CD4 T lymphocyte levels and PPD skin test measurements in adult AIDS patients with pulmonary tuberculosis

This pilot study was carried out at the Chonburi General hospital and the zonal tuberculosis [TB] center in Chonburi, Thailand. A total of 22 AIDS patients with pulmonary tuberculosis and 20 HIV seronegative pulmonary tuberculosis patients [Controls] were skin tested with 5 tuberculin units [TU] of PPD. Anergy was observed in 82% of AIDS cases, all with very low CD4 counts. The remaining 18% showed skin reactions ranging between 1 mm and 9 mm. The Pearsons correlation coefficient test showed a good correlation between the PPD induration measurement and the absolute CD4 counts. The coefficient r=0.79 [p< 0.001] with the absolute CD4 counts, and r=0.60[P< 0.001] with the percentage of CD4 lymphocytes. In the control group, no such correlation was found and anergy was not observed in any of the patients. Relationship was established between CD4 counts and the PPD skin induration measurement, though with a larger sample size, the association may be better established and may predict the level of CD4 T lymphocytes and hence disease progression, especially in areas of high case load of AIDS and tuberculosis

Screening of tuberculosis in the clientel of new children's hospital, Cairo university

The work was done on 100 patients suffering from tuberculosis from the clientele of New Children's Hospital. Diagnosis of tuberculosis was based on the history of contact, the symptoms and signs suggestive of TB as well as the findings of positive tuberculin reaction, positive laboratory and radiological results in favor of this diagnosis. The age of the patients was ranging from 6 months to 12 years, 60% of which was below 6 years. It was found that pulmonary TB was more common than extrapulmonary TB [64% and 36% respectively]. The commonest type of extrapulmonary TB encountered was lymphadenitis. 22% of the patients were previously BCG vaccinated during infancy. A positive family history of TB was detected in 32% of the patients. 18% of the patients showed negative tuberculin test especially in emaciated patients with peritonitis. Combination of lesions were presented in 23% of patients. As regards extrapulmonary TB found that Pott's disease of the thoracic vertebrae and caseous peritonitis were the commonest skeletal and abdominal TB respectively, there was only one patient suffering from tuberculoma of the cerebellum. TB meningitis was not met in this study as there is no isolation section

Lower lung field tuberculosis: an analysis of 146 cases

Medical records of 146 patients with lower lung field tuberculosis were reviewed. There was a female to male ratio of 5:4. More than 75% of patients were under 35 years of age and average duration of symptoms before diagnosis was less than one month in 7%, between 1-6 months the in 63% and more than 12 months in 10% of our patients. PPD test was positive in 80% and direct sputum smear for acid-fast bacilli was positive in 88% of cases. Radiologically, tuberculous lesion was limited to right lower lobe [RLL] alone in more than 50%, left lower lobe [LLL] alone in 35%, while bilateral lower lobe involvement was found in 15% of our patients. Superior segments of right and left lower lobes were the most commonly involved segments respectively. Pulmonary infiltrates were nonhomogenous in more than 80% of cases while homogenous pneumonia-like consolidations were found in 15% of our series. 66% of patients had cavitary changes with air-fluid levels in 20%. Hilar adenopathy alone or in combination with paratracheal adenopathy was found in chest x-rays of 9% of cases. Fasting and two hour postprandial blood sugars were measured in 98 patients. Seven [7.1%] had overt diabetes mellitus and all of them were diabetic at the time of diagnosis of tuberculosis. Five pregnant women, a medical student, a radiology technician, an old male with metastatic carcinoma of unknown primary origin under chemotherapy, a middle-aged woman with rheumatic heart disease [mitral stenosis] who acquired tuberculosis of superior segment of RLL after valve replacement, an old female with rheumatoid arthritis on nonsteroid anti- inflammatory agents, a male with history of alcohol intake, a young male with alopecia totalis and a young female with tuberous sclerosis were included among our patients

Tuberculosis of the skin in Hazara

The incidence and pattern of the tuberculosis of skin was studied among patients of Hazara Division reporting at DHQ Teaching Hospital Abbottabad. Between June 1982 and May 1984, sixty cases were suspected to have tuberculosis of skin. Histological examination confirmed the diagnosis in 68.33% cases, while in 159 cases the diagnosis was ruled out and the remaining 16.66% cases suffered from non-specific inflaination. Tuberculous Chancre /19.51%], Scrofuloderma [19.51%] and Tuberculous gurnma [17.67%] were the most common clinical presentation. The study suggests that in Hazara Division, tuberculosis of skin is not rare but needs a high degree of suspicion for diagnosis