scholarly journals Is Multidrug-resistant Extrapulmonary Tuberculosis Important? If So, What Is Our Strategy?

2021 ◽  
Vol 44 (4) ◽  
pp. 148-149
Author(s):  
Seong-Eun Kim
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Multidrug Resistant

Isolated multidrug-resistant tubercular tenosynovitis of the flexor tendon of the little finger

2021 ◽  
Vol 14 (2) ◽  
pp. e238339
Author(s):  
Sunny Chaudhary ◽  
Subhajit Maji ◽  
Varun Garg ◽  
Vivek Singh
Keyword(s):  
Flexor Tendon ◽  
Extrapulmonary Tuberculosis ◽  
Functional Limitation ◽  
Clinical Signs ◽  
Multidrug Resistant ◽  
Interesting Case ◽  
Antitubercular Therapy ◽  
Histopathological Diagnosis ◽  
Rare Presentation ◽  
Little Finger

Isolated multidrug-resistant (MDR) tubercular tenosynovitis of the flexor tendons of finger without involvement of wrist is a rare presentation. Tenosynovitis of hand is an uncommon manifestation of extrapulmonary tuberculosis. Pyogenic flexor tenosynovitis of hand is frequently seen and is the closest differential. Non-specific clinical signs may lead to delay in diagnosis, which is often made after biopsy. Management includes surgical excision of necrotic tissue and infected synovium along with antitubercular therapy after histopathological diagnosis. MDR tuberculosis of hand is extremely rare and, to the best of our knowledge, has not been reported in the literature so far. We report an interesting case of MDR tubercular flexor tendon tenosynovitis of the little finger without any pulmonary involvement in an immunocompetent patient. The case was managed by complete synovectomy and second-line antitubercular therapy with complete resolution of disease and had no functional limitation.

scholarly journals Utility of GeneXpert in Diagnosis of Multidrug-resistant Extrapulmonary Tuberculosis

2017 ◽  
Vol 03 (02) ◽  
pp. 085-087
Author(s):  
Ankush Chaudhary ◽  
Ketaki Utpat ◽  
Unnati Desai ◽  
Jyotsna Joshi
Keyword(s):  
Lymph Node ◽  
Psoas Abscess ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
False Negative ◽  
Multidrug Resistant ◽  
Nucleic Acid Amplification ◽  
Lower Sensitivity ◽  
Care Hospital ◽  
Gluteal Abscess

ABSTRACT Background: The Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF) assay (GeneXpert) is a rapid semi-quantitative nucleic acid amplification test with established role in the diagnosis of pulmonary tuberculosis (PTB) and multidrug-resistant (MDR) PTB. We determined the performance of the GeneXpert assay for the diagnosis of extrapulmonary tuberculosis (EPTB) MDR cases. Aims and objectives: To study the role of GeneXpert in the diagnosis of EPTB MDR. Materials and methods: A retrospective study was conducted over a period of 2 years at a tertiary care hospital after Ethics Committee permission. Data of 44 consecutive patients of diagnosed EPTB MDR were retrieved for GeneXpert and culture drug susceptibility test (DST). Sensitivity of GeneXpert in the diagnosis of EPTB MDR was calculated comparing culture DST results. Results: Various EPTB MDR cases studied were lymph node TB (n = 23) 51%, pleural effusion (n = 14) 32%, central nervous system TB/spinal TB/psoas abscess/gluteal abscess (n = 7) 17%. Sensitivity for GeneXpert was found to be 91.30, 57, 100% respectively. True positive and false negative were 36 and 8 cases respectively. The overall sensitivity of GeneXpert in diagnosing EPTB MDR was 81.80%. The sensitivity among lymph node, pleural effusions, and spinal/psoas abscess/gluteal abscess was 91.30, 57.14, and 100% respectively. Conclusion: GeneXpert sensitivity for the diagnosis of EPTB MDR varied with site of extrapulmonary involvement, with lower sensitivity in pleural fluid as compared with higher sensitivity among lymph node and spine TB. Nevertheless, given the rapid turnaround time and simplicity, it is a useful tool in the diagnosis of EPTB MDR when used in correct clinical context. Subsequent confirmation with culture DST, however, is recommended to diagnose false negatives.

scholarly journals Epidemiology of HIV-negative Rifampicin Resistance /Multidrug-Resistant Extrapulmonary Tuberculosis: 5 Years-experience From a National Tuberculosis Clinical Research Center in China

2021 ◽  
Author(s):  
Jun Ma ◽  
Lin Fan ◽  
Hongcheng Liu ◽  
Wenting Li ◽  
Wenwen Sun
Keyword(s):  
Early Stage ◽  
Extrapulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Rifampicin Resistance ◽  
Anatomical Site ◽  
Successful Treatment Outcome ◽  
National Tuberculosis ◽  
Control Programmes ◽  
Mdr Tb ◽  
Positive Rate

Abstract Background: China is a region with a high global burden of Rifampicin Resistance ／Multidrug-Resistant tuberculosis (RR/MDR-TB) and low HIV incidence. Our aim was to assess the epidemiological and clinical characteristics of RR/MDR-extrapulmonary tuberculosis (EPTB) over the past five years in China to inform national TB control programmes.Methods: We investigated the epidemiological and clinical datas of all MDR/RR-EPTB cases in a TB specialized hospitals in China over a five-year period and compared cases with a cohort of MDR/RR-PTB patients over the same period.Results: Of the 1,700 RR/MDR-TB patients enrolled, 17.76% were EPTB. The incidence of RR／MDR-EPTB were increasing.The most common anatomical site was pleura/chest wall (20.20%). Compared with RR／MDR-Pulmonary tuberculosis (PTB），RR/MDR-EPTB were were predominately female (50.66%, P< 0.01) 、more prone to delay (P<0.01) in RR/ MDR-EPTB detection with the median time of 145（14 ,341）days since first visit、more less likely to develop diabetes (22.85 %, P<0.01) 、more likely to be newly diagnosed ( 56.95%, P<0.01) 、lower successful treatment outcome（69.56%，p <0.01）、more dependent on Xpert (93.71%) for resistance detection、lower culture positive rate (56.95% , P< 0.01). RR/ MDR-EPTB also showed a significantly higher rate of pre-XDR/XDR (32.45%, P <0.01) . Conclusion: RR/MDR-EPTB is different from RR-MDR/PTB in both epidemiology and clinical. Clinicians should recommend Xpert in early stage and use fluoroquinolones cautiously in cases suspected TB.

Drug-resistant genital tuberculosis of the penis in a human immunodeficiency virus non-reactive individual

2007 ◽  
Vol 56 (5) ◽  
pp. 694-695 ◽  
Author(s):  
C. P. Baveja ◽  
Gumma Vidyanidhi ◽  
Manisha Jain ◽  
Trishla Kumari ◽  
V. K. Sharma
Keyword(s):  
Drug Resistance ◽  
Multiple Drug Resistance ◽  
Extrapulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Drug Resistant ◽  
First Line ◽  
Antitubercular Drugs ◽  
Immunodeficiency Virus ◽  
Superficial Ulcer

The genitourinary tract is the most common site for extrapulmonary tuberculosis (TB). Penile TB is extremely rare comprising less than 1 % of all genital TB cases in males. It most commonly presents either as a superficial ulcer on the glans or around the corona. Diagnosis of penile TB is often difficult because it can mimic numerous other diseases. The association of TB with AIDS, and the increasing incidence of multiple drug resistance has further compounded the problem. The case described herein involves a patient with multidrug-resistant smear-positive penile TB that was undiagnosed initially due to the lack of clinical suspicion of TB, and once diagnosed failed to respond to first line antitubercular drugs because of multiple drug resistance.

scholarly journals Multidrug resistant tuberculous meningitis in pregnancy: a rare case report

2019 ◽  
Vol 8 (4) ◽  
pp. 1692
Author(s):  
U. Nagashree ◽  
Charumathi . ◽  
U. Meenakshisundaram
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Extrapulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Pulmonary Tb ◽  
Foetal Growth ◽  
Rare Case Report ◽  
Surgical Options ◽  
Extra Pulmonary ◽  
Tuberculosis Meningitis

The prevalence of tuberculosis, especially extrapulmonary tuberculosis is increasing worldwide. TB meningitis is one of severe manifestations of extra pulmonary TB. Prognosis of cases of multidrug resistance tuberculosis meningitis is worse and even more challenging in pregnant women. It’s mostly associated with increased frequency of maternal disability, hospitalisation during pregnancy, foetal growth retardation, prematurity, low-birth weight and increased perinatal mortality. As information on outcome of pregnancy among women with extra pulmonary TB is limited; various medical and surgical options for timely management has been discussed. Authors bring out a case report of a primigravida at 26 weeks gestation with severe multidrug resistant TB meningitis who was successfully managed at our hospital with a healthy infant. 

RISK FACTORS FOR THE DEVELOPMENT OF CRITICAL CONDITIONS REQUIRING HOSPITALIZATION IN THE INTENSIVE CARE UNIT AND INTENSIVE CARE UNIT IN PATIENTS WITH TUBERCULOSIS

2021 ◽  
pp. 44-48
Author(s):  
S. N. Alyushin ◽  
A. M. Skrahina ◽  
M. I. Dziusmikeyeva ◽  
V. V. Solodovnikova ◽  
A. Y. Skrahin
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Extrapulmonary Tuberculosis ◽  
Underlying Disease ◽  
Multidrug Resistant ◽  
Critical Conditions ◽  
Cd4 Cell Count ◽  
Resistant Tuberculosis ◽  
Cd4 Cell

The mortality rate among tuberculosis patients requiring intensive care is high. The development of severe conditions in patients with tuberculosis may be associated with the course of the underlying disease and with concomitant pathology. The aim of this work was to study the risk factors for the development of severe conditions in patients with tuberculosis to prevent death. A retrospective study of risk factors for the development of critical conditions, depending on the nature of the tuberculosis process, co-infection, concomitant diseases and bad habits, was carried out in 154 patients with pulmonary tuberculosis and extrapulmonary tuberculosis hospitalized in the intensive care unit. In a cohort of patients admitted to the intensive care unit and intensive care unit, statistically significant factors influencing the development of critical conditions were: the presence of extrapulmonary localization of the tuberculous process; the presence of bilateral tuberculous lung lesions; the presence of destructive forms of tuberculosis; the presence of tuberculous meningitis/encephalitis; the presence of multidrug-resistant and extensively drug-resistant tuberculosis; application of the traditional "old" treatment regimen; the presence of concomitant HIV infection with a CD4 cell count of less than 200/ul; the presence of concomitant diabetes.

scholarly journals Primary multi-drug resistant tuberculosis presented as lymphadenitis in a patient without HIV infection

2004 ◽  
Vol 61 (4) ◽  
Author(s):  
S.M. Mirsaeidi ◽  
P. Tabarsi ◽  
M.O. Edrissian ◽  
M. Amiri ◽  
P. Farnia ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Extrapulmonary Tuberculosis ◽  
Cervical Lymphadenopathy ◽  
Excisional Biopsy ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
The World

Primary multi-drug resistant extrapulmonary tuberculosis is an uncommon form of the disease, but it seems that by increasing the number drug resistant tuberculosis around the world, the number of cases of primary multidrug resistant tuberculosis with extrapulmonary presentation also is going to rise. In this report, we describe a 19- year old, HIV negative man with primary multi-drug resistant TB lymphadenitis, presented with cervical lymphadenopathy and sinus discharge at the site of involved lymph nodes. The Acid Fast Bacilli (AFB) smear of sputum was negative but the AFB smear of discharged fluid as well as the excisional biopsy of the lymph nodes confirmed the M. tuberculosis infection. The patient underwent the treatment with a combination of isoniazide, clofazimine, pyrazinamide, ofloxacin and amikacin with promising results. By increasing the number of drug resistant tuberculosis patients around the world, appropriate diagnosis and treatment of different presentations of the disease need a special attention.

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