scholarly journals Clinical spectrum and outcome of extra-pulmonary tuberculosis in children.

2021 ◽  
Vol 28 (09) ◽  
pp. 1336-1340
Author(s):  
Asma Mushtaq ◽  
Aysha Mansoor Lodhi ◽  
Wajiha Rizwan ◽  
Carol Ruth ◽  
Meher Muzaffar ◽  
...  
Keyword(s):  
Weight Loss ◽  
Pulmonary Tuberculosis ◽  
Lymph Nodes ◽  
Tertiary Care ◽  
Clinical Spectrum ◽  
Care Hospital ◽  
Cross Sectional ◽  
Duration Of Symptoms ◽  
Extra Pulmonary Tuberculosis ◽  
Extra Pulmonary

Objective: To determine the types, clinical spectrum and outcome of Extra-Pulmonary Tuberculosis (EPTB) in children admitted at a tertiary care hospital. Study Design: Cross Sectional study. Setting: The Children's Hospital and The Institute of Child Health, Lahore. Period: May to December 2019. Material & Methods: A total of 63 patients diagnosed with EPTB aged 1 month to 16 years were included. All patients with lung involvement were excluded from the study. Anti-tuberculous therapy (ATT) was started in all patients and outcome was monitored during the hospital stay. Results: In a total of 63 patients, mean age was 9.03+3.1 years. There were 35 (55.5%) male and 28 (44.4%) female. The mean duration of symptoms at the time of presentation was 5.93+2.4 months. The common sites of EPTB were meninges noted in 17(26.9%), pleural in 13 (20.6%), abdominal in 12 (19.04%), lymph nodes in 11 (17.4%), disseminated in 6 (9.52%) and bone and joints in 4 (6.34%) patients. The most common systemic complaints were fever in 58 (92.06%), weight loss in 48 (76.1%) and anorexia in 45 (71.4%). After treatment, fifty-four patients improved and discharged while 9 (14.2%) patients died. Conclusion: The commonest sites of EPTB were meninges, pleural, abdomen and lymph nodes. Fever, weight loss and anorexia were the most frequent systemic complaints. Most of the patients recovered while the most common cause of mortality was tuberculous meningitis.

scholarly journals Aetiology of Fever of Unknown Origin: One-Year Experience in a Tertiary Care Hospital of Bangladesh

2016 ◽  
Vol 6 (1) ◽  
pp. 7-11
Author(s):  
Muhammad Abdur Rahimi ◽  
AKM Shaheen Ahmed ◽  
Md Delwar Hossain ◽  
Md Raziur Rahman ◽  
Swapan Kumar Ghosh ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lupus Erythematosus ◽  
Fever Of Unknown Origin ◽  
Tertiary Care ◽  
Unknown Origin ◽  
Care Hospital ◽  
Cross Sectional ◽  
Extra Pulmonary Tuberculosis ◽  
Common Causes ◽  
Extra Pulmonary

Background: Fever of unknown origin (FUO) is not an uncommon problem in general medical practice. Sometimes extensive investigations fail to reach an aetiological diagnosis; on the other hand, in few cases, fever resolves spontaneously. This study was aimed to evaluate the aetiology of FUO in a tertiary care setting.Methods: This cross-sectional study was done in the Department of Internal Medicine of BIRDEM General Hospital, Dhaka, Bangladesh from July 2012 to June 2013.Results: Among the 33 patients studied (1.23% of total admissions), 22 (66.7%) were male. Mean age of the study population was 40.2±7.9 years. Most patients (84.8%) were diabetic. Infection (20, 60.6%) was the commonest cause, followed by malignancy (9, 27.3%). Among the infective causes (20), extra-pulmonary tuberculosis (5, 25%) was the commonest, followed by liver abscess (4, 20%). Other less common causes were Kala-azar (1), malaria (2), histoplasmosis (2), melioidosis (1), cholecystitis (1), renal abscess (1), rickettsial fever (1), apical dental abscess (1) and infective endocarditis (1). Non-Hodgkin’s lymphoma (6), renal cell carcinoma (2) and hepatocellular carcinoma (1) constituted the malignant causes of FUO in this series. Systemic lupus erythematosus was the aetiology of FUO in 1 case. One case remained undiagnosed and 2 patients left hospital before a definite diagnosis could be made.Conclusion: Extra-pulmonary tuberculosis and non-Hodgkin’s lymphoma were the two most common causes of FUO in this study. Repeated history taking, clinical examinations and careful stepwise investigations can diagnose the aetiolgy in most cases of FUO.Birdem Med J 2016; 6(1): 7-11

scholarly journals Prevalence Of Tuberculosis Among Hiv Positive Patients Attending Ictc In A Tertiary Care Institute In Ahmadabad, A Western City Of India

2013 ◽  
Vol 10 (1) ◽  
pp. 13-18
Author(s):  
Sunil Nayak ◽  
J Karia ◽  
P Patel ◽  
B Modi ◽  
K Desai ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Abdominal Tuberculosis ◽  
Hiv Positive ◽  
Care Hospital ◽  
Extra Pulmonary Tuberculosis ◽  
Counseling And Testing ◽  
Common Opportunistic Infection ◽  
Extra Pulmonary ◽  
Integrated Counseling

Introduction: In India, tuberculosis is the most common opportunistic infection among HIV positive patients. This study estimates the prevalence of tuberculosis amongst HIV patients in Ahmadabad, Gujarat. Methodology: The present study was conducted at Integrated Counseling and Testing Center for HIV at Sola civil hospital, a public sector tertiary care hospital in Ahmadabad for a twenty month period from January, 2009 to August, 2010. All the patients visiting the center during the study period were screened for HIV. All the patients who were diagnosed HIV positive were subjected for active search of tuberculosis; clinically, radiological as well as by histopathology and laboratory tests. Results: Total 6846 patients were screened for HIV, out of which 167(2.44%) patients were tested HIV positive. Out of 167 HIV positive patients, 22 (13.17%) were diagnosed as cases of tuberculosis. Out of these 22 patients, 18(81.82%) had pulmonary tuberculosis while 4(18.18%) were extra-pulmonary tuberculosis patients. Amongst the four extra-pulmonary tuberculosis cases, one (25.00%) case was of tuberculous meningitis, one (25.00%) was of abdominal tuberculosis and two (50.00%) had tuberculous lymphatic swelling. Conclusion: The prevalence of tuberculosis in HIV positive patients found in this study was 13.17%, which is substantially lower than that reported in previous studies. Appropriate management of these patients requires a strengthened mechanism of cross reference and inter sectoral co-ordination between the two diseases at all levels. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(1); 13-18 DOI: http://dx.doi.org/10.3126/saarctb.v10i1.8672

A STUDY ON EXTRA PULMONARY TUBERCULOSIS: SITE DISTRIBUTION

2021 ◽  
pp. 25-26
Author(s):  
Chhotala Yagnik ◽  
Vishal Oza ◽  
Chetal Suva
Keyword(s):  
Lymph Node ◽  
Pulmonary Tuberculosis ◽  
Tertiary Care Hospital ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Abdominal Tuberculosis ◽  
Care Hospital ◽  
Extra Pulmonary Tuberculosis ◽  
Site Distribution ◽  
Extra Pulmonary

Background:Extra-pulmonary tuberculosis can affect the lymph nodes, pleura, bones, joints, genito-urinary tract, nervous system (meningitis, tuberculoma), abdominal tuberculosis (intestines, mesentery, solid organs), skin. Materials and Methods: It is a record based, observational prospective study which assesses the presentation and evaluation of the site of distribution of extrapulmonary tuberculosis and management of it in a tertiary care hospital. Result:In present study, 26% of cases from lymph node TB, 20% cases from CNS and pleural TB, 18% cases from GIT, 8% cases from skeletal TB, 4% cases from GUT, 2% cases from ocular and 2% cases from pericardial TB Conclusion:The frequency of extrapulmonary TB in this study was highest in lymph node followed by pleural, CNS, GIT, skeletal and others respectively

Sensitivity of sputum exam with respect to gene expert in detection of MTB at tertiary care hospital

2021 ◽  
Vol 19 (3) ◽  
pp. 126-129
Author(s):  
Sanjiv Vithalrao Zangde ◽  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Predictive Value ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Reliable Technique ◽  
Extra Pulmonary Tuberculosis ◽  
Smear Negative ◽  
Extra Pulmonary ◽  
Incident Cases

Background: According to the WHO Tuberculosis Report 2014, there were 9 million incident cases of TB worldwide, with the South–East Asia and Western Pacific areas accounting for 58 percent of the global burden and India accounting for 24 percent. Aims and Objective: To study Sensitivity of sputum exam with respect to gene expert in detection of MTB at tertiary care hospital Methodology: The present study is an observational cross-sectional study of the patients with pulmonary tuberculosis attending Department of Pulmonary Medicine at a tertiary care centre during period of 1 January 2019 to 30 June 2020 by the permission of Institutional Ethical Committee . Genexpert test / CBNAAT [ Xpert MTB/RIF Assay] Statistical analysis done buy of (version 20) for Windows package (SPSS Science, Chicago, IL, USA). Result: Ziehl and Neelsen staining was done for 200 samples of cases of pulmonary tuberculosis. Out of these 55(27.50%) sputa samples were ZN smear positive and 145(72.50%) were negative. Then all the samples were tested on Gene Xpert MTB/RIF assay. Out of these 200 patients, 186(93%) were MTB detected and 14(7.00%) were MTB not detected. The MTB/RIF assay detect the agent in 54 out of 55 ZN smear positive cases and 132 out of 145 AFB smear negative cases as shown in table No.10. So, MTB detection rate by Gene Xpert 186cases (93.00%) is more as compared to ZN staining 55cases (27.50%). Out of 55 sputum positive cases, 54 were positive for MTB by Gene Xpert but in 01 sputum positive case MTB was not detected by Gene Xpert assay. There was statistically significant better detection with Genexpert when compared to microscopy AFB test in pulmonary tuberculosis patients.The Sensitivity of Sputum was 29.03% and Specificity was 92.86%, Positive Likelihood Ratio4.06, Negative Likelihood Ratio 0.76, Positive Predictive Value (*) was 98.18% and Negative Predictive Value (*) was 8.97%. Conclusion: It can be concluded from our study that the Genexpert is highly sensitive test for the detection of the Mycobacteria and Xpert MTB/RIF assay can quickly identify possible multidrug-resistant TB. From our study we conclude that Gene Xpert MTB/RIF is simple and reliable technique for diagnosing extra pulmonary tuberculosis with high sensitivity and specificity not only in smear positive cases but also in smear negative cases. It is a game changer not only in pulmonary tuberculosis control but probably also in extra pulmonary tuberculosis.

scholarly journals Profile and outcome of childhood tuberculosis treated with DOTS at a tertiary care hospital in central India: an observational study

2018 ◽  
Vol 5 (2) ◽  
pp. 324
Author(s):  
Anjali Bharani ◽  
Mohini Harshey ◽  
Swati Raipurkar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Mantoux Test ◽  
Care Hospital ◽  
Age Group ◽  
Pediatric Age ◽  
Extra Pulmonary Tuberculosis ◽  
Pediatric Age Group ◽  
Extra Pulmonary

Background: Children contribute a significant proportion of the tuberculosis (TB) burden in India and suffer severe TB related morbidity and mortality, particularly in endemic areas. Diagnosis and management of pediatric TB especially Extra pulmonary (EPTB) is challenging. The present study was designed to study clinical, laboratory characteristics and outcome of childhood tuberculosis.Methods: A retrospective analysis of 90 cases of TB in children within 2 year period was conducted at Pediatric Department and DOTS center at a tertiary care hospital from January 2015 to December 2016.Results: In the present study 20% of the total TB patients attending DOTS OPD were Children. Most common symptoms were Fever (53.3 %), Cough (46.6%), abdominal pain (18.8%), lymphadenopathy (13.3%), osteo-articular symptoms (13.3%), weight loss (10%), CNS related complaints like convulsions and unconsciousness (6.6%). History of contact was present in 10 cases (11%). Sputum examination was positive in 9 cases (10%) who were predominantly older children above 12 years. Mantoux test was positive in 9 cases (10%). Only one patient was HIV positive.  Extra pulmonary tuberculosis (EPTB) patients were more common than pulmonary. 47 out of the 90 cases (52%) were receiving DOTS for EPTB. Out of the 90 cases 84 (93.3%) were on New Category 1 treatment and 6 (6.6%) were on Cat 2 treatment. Out of the total 90 cases 3 defaulted, 3 died, rest completed treatment with good compliance and no side-effects and were declared cured.Conclusions: In present study, it was found that extra-pulmonary tuberculosis (EPTB) patients are more common than pulmonary tuberculosis in pediatric age group. Sputum positivity yield is very low in pediatric age group. Success of treatment with DOTS is good (94.4%). No adverse effects of ATT were observed.

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