scholarly journals Warty cutaneous tuberculosis of the nose: A rare localization

2022 ◽  
Vol 13 (1) ◽  
pp. 50-52
Author(s):  
Moussa Doulla ◽  
Laouali Salissou ◽  
Nina Korsaga/Some ◽  
Maimouna Mamadou Ouedraogo ◽  
Larabou Aminou ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Protocol ◽  
Tuberculosis Treatment ◽  
Tuberculosis Complex ◽  
Diagnostic Challenge ◽  
Cutaneous Tuberculosis ◽  
Extra Pulmonary ◽  
Surface Spreading

Cutaneous tuberculosis is a rare, extra-pulmonary form of tuberculosis caused by mycobacteria of the tuberculosis complex. It is characterized by clinical polymorphism often posing a difficult diagnostic challenge. Herein, we report a case of cutaneous tuberculosis in its warty form located on the nose. This was a 57-year-old patient who was infected in the classroom three months previously while taking lessons from a woman with pulmonary tuberculosis. A facial examination revealed a blackish, papillomatous patch invading almost the entire nose, with a keratotic surface spreading over the wings of the nose. The diagnosis of verrucous tuberculosis was reached on the basis of epidemiological, clinical, and paraclinical arguments. Under anti-tuberculosis treatment for six months, the lesion had healed without sequelae. The diagnosis of verrucous cutaneous tuberculosis must be established in the presence of any chronic and crusty lesion. The management responds to the treatment protocol for all forms of tuberculosis.

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

scholarly journals Epidemiology and the diagnostic challenge of extra-pulmonary tuberculosis in a teaching hospital in Ethiopia

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243945
Author(s):  
Balew Arega ◽  
Amdemeskel Mersha ◽  
Abraham Minda ◽  
Yitagesu Getachew ◽  
Alazar Sitotaw ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Teaching Hospital ◽  
Laboratory Diagnosis ◽  
High Rate ◽  
Diagnostic Challenge ◽  
Extra Pulmonary Tuberculosis ◽  
Histopathology Finding ◽  
Extra Pulmonary ◽  
Tubercular Lymphadenitis ◽  
Recorded Diagnosis

Background Ethiopia reported a high rate of extra-pulmonary tuberculosis (EPTB) and the cases are increasing since the last three decades. However, diagnostic evidence to initiate TB treatment among EPTB cases is not well known. Therefore, we described the epidemiology and assessed how EPTB is diagnosed in a teaching hospital in Ethiopia. Methods We conducted a retrospective review among all adult EPTB cases diagnosed in Yekatit 12 Hospital Medical College from 2015 to 2019. Using a standardized data abstraction sheet, we collected data from patients’ medical records on sociodemographic, sites, and laboratory diagnosis of EPTB cases. Results Of the 965 total TB cases, 49.8%(481) had a recorded diagnosis of EPTB during the study period. The mean age of EPTB patients was 32.9 years (SD±13.9) and 50.7% were males. Tubercular lymphadenitis (40.3%), abdominal (23.4%), and pleural TB(13.5%) were the most common sites of EPTB involvement, followed in descending order by the genitourinary, skeletal, central nervous system, abscess, breast, and laryngeal TB. We found a histopathology finding consistent with EPTB in 59.1% of cases, Acid-fast bacilli positive in 1.5%, and the rest diagnosed on radiological grounds. In the majority of cases, more than one diagnostic method was used to diagnose EPTB cases. Conclusions Nearly half of TB patients had a recorded diagnosis of EPTB that comprise heterogeneous anatomical sites. All EPTB patients were started anti-TB therapy without definitive microbiology results. This indicates the diagnostic challenge of EPTB faced in our setting and proves to be significant for TB control in Ethiopia.

scholarly journals Comparative Evaluation between Detection of Mycobacterium Tuberculosis Complex in Samples of Extra Pulmonary Tuberculosis using Gene Xpert MTB/RIF Assay and Ziehl-Neelsen Staining in a Tertiary Care Hospital

2020 ◽  
Vol 5 (6) ◽  
pp. 1139-1141
Author(s):  
Om Prakash Bharati ◽  
Manoj Kumar ◽  
Ashok Kumar Sharma
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Predictive Value ◽  
Mycobacterium Tuberculosis Complex ◽  
Care Hospital ◽  
Tuberculosis Complex ◽  
Extra Pulmonary Tuberculosis ◽  
Two Samples ◽  
Extra Pulmonary ◽  
Sensitivity Specificity

Tuberculosis is a global problem and incidence of extra pulmonary tuberculosis is increasing day by day. Diagnosis of extra pulmonary tuberculosis is a little bit difficult than pulmonary tuberculosis.Aim and Objective: The aim of this study is to correlate between isolates of mycobacterium in GeneXpert and ZiehlNeelsen (ZN) staining. It also detects the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of GeneXpert assay and ZN staining.This prospective study was carried out in the Department of Microbiology, RIMS, Ranchi, Jharkhand. Seventy two samples from suspected patients of Extra pulmonary tuberculosis were taken. These samples were processed for test in GeneXpert assay, ZN staining and MGIT culture. Mycobacterium tuberculosis complex isolated from culture was taken as gold standard and compared with result of GeneXpert and ZN staining. Result: Out of 72 samples, detection rate of GeneXpert, MGIT and ZN staining were 27.77%, 26.38% and 18%. The sensitivity, specificity, PPV and NPV of ZN staining and GeneXpert were 63.15%, 98.11%, 92.3%, 88.13% and 94.73%, 96.22%, 90%, 98% respectively. GeneXpert is a rapid and easy method for extra pulmonary tuberculosis diagnosis. It not only detect the bacilli but also diagnose rifampicin drug resistance. This method prompts in diagnosis and treatment.

scholarly journals Lupus Vulgaris: A Diagnostic Challenge

2021 ◽  
Vol 79 (1) ◽  
pp. 75-77
Author(s):  
Hisabella Lorena Simões Porto ◽  
Isabela Alves Guerra ◽  
Barbara Figueiredo Bastos ◽  
Marina Ferreira ◽  
Marcelino Pereira Martins Neto ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Mycobacterium Tuberculosis Complex ◽  
Immunocompetent Patient ◽  
Tuberculosis Complex ◽  
Lupus Vulgaris ◽  
Diagnostic Challenge ◽  
Cutaneous Tuberculosis ◽  
Important Differential Diagnosis ◽  
Clinical Variant ◽  
The Face

Lupus vulgaris is a clinical variant of cutaneous tuberculosis, a rare subtype of extrapulmonary infection caused by the Mycobacterium tuberculosis complex. A paucibacillary form associated with high degrees of immunity, predominantly in the face, may present several clinical and histopathological differential diagnoses, which makes its diagnosis challenging. We present a case of lupus vulgaris in an immunocompetent patient, whose initial clinical presentation and histopathology did not suggest the condition. The objective is to highlight the relevance of the hypothesis of cutaneous tuberculosis as an important differential diagnosis, especially in endemic areas.

scholarly journals 797. Tuberculosis Treatment: Combined Forms vs. Dissociated Forms

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S286-S286
Author(s):  
Maroua Trigui ◽  
Makram Koubaa ◽  
Houda Ben Ayed ◽  
Chakib Marrakchi ◽  
Fatma Hammami ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Synergistic Effects ◽  
Tuberculosis Treatment ◽  
Duration Of Treatment ◽  
Combination Drug ◽  
Extra Pulmonary Tuberculosis ◽  
Male Predominance ◽  
National Tuberculosis ◽  
Extra Pulmonary ◽  
The Government

Abstract Background Tuberculosis treatment is based on the regular and concomitant intake of several antibiotics. The goal of this multidrug therapy is to prevent the selection of mutants resistant. This combination drug comes in two regimens with dissociated forms (DF) and combined forms (CF). Our study aimed to compare both forms of anti-tubercular treatment. Methods We retrospectively collected data from the regional registry of tuberculosis in the government of Sfax as a part of the National Tuberculosis Program. We included all new cases of tuberculosis from January 1995 to December 2016. Results We counted 2,771 cases of tuberculosis. There were 59.5% cases with extra-pulmonary (n = 1,650) forms and 40.5% with pulmonary forms (n = 1,121). The median age was 38 years (IQR = [25–55 years]) with a male predominance (n = 1,508; 54.4%). We noted that 72.9% of patients (n = 1,985) received the DF, 26.2% (n = 714) received the CF and 0.8% (n = 23) received both forms of treatment. DF was significantly more prescribed in patients with extra-pulmonary tuberculosis (75.4% vs. 72%; OR = 0.837; P = 0.043) whereas CF was significantly prescribed in patients with pulmonary tuberculosis (28% vs. 24.6%; OR = 0.837; P = 0.043). DF was more used in patients with primary tuberculosis infection (30.3% vs. 21.6%; OR = 0.632; P < 0.001). The duration of treatment was significantly higher in patients who received DF (9 months vs. 8 months; P < 0.001). We did not find a difference in the evolution between patients treated with DF and those treated with CF. Conclusion CF are of a great importance to ensure better compliance and synergistic effects of different antibiotics with a reduced duration. Disclosures All authors: No reported disclosures.

scholarly journals Case Series of Three Patients with Rifampicin-Induced Thrombocytopenia

2020 ◽  
Author(s):  
Chandramouli M.T
Keyword(s):  
Pulmonary Tuberculosis ◽  
Adverse Reactions ◽  
Rare Complication ◽  
Case Series ◽  
Tuberculosis Treatment ◽  
Effective Drug ◽  
Antitubercular Drugs ◽  
Short Course ◽  
Life Threatening

AbstractLife-threatening adverse reactions of antitubercular drugs are uncommon; however, thrombocytopenia is one such rare complication encountered with rifampicin, isoniazid, ethambutol, and pyrazinamide. Rifampicin is the most effective drug and its use in the tuberculosis treatment led to the emergence of modern and effective short-course regimens. I am reporting case series of three patients with pulmonary tuberculosis presented with rifampicin-induced thrombocytopenia.

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