EXPERIENCE OF USING RECOMBINANT ALLERGEN OF MYCOBACTERIUM TUBERCULOSIS FOR DIAGNOSTICS OF TUBERCULOUS INFECTION

Introduction: The term spondylodiscitis aims to describe any spinal infection. Medical treatment is the gold standard; nevertheless, surgical treatment can be indicated. The aim of this work was to study the epidemiological profile in a group of patients with spondylodiscitis surgically treated in the same medical institution between 1997 and 2013. Material and Methods: Eighty five patients with spondylodiscitis were surgically treated in this period. The authors analysed clinical data and image studies for each patient. Results: We treated 51 male and 34 female patients with an average age of 48 years old (min: 6 - max: 80). The lumbar spine was more often affected and Mycobacterium tuberculosis the most frequent pathogen. The number of cases through the years has been grossly stable, with a slight increase of dyscitis due to Staphylococcus aureus and decrease of the dyscitis without pathogen identification. Paravertebral abscess was identified in 39 patients and 17 had also neurological impairment, mostly located in the thoracic spine and with tuberculous aetheology. Immunosuppression was documented in 10 patients. Discussion: In this epidemiologic study we found a tuberculous infection, male gender and young age predominance. Despite a relative constant number of patients operated over the years, pyogenic infections due to Staphylococcus aureus seems to be uprising. Paravertebral abscess and neurological impairment are important dyscitis complications, especially in tuberculous cases. Conclusion: Spinal infections requiring surgical treatment are still an important clinical condition. Mycobacterium tuberculosis and Staphylococcus aureus represent the main pathogens with a growing incidence for the latest.

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Endobronchial tuberculosis: histopathological subsets and microbiological results

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2012.621 ◽

2012 ◽

Vol 7 ◽

Cited By ~ 1

Author(s):

Sevket Ozkaya ◽

Salih Bilgin ◽

Serhat Findik ◽

Hayriye Çete Kök ◽

Canan Yuksel ◽

...

Keyword(s):

Mycobacterium Tuberculosis ◽

Lavage Fluid ◽

Tracheobronchial Tree ◽

Sputum Smear ◽

Tuberculous Infection ◽

Bronchial Lavage ◽

Culture Positivity ◽

Endobronchial Tuberculosis ◽

Smear Negative ◽

Histopathological Evidence

Background: Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. Bronchoscopic appearances of EBTB have been divided into seven subtypes: actively caseating, edematous-hyperemic, fibrostenotic, tumorous, granular, ulcerative, and nonspecific bronchitic. However, information for establishing a definite microbiological diagnosis in each of these categories is lacking. We aimed to present bronchoscopic appearances and percentages for the EBTB subtypes and to compare bronchoscopic appearances with microbiological positivity in bronchial lavage fluid. Methods: From 2003 to 2009, 23 biopsy-proven EBTB patients were enrolled in the study. Diagnosis of EBTB was histopathologically confirmed in all patients. Results: The commonest subtype was the edematous-hyperemic type (34.7%); other subtypes in order of occurrence were: tumorous (21.7%), granular (17.3%), actively caseating (17.3%), fibrostenotic (4.3%), and nonspecific bronchitic (4.3%). Although all patients were sputum-smear-negative for acid-fast bacilli (AFB), 26% of patients were smear-positive for AFB in the bronchial lavage fluid. The bronchial lavage fluid grew Mycobacterium tuberculosis in 39.1% of all patients. The bronchial lavage smear positivity for AFB in the bronchial lavage fluid was 75%, 25%, 20%, 12.5%, 0%, and 0% for the granular, actively caseating, tumorous, edematous-hyperemic, fibrostenotic, and nonspecific bronchitic subtypes of EBTB, respectively. Culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid was 75%, 50%, 40%, 25%, 0%, and 0%, respectively. Conclusion: The commonest subtype of EBTB was the edematous-hyperemic subtype. The granular type had the highest smear positivity and culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid. Bronchoscopy should be performed in all patients suspected to have EBTB.

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MANIFESTATIONS OF TUBERCULOUS INFECTION IN CHILDREN WITH A POSITIVE RESULT OF THE TEST WITH TUBERCULOSIS RECOMBINANT ALLERGEN

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2019-97-8-32-37 ◽

2019 ◽

Vol 97 (8) ◽

pp. 32-37

Author(s):

E. P. SHILOVА ◽

◽

L. V. PODDUBNАYA ◽

I. M. STEPCHENKO ◽

◽

...

Keyword(s):

Positive Result ◽

Recombinant Allergen ◽

Tuberculous Infection

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Fatal central nervous system co-infection with SARS-CoV-2 and tuberculosis in a healthy child

BMC Pediatrics ◽

10.1186/s12887-020-02308-1 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Bishara J. Freij ◽

Bassam M. Gebara ◽

Rabail Tariq ◽

Ay-Ming Wang ◽

John Gibson ◽

...

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Mycobacterium Tuberculosis ◽

Tuberculous Infection ◽

Local Health ◽

Imaging Findings ◽

Brain Herniation ◽

Radiographic Findings ◽

Cerebellar Tissue

Abstract Background Central and peripheral nervous system symptoms and complications are being increasingly recognized among individuals with pandemic SARS-CoV-2 infections, but actual detection of the virus or its RNA in the central nervous system has rarely been sought or demonstrated. Severe or fatal illnesses are attributed to SARS-CoV-2, generally without attempting to evaluate for alternative causes or co-pathogens. Case presentation A five-year-old girl with fever and headache was diagnosed with acute SARS-CoV-2-associated meningoencephalitis based on the detection of its RNA on a nasopharyngeal swab, cerebrospinal fluid analysis, and magnetic resonance imaging findings. Serial serologic tests for SARS-CoV-2 IgG and IgA showed seroconversion, consistent with an acute infection. Mental status and brain imaging findings gradually worsened despite antiviral therapy and intravenous dexamethasone. Decompressive suboccipital craniectomy for brain herniation with cerebellar biopsy on day 30 of illness, shortly before death, revealed SARS-CoV-2 RNA in cerebellar tissue using the Centers for Disease Control and Prevention 2019-nCoV Real-Time Reverse Transcriptase-PCR Diagnostic Panel. On histopathology, necrotizing granulomas with numerous acid-fast bacilli were visualized, and Mycobacterium tuberculosis complex DNA was detected by PCR. Ventricular cerebrospinal fluid that day was negative for mycobacterial DNA. Tracheal aspirate samples for mycobacterial DNA and culture from days 22 and 27 of illness were negative by PCR but grew Mycobacterium tuberculosis after 8 weeks, long after the child’s passing. She had no known exposures to tuberculosis and no chest radiographic findings to suggest it. All 6 family members had normal chest radiographs and negative interferon-γ release assay results. The source of her tuberculous infection was not identified, and further investigations by the local health department were not possible because of the State of Michigan-mandated lockdown for control of SARS-CoV-2 spread. Conclusion The detection of SARS-CoV-2 RNA in cerebellar tissue and the demonstration of seroconversion in IgG and IgA assays was consistent with acute SARS-CoV-2 infection of the central nervous infection. However, the cause of death was brain herniation from her rapidly progressive central nervous system tuberculosis. SARS-CoV-2 may mask or worsen occult tuberculous infection with severe or fatal consequences.

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Mast cell response during the early phase of tuberculosis: an electron-microscopic study

Canadian Journal of Microbiology ◽

10.1139/m77-186 ◽

1977 ◽

Vol 23 (9) ◽

pp. 1245-1251 ◽

Cited By ~ 5

Author(s):

Samuel Ratnam ◽

Shobhitha Ratnam ◽

B. K. Puri ◽

Saroj Chandrasekhar

Keyword(s):

Mast Cell ◽

Mycobacterium Tuberculosis ◽

Electron Microscope ◽

Host Tissue ◽

Tuberculous Infection ◽

Electron Microscopic ◽

Morphological Alterations ◽

Dense Bodies ◽

Large Numbers ◽

Host Tissues

Guinea pig lungs were infected with Mycobacterium tuberculosis by intratracheal route and examined under electron microscope to investigate the morphological alterations of the organisms, if any, and the response of the host tissue. The bacilli showed no changes in their morphology, while the host tissues revealed several cells containing many electron-dense intracytoplasmic granules. These cells were predominantly seen during the 1st week of infection. The electron-dense bodies of these cells may be the ones observed by earlier workers and suggested to be the altered forms of tubercle bacilli. The present investigation, however, revealed them to be the granules of the mast cells. These cells were observed to respond to tuberculous infection during the first few days by appearing in large numbers crowded with intracytoplasmic granules and soon disintegrating as the result of subsequent degranulation. The above observation is presented and its significance discussed.

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Immunodiagnostic Tests in the Assessment of Specific Sensitization to M. tuberculosis in Children under the Current Epidemical Situation

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2021-99-11-47-54 ◽

2021 ◽

Vol 99 (11) ◽

pp. 47-54

Author(s):

L. V. Poddubnаya ◽

E. P. Shilovа ◽

D. A. Kudlаy ◽

N. P. Doktorovа

Keyword(s):

High Risk ◽

Age Groups ◽

Tuberculin Test ◽

Mantoux Test ◽

Recombinant Allergen ◽

Tuberculous Infection ◽

Tuberculosis Case ◽

Degree Of Sensitization ◽

High Degree ◽

Immunodiagnostic Tests

The objective: to study the degree of specific sensitization according to the results of intradermal immunodiagnostic tests in children with different manifestations of tuberculosis infection under the current epidemic situation.Subjects and Methods. The degree of tuberculin sensitization was studied in 299 children from different age groups (0-14 years old) who were registered for dispensary follow-up in 2018-2019.Based on the results of a tuberculosis recombinant allergen test (TRA), the degree of specific sensitization was studied in children with tuberculin tests conversion (n = 102) and infected with Mycobacterium tuberculosis (MTB) for 2 years or more (n = 165) exposed to tuberculous infection in their families and from healthy environment, and 145 patients under 14 years old with local respiratory tuberculosis.Results. Moderate sensitization to tuberculin predominated in children with converted tuberculin test exposed to tuberculous infection in their families and those from healthy environments. According to the results of TRA test, a high degree of sensitization was observed 4.7 times more frequently in children with tuberculin test conversion exposed to tuberculosis in their families. In children from healthy environments, negative responses to TRA test were registered 2.4 times more frequently. In 73% of children infected with MTB, results of annual Mantoux tests didn’t differ much. Hyperergic reactions to TRA test in infected children exposed to tuberculous infection were 10 times more frequent than in those from healthy environments. A direct correlation was found between the high degree of sensitization to active M. tuberculosis and exposure to a tuberculosis case with a positive result of sputum test (χ2 < 0.001, p < 0.05). In the case of converted tuberculin test and infection with M. tuberculosis for 2 years or more, pronounced and hyperergic reactions to TRA test were registered with equal frequency and did not depend on the timing and duration of infection. A high risk factor and predictor of the disease development is high sensitization of the host to active M. tuberculosis which is found in patients with tuberculosis using TRA test six times more frequently versus Mantoux test (OR 5.951, 95% CI 3.548 and 9.981). The demonstrated results are important for the identification of children facing a high risk to develop active tuberculosis and preventive treatment prescription.

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Total Hip Arthroplasty Loosening Due to Mycobacterium Tuberculosis: A Case Report and Review of the Literature

Reconstructive Review ◽

10.15438/rr.7.1.160 ◽

2017 ◽

Vol 7 (1) ◽

Author(s):

Anis Tebourbi ◽

Ahmed Elloumi ◽

Khaled Hadhri ◽

Mohamed Ben Salah ◽

Mouadh Nefiss ◽

...

Keyword(s):

Mycobacterium Tuberculosis ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Joint Infection ◽

Previous History ◽

Tuberculous Infection ◽

Total Hip ◽

One Stage ◽

History Of ◽

Arthroplasty Loosening

Context:Prosthetic joint infection due to Mycobacterium tuberculosis with no previous history of pulmonary or extra pulmonary tuberculosis is an extremely rare complication.AimsTo report the case of a patient with tuberculous mycobacterial prosthetic hip infection, 14 years after surgery for post traumatic osteoarthritis, with no previous history of tuberculosis.MethodsA 46-year-old male presented an acetabular loosening of a cemented total hip arthroplasty with subnormal biologic parameters. A one stage revision surgery was planned. Intraoperative findings suggested mycobacterial tuberculous infection with presence of periacetabular yellowish rice-shaped granules.ResultsA one-stage prosthesis exchange was performed; Culture on Löwenstein-Jensen medium grew MTB days after inoculation and histological examination confirmed tuberculous infection. Patient was treated by antituberculous agents for 12 months with optimal clinical and biological response and no prosthetic loosening signs at eighteen months follow up.ConclusionsTotal hip arthroplasty loosening due to mycobacterium tuberculosis is a rare entity, which should be evoked even when no inflammatory signs are shown. Discovery of yellowish rice-shaped granules is an indicator to investigate for tuberculosis. Management of prosthetic joint infection due to M.tuberculosis must involve both medical and surgical approach.

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The Inducible Nitric Oxide Synthase Locus Confers Protection against Aerogenic Challenge of Both Clinical and Laboratory Strains of Mycobacterium tuberculosis in Mice

Infection and Immunity ◽

10.1128/iai.69.12.7711-7717.2001 ◽

2001 ◽

Vol 69 (12) ◽

pp. 7711-7717 ◽

Cited By ~ 108

Author(s):

Charles A. Scanga ◽

Vellore P. Mohan ◽

Kathryn Tanaka ◽

David Alland ◽

JoAnne L. Flynn ◽

...

Keyword(s):

Nitric Oxide ◽

Mycobacterium Tuberculosis ◽

Nitric Oxide Synthase ◽

Protective Role ◽

Clinical Isolates ◽

Intravenous Route ◽

Tuberculous Infection ◽

Oxide Synthase

ABSTRACT Murine macrophages effect potent antimycobacterial function via the production of nitric oxide by the inducible isoform of the enzyme nitric oxide synthase (NOS2). The protective role of reactive nitrogen intermediates (RNI) against Mycobacterium tuberculosisinfection has been well established in various murine experimental tuberculosis models using laboratory strains of the tubercle bacillus to establish infection by the intravenous route. However, important questions remain about the in vivo importance of RNI in host defense against M. tuberculosis. There is some evidence that RNI play a lesser role following aerogenic, rather than intravenous,M. tuberculosis infection of mice. Furthermore, in vitro studies have demonstrated that different strains of M. tuberculosis, including clinical isolates, vary widely in their susceptibility to the antimycobacterial effects of RNI. Thus, we sought to test rigorously the protective role of RNI against infection with recent clinical isolates of M. tuberculosis following both aerogenic and intravenous challenges. Three recently isolated and unique M. tuberculosis strains were used to infect both wild-type (wt) C57BL/6 and NOS2 gene-disrupted mice. Regardless of the route of infection, NOS2−/− mice were much more susceptible than wt mice to any of the clinical isolates or to either the Erdman or H37Rv laboratory strain of M. tuberculosis. Mycobacteria replicated to much higher levels in the organs of NOS2−/− mice than in those of wt mice. Although the clinical isolates all exhibited enhanced virulence in NOS2−/− mice, they displayed distinct growth rates in vivo. The present study has provided results indicating that RNI are required for the control of murine tuberculous infection caused by both laboratory and clinical strains of M. tuberculosis. This protective role of RNI is essential for the control of infection established by either intravenous or aerogenic challenge.

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ACTUAL ISSUES OF TUBERCULOSIS IN ADOLESCENTS EXPOSED TO TUBERCULOSIS INFECTION

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2018-96-6-17-20 ◽

2018 ◽

Vol 96 (6) ◽

pp. 17-20 ◽

Cited By ~ 1

Author(s):

E. S. Ovsyankina ◽

L. V. Panova ◽

F. A. Poluektova ◽

A. Yu. Khiteva ◽

E. A. Viechelli

Keyword(s):

Health Education ◽

Life Quality ◽

Poor Performance ◽

Diagnostic Procedures ◽

Mantoux Test ◽

Skin Tests ◽

Recombinant Allergen ◽

Tuberculous Infection ◽

Hygienic Measures ◽

Close Relatives

The article characterizes respiratory tuberculosis in adolescents exposed to tuberculous infection. Exposure to tuberculosis in the family or when contacting close relatives makes the biggest contribution into development of the disease unless the patient is isolated from those exposed. Advanced and severe forms of tuberculosis with bacillary excretion are detected, compromising the life quality of adolescents. The main causes of late diagnostics are poor performance of TB services, primary medical units, low level of health education aimed at the increase of motivation to have planned medical examinations in the general population and to take relevant sanitary and hygienic measures in the sites of infection. Adolescents from the sites with bacillary excretion, and, first of all, if multiple or extensive drug resistant tuberculosis is detected, are to be considered a high priority group facing the risk to develop the disease with more frequent monitoring and deeper examination. In primary medical units, should any sings typical of tuberculosis be presented, it is sensible to add skin tests (Mantoux test and test with tuberculous recombinant allergen) to the minimum diagnostic procedures. Organizational, methodical and health education activities in the sites of infection are to be improved.

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Clinical Features and Treatment Outcomes of Bone-Joint Infection Between Bacteria and Mycobacterium Tuberculosis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.088 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S102-S102

Author(s):

Chumsaeng Chumsaengsri ◽

Parichat Salee ◽

Worawit Louthrenoo

Keyword(s):

Mycobacterium Tuberculosis ◽

Bacterial Infection ◽

Treatment Outcomes ◽

Clinical Improvement ◽

Clinical Features ◽

Joint Infection ◽

Recurrent Infection ◽

Joint Involvement ◽

Symptom Duration ◽

Tuberculous Infection

Abstract Background Bone-joint infection is an emergency condition that requires immediate management. Delayed in treatment or improper management can lead to a significant morbidity and mortality. Methods The medical records of patients with bone-joint infection seen at Maharaj Nakorn Chiang Mai Hospital between 1 November 2010 and 30 September 2015 were reviewed. The diagnosis of bone-joint infection was confirmed by pathogen identification or pathohistological report. Only those with adequate clinical features and treatment outcomes were included for analysis. Results Of 125 bone-joint infected patients seen during the study period, 92 patients were caused by bacterial infection and 33 from tuberculous infection. Their mean ± standard deviation age was 55.3 ± 17.7 years, and had total disease duration of 7.1 ± 8.2 months. Sixty-four percent were men. Of 33 TB cases, 24 (72.7%) had spinal involvement. Among 92 cases with bacterial infection, 52 (56.5%) had non-spinal joint involvement, and 38 (41.3%) had non-spinal bone involvement. Regarding clinical features, TB cases had mean duration of symptom of 5.3 ± 6.1 months. Multivariate logistic regression analyses showed that neurological manifestations (adjusted OR = 314.1, 95% CI 14.4–6831, P < 0.001), pulmonary symptoms (AOR = 222.1, 95% CI 3.0–16,560, P = 0.014), symptom duration over 1 month (AOR = 67.4, 95% CI 4.2–1070, P = 0.003), afebrile illness (AOR = 24.1, 95%CI 1.2–493.7, P = 0.039), ESR <70 mm/hour (AOR = 4.7, 95% CI 1.1–19.9, P = 0.039), and CRP <30 mg/l (AOR = 7.0, 95% CI 1.6–31.2, P = 0.010) were risk factor of TB bone-joint infection. There were 120 (96.0%) patients with clinical improvement, and five (4.0%) died patients. There were no significant differences among the clinical improvement, recurrent infection, and mortality between the two groups. Conclusion Distinguish of bone-joint infection between bacteria and mycobacterium tuberculosis is difficult. However, patients with TB bone-joint infections significantly had more symptom duration over 1 month, the presence of paraplegia, the presence of pulmonary symptoms, and the presence of afebrile illness than those with bacterial infection. There were no significant differences among treatment outcomes and mortality between the two groups. Disclosures All authors: No reported disclosures.

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