Tuberculosis in Children in a Pediatric Hospital in Mexico

2021 ◽  
Author(s):  
Napoleón González Saldaña ◽  
Mercedes Macías Parra ◽  
Hugo Juárez Olguín ◽  
José Iván Castillo Bejarano ◽  
Monica Punzo Soto ◽  
...  
Keyword(s):  
Pediatric Hospital ◽  
Diagnostic Challenge ◽  
Abnormal Chest ◽  
Culture Sensitivity ◽  
History Of ◽  
Chest X Ray ◽  
Epidemiological Evaluation ◽  
Polymerase Chain ◽  
Tuberculosis In Children ◽  
Skin Test Result

Tuberculosis (TB) remains a global problem and a diagnostic challenge, especially in pediatrics. The aim of this study was to describe the clinical, microbiological, radiological, and histopathological data of TB in children. A 7-year retrospective and descriptive cohort study that included 127 patients under 18 years of age with diagnosis of active TB was conducted from 2011 to 2018 in a pediatric hospital. Tuberculosis was microbiologically confirmed using Ziehl–Neelsen (ZN) staining, culture or polymerase chain reaction (PCR) in a total of 94 (74%) cases. Thirty-three cases were defined as probable TB based on tuberculin skin test result and epidemiological evaluation. The TB forms found were lymph node (39.3%), bone (15.7%), lung (13.6%), and meningeal TB (8.6%). The most common symptoms were fever (48.8%) and adenopathy (45.6%). History of contact was established in 34.6%. Positive ZN staining (sensitivity 30%) and culture (sensitivity 37%) were found in 29% and 37.7% of subjects, respectively. About 64.5% depicted abnormal chest X-ray. Xpert MTB/RIF® (PCR) was positive in 9.4% and biopsy was compatible in 52.7% of these samples. It is fundamental to have laboratory and epidemiological evaluation that support the diagnosis of the disease in children and thus, define its management; since, in most cases, early microbiologic confirmation is lacking.

scholarly journals Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani
Keyword(s):  
Laryngeal Carcinoma ◽  
Incidental Finding ◽  
Chain Reaction ◽  
Rare Presentation ◽  
Case Presentation ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

scholarly journals Unilateral pulmonary hypoplasia in an adult patient

2018 ◽  
Vol 88 (1) ◽  
Author(s):  
Dimitrios Papadopoulos ◽  
Panagiotis Misthos ◽  
Maria Chorti ◽  
Vlasios Skopas ◽  
Alexandra Nakou ◽  
...  
Keyword(s):  
Pulmonary Hypoplasia ◽  
Respiratory Infections ◽  
Imaging Technique ◽  
Lung Parenchyma ◽  
X Ray ◽  
Recurrent Respiratory Infections ◽  
Abnormal Chest ◽  
Cystic Changes ◽  
History Of ◽  
Chest X Ray

Pulmonary hypoplasia (PH) is a developmental anomaly of the lung parenchyma, characterized by a decrease in the number and size of airways, alveoli and vessels. We present a case of a 31-year-old patient with a history of chronic productive cough and frequent respiratory infections, who was referred for investigation of abnormal chest x-ray. The combination of chest computed tomography (CT) and bronchoscopy set the diagnosis of left pulmonary hypoplasia and the patient was treated surgically with a left pneumonectomy. PH is usually diagnosed immediately after birth, causing severe respiratory failure with high mortality. The less severe, unilateral forms can possibly survive by causing compensatory hyperinflation of the other lung and remain undiagnosed until adulthood, presenting either asymptomatic or with symptoms of chronic bronchitis and recurrent respiratory infections. Chest CT is considered the imaging technique of choice for the diagnosis and for the differential diagnosis from other congenital or acquired conditions. The treatment is usually conservative, although surgical resection is indicated in cases of severe cystic changes and intense symptomatology.

scholarly journals Additive effect of dabigatran and high-dose aspirin in the development of haemorrhagic pleural effusion in a patient with tuberculous pleuritis

2020 ◽  
Vol 32 (3) ◽  
pp. 176-179
Author(s):  
Duygu Karagül
Keyword(s):  
Pleural Effusion ◽  
Dabigatran Etexilate ◽  
Chronic Atrial Fibrillation ◽  
The Elderly ◽  
Additive Effect ◽  
High Dose ◽  
History Of ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
High Doses

Tuberculous pleuritis can rarely cause haemorrhagic pleural effusion. Dabigatran etexilate can have an additive effect on increasing the risk of haemorrhage. Aspirin cannot cause major haemorrhage, but in the elderly it can cause gastrointestinal bleeding via ulceration of the gastrointestinal mucosa. We report here the case of a 77-year-old male who presented to the hospital with a 2-month history of progressive dyspnoea. He had been taking dabigatran etexilate (220 mg) and high-dose acetylsalicylic acid (aspirin; 300 mg) daily for chronic atrial fibrillation. A chest X-ray revealed a moderately sized right pleural effusion confirmed by a computed tomography scan, which also showed bronchiectasis of both lungs. Dabigatran was discontinued and aspirin was decreased to the minimal therapeutic dose of 100 mg before thoracentesis was performed. Lymphocyte-predominant (50%) haemorrhagic fluid of 500 ml was drained, positive for acid-fast bacilli smear and polymerase chain reaction of Mycobacterium tuberculosis. A chest tube was placed and an additional 1250 ml of haemorrhagic exudate drained out. We treated the patient with a routine regimen of antituberculous medication and the infection resolved without complications other than the bronchiectasis present before treatment. We think that the combination of dabigatran etexilate and high doses of aspirin increased the risk of pleural haemorrhage in this patient with tuberculous pleuritis

scholarly journals Chest pain and an abnormal chest X-ray – a case report

2013 ◽  
Vol 12 (4) ◽  
pp. 227-229
Author(s):  
Nicholas Smallwood ◽  
◽  
Sarah Perrio ◽  
Keyword(s):  
Chest Pain ◽  
Common Symptom ◽  
C Reactive Protein ◽  
Diagnostic Challenge ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Acute Medical Unit ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Early Surgical Intervention

Chest pain is a common symptom amongst patients presenting to the acute medical unit, and presents a diagnostic challenge. We present the case of a previously healthy 65 year old year old gentleman with chest pain and subsequent vomiting, treated initially as an acute coronary syndrome, despite normal ECG and troponin. Chest radiograph revealed left basal consolidation with an effusion, suggesting pneumonia. The absence of symptoms of respiratory infection along with a normal C-reactive protein level led to further investigation with CT. This revealed evidence of oesophageal rupture (Boerhaave’s syndrome). Despite early surgical intervention our patient suffered a number of complications and continues his recovery in hospital three months post presentation.

scholarly journals Prevalence of Tuberculosis in Diabetic Patients Living in Rural Areas of Northern Iran in 2016

2021 ◽  
Vol 29 (4) ◽  
pp. 114-121
Author(s):  
Arash Naghipour ◽  
◽  
Zahra Khatirnamani2 ◽  
Ehsan Allah Kalteh ◽  
Sonbol Taramian ◽  
...  
Keyword(s):  
Skin Test ◽  
Rural Areas ◽  
Sputum Smear ◽  
Diabetic Patients ◽  
Northern Iran ◽  
Abnormal Chest ◽  
Night Sweats ◽  
History Of ◽  
Chest X Ray ◽  
And Control

Background: Tuberculosis (TB) is a chronic bacterial infection. Simultaneous onset of diabetes and TB can interfere with the treatment and control of TB. Objective: This study aims to investigate the prevalence of TB in diabetic patients living in rural areas of northern Iran. Materials and Methods: Participants were 925 diabetic patients living in rural areas of Kordkuy County, Golestan, Iran. Data were collected using a checklist surveying demographic characteristics and medical records of patients. To diagnose TB, they underwent a TB skin test, sputum smear test, chest radiography, and referring to an infectious diseases specialist, if needed. Results: Seven hundred sixteen of participants were female. The mean age of participants and their mean duration of diabetes were 58.4±11.1 and 8.39±5.47 years, respectively. Results of test showed that 62 patients had abnormal chest x-ray; 14 had coughing more than two weeks; 1 had fever; 2 had night sweats; 11 had sputum; 152 had positive TB skin test result; 10 had a history of previous TB; and 1 had active TB. Conclusion: The prevalence and incidence of TB in diabetic patients is 60 and 6 times higher than in general population, respectively.

Torque Teno Virus in Nasopharyngeal Aspirate of Children With Respiratory Infections

2022 ◽  
Author(s):  
Teresa del Rosal ◽  
María Luz García-García ◽  
Inmaculada Casas ◽  
Sonia Alcolea ◽  
María Iglesias-Caballero ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Torque Teno Virus ◽  
Hospitalized Children ◽  
Nasopharyngeal Aspirate ◽  
Persistent Infections ◽  
Abnormal Chest ◽  
Healthy Control ◽  
Chest X Ray ◽  
Polymerase Chain

Abstract Torque teno virus (TTV) is responsible for persistent infections and is considered a marker of immune function. The role of TTV as a facilitator of respiratory infections(RIs) is unknown. We aimed to estimate the prevalence of TTV in the nasopharyngeal aspirate (NPA) of hospitalized children with RIs and correlate them with outcomes and immune response. NPA was taken for testing 16 respiratory viruses by RT-polymerase chain reaction (PCR), TTV PCR, and immunological study.Sixty hospitalized children with an RI and 3 healthy control infants were included. A total of 51/60 patients had a positive common respiratory viral (CRV) identification. A total of 24/63 (38.1%) children were TTV+ and had other CRVs in 95.8% of cases vs 74.4% in TTV- (p=0.029). TTV+ patients tended to be older, have fever, and need PICU admission more often than TTV- patients. Abnormal chest X-ray was more frequent in the TTV+ patients, OR 2.6(95% CI:1.3-5.2).The genetic expression of filaggrin (involved in epithelial barrier integrity) was lower in TTV+ patients; however, levels of filaggrin in the NPA were increased.In summary, TTV infection is common in children with RI and could be associated with pneumonia, greater severity, and alteration in filaggrin gene expression and protein release.

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

Refractory Ascites as the Only Presenting Symptom of Chronic Calcified Constrictive Pericarditis: A Diagnostic Challenge

2014 ◽  
Vol 17 (1) ◽  
pp. 42
Author(s):  
Shi-Min Yuan
Keyword(s):  
Computed Tomography ◽  
Liver Cirrhosis ◽  
Female Patient ◽  
Constrictive Pericarditis ◽  
Delayed Diagnosis ◽  
Young Female ◽  
Refractory Ascites ◽  
Diagnostic Challenge ◽  
Massive Ascites ◽  
History Of

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.

A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Femoral Hernia ◽  
Rare Case ◽  
Hernia Recurrence ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

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