Pulmonary lesions in visceral toxocariasis in children in the phthisiatric practice (clinical case)

Background. The clinical and radiological picture of pulmonary tuberculosis has many common features with a large number of diseases. Therefore, differential diagnosis is very important when detecting tuberculosis. The purpose of the work: on the example of a clinical case to present the complexity of the differential diagnosis between pulmonary lesion in visceral toxocariasis and tuberculosis in children. Results. The child was diagnosed with an infiltrate in the third segment of the left lung with lesions of the intrathoracic lymph nodes, which is characteristic of the primary tuberculosis. The volatility of the infiltrate was not determined. All general blood test hadn’t shown an increase in eosinophils and white blood cells. According to the literature data, the appearance of persistent and prolonged eosinophilia with the development of eosinophilic leukemoid reactions of the blood, an increase in the level of leukocytes are the main and one of the constant manifestations of toxocariasis. The child was diagnosed with moderate hepatomegaly, which is cha­racteristic for both diseases. The patient was registered at a pediatric tuberculosis clinic due to a shift in tuberculin tests. At the time of hospitalization, there were not reasons to suspect visceral toxocariasis. Due to the examination data, first of all the absence of bacterial excretion and negative tuberculin tests, and the pre­sence in the child’s house of the dogs and cats, it was decided to recommend the consultation of the infectionist to exclude any parasitic disease. At the end, the correct diagnosis was established in this child at time and the necessary treatment was prescribed. Conclusions. This clinical case demonstrates the difficulties of differential diagnosis of visceral toxocariasis in lung lesion and tuberculosis. First of all, this is due to the asymptomatic clinical picture of toxocariasis, the diagnosis of which was established by X-ray data, blood test for IgG antibodies to Toxocara and epidemiological history. Given the fact that toxocariasis includes a large spectrum of masks of various diseases, and children who are infected by Toxocara do not have specific clinical symptoms, doctors should remember to prescribe the additional examination for the presence of parasitic diseases, including toxocariasis, especially if pets live in the child’s home.

Genomic analysis of an outbreak of bovine tuberculosis in a man-made multi-host species system: a call for action on wildlife in Brazil

We report on a 15-year-long outbreak of bovine tuberculosis (bTB) in wildlife from a Brazilian safari park. A timeline of diagnostic events and whole-genome sequencing (WGS) of 21 Mycobacterium bovis isolates from deer and llamas were analyzed. Accordingly, from 2003 to 2018, at least 16 animals, from 8 species, died due to TB, which is likely an underestimated number. In three occasions since 2013, the deer presented positive tuberculin tests, leading to the park closure and culling of all deer. WGS indicated that multiple M. bovis strains were circulating, with at least three founding introductions since the park inauguration in 1977. Recent transmission events between nearby farms and the park were not found based on WGS. Lastly, by discussing socio-economic and environmental factors escaping current regulatory gaps that were determinant of this outbreak, we pledge for the development of a plan to report and control bTB in wildlife in Brazil.

Occurrence of Mycobacterium bovis infection in cattle in Kaduna metropolis and its environs

The tedious nature of tuberculin tests in Nigeria, warrants the need for an alternative rapid animal-side means of diagnosis. The aim of this study was to provide information on the epidemiology of Mycobacterium bovis infection in cattle. An experiment was conducted to evaluate the occurrence of M. bovis infection in cattle in Kaduna metropolis and it's environ. A total 239 heads of cattle from 8 herds were randomly selected and tuberculin tested, two herds being from each of the four local government areas involved and pooled milk samples from the eight herds were tested for acid fastness. Also, all heads of cattle totaling 2978 slaughtered at the 2 abattoirs during the month of May, 2012 were examined at postmortem and tissues with lesions compatible with lesions of were collected and tested for acid fastness. The results of the experiment showed that only 23 (9.6%) of the animals tested were classified as reactors and these came from only one of the eight herds studied. A clear swelling was seen in each of the positive cases. Out of the eight herds tested, 6 (75%) were settled and the remaining 2 (25%) were semi- settled. Similarly, 6 (75%) of the herds were for mixed production system and 2(25%) were kept solely as dairy herds. Positive tuberculin test was only observed from among one of the six settled herds 1(17%) while cattle in the remaining 5(83%} settled herds all tested negative. All the two semi-settled herds (100%) tested negative. The tuberculin reaction among different production systems showed that only 1 (50%) of the dairy herds tested positive and all the 6 (100%) mixed herds tested negative. Atuberculin positive reaction of 19 (7.9%) was observed among the females and 4 (1.67%) among the males. The chi-square test of significance between the tuberculin reaction and sex of the animals showed no significant effect (P > 0.05). Hence, it can be concluded that, Mycobacterium bovis was neither cultured nor isolated and therefore, could not be confirmed responsible for the observed reactions. However, its involvement is strongly suggested by both its higher values compared to those for Mycobacterium avium in the single intradermal comparative tuberculin test and the observed in the stained smears of both the milk samples collected and the bovine tissues from the abattoirs.

Idiopatic Lobular Panniculitis as a common clinical problem

Aim. To present clinical and laboratory characteristics of various forms of idiopatic lobular panniculitis (ILP) in modern rheumatology practice. Materials and methods. The study included 67 people (58 women and 9 men aged 20 to 76) with the referral diagnosis of "Erythema nodosa? Undifferentiated panniculitis?" in 76.2% of cases with a median disease duration of 78.91 [48; 540] months observed in the V.A. Nasonova Research Institute of Rheumatology. In 2007-2017 in addition to general clinical examination immunological, histological and immunohistochemical studies, computed tomography (CT) of the chest organs and tuberculin tests were performed. Results. Analysis of clinical manifestations allowed to distinguish four forms of ILP: nodular (n=30), plaque (n=10), infiltrative (n=15) and mesentric (n=12). The minimum median duration of the disease was detected in plaque form (8 [5; 11.5] months), while the median duration in case of infitrative form was 8.25 times longer (66 [36; 102] months, p38 °C and a small number (up to 5) of drain nodes; infiltrative - fever >38 °C, ulceration of nodes with the expiration of oily mass and scarring; mesenteric - pain in the abdominal area, the number of nodes less than 5 and the abdominal cavity CT results (inflammation of the adiopose tissue of the intestinal mesentery, omentum, adipose tissue of the pre - and retroperitoneal areas). Conclusion. The forms and activity of the disease determine the approaches to treatment in modern clinical practice. There is an obvious need to expand knowledge about this pathology among doctors and conduct further research in order to timely diagnose and search for the most effective methods of ILP treatment.

DETECTION OF SPECIFIC CAUSES OF TUBERCULOSIS IN THE DAIRY CATTLE OF BANGLADESH AGRICULTURAL UNIVERSITY BY SEQUENCING AND SEQUENCE ANALYSIS

Tuberculosis (TB) is a chronic disease of man and animal. In this study intradermal tuberculin test, necropsy, histopathology, polymerase chain reaction (PCR) and sequencing techniques were used to diagnose specific cause of TB in dairy cattle of Bangladesh Agricultural University, Mymensingh. Intradermal tuberculin tests were carried out on randomly selected 100 dairy cattle. Tuberculin test positive cattle (N=05) were examined at necropsy and granulomas in lungs was seen in three cattle. Caseous necrosis and swelling of lymphnodes was seen in prescapular (N=01) and mesenteric (N=02) lymphnodes. In a case nodular lesion was seen in lungs and mesenteric lymphnodes. Portion of infected lungs and lymphnodes were snap frozen, extracted genomic DNA and PCR protocols was adapted targeting MPB83 gene. Result of PCR showed amplification of 600bp fragments in five cases. The MPB83 gene although specific for M. Bovis, the gene is less abundantly expressed by M. tuberculosis. To differentiate infectivity due to M. Bovis and M. Tuberculosis, two more PCR were adapted targeting pncA and oxyR genes. Out of five cattle tested in PCR all samples generated pncA specific 185bp and oxyR gene specific 270bp amplicons. The sequencing of MPB83, pncA and oxyR genes were carried out. Results of sequencing did not show mutation in MPB83 gene. Sequencing of pncA gene showed replacement of nucleic acid base (guanine to cytosin) in position 169 in cattle no. 5. Similarly, sequence analysis of oxyR gene (n=05) showed replacement of nucleic acid base (adenine to guanine) in position 285 in cattle no. 5. The cattle no. 5 was confirmedly infected with M. Tuberculosis and rest of the cattle were infected with M. Bovis. The tuberculin tests, necropsy, histopathology and PCR amplification of MPB83 gene may not contribute species specific detection of Mycobacterial infectivity in cattle. Sequencing and sequence analysis of pncA and oxyR genes found to differentiate infectivity in cattle due to M. Bovis and M. Tuberculosis. Both of the bacterial species are extremely zoonotic and dairy cattle of Bangladesh Agricultural University were infected with both M. Bovis and M. Tuberculosis. It needs to tests all the dairy cattle twice in a year with tuberculin tests and dispose test reactors in order to minimize zoonotic risk.

Epidemiological situation of bovine tuberculosis in the State of Mato Grosso, Brazil

In 2009, the epidemiological situation of bovine tuberculosis was studied in the state of Mato Grosso, which is a traditional beef exporter. The state was divided into four regions. In each region, properties were selected randomly. A predetermined random number of animals were chosen from these properties, and comparative cervical tuberculin tests were conducted. In total, 28,878 animals from 1,133 properties underwent examination. The animals with inconclusive results were reexamined with the same diagnostic procedure in a minimal interval of 60 days. In each sampled property, a questionnaire-based survey was conducted to identify possible risk factors for the disease. In the state, the prevalence of infected herds and animals was 1.3% [0.7; 2.4] and 0.12% [0.03; 0.44], respectively. Further, the prevalence of infected herds and animals were 0.0% [0.0; 2.0] and 0.0% [0.0; 0.08] in the Pantanal region, 1.3% [0.5; 3.1] and 0.04% [0.01; 0.17] in the dairy region, 0.7% [0.2; 2.7] and 0.01% [0.003; 0.04] in the fattening region, and 1.7% [0.7; 4.1] and 0.24% [0.06; 0.90] in the breeding region, respectively. It was observed that the condition of the herds infected with bovine tuberculosis was associated with milk production, European or mestizo breeds, degree of sophistication in the production mode, and herd size of up to 486 animals. Therefore, the implementation of a monitoring system for detection and elimination of the residual infected herds along with incorporation of risk-based monitoring elements is the best strategy for the state.

Features Immunodiagnostic Local Forms of Tuberculosis in Children

The 100 children with local forms of tuberculosis (LFT) were examinated used by the method of continuous sampling. The results of the LFT immunodiagnostic with the Diaskintest (DST) in the children were evaluated. Diaskintest were started applying in Samara one of the first from Russia. The confirmation of the tuberculosis in children with LFT was done in 99% of cases by the positive skin tuberculin tests and in 84% by Diaskintest positive. It is shown that Diaskintest can not be taken as an absolute diagnostic criteria for the diagnosis of the tuberculosis. Were noted that the FGA stimulated IFN-γγ production level were significantly reduced (1,7 times), the DST stimulated IFN-γγ production level were elevated more than 18 pg/ml in the children with negative skin Diaskintest. This observation shows that the issues in the fields of tuberculosis immunodiagnostic require further investigations.

Bacteriological and molecular detection of Mycobacterium bovis in cattle with inconclusive results to intradermal tuberculin tests

SUMMARYA dairy herd (77 cows) from Rio de Janeiro, Brazil, with a history of tuberculosis infection was tested by a comparative cervical test (CCT). Seventeen cows were reactive and seven were inconclusive (swelling ⩾2·0 mm and ⩽3·9 mm, respectively). All of these 24 cows were slaughtered and necropsied; samples from lungs and lymph nodes were collected for multiplex polymerase chain reaction (PCR) and culturing. Infection was confirmed in 23/24 (95·8%) of the slaughtered animals (five by culturing, four by PCR, and 14 by both tests). All cows with inconclusive results at CCT were confirmed as infected. Although slaughter of inconclusive reactor cows is not mandatory in many countries, our study provided evidence to support the slaughter of these cows, at least during an outbreak.