Predictors of pulmonary involvement in patients with extra-pulmonary tuberculosis

The aim of this study is to assess the value of chest radiographs [CXRs] and sputum examinations in detecting pulmonary involvement of tuberculosis [TB] in patients with extra-pulmonary tuberculosis [EPTB]. A retrospective analysis was performed among 248 EPTB patients with culture-proven diagnosis of tuberculosis seen between January 2001 and December 2007 at a tertiary teaching hospital, Riyadh, Saudi Arabia. Demographics, clinical, laboratory and radiological findings were reviewed and assessed. This study was approved by the hospital ethics and research committee. One hundred twenty five of 233 EPTB patients [53.6%] had abnormal CXR findings. There was a significant difference in the occurrence of positive sputum culture results between patients with abnormal CXR findings [30/57] and those with normal CXR findings [4/17] [P = 0.04]. Of 17 HIV-negative/unknown HIV-status EPTB patients with normal CXR results, 4 patients [23.5%] had positive sputum culture results. Intrathoracic lymphadenopathy [P < 0.001], pleural TB [P < 0. 001] and disseminated TB [P = 0.004] were associated with an increased risk of abnormal CXR findings. Patients with cough [52.9%], weight loss [41.2%] and night sweats [26.5%] are more likely to have positive sputum culture results. CXR findings are predictive of positive sputum culture results. However, the rate of normal CXR among EPTB patients with positive sputum culture results was relatively high. Therefore, respiratory specimen cultures should be obtained in TB suspects with a normal CXR to identify potentially infectious cases of TB

Panton-Valentine leukocidin Staphylococcus aureus osteomyelitis of the femur in a Saudi child

Staphylococcus aureus producing Panton-Valentine leukocidin [PVL] is well recognized to cause severe skin and soft tissue infections. Recently, it has been increasingly recognized as causing life-threatening musculoskeletal infection. We reported previously 3 children who had osteomyelitis caused by methicillin resistant Staphylococcus aureus. We report and discuss a case of Methicillin sensitive Staphylococcus aureus encoding the PVL genes isolated from a child with acute osteomyelitis from Saudi Arabia

Investigation of cross-contamination in a Mycobacterium tuberculosis laboratory using epidemiological data and spoligotyping

To investigate possible pseudo-outbreak of Mycobacterium tuberculosis [MTB] during a two week period July 2-15th 2005, as suggested by an increase in incidence of newly diagnosed patients with tuberculosis. Many of them had negative - smears for AFB and only one positive-MTB culture. Retrorespective surveys of all medical and laboratory data using standard epidemiological tools and DNA fingerprinting in King Khalid University Hospital, Riyadh, Saudi Arabia. A total of 22 samples representing 20 individual patients were examined. Epidemiological and laboratory analysis of these samples revealed that 14 were identified as presumed false-positive reports due to laboratory cross-contamination. In a further 5 cases, patients were diagnosed clinically as having tuberculosis and were defined as cases of possible cross-contamination. The source was a patient with both clinical and radiographic evidence of TB and was the only one who was smear and culture positive for TB. Molecular analysis and epidemiological studies revealed that specimen patching and multi-use vials of buffer solution were the source of cross-contamination. This investigation strongly supports the idea that M.tuberculosis grown from smear-negative specimens from patients without clinical evidence of tuberculosis should be analyzed by rapid and reliable strain differentiation techniques, such as spoligotyping, to help rule-out laboratory contamination

Prevalence of HBV, HCV, HIV - 1,2 and HTLV - I/II infections among blood donors in a teaching hospital in the central region of Saudi Arabia.

Several infectious diseases are transmissible by blood transfusion, especially viral infections. The most common blood-transmitted viruses are hepatitis B virus [HBV], hepatitis C virus [HCV] and human immunodeficiency virus [HIV]. These viruses cause fatal, chronic and life-threatening disorders. The prevalence of these viruses varies by nationality and geography. The purpose of this study was to establish the current prevalence of hepatitis viruses [B and C] and human retroviruses [HIV-1, 2 and human T-lymphotropic virus type I and II, HTLV-I /II] among blood donors at King Khalid University Hospital [KKUH], Riyadh, Kingdom of Saudi Arabia [KSA]. Serological markers of HBV, HCV, HIV 1, 2 and HTLV-I/II were studied in 24173 [23952 males and 221 females], 20423 Saudi and 3750 non-Saudi blood donors, using commercially available kits, over a period of 3 years from January 2000 to December 2002 at KKUH, Riyadh, KSA. The prevalence of confirmed-positive test results of these viruses was evaluated among different gender, ages and nationalities. During the study period, prevalence rates of HBV and HCV infections were 1.5% and 0.4%, and zero for retroviral infections. The prevalence was not significantly higher in male than in female donors. Hepatitis B surface antigen [HBsAg] and anti-HCV positivity tend to increase with increase in age. The prevalence of HBsAg and anti-HCV positivity was significantly more prevalent among non-Saudi compared to Saudi donors. This study highlights the prevalence rates of HBV and HCV among different groups. The prevalence varies from one group to another, being the lowest among Saudi and young donors. Therefore, extensive recruitment of Saudi and young donors should help ensure a long-term increase in the blood supply without jeopardizing safety