scholarly journals Pulmonary tuberculosis with atypical presentation because of unknown previous HIV infection – case report

Pneumologia ◽  
2019 ◽  
Vol 68 (1) ◽  
pp. 41-45
Author(s):  
Cristina Călărașu ◽  
Mimi Niţu ◽  
Mădălina Olteanu ◽  
Andreea Loredana Golli ◽  
Florentina Dumitrescu ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Wide Spectrum ◽  
Young Male ◽  
X Ray ◽  
Infected People ◽  
Tb Treatment ◽  
Immunodeficiency Virus ◽  
Chest X Ray ◽  
Mediastinal Adenopathy

Abstract Background People coinfected with tuberculosis (TB) and human immunodeficiency virus (HIV) are 20–37 times more likely to develop active TB disease than non-HIV-infected people. Syndemic interaction between HIV and TB epidemics has made testing for TB a must for HIV-infected people and vice versa. We present the case of a young male diagnosed with HIV infection, due to mandatory HIV testing for all TB cases in Romania. Case presentation A 30-year-old man was hospitalized for fever, chills and productive cough not influenced by previous antibiotic home treatment. He was admitted with tachycardia and bilateral presence of coarse crackles in lower pulmonary areas. Chest X-ray suggested bilateral bronchopneumonia; the results from blood tests showed inflammation, leukocytosis and anaemia. Hemocultures were negative. Under wide-spectrum antibiotic treatment, his general condition partially improved, but on the seventh day, chest X-ray revealed abscess in the left inferior lobe and the progression of previous lesions. Chest computed tomography revealed multiple large consolidation areas in both lung areas, a 13 cm diameter abscess and multiple mediastinal adenopathy of 2–4 cm in diameter. Acid fast bacilli smear from sputum was positive. After the diagnosis of pulmonary TB, anti-TB treatment was started; the patient was subsequently diagnosed with HIV infection. He received specific anti-TB treatment, and 3 weeks later, retroviral treatment was initiated. Clinical evolution was favourable and radiological appearance improved. In addition, he did not present any adverse effects of therapy. Conclusions HIV testing for all TB cases is a must because HIV-TB coinfection raises important diagnostic and treatment problems.

Health and social problems associated with HIV infection and AIDS in the professional activity of specialists with secondary medical education

2020 ◽  
pp. 5-13
Author(s):  
L. Guseva
Keyword(s):  
Medical Education ◽  
Hiv Infection ◽  
Clinical Signs ◽  
Modern Society ◽  
Progressive Increase ◽  
Professional Activity ◽  
Infected People ◽  
Immunodeficiency Virus ◽  
Epidemiological Characteristics

The article considers urgent problem of modern society – progressive increase in the number of people infected with the human immunodeficiency virus (HIV). Epidemiological characteristics of the pathogen are given, clinical signs of the disease and a modern strategy aimed at reducing the number of infected people are presented. The role of specialists with secondary medical education in the implementation of the Strategy aimed at combating the spread of HIV infection epidemic in the Russian Federation is emphasized.

scholarly journals Incorporating Rapid HIV Testing into Partner Counseling and Referral Services

2008 ◽  
Vol 123 (3_suppl) ◽  
pp. 126-135 ◽  
Author(s):  
Elin B. Begley ◽  
Alexandra M. Oster ◽  
Binwei Song ◽  
Linda Lesondak ◽  
Kelly Voorhees ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Hiv Testing ◽  
The United States ◽  
High Risk Population ◽  
Newly Diagnosed ◽  
Infected People ◽  
Rapid Hiv Testing ◽  
Undiagnosed Hiv ◽  
Locating Information

Objectives. Partner counseling and referral services (PCRS) provide a unique opportunity to decrease transmission of human immunodeficiency virus (HIV) by notifying sex and drug-injection partners of HIV-infected individuals of their exposure to HIV. We incorporated rapid HIV testing into PCRS to reduce barriers associated with conventional HIV testing and identify undiagnosed HIV infection within this high-risk population. Methods. From April 2004 through June 2006, HIV-infected people (index clients) were interviewed, and their partners were notified of their potential exposure to HIV and offered rapid HIV testing at six sites in the United States. The numbers of index clients participating and the numbers of partners interviewed and tested were compared by site. Descriptive and bivariate analyses were performed. Results. A total of 2,678 index clients were identified, of whom 779 (29%) provided partner locating information. A total of 1,048 partners were elicited, of whom 463 (44%) were both interviewed and tested for HIV. Thirty-seven partners (8%) were newly diagnosed with HIV. The number of index clients interviewed to identify one partner with newly diagnosed HIV infection ranged from 10 to 137 at the participating sites. Conclusions. PCRS provides testing and prevention services to people at high risk for HIV infection. Incorporating rapid HIV testing into PCRS and identifying previously undiagnosed infections likely confer individual and public health benefits. Further evaluation is needed to determine the best methods of identifying partners with previously unrecognized HIV infection.

scholarly journals Aurea diagnosis of pneumomediastinum. A case report

2020 ◽  
Vol 14 (3) ◽  
pp. 179-183
Author(s):  
Lucio Brugioni ◽  
Francesca De Niederhausern ◽  
Chiara Gozzi ◽  
Pietro Martella ◽  
Elisa Romagnoli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Chest Pain ◽  
Correct Diagnosis ◽  
Young Male ◽  
Differential Diagnoses ◽  
Diagnostic Process ◽  
Acute Aortic Syndrome ◽  
X Ray ◽  
Chest X Ray

Pericarditis and spontaneous pneumomediastinum are among the pathologies that are in differential diagnoses when a patient describes dorsal irradiated chest pain: if the patient is young, male, and long-limbed, it is necessary to exclude an acute aortic syndrome firstly. We present the case of a young man who arrived at the Emergency Department for chest pain: an echocardiogram performed an immediate diagnosis of pericarditis. However, if the patient had performed a chest X-ray, this would have enabled the observation of pneumomediastinum, allowing a correct diagnosis of pneumomediastinum and treatment. The purpose of this report is to highlight the importance of the diagnostic process.

scholarly journals The Pattern of Presentation and Prevalence of Tuberculosis in HIV-Seropositive Patients Seen at Benin City, Nigeria

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Christopher C. Affusim ◽  
Emeka Kesieme ◽  
Vivien O. Abah
Keyword(s):  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Hiv Positive ◽  
X Ray ◽  
Benin City ◽  
Immunodeficiency Virus ◽  
High Incidence ◽  
Chest X Ray ◽  
Negative Sputum ◽  
Hiv Seropositive

Background. The emergence of Human immunodeficiency virus (HIV), led to the rise in the incidence and prevalence of tuberculosis (TB) worldwide. However, the trend is being reversed recently due to the widespread use of effective Anti-Retrovirals. Immunosuppression induced by HIV infection modified the clinical presentation of TB, resulting in atypical signs and symptoms, and a more frequent extrapulmonary presentation. This study was undertaken to determine the pattern of presentation and prevalence of TB in HIV seropositive patients seen in Benin City, Nigeria, from January to April, 2007. Method. The study was done using 330 HIV positive patients (123 males and 207 females). A designed questionnaire was used as a diagnostic instrument. Results. The prevalence of TB HIV was found to be 33.9%. It was found to be commoner in females, commonest in the age group 30–39 years. Pulmonary TB was the commonest type of TB found (78.6%). This was followed by TB adenitis (12.5%). The incidence of extrapulmonary TB was 21.4%. There was a high incidence of atypical chest X-ray features and high frequency of negative sputum smears. Conclusions. The overall prevalence rate of TB in HIV (33.9%), and the extrapulmonary presentation of TB are high. Some investigation results were found to be atypical in those with both infections. Physicians should be aware of this pattern of presentation and the atypical findings on investigation for early diagnosis and treatment.

scholarly journals Occult HIV infection in a large sample of health-care users in Lombardy, Italy in 2014–2015: implications for control strategies

2017 ◽  
Vol 145 (11) ◽  
pp. 2352-2359
Author(s):  
L. SCUDELLER ◽  
F. GENCO ◽  
F. BALDANTI ◽  
G. COMOLLI ◽  
G. ALBONICO ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Control Strategies ◽  
Population Level ◽  
Plasma Samples ◽  
Positive Individual ◽  
Immunodeficiency Virus ◽  
Hiv Antigen ◽  
Confirmatory Tests ◽  
New Strategies

SUMMARYWe estimated the number of people unaware of their human immunodeficiency virus (HIV) infection in our province, Pavia (population 540 000) in Lombardy, Italy, by means of anonymous unlinked testing of 10 044 serum/plasma samples residual from clinical analyses at the outpatient clinic of Policlinico San Matteo in 2014 and 2015. Ethical and legal approval was obtained prior to study start. Samples were irreversibly anonymised, only retaining gender and 5-year age class. Five sample pools were tested for HIV using LIAISON® XL MUREX HIV Ab/Ag (DiaSorin, Saluggia, Italy). If the pool tested positive, individual samples underwent confirmatory tests, Innotest HIV Antigen mAb (Fujirebio Europe, Gent, Belgium) and HIV BLOT 2·2 (MP Diagnostics, Singapore). Among the 10 044 samples processed, eight were confirmed positive (0·08%, 95% confidence interval 0·03–0·16%), all were males and age was >50 in 3 (37·5%). If projected to the entire population of the Pavia province, this would result in approximately 1000 people unaware of their HIV infection, with age older than expected. In Italy, HIV testing is voluntary, universally free-of-charge and (upon request) anonymous. Nevertheless, this study demonstrates that it is suboptimally employed, and that new strategies and population-level actions will be needed to achieve better implementation of HIV testing and HIV control in our province.

scholarly journals Fear of HIV Infection and Impact of Training on the Attitudes of Surgical and Emergency Nurses Toward Inpatient HIV Testing

2007 ◽  
Vol 28 (2) ◽  
pp. 230-233 ◽  
Author(s):  
Maria Gańczak ◽  
Peter Barss
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Surgical Patients ◽  
Hiv Positive ◽  
Emergency Nurses ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Testing Policies ◽  
Previous Training

This study evaluates the association between the degree of fear of human immunodeficiency virus (HIV) infection and support for different HIV testing policies. A strong fear of acquiring HIV infection at work was widespread among a sample of 601 Polish surgical and emergency nurses. Most favored inappropriate HIV testing of all surgical patients and inpatients. Previous training about HIV and acquired immunodeficiency syndrome (AIDS) and experience caring for HIV-positive patients had a significant impact on reducing support for testing of all inpatients but not for testing of surgical patients.

scholarly journals Role of gene Xpert test in clinical TB suspect in children

2018 ◽  
Vol 5 (4) ◽  
pp. 1657
Author(s):  
Sheenu Gupta ◽  
Veerana Kotrashetti ◽  
Rizwan Ahmed
Keyword(s):  
Diagnostic Tests ◽  
Clinical Manifestations ◽  
Childhood Tuberculosis ◽  
Mantoux Test ◽  
Gastric Aspirate ◽  
X Ray ◽  
Tb Treatment ◽  
Childhood Tb ◽  
History Of ◽  
Chest X Ray

Background: Tuberculosis (TB) is a major global health problem. Childhood tuberculosis (TB) is common in our community but it is relatively neglected, due to greater challenges in diagnosis. Clinical manifestations of childhood TB differ from adults. The diagnosis in most cases is based on clinical evidence but chest X-ray, Mantoux test, history of Kochs contact, malnutrition and sputum/gastric sample microscopy are important supporting investigations. WHO recommended use of newer diagnostic tests like Gene Xpert in pediatric cases where TB is mostly paucibacillary and identification of TB bacilli is difficult for confirmation of diagnosis.Methods: This prospective study was conducted among admitted and OPD patients in the department of Pediatrics over a period of 1and half year. Clinically suspected cases of TB in the age group 0-12 years who met the diagnostic criteria made the study group. Refusal of consent by parent and children already on TB treatment were excluded from this study. Investigations like chest X-ray, Mantoux test, sputum/gastric aspirate microscopy and Gene Expert were done to confirm the clinical diagnosis.Results: Pulmonary tuberculosis was more common (28%), TB lymphadenitis 22%, TB meningitis 14%, Tubercular Pleural effusion 12 %. and rest were no TB. BCG scar was present in 90%. History of contact was present in 76% and Mantoux test was positive in 76%. Gene Expert was positive only in one case in our study rest 49 cases were negative. The most common symptoms were fever (72%), cough (52%) and weight loss (40%).Conclusions: This study supports that detailed history, clinical evaluation and active investigative workup in addition to newer diagnostic tests like Gene Xpert has a major role in diagnosing childhood tuberculosis.

scholarly journals An observational report of universal GeneXpert testing of inpatients with diagnosed or presumptive TB in the Philippines

2020 ◽  
Vol 114 (9) ◽  
pp. 682-686
Author(s):  
Aye Myat Thi ◽  
Nathaniel Lee ◽  
Victoria Parris ◽  
Flora P Marin ◽  
Lynsil Roy ◽  
...  
Keyword(s):  
Scale Up ◽  
Multidrug Resistant ◽  
The Philippines ◽  
Rifampicin Resistance ◽  
X Ray ◽  
Tb Treatment ◽  
High Incidence ◽  
Chest X Ray ◽  
Smear Negative ◽  
Observational Report

Abstract Background The Philippines is a high TB and multidrug-resistant TB burden country. Although the scale-up of GeneXpert testing is occurring, the benefits of universal Xpert-Mycobacterium tuberculosis/ rifampicin (MTB/RIF) testing in inpatients have not been documented. Methods Routine GeneXpert testing irrespective of priority criteria for testing was conducted within a prospective cohort of all adults with known or presumptive TB admitted to a tertiary infectious diseases hospital in Manila. Study-specific TB diagnosis was decided upon bacteriological results, chest x-ray assessment, if already on anti-TB treatment (ATT) at admission and a cough duration of ≥2 wk. Results Of submitted sputum samples, 87.1% (277/318) had valid acid-fast bacilli (AFB) microscopy and Xpert® MTB/RIF results. Xpert® MTB/RIF was positive in 97.7% (n = 87/89) of AFB-positive patients and 25.5% (n = 48/188) of AFB-negative patients. Bacteriological confirmation in smear negative cases not on ATT prior to admission was 25.2% (34/135). Rifampicin resistance was detected in 26/135 Xpert positive cases (19.3%), including nine who might not otherwise have been detected, representing a 53% increase in yield. Conclusion Universal GeneXpert testing in this setting enhanced the yield of bacterial confirmation, revealing a high incidence of rifampicin resistance and suggesting a need for further investigations in Xpert-negative/smear-positive patients who may not have mycobacterial TB.

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