reduction counseling and treatment.

Pathologic Features of Mycobacterium kansasii Infection in Patients With Acquired Immunodeficiency Syndrome

2003 ◽  
Vol 127 (5) ◽  
pp. 554-560 ◽  
Author(s):  
Michael B. Smith ◽  
Claudia P. Molina ◽  
Vicki J. Schnadig ◽  
Michael C. Boyars ◽  
Judith F. Aronson
Keyword(s):  
Lymph Node ◽  
Acquired Immunodeficiency Syndrome ◽  
Pulmonary Infection ◽  
Mycobacterium Kansasii ◽  
Abdominal Lymph Node ◽  
Inflammatory Reactions ◽  
Pathologic Features ◽  
Wide Range ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Abstract Context.—Mycobacterium kansasii is a slow-growing photochromogenic mycobacterium that may infect patients with human immunodeficiency virus (HIV) late in the course of acquired immunodeficiency syndrome (AIDS). The clinical features of pulmonary and extrapulmonary infections have been described in the literature; however, the pathology of infection has not been adequately addressed. Objective.—This report describes the pathologic features of 12 cases of M kansasii infection in patients with AIDS. Design.—The medical records, autopsy protocols, cytologic material, and histologic material from patients with AIDS and concomitant M kansasii infection at a tertiary-care medical center during 1990–2001 were reviewed. Results.—Twelve cases were identified, 6 by autopsy, 5 of which were diagnosed postmortem. Four of the 12 cases had cytologic material and 4 cases had histologic biopsies available for review. Pulmonary infection was most common (9/12), and all patients in whom thoracic lymph nodes were assessed showed involvement (7/7). Abdominal infection was less frequent, with only 1 of 6, 2 of 6, and 2 of 6, demonstrating liver, spleen, and abdominal lymph node infection, respectively. Isolated infections without documented pulmonary infection included brain abscess (n = 1), ulnar osteomyelitis (n = 1), and paratracheal mass (n = 1). Cytologic and histologic material showed a wide range of inflammatory reactions, including granulomas with and without necrosis, neutrophilic abscesses, spindle-cell proliferations, and foci of granular eosinophilic necrosis. The M kansasii bacillus was characteristically long, coarsely beaded, and frequently showed folded, bent, or curved ends. Intracellular bacilli were randomly or haphazardly distributed within histiocytes. Conclusion.—Mycobacterium kansasii infection produces predominately pulmonary infection in late-stage AIDS with a high incidence of thoracic lymph node involvement and a much lower incidence of dissemination to other sites. Infection is manifest as a wide variety of inflammatory reactions on cytology and histology; however, the characteristic appearance of the bacillus on acid-fast bacilli stain and its intracellular arrangement in histiocytes can allow a presumptive identification.

Epidemiology of Nontuberculous Mycobacterial Infection in Tuberculosis Suspects

2021 ◽  
Author(s):  
Parasmal Suresh ◽  
Anil Kumar ◽  
Raja Biswas ◽  
Divya Vijayakumar ◽  
Swathy Thulasidharan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Species Diversity ◽  
Mycobacterial Infection ◽  
Opportunistic Pathogens ◽  
Appropriate Treatment ◽  
Wide Range ◽  
High Species Diversity ◽  
Nontuberculous Mycobacterial Infection ◽  
Low Prevalence ◽  
Culture Positive

Nontuberculosis mycobacteria (NTM) are opportunistic pathogens that cause a wide range of illnesses. Here, the species distribution and prevalence of NTM infections in tuberculosis suspects was analyzed. A total of 7,073 specimens from pulmonary and extrapulmonary sites were analyzed, and 709 (10%) were found to be culture positive for mycobacteria. Of these, 85.2% were identified as Mycobacterium tuberculosis complex and 14.8% as NTM (65.7% rapid growers and 34.3% slow growers). Speciation of the NTM isolates (n = 69) identified 19 NTM species. M. abscessus (33.3%) and M. fortuitum (24.6%) were the most dominant NTM species isolated from the patients, followed by M. porcinum (5.8%) and M. parascrofulaceum (4.3%). We also report peritonitis caused by rapidly growing NTM among the patients undergoing continuous ambulatory peritoneal dialysis and a case of M. senegalense peritonitis. A low prevalence but high species diversity of NTM was detected in our study. The high species diversity of NTM necessitates the need to unequivocally identify mycobacterial isolates for appropriate treatment.

Amphotericin B Formulation Confusion and Mortality in an HIV-Seropositive Patient

2007 ◽  
Vol 42 (6) ◽  
pp. 532-536 ◽  
Author(s):  
Jeffrey S. Stroup ◽  
Johnny R. Stephens ◽  
Damon L. Baker ◽  
Madhuri Lad
Keyword(s):  
Amphotericin B ◽  
Histoplasma Capsulatum ◽  
Fungal Infections ◽  
Hiv Positive ◽  
Seropositive Patient ◽  
New Agents ◽  
Liposomal Formulations ◽  
Immunodeficiency Virus ◽  
Cryptococcus Spp ◽  
Hiv Seropositive

Amphotericin B (AmB) is commonly used in patients with a human immunodeficiency virus (HIV)-positive diagnosis for the treatment of disseminated fungal infections such as Histoplasma spp. or Cryptococcus spp. Newer liposomal formulations of AmB have been introduced to the market to avoid the toxic effects of the traditional agent. With the introduction of these new agents, there is a risk of confusion between the agents in regards to dosing, which may lead to toxicity. We report the case of an HIV-seropositive patient who inadvertently received five times the dose of AmB deoxycholate for disseminated Histoplasma capsulatum and died.

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