scholarly journals Extra pulmonary tuberculosis manifestation in head and neck and its diagnosis with recent tools like cartridge based nucleic acid amplification test

2021 ◽  
Vol 7 (5) ◽  
pp. 829
Author(s):  
Richa Vatsyayan ◽  
Kavita Sachdeva
Keyword(s):  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Head And Neck ◽  
Clinical Manifestations ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Extra Pulmonary Tuberculosis ◽  
Pulmonary Tb ◽  
Extra Pulmonary ◽  
Sensitivity Specificity

<p class="abstract"><strong>Background:</strong> The study aimed to assess the clinical manifestations of extra-pulmonary tuberculosis (head and neck) in diagnosed pulmonary tuberculosis (TB) patients and without pulmonary TB and to determine the sensitivity and specificity of cartridge based nucleic acid amplification test (CBNAAT) in the diagnosis of extra-pulmonary TB.</p><p class="abstract"><strong>Methods:</strong> The study was conducted as an observational study at the Department of Otorhinolaryngology, tertiary care center, Jabalpur (Madhya Pradesh) for a period of 18 months i.e. from 01 March 2019 to 31 August 2020 on 30 patients presenting with lesions in ear, nose and throat (ENT), head and neck region. All necessary investigations with TB workup were done. Sputum samples were analyzed by CBNAAT on Xpert- <em>Mycobacterium tuberculosis</em> complex/resistance to rifampin (MTB/RIF). Patients were treated accordingly. Appropriate surgical intervention was done in necessary cases. Using statistical analysis, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy was calculated for CBNAAT.  </p><p class="abstract"><strong>Results:</strong> Neck swelling and ear discharge were the most common features observed in 66.7% of cases. In cases with pulmonary TB, systemic features were the most predominant features whereas in cases with extra-pulmonary TB, local features were predominant. Sensitivity, specificity, PPV and NPV of CBNAAT were documented to be 85%, 50%, 89.5% and 40% respectively.</p><p class="abstract"><strong>Conclusions:</strong> TB of the head and neck are commonly encountered in clinical practice. The patients usually present with variable clinical manifestations depending upon the site of involvement. The middle ear is the most common site affected by head and neck tuberculosis. CBNAAT is a sensitive tool for the diagnosis of extra-pulmonary TB with and without associated pulmonary TB.</p>

scholarly journals Utility of cartridge based nucleic acid amplification test in the diagnosis of extra pulmonary tuberculosis

2019 ◽  
Vol 6 (6) ◽  
pp. 1801
Author(s):  
Mahesh Chand Bairwa ◽  
Mahendra Kumar Banera ◽  
Chandan Mal Fatehpuria
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Pleural Fluid ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
World Health ◽  
Rifampicin Resistance ◽  
Extra Pulmonary Tuberculosis ◽  
Extra Pulmonary

Background: Tuberculosis is one of the top 10 cause of death globally. Extra-pulmonary tuberculosis is an important clinical problem. Extra-pulmonary tuberculosis range from 30%-53% in India. Diagnosis of extra-pulmonary tuberculosis is still challenging despite many investigations. World Health Organization recommends Gene-Xpert Mycobacterium Tuberculosis/Rifampicin (Cartridge Based Nucleic Acid Amplification Test-CBNAAT) over conventional tests for diagnosis of extra-pulmonary tuberculosis which permits rapid tuberculosis diagnosis through detection of the genetic sequence of DNA of mycobacterium tuberculosis and simultaneous identification of a majority of the mutations that confirm Rifampicin resistance which is highly predictive of multi-drug resistant tuberculosis.Methods: Study was carried out over a period of one year.  Patients with suggestive of extra-pulmonary tuberculosis were included in study. Diagnosis of extra-pulmonary tuberculosis carried out by clinical, radiological, biochemical analysis, cytological, bacteriological confirmation. Based on mycobacterium tuberculosis result, the study population were divided into ‘Mycobacterium Tuberculosis detected’ and ‘Mycobacterium Tuberculosis not detected’ groups. Mycobacterium Tuberculosis detected group was further divided into ‘Rifampicin resistant’ and ‘Rifampicin sensitive’.Results:  Total 220 patients were included. Among extra-pulmonary tuberculosis, there were 83.64% were pleural fluid. 65.91% patients where be <45 years of age. Mostly patients were from rural areas and illiterate. Diabetes Mellitus found as the most common co-morbidities. CB-NAAT was able to detect mycobacterium tuberculosis in 35% (77) extra-pulmonary samples, out of which 6 were rifampicin resistant. Out of 184 samples of pleural fluid, 53 were rifampicin sensitive and 4 were found rifampicin resistant.Conclusions: CB-NAAT has to be endorsed in every health care centres as the test gives rapid result and also detection of rifampicin resistance which is the major concern for every clinician.

scholarly journals 1633. Improving the diagnosis of extra-pulmonary tuberculosis (EPTB): experience from north India

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S808-S808
Author(s):  
Anchal Sharma ◽  
Kusum Sharma ◽  
Manish Modi ◽  
Aman Sharma
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Mycobacterium Tuberculosis Complex ◽  
Lamp Assay ◽  
Nucleic Acid Amplification ◽  
Rural Setting ◽  
Tuberculosis Complex ◽  
Extra Pulmonary Tuberculosis ◽  
Resource Poor ◽  
Extra Pulmonary

Abstract Background Rapid and accurate diagnosis of extra-pulmonary tuberculosis (EPTB) is imperative for early treatment and better patient outcome. Loop-mediated Isothermal Amplification (LAMP) is a promising nucleic-acid amplification assay. LAMP assay could be carried out in simple water bath under isothermal conditions in 60 minutes, and can be performed in any laboratory even in rural setting in resource poor endemic countries. We evaluated LAMP assay using two different target regions LAMP primers specific for Mycobacterium tuberculosis complex for the diagnosis of EPTB. Methods LAMP assay using 6 primers (each for IS6110 and IS1081) specific for Mycobacterium tuberculosis complex were performed on patients suspected of EPTB on various EPTB samples(CSF, Synovial fluid, Lymaphnode and tissue biopsies and various other samples) of 150 patients (50 confirmed, 100 suspected) Clinically suspected of EPTB and 100 non-TB control subjects. Results Overall LAMP test (using any of the two targets) had sensitivity and specificity of 96% and 100% for confirmed (50 culture positive) EPTB cases. In 100 clinically suspected but unconfirmed EPTB cases, LAMP was positive in 87 out of 100 cases (87%). Sensitivity of IS6110 LAMP, 1S1081 LAMP and IS6110 PCR for clinically suspected cases was 78 (78%), 84 (84%) and 70 (70%), respectively. In total 150 EPTB patients, the overall sensitivity of microscopy, culture, IS6110 PCR, IS6110 LAMP, 1081 LAMP and the LAMP test (if any of the two targets were used) were 4%, 33.3%, 74.6%, 82.66%, 87% and 92%, respectively. Specificity of all the tests was 100%. There were 8 cases which were missed by IS6110 LAMP and 2 cases by 1081 LAMP. Conclusion LAMP assay using two targets is a promising technique for rapid diagnosis of EPTB in 60 minutes especially in a resource poor setting who are still battling with this deadly disease. Disclosures All Authors: No reported disclosures

The role of bronchoscopy and nucleic acid amplification test in pulmonary tuberculosis diagnosis

2017 ◽  
Author(s):  
Maria Alvarenga Santos ◽  
Joana Branco ◽  
Margarida Aguiar ◽  
Susana Clemente ◽  
Vera Martins ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Tuberculosis Diagnosis

scholarly journals Diagnosis of pulmonary tuberculosis with cartridge based nucleic acid amplification test and light emitting diode fluorescent microscopy: a comparative study

2019 ◽  
Vol 6 (5) ◽  
pp. 1580 ◽  
Author(s):  
Pratik Kumar ◽  
Puneet Bhardwaj
Keyword(s):  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Light Emitting Diode ◽  
Fluorescent Microscopy ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Smear Microscopy ◽  
Light Emitting

Background: Due to low sensitivity and inability to detect drug resistance, smear microscopy limits its impact on TB control. Culture methods and drug susceptibility testing is complex, time consuming, and takes around 6-8 weeks. A new diagnostic test, cartridge based nucleic acid amplification test (CBNAAT) was developed based on real-time polymerase chain reaction (RT PCR). Objective of this study to compare the results of CBNAAT for diagnosis of pulmonary tuberculosis with LED fluorescent microscopy and sputum culture.Methods: A cross-sectional study was conducted in the department of Chest and TB, CIMS, Bilaspur. Each Sputum sample of presumptive TB patients were tested with CBNAAT, sputum smear  microscopy by light emitting diode (LED) fluorescent microscopy (FM) and solid and liquid culture for diagnosis of Tuberculosis. Results of CBNAAT, Fluorescent Microscopy and Culture for detection of Mycobacterium Tuberculosis were compared.Results: The sensitivity and specificity for CBNAAT were 97% and 100% respectively; while that for Fluorescent microscopy were 70% and 100% respectively. The positive and negative predictive value for CBNAAT was 100% and 96% respectively. The positive and negative predictive value for Fluorescent microscopy was 100% and 73% respectively.Conclusion: CBNAAT is having high sensitivity and specificity for diagnosis of pulmonary tuberculosis. It should be routinely used under national health programme to detect a tuberculosis case efficiently.

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