Crown disease with extrainterinal manifestations in the form of granulematous alveolitis

Objective: To present a clinical description of the observation of a patient with Crohn’s disease (CD) with extraintestinal manifestations in the form of granulomatous alveolitis.Materials and Methods: A brief review of the literature on the current understanding of the prevalence and clinical manifestations of lung lesions in inflammatory bowel diseases (IBD) and CD, as well as a description of a patient with this pathology with the results of autopsy is presented.Results: The rare presence of granulomatous lung lesions in a patient with CD was proved.Conclusion: Difficulties in the differential diagnosis and treatment of CD lung lesions are shown. In particular, suspicion of tuberculous lesion, lung abscess creates potential risks of generalization of the process when using such therapeutic effects as glucocorticosteroids, cytostatics, immunosuppressants, biological genetically engineered drugs and active surgical intervention. The authors hope that the described observation will alert doctors in terms of possible systemic pulmonary lesions in CD.

Single cervical spinal extramedullary tuberculous lesion in a young female – case report

Skeletal tuberculosis is the main extrapulmonary site for Mycobacterium tuberculosis infection disemination. As for the nervous sistem tuberculosis or spinal tuberculous disease in particular, the osseos elements are more frequently involved than the cerebral tissue or the spinal cord. We present the case of a previously healthy 32 year old female with no known TB history, reffered to our clinic for neck pain thought to be due to degenerative spinal disc disease. In the absence of general signs of the disease, the right surgical management and biopsy were the key factors for corect diagnosis.

Features of the diagnosis of miliary forms of tuberculosis

Miliary tuberculosis is a special form of the disease with a hematogenous transmission route and multiple lesions of internal organs in the form of tiny tubercles resembling millet grains. This infectious disease is one of the forms of disseminated tuberculous lesion, it has a hematogenous transmission route and develops against the background of mycobacteremia. Miliary tuberculosis accounts for about 2 % of all cases and about 20 % of cases of extrapulmonary tuberculosis. In children, miliary tuberculosis most often manifests itself against the background of the primary pulmonary process immediately after infection, in adults, as a rule, this form of tuberculosis lesion develops from the reactivation of hematogenous dissemination. Serous membranes, lungs, lymph nodes, kidneys and bones are most often affected. With this form of the disease, the primary stage of lymphogenous lesion is most often absent, and diagnosis presents significant difficulties due to the absence of specific symptoms and a blurred clinical picture of the disease. Against the background of difficulties in diagnosis, very often, treatment measures begin quite late, which can lead to the development of neglected cases and cause death.

A case of primary tuberculosis of the internal genital organs in a woman

The author describes a case where a postmortem autopsy of one woman found a tuberculous lesion of the uterus, tubes, ovaries, pleura, liver, peritoneum, mesenteric glands and lungs.

A surgical case of cerebellar tuberculoma caused by a paradoxical reaction while on therapy for tuberculosis spondylitis

Background: A paradoxical reaction (PR) is a phenomenon in which the primary tuberculous lesion worsens or another de novo tuberculous lesion appears while on anti-tuberculosis therapy. Here, we report a rare case of cerebellar tuberculoma caused by a PR during therapy for lumbar tuberculous spondylitis (Pott’s disease). Case Description: A 47-year-old male with human immunodeficiency virus seronegative was diagnosed with lumber tuberculous spondylitis (Pott’s disease) and prescribed anti-tuberculous agents. His lower back pain and inflammatory condition recovered after initiation of anti-tuberculous therapy. Two months later, he complained of headache, nausea, and staggering. Magnetic resonance images revealed a ring-enhanced lesion located at the cerebellar hemisphere extending to the vermis, which caused perifocal edema and bilateral ventriculomegaly. These findings were consistent with his symptoms of hydrocephalus. He did not have preceding clinical findings of meningitis, and a PR was suggested to cause de novo aggregation of cerebellar tuberculoma. A lesionectomy was performed, and the surgical specimen was pathologically diagnosed as a tuberculoma. He recovered well from neurological disorders after the resection. Conclusion: De novo formation of intracranial tuberculoma alone caused by a PR without preceding meningitis is very rare. Lesionectomy is needed for intracranial tuberculoma, which manifests as a mass effect, as well as antituberculous therapy.

Intraoperative rupture of tuberculous pseudoaneurysm associated with spinal tuberculosis: A case report and literature review

Introduction: The increase in the incidence of tuberculosis in developing countries has resulted in increased reporting on more related complications. We report the successful management of an intraoperative spontaneous rupture of a tuberculous pseudo aneurysm associated with spinal tuberculosis. Methodology: We report the case of a 66 years old woman diagnosed with spinal tuberculosis of the T3/T4 vertebrae. During an anterior approach surgical reconstruction for the degenerative vertebrae, massive hemorrhage was observed after the removal of a portion of the prevertebral fascia of the affected vertebrae. This led to the exploration of the hilar fascia for the possibility of hilar hemorrhage, and when no hemorrhage was observed, aneurysm rupture was suspected. A portion of the hilar fascia was then sutured to the prevertebral fascia and the hemorrhage was partially controlled. Results: On the 32nd month post-operative follow-up, the symptoms of chest and back pain had disappeared and the tuberculous lesion eradicated. Conclusion: Presently, there are few reports on the successful treatment of intraoperative spontaneous rupture of tuberculous pseudoaneurysms. We therefore report on the successful management of such a case.

Treatment of In-Patient Pulmonary Tuberculosis

The progress of a tuberculous lesion was discussed. A treatment regimen of pulmonary tuberculosis in the wards mas layed out, especially for the "Persahabatan" Hospital, Jakarta. Rifampicin seems to be a potent drug. However, for developing countries like Indonesia it is still very expensive. Possibly a combinations of INH + RMP + EB will be most effective at present. Only a daily treatment is carried out in ”Persahabatan” Hospital.