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1.
Rev. méd. hondur ; 88(1): 22-26, ene.- jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1128537

ABSTRACT

En 2015, la tasa global de incidencia de tuberculosis por 100,000 habitantes fue 43 en Honduras y 29 en el Municipio del Distrito Central. Objetivo: Caracterizar clínica y epidemiológicamente los casos de tuberculosis infantil, Región Sanitaria Metropolitana del Distrito Central (RSMDC), 2016. Métodos: Estudio descriptivo transversal. Se revisaron las Fichas de Notificación de Casos de Tuberculosis en pacientes menor o igual a18 años, registrados durante 2016. Se analizaron variables sociodemográficas y clínicas. Se diseñó una base de datos en EpiInfo 7.2.1. Se obtuvo autorización institucional. La información personal de los casos se manejó confidencialmente. Resultados: Del total de 400 fichas registradas, 13 (3.2%) contenían información completa. La caracterización se realizó a partir de estos 13 casos, 53.8% eran niñas, 46.2% entre 15 y 18 años. En 67% el diagnóstico fue clínico, 27% tenía tuberculosis pulmonar y 16.7% extrapulmonar. El método de diagnóstico más utilizado fue baciloscopía (38.5%). Todosrecibieron tratamiento básico primario, sin comorbilidades, no vivían en condición de riesgo o pertenecían a grupo de riesgo; no presentaron recaídas ni co-infección VIH. Discusión: El sistema de notificación de casos en RSMDC denota un déficit extraordinario e inaceptable en el registro de la información. Aunque la caracterización realizada puede estar sesgada por el número reducido de casos, sus características son similares a lo descrito para la tuberculosis infantil. Es imperativo fortalecer la vigilancia epidemiológica de la tuberculosis en Honduras con énfasis en la tuberculosis infantil y la detección y tratamiento de los contactos...(AU)


Subject(s)
Humans , Child , Adolescent , Tuberculosis/epidemiology , Mycobacterium , Tuberculosis, Lymph Node/complications , Tuberculosis, Pulmonary
2.
Cambios rev. méd ; 18(2): 87-91, 2019/12/27. tabs.
Article in Spanish | LILACS | ID: biblio-1099728

ABSTRACT

INTRODUCCIÓN. A nivel mundial la tuberculosis es una de las diez causas de muerte, con una incidencia de 7 920 pacientes entre 0 ­ 14 años en la región de América; siendo el abdomen el sitio extrapulmonar más común. OBJETIVOS. Describir las características etarias, clínicas, microbio-lógicas, complicaciones y comorbilidades asociadas en los pacientes pediátricos con tuberculosis abdominal. MATERIALES Y MÉTODOS. Estudio retrospectivo, base de datos de 23 pacientes y edades de 0 meses a 17 años 11 meses y 29 días de edad con evidencia confirmatoria de la presencia del microorganismo; de los servicios de Gastroenterología y Epidemiología en el Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca ", período 2007 a 2018. RESULTADOS. Se informaron 47,8% (11; 23) de sexo masculino y 52,2% (12; 23) de sexo femenino; 26,1% (6; 23) con antecedente de ingesta de lácteos no pasteurizados. Los tres datos clínicos más frecuentes fueron dolor abdominal, fiebre y pérdida de peso. El 8,7% (2;23) tuvieron convivencia con personas con tuberculosis activa positivo; 30,4% (7; 23) registraron prueba cutánea de derivado proteico pu-rificado positiva; 30,4% (7; 23) identificación de bacterias ácido-alcohol resistentes positivo; 43,5% (10; 23) estudios de imagen compatibles; 8,7% (2; 23) proteína C reactiva de mucosa intestinal po-sitivo; 4,3% (1; 36) cultivo positivo y 8,7% (2; 23) pacientes con inmunodeficiencia. CONCLUSIÓN. La tuberculosis abdominal, se presentó en menores de edad con síntomas inespecíficos de dolor abdominal, fiebre y pérdida de peso, expuestos a ingesta de productos lácteos no pasteurizados, combe positivo e inmunodeficiencia.


INTRODUCTION. Worldwide, tuberculosis is one of the ten causes of death, with an incidence of 7 920 patients between 0 - 14 years in the Americas region; the abdomen being the most common extrapulmonary site. OBJECTIVES. Describe the age, clinical, microbiological, complications and associated comorbidities in pediatric patients with abdominal tuberculosis. MATERIALS AND ME-THODS. Retrospective study, database of 23 patients and ages from 0 months of age to 17 years 11 months and 29 days of age with confirmatory evidence of the presence of the microorganism; of the Gastroenterology and Epidemiology services at the New Civil Hospital of Guadalajara "Dr. Juan I. Menchaca ", period 2 007 to 2 018. RESULTS. 47,8% (11; 23) men and 52,2% (12; 23) women were reported; 26,1% (6; 23) with a history of unpasteurized dairy intake. The three most frequent clinical data were abdominal pain, fever and weight loss. 8,7% (2; 23) lived together with people with positive active tuberculosis; 30,4% (7; 23) recorded a positive purified protein derivative skin test; 30,4% (7; 23) positive acid-alcohol resistant bacteria identification; 43,5% (10; 23) compatible imaging studies; 8,7% (2; 23) positive intestinal mucosal C-reactive protein; 4,3% (1; 36) positive culture and 8,7% (2; 23) patients with immunodeficiency. CONCLUSION. Abdominal tuberculosis occurred in minors with nonspecific symptoms of abdominal pain, fever and weight loss, exposed to intake of unpasteurized dairy products, positive combe and immunodeficiency


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Tuberculosis, Bovine , Tuberculosis, Gastrointestinal , Tuberculosis, Lymph Node , Diagnostic Imaging , Dairy Products , Mycobacterium tuberculosis , Tomography , Food Contamination , Polymerase Chain Reaction , Epidemiology , Diagnosis , Intestinal Perforation , Laparotomy , Mycobacterium bovis
3.
Braz. j. otorhinolaryngol. (Impr.) ; 85(5): 617-622, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1039286

ABSTRACT

Abstract Introduction: The fine-needle cytology is being used as a first line of investigation in the diagnosis of head and neck swellings, as it is simple, cost effective and less invasive as compared to biopsy. Objective: The aims of this study were to evaluate the results of the fine-needle non-aspiration cytology of cervical lymphadenopathy and to study the factors influencing the rate of non-diagnosis results. Methods: This retrospective study was conducted on selected patients with cervical lymphadenopathy that had undergone a fine-needle non-aspiration cytology followed by a histological biopsy. The sensitivity, specificity, positive predictive value and negative predictive value of fine-needle non-aspiration cytology for diagnosing tuberculosis were estimated. The risk factors of non-diagnosis results were evaluated. Results: The sensitivity, specificity, positive predictive value rates of fine-needle non-aspiration cytology for tuberculosis were 83.3%, 83.3%, 78.9% and 86.9% respectively. In total, 47 out of the 131 samples (35.8%) were considered non-diagnosis. Of the non-diagnosis samples, 84.2% (38 out of 47) were benign mostly due to tuberculosis (30 cases). Among the studied factors, only tuberculosis (confirmed by histopathological examination) was significantly associated with non-diagnosis cytology (p = 0.02, Odds-Ratio = 2.35). Conclusion: Tuberculosis is currently the commonest cause of cervical lymphadenopathy in North Africa. Fine-needle non-aspiration cytology is safe and accurate in the diagnosis of cervical tuberculous lymph node that is associated with the risk of non-diagnosis cytology.


Resumo Introdução: A punção não aspirativa com agulha fina tem sido utilizada como primeira linha de investigação no diagnóstico de tumores de cabeça e pescoço, por ser uma técnica simples, custo-efetiva e menos invasiva quando comparada à biópsia. Objetivo: Os objetivos deste estudo foram avaliar os resultados de citologia por punção não-aspirativa com agulha fina de linfadenopatias cervicais e estudar os fatores que influenciam a taxa de falha diagnóstica. Método: Este estudo retrospectivo foi realizado em pacientes selecionados com linfadenopatia cervical submetidos a punção não aspirativa com agulha fina, seguida por biópsia histológica. Foram estimadas a sensibilidade, especificidade, o valor preditivo positivo e valor preditivo negativo da punção não aspirativa com agulha fina para o diagnóstico de tuberculose. Os fatores de risco dos resultados com falha diagnóstica foram avaliados. Resultados: As taxas de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo da punção não aspirativa com agulha fina para tuberculose foram de 83,3%, 83,3%, 78,9% e 86,9%, respectivamente. Das 131 amostras, 47 (35,8%) foram consideradas como falha diagnóstica. Das amostras não diagnosticadas, 84,2% (38 de 47) eram benignas, principalmente devido à tuberculose (30 casos). Entre os fatores estudados, apenas a tuberculose (confirmada pelo exame histopatológico) estava significativamente associada à citologia com falha diagnóstica (p = 0,02, odds ratio = 2,35). Conclusão: A tuberculose é atualmente a causa mais comum de linfadenopatia cervical no norte da África. A punção não aspirativa com agulha fina é uma técnica segura e precisa no diagnóstico de linfonodos cervicais associados ao risco de citologia com falha diagnóstica.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Tuberculosis, Lymph Node/diagnosis , Biopsy, Fine-Needle/methods , Lymph Nodes/pathology , Tuberculosis, Lymph Node/pathology , Retrospective Studies
4.
Article in French | AIM | ID: biblio-1264217

ABSTRACT

Les tuberculoses extra-pulmonaires (TEP) représentent une proportion élevée de toutes les formes de tuberculose et leurs manifestations cliniques polymorphes rendent le diagnostic souvent difficile. L'objectif de notre étude était de décrire les caractéristiques épidémiologiques et histologiques des TEP diagnostiquées dans deux laboratoires d'anatomie pathologique de Cotonou. Nous avons mené une étude transversale descriptive portant sur 53 dossiers de patients atteints de tuberculose extra-pulmonaire dans les laboratoires d'anatomie pathologique de la Faculté des Sciences de la Santé et de la Cité Houéyiho à Cotonou sur une période de 10 ans (juin 2007 - juin 2018). L'âge moyen était de 46,5 ans avec une prédominance féminine (54,7 %). Les principales localisations étaient : la tuberculose ganglionnaire à 71,7 %, suivie par la tuberculose digestive (17 %) et de la tuberculose urogénitale (9,4%). Dans les différentes formes, le type histologique le plus fréquent était le type caséo-folliculaire. Notre travail a montré une fréquence élevée de l'atteinte ganglionnaire avec le type caséo-folliculaire comme le type histologique dominant


Subject(s)
Benin , Histology , Tuberculosis, Gastrointestinal , Tuberculosis, Lymph Node , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Urogenital
5.
Article in French | AIM | ID: biblio-1264225

ABSTRACT

Les tuberculoses extra-pulmonaires (TEP) représentent une proportion élevée de toutes les formes de tuberculose et leurs manifestations cliniques polymorphes rendent le diagnostic souvent difficile. L'objectif de notre étude était de décrire les caractéristiques épidémiologiques et histologiques des TEP diagnostiquées dans deux laboratoires d'anatomie pathologique de Cotonou. Nous avons mené une étude transversale descriptive portant sur 53 dossiers de patients atteints de tuberculose extra-pulmonaire dans les laboratoires d'anatomie pathologique de la Faculté des Sciences de la Santé et de la Cité Houéyiho à Cotonou sur une période de 10 ans (juin 2007 - juin 2018). L'âge moyen était de 46,5 ans avec une prédominance féminine (54,7 %). Les principales localisations étaient : la tuberculose ganglionnaire à 71,7 %, suivie par la tuberculose digestive (17 %) et de la tuberculose urogénitale (9,4%). Dans les différentes formes, le type histologique le plus fréquent était le type caséo-folliculaire. Notre travail a montré une fréquence élevée de l'atteinte ganglionnaire avec le type caséo-folliculaire comme le type histologique dominant


Subject(s)
Benin , Histology , Tuberculosis, Gastrointestinal , Tuberculosis, Lymph Node , Tuberculosis, Urogenital , Tuberculosis/diagnosis , Tuberculosis/epidemiology
6.
Article in English | WPRIM | ID: wpr-765133

ABSTRACT

BACKGROUND: Nontuberculous mycobacteria (NTM) lymphadenitis is an under-recognized entity, and data of the true burden in children are limited. Without a high index of suspicion, diagnosis may be delayed and microbiological detection is challenging. Here, we report a cluster of NTM lymphadenitis experienced in Korean children. METHODS: Subjects under 19 years of age diagnosed with NTM lymphadenitis during November 2016–April 2017 and April 2018 were included. Electronic medical records were reviewed for clinical, laboratory and pathological findings. Information regarding underlying health conditions and environmental exposure factors was obtained through interview and questionnaires. RESULTS: A total of ten subjects were diagnosed during 18 months. All subjects were 8–15 years of age, previously healthy, male and had unilateral, nontender, cervicofacial lymphadenitis for more than 3 weeks with no significant systemic symptoms and no response to empirical antibiotics. Lymph nodes involved were submandibular (n = 8), preauricular (n = 6) and submental (n = 1). Five patients had two infected nodes and violaceous discoloration was seen in seven subjects. Biopsy specimens revealed chronic granulomatous inflammation and acid-fast bacteria culture identified Mycobacterium haemophilum in two cases and NTM polymerase chain reaction was positive in two cases. Survey revealed various common exposure sources. CONCLUSION: NTM lymphadenitis is rare but increasing in detection and it may occur in children and adolescents. Diagnosis requires high index of suspicion and communication between clinicians and the laboratory is essential for identification of NTM.


Subject(s)
Adolescent , Anti-Bacterial Agents , Bacteria , Biopsy , Child , Diagnosis , Electronic Health Records , Environmental Exposure , Humans , Inflammation , Lymph Nodes , Lymphadenitis , Male , Mycobacterium , Mycobacterium haemophilum , Nontuberculous Mycobacteria , Polymerase Chain Reaction , Tuberculosis, Lymph Node
7.
Arch. argent. pediatr ; 116(6): 430-436, dic. 2018. tab, graf
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1038447

ABSTRACT

La tuberculosis extrapulmonar representa el 1520 % de todas las formas de presentación. La tuberculosis ganglionar periférica es la segunda forma extrapulmonar más frecuente en niños de Argentina, luego de la pleural. En el Servicio de Tisiología del Hospital de Niños "Dr. Ricardo Gutiérrez", se analizaron en forma retrospectiva 92 casos de tuberculosis ganglionar periférica asistidos entre agosto, 2000-septiembre, 2015. La edad media fue 8,7 ± 5 años. Las adenopatías fueron periféricas únicas (31,5 %), periféricas múltiples (20,6 %) y periféricas asociadas a profundas (47,8 %). Predominó la localización cervical (80 %). El 80 % recibió antibioticoterapia previa, sin respuesta. El 56 % tenía foco de contagio conocido; 69 %, prueba cutánea de tuberculina positiva y 54 %, radiografía de tórax patológica. Todos iniciaron tratamiento antifímico por clínica compatible, exposición y/o prueba cutánea de tuberculina positiva, antes de la confirmación microbiológica o histológica. La evolución fue curación (81,5 %), derivación cercana al domicilio (8,7 %), abandono (8,7 %). Un paciente falleció.


Extrapulmonary tuberculosis accounts for 15-20 % of all clinical presentations of tuberculosis. Peripheral tuberculous lymphadenitis is the second most common presentation of extrapulmonary tuberculosis in children, after pleural tuberculosis, in Argentina. We analyzed 92 patients with peripheral tuberculous lymphadenitis seen at the Department of Tisiology of Hospital de Niños "Dr. Ricardo Gutiérrez" between August 2000 and September 2015. The patients' mean age was 8.7 ± 5 years. Nodal sites corresponded to single peripheral (31.5 %), multiple peripheral (20.6 %), and peripheral associated with deep nodes (47.8 %). Cervical lymph nodes were the most common site of involvement (80 %). In 80 % of patients previous antibiotic therapy had been administered, without response. The tuberculosis source was known in 56 %; 69 % had a positive tuberculin skin test; and 54 %, a pathological chest X-ray. Tuberculosis treatment was started on all patients based on clinical criteria, exposure and/or positive tuberculin skin test, prior to microbiological or histological confirmation. The clinical course was either healing (81.5 %), referral to a facility near home (8.7 %) or dropout (8.7 %). One patient died.


Subject(s)
Humans , Child , Pediatrics , Tuberculosis , Tuberculosis, Lymph Node , Lymphadenopathy , Mycobacterium
8.
Rev. Ciênc. Méd. Biol. (Impr.) ; 17(3): 330-336, nov 19, 2018. tab
Article in Portuguese | LILACS | ID: biblio-1247791

ABSTRACT

Introdução: corynebacterium pseudotuberculosis é uma bactéria com importância em medicina veterinária por ser o agente etiológico da Linfadenite Caseosa (LC) em pequenos ruminantes. A doença leva a perdas econômicas devido a condenação de carcaças, diminuição de produtividade e redução do valor comercial do couro dos animais acometidos. O tratamento da doença é pouco eficaz, pois os agentes antimicrobianos não conseguem atravessar a barreira dos granulomas, mas tem sido proposta a inoculação intracapsular de antibióticos como tratamento e como medida de prevenção de contaminação ambiental. Objetivo: devido a esse fato, o presente estudo teve como objetivo avaliar a sensibilidade in vitro de isolados clínicos de Corynebacterium pseudotuberculosis isolados de animais da região Centro-Norte do estado da Bahia. Metodologia: foram retirados material de granulomas de 11 animais de uma fazenda na região acima mencionada, e as bactérias foram isoladas a partir desse material. Esses isolados então foram submetidos a metodologia de difusão em disco de ágar utilizando-se discos impregnados com doze antibióticos diferentes. Resultados: 90,9% (10/11) dos isolados foram resistentes a oxacilina. Com relação à sensibilidade, 100% dos isolados foram sensíveis a ampicilina, amicacina, amoxicilina, cefalotina, ceftriaxona, ciprofloxacina, enrofloxacina, neomicina e penicilina, enquanto 90,9% destes apresentaram sensibilidade a bactericina e doxiciclina. Conclusão: pode-se concluir que os isolados de C. pseudotuberculosis da região estudada apresentam sensibilidade a diversos antibióticos, o que pode facilitar na escolha de um antimicrobiano com menor toxicidade para fins de tratamento com inoculação intracapsular do medicamento.


Background: corynebacterium pseudotuberculosisis important bacteria in veterinary medicine because it is the Etiologic Agent of Caseous Lymphadenitis (CL) in small ruminants. The disease leads to economic losses due to condemnation of carcasses, productivity decrease and leather commercial value reduction of affected animals affected. The treatment of the disease is not very effective, because antimicrobial agents cannot cross the barrier of granulomas, but it has been proposed the intracapsular inoculation of antibiotics as treatment and as a measure of prevention of environmental contamination. Objective: due to this fact, the present study aimed to evaluate the in vitro susceptibility of clinical isolates of Corynebacterium pseudotuberculosis isolated from animals in the North Central region of the State of Bahia. Methodology: granuloma material were removed from 11 animals from a farm in the above mentioned area, and the bacteria were isolated from this material. These isolated bacteria were then subjected to disk diffusion method of agar using disks impregnated with twelve different antibiotics. Results: 90,9% (10/11) the isolated bacteria were resistant to oxacillin.With respect to sensitivity, 100% of the isolates bacteria were susceptible to amikacin, ampicillin, amoxicillin, cephalotin, ceftriaxone, ciprofloxacin, enrofloxacin, neomycin and penicillin, while 90.9% of these showed sensitivity to bacitracin and doxycycline. Conclusion: it can be concluded that the isolated bacteria of C. pseudotuberculosis from the region studied present sensitivity to different antibiotics, which can facilitate the choice of a less toxic antimicrobial for treating with intracapsular inoculation of the medicine.


Subject(s)
Animals , Ruminants/microbiology , Drug Resistance, Microbial , Sheep/microbiology , Corynebacterium pseudotuberculosis/drug effects , Anti-Bacterial Agents/pharmacology , Tuberculosis, Lymph Node/veterinary , Microbial Sensitivity Tests , Corynebacterium pseudotuberculosis/isolation & purification
9.
Medisan ; 22(7)jul.-ago. 2018. ilus
Article in Spanish | LILACS | ID: biblio-955056

ABSTRACT

Se describe el caso clínico de un paciente de 34 años de edad, quien acudió a consulta de Dermatología por presentar máculas eritematosas pruriginosas generalizadas. A los 3 meses con tratamiento específico comenzó a presentar febrículas vespertinas y adenopatías cervicales dolorosas, por lo que se indicó una baciloscopia en ambos codos y pabellones auriculares, pero no se halló el Mycobacterium leprae; además se realizó biopsia por aspiración con aguja fina de un ganglio cervical, cuyo resultado reveló una tuberculosis ganglionar. Finalmente se diagnosticó una coinfección por lepra y tuberculosis ganglionar, dos enfermedades producidas por el Mycobacterium, cuya coexistencia es rara.


The case report of a 34 year-old patient is described who came to the Dermatology Service due to disseminated pruritic erythematous stains. After 3 months with specific treatment he began to present evening low fevers and painful cervical adenopathies, reason why a baciloscopy was indicated in both elbows and ear pavilions, but the Mycobacterium leprae was not found; besides aspiration biopsy with fine needle of a cervical ganglion was also carried out, which result revealed a ganglionar tuberculosis. Finally a leprosy and tuberculosis ganglionar coinfection was diagnosed, two diseases emerging due to the Mycobacterium, which coexistence is strange.


Subject(s)
Humans , Male , Adult , Tuberculosis, Lymph Node/diagnosis , Coinfection/diagnosis , Leprosy/diagnosis , Tuberculosis, Lymph Node/drug therapy , Leprosy/drug therapy , Mycobacterium
10.
Rev. cuba. med. mil ; 47(2): 0-0, abr.-jun. 2018. ilus
Article in Spanish | LILACS | ID: biblio-960601

ABSTRACT

Introducción: La tuberculosis es una enfermedad que aún se diagnostica en Cuba. Aunque la forma pulmonar predomina, se presentan en ocasiones diversas formas localizadas a otros órganos y tejidos, dentro de ellas la forma ganglionar. Caso clínico: Se presenta una joven de 21 años con fiebre de 15 días de evolución y aumento de volumen no doloroso de los ganglios del cuello y preauricular izquierdo. Luego de tratamiento antibiótico la fiebre desaparece pero las adenopatías persisten. Se hace una primera exéresis ganglionar la cual arroja una adenitis crónica agudizada con abscedación. Se realiza Mantoux el cual arroja un resultado de 32 mm. El Rx de tórax y la tomografía axial computadorizada tóraco-abdominal no arrojaron ninguna alteración. Se hace una nueva exéresis ganglionar cuyo estudio anatomopatológico informa la presencia de granulomas caseificados. El estudio microbiológico del tejido arrojó Mycobacterium tuberculosos, codificación 8. Comentarios: La tuberculosis ganglionar es la primera forma de tuberculosis extrapulmonar en aquellos países con baja incidencia de esta enfermedad. Es más frecuente en mujeres y en la localización cervical. La cutirreacción de Mantoux hiperérgica es orientadora en el diagnóstico, pero se requiere del estudio histológico de un ganglio con la presencia de granulomas caseificados y la demostración del bacilo en este tejido. Se presenta este caso para recordar que esta entidad debe ser tenida en cuenta en el estudio de todo síndrome adénico febril y que es necesario que en el estudio histológico de toda exéresis ganglionar deben realizarse las técnicas necesarias para llegar a este diagnóstico(AU)


Introduction: Tuberculosis continues to be a disease diagnosed in Cuba. Although the pulmonary form continues to predominate, several localized forms are sometimes presented to other organs and tissues, including the ganglionic form. Clinical case: A 21-year-old girl presented with a fever of 15 days of evolution and a non-painful volume increase of the neck and left preauricular lymph nodes. After antibiotic treatment the fever disappears but the adenopathies persist. A first lymph node excision is performed, which results in acute chronic adenitis with abscess. Mantoux is performed with a result of 32 mm. The chest X-ray and the thoraco-abdominal CT scan did not show any alteration. A new lymph node excision is performed, whose anatomopathological study reports the presence of caseified granulomas. The microbiological study of the tissue resulted tuberculous Mycobacterium, coding 8. Comments: Lymph node tuberculosis is the first form of extrapulmonary tuberculosis in those countries with low incidence of this disease. It is more frequent in women and in the cervical location. The hyperergic Mantoux is a guide in the diagnosis, but the histological study of a ganglion with the presence of caseified granulomas and the demonstration of the bacillus in this tissue is required. This case is presented to remember that this entity must be taken into account in the study of any febrile adenic syndrome and that it is necessary that in the histological study of any lymph node excision the necessary techniques must be performed to reach this diagnosis(AU)


Subject(s)
Humans , Female , Adult , Tuberculosis/epidemiology , Tuberculosis, Lymph Node/diagnostic imaging , Lymphadenitis/diagnosis , Microbiological Techniques/methods
11.
Rev. argent. radiol ; 82(1): 28-35, mar. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1041865

ABSTRACT

La Tuberculosis (TBC) es una patología infecto-contagiosa de alta morbimortalidad en Chile y en el mundo, siendo la segunda causa de muerte por cuestión infecciosa y es considerada una patología de alta relevancia a nivel de salud pública. Es causada por una bacteria de alta virulencia y contagio llamada mycobacterium tuberculosis. En la actualidad contamos con protocolos de detección y tratamiento muy eficaces, que la convierten en una enfermedad prevenible y curable. El diagnóstico se realiza con estudios bacteriológicos específicos frente a una sospecha clínica-epidemiológica sugerente. Sin embargo, el uso de imágenes forma parte casi obligatoria de su estudio y control. Debido a que el órgano diana de la TBC es el pulmón, es habitual utilizar como apoyo diagnóstico una radiografía de tórax, la cual es útil, en caso de TBC pulmonar, al presentar hallazgos característicos y orientadores para su diagnóstico. Es importante destacar que el mycobacterium tuberculosis tiene alto potencial de diseminación por contigüidad, vía linfática y/o hematógena, siendo esa última vía la causante de la mayoría de las TBC extrapulmonares, las cuales se presentan en un 20% de pacientes inmunocompetentes y hasta en un 60% de inmunocomprometidos. La principal localización de una TBC extrapulmonar es a nivel pleural, seguida del compromiso ganglionar, urogenital y osteoarticular, siendo el resto de las localizaciones muy infrecuentes. Para esos casos la tomografía computada (TC) es el estudio por imágenes de elección para el diagnóstico y control, además de ser una herramienta muy útil para la detección de complicaciones.


Tuberculosis (TB) is an infectious disease of high morbility and mortality in Chile and in the world. It is the second cause of death due to infectious causes in the world, and is considered of high relevance to public health. TB is caused by a highly pathogenic and virulent bacterium denominated mycobacterium tuberculosis. Nowadays, there are effective protocols for detection and treatment of this disease, which make it preventable and curable. Diagnosis is reached by specific bacteriological studies in the presence of a clinical epidemiological suspicion. Nevertheless, imagining methods are almost an obligatory part of tuberculosis study and control. Since the lung is the target organ of TB, chest X-ray is commonly used as a support for diagnosis, which is very useful in case of pulmonary TB because it provides characteristic findings to guide diagnosis. It is important to highlight that the mycobacterium tuberculosis has a high potential for dissemination by contiguity, via lymphatic and/or haematogenous, the latter being the cause of the majority of extrapulmonary TB, which are presented in 20% of immunocompetent patients and by up to 60% of immunocompromised. The main site of extrapulmonary TB is into the pleural space, followed by the lymph node, urogenital and osteoarticular involvement, the remainder being infrequent localizations. In these cases, a computed tomography (CT) study based on the selection of images, is the tool used for diagnosis and control, which is also useful for the detection of complications.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tuberculosis/classification , Tuberculosis/complications , Tuberculosis/diagnostic imaging , Tuberculosis, Lymph Node/diagnostic imaging , Tuberculosis, Miliary/diagnostic imaging , Tuberculosis, Osteoarticular/diagnostic imaging , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Urogenital/diagnostic imaging , Radiography, Thoracic/methods , Tomography, X-Ray Computed/methods , Lung/pathology
12.
Korean Journal of Medicine ; : 306-310, 2018.
Article in Korean | WPRIM | ID: wpr-715340

ABSTRACT

Pyrazinamide (PZA) is an anti-tuberculosis drug and an essential component of the standard four-drug regimen for tuberculosis. Here, we report a case of immediate angioedema secondary to PZA administration intended for pulmonary tuberculosis treatment. A previously healthy 48-year-old woman was diagnosed with pulmonary tuberculosis and tuberculous lymphadenitis. Thirty minutes after taking the first dose of isoniazid, rifampicin, pyrazinamide, and ethambutol, the patient developed facial edema, generalized rash, and dizziness. An oral provocation test was performed on the four drugs, and 1,000 mg pyrazinamide showed a positive result characterized by 50 minutes of urticaria, angioedema, and hypotension. As the prevalence of tuberculosis increases, prescriptions for anti-tuberculosis drugs may increase as well. Clinicians should be aware of the possibility of immediate hypersensitivity as well as delayed hypersensitivity to anti-tuberculosis drugs.


Subject(s)
Angioedema , Dizziness , Drug Hypersensitivity , Edema , Ethambutol , Exanthema , Female , Humans , Hypersensitivity, Delayed , Hypersensitivity, Immediate , Hypotension , Isoniazid , Middle Aged , Prescriptions , Prevalence , Pyrazinamide , Rifampin , Tuberculosis , Tuberculosis, Lymph Node , Tuberculosis, Pulmonary , Urticaria
13.
Article in English | WPRIM | ID: wpr-738949

ABSTRACT

A gastric subepithelial tumor (SET) is commonly detected during a diagnostic endoscopic examination. Gastric tuberculosis (TB), in particular, can present as a SET of the gastric wall. A few cases of gastric TB mimicking a SET have recently been reported. Radiological imaging combined with endoscopic biopsy can aid in the early diagnosis of TB without surgical intervention. A 41-year-old man visited our health promotion center for a regular check-up. Esophagogastroduodenoscopy (EGD) revealed a round and smooth, bulging mucosal lesion suggesting a gastric SET in the upper body of the stomach. Endoscopic ultrasound (EUS) demonstrated a hypoechoic lesion measuring 18 mm, with an obscure layer of origin, and EUS-guided fine-needle aspiration was performed. Microscopic examination of the sample showed chronic granulomatous inflammation. Histopathologically, the aspirated sample showed positive Ziehl-Neelsen staining, confirming a diagnosis of tuberculous lymphadenitis. We describe a case of a patient who presented with tuberculous lymphadenitis mimicking a SET of the stomach. The lesion was found on EGD and confirmed using EUS-guided fine-needle aspiration.


Subject(s)
Adult , Biopsy , Biopsy, Fine-Needle , Diagnosis , Early Diagnosis , Endoscopy, Digestive System , Health Promotion , Humans , Inflammation , Stomach , Tuberculosis , Tuberculosis, Lymph Node , Ultrasonography
14.
ARS med. (Santiago, En línea) ; 43(3): 92-98, 2018.
Article in Spanish | LILACS | ID: biblio-1024186

ABSTRACT

n Desde la antigüedad la escrófula o lamparón era descrita como tumefacción crónica de ganglios linfáticos cervicales, que afectaba principalmente a niños, adolescentes y jóvenes. Se pensaba que algunas veces también podía comprometer otras partes del cuerpo y cursar con caquexia letal. En el presente artículo se intentó indagar las ideas reinantes en Chile sobre las características y tratamiento de la escrófula, antes del descubrimiento del bacilo tuberculoso. Se revisaron estadísticas principalmente hospitalarias, textos extranjeros disponibles y opiniones de médicos que trabajaron en Chile. Se consignaba el diagnóstico de escrófula en aproximadamente 2,2% de los pacientes, y tisis en 3,8 porciento. Sin embargo, ambas condiciones pueden haber sido inadecuadamente identificadas, especialmente debido a sub-diagnóstico de tisis pulmonar en casos clasificados como neumonía o pleuresía. En el tiempo descrito se opinaba que la escrófula era causada principalmente por transmisión hereditaria, alimentación inadecuada o sífilis en individuos predispuestos por un temperamento linfático. No se encontraron textos chilenos en que se normaran criterios para el diagnóstico de escrófula. Para el tratamiento se mencionaban plantas medicinales y algunos compuestos químicos administrados en infusiones o emplastos. Quedan dudas para interpretar lo que se pensaba sobre el significado y límites de las condiciones denominadas escrófula, escrofuloso y tisis. Este problema se aprecia también en la literatura clínic. (AU)


Since ancient times, scrofula was described as a chronic swelling of cervical lymph nodes, affecting mostly children and young people, and that sometimes it could also compromise other parts of the body, evolving into a lethal consumptive disease. The purpose of this study was to determine the main perceptions about scrofula in Chile, its characteristics and treatment, before the discovery of the tubercle bacillus. Hospital statistics on diseases, available foreign literature, and opinions of physicians who had worked in Chile were reviewed. Scrofula was diagnosed in roughly 2.2 percent of patients, and phthisis in 3.8 percent. Nevertheless, both conditions may have been inadequately identified, especially due to underdiagnosis of pulmonary phthisis, classified as pneumonia or pleurisy in some cases. Scrofula was considered to be caused chiefly by hereditary transmission, an inadequate diet, or syphilis, in people predisposed by a lymphatic temperament. No Chilean texts establishing criteria for diagnosing scrofula were found. Some writings suggested using medicinal plant infusions or poultices to treat scrofula. Uncertainty persists to understand the meaning and limits assigned to the conditions named scrofula, scrofulous and phthisis. This dilemma is also found in the international clinical literature, being attributed mainly to insufficient scientific and methodological development in that epoch.(Au)


Subject(s)
Humans , Child , Adolescent , Young Adult , Tuberculosis, Lymph Node , Tuberculosis, Pulmonary , Chile , Medicine
15.
Korean Journal of Medicine ; : 477-481, 2018.
Article in Korean | WPRIM | ID: wpr-717447

ABSTRACT

Tuberculosis rarely involves the esophagus, and most esophageal tuberculosis occurs secondary to adjacent tuberculous lymphadenitis. An esophago-mediastinal fistula is a very unusual complication of tuberculous lymphadenitis. Herein, we report a case of an esophago-mediastinal fistula due to tuberculous lymphadenitis. A 28-year-old woman who had dysphagia was assessed by chest computed tomography, endoscopy, esophagogram, and a lymph node biopsy. An esophago-mediastinal fistula was found and an antituberculous agent was considered initially. However, because of her severe dysphagia, she managed with endoscopic clipping as an alternative. However, the fistula remained on follow-up esophagography. A gastrostomy was eventually performed, and she was treated with an antituberculous agent. The fistula had closed after 4 weeks of medication. Antituberculous agents are the mainstay treatment for esophago-mediastinal fistula due to tuberculous lymphadenitis; endoscopic clipping may be a complementary treatment.


Subject(s)
Adult , Biopsy , Deglutition Disorders , Endoscopy , Esophageal Fistula , Esophagus , Female , Fistula , Follow-Up Studies , Gastrostomy , Humans , Lymph Nodes , Lymphadenitis , Thorax , Tuberculosis , Tuberculosis, Lymph Node
16.
Rev. chil. infectol ; 34(6): 589-595, dic. 2017. graf
Article in Spanish | LILACS | ID: biblio-899764

ABSTRACT

Resumen En el siglo XIX se pensaba que la tuberculosis y la tumefacción ganglionar cervical llamada escrófula afectaban a individuos predispuestos por una "constitución diatésica" heredada. En 1882 Robert Koch demostró que lesiones tuberculosas y escrofulosas humanas eran causadas por el bacilo Mycobacterium tuberculosis. A principios del siglo XX se estableció que Mycobacterium bovis, bacilo de la tuberculosis del ganado, podía también causar linfoadenitis cervical en humanos, especialmente en niños, por la ingestión de leche de vacas enfermas. La condición disminuyó después que se controló la infección en el ganado y se introdujo la pasteurización de la leche. En 1956 se describió la linfoadenitis cervicofacial granulomatosa necrosante y supurada causada por micobacterias no tuberculosas. Afecta principalmente a niños bajo los cinco años, especialmente en países sin endemia de tuberculosis. Las linfoadenitis cervicales tuberculosas predominan en adultos jóvenes en países con tuberculosis endémica y en individuos infectados por VIH.


In the 19th century it was widely believed that both tuberculosis and cervical lymph node swelling, known as scrophula, affected individuals predisposed to an inherited "diathetic constitution". In 1882 Robert Koch proved that human tuberculosis and scrophulous lesions were caused by the bacillus Mycobacterium tuberculosis. In the early twentieth century it was stated that Mycobacterium bovis, the bacillus of cattle tuberculosis, could also cause cervical lymphoadenitis in humans, especially in children, by the intake of milk from sick cows. The incidence of this condition decreased after the infection was controlled in cattle and pasteurization of the milk was introduced. A type of granulomatous necrotizing and suppurative cervico-facial lymphadenitis associated to non-tuberculous mycobacteria was described in 1956. It mainly affects children younger than 5 years old, particularly those born in countries with non-endemic tuberculosis. Tuberculous cervical lymphadenitis is prevalent in young adults from tuberculosis-endemic countries and in HIV-infected subjects. Infectious etiology displaced the importance of a personal disposition in the development of scrophula. Nevertheless, mutations that confer susceptibility to mycobacterial infection are currently investigated.


Subject(s)
Humans , History, 19th Century , History, 20th Century , Tuberculosis, Lymph Node/history , Lymphadenitis/history , Tuberculosis, Lymph Node/microbiology , Tuberculosis, Lymph Node/pathology , Superior Cervical Ganglion/microbiology , Superior Cervical Ganglion/pathology , Lymph Nodes/microbiology , Lymph Nodes/pathology , Lymphadenitis/microbiology , Lymphadenitis/pathology , Mycobacterium/pathogenicity
17.
Rev. otorrinolaringol. cir. cabeza cuello ; 77(3): 311-316, set. 2017. ilus
Article in Spanish | LILACS | ID: biblio-902782

ABSTRACT

La tuberculosis (TBC) es una enfermedad infecto-contagiosa de distribución mundial causada por Mycobacterium tuberculosis, y otras micobacterias atípicas. La afectación ganglionar es tardía y sus manifestaciones clínicas asociadas suelen ser inespecíficas, por eso, el diagnóstico de tuberculosis ganglionar a menudo se retrasa y es un hallazgo inesperado en numerosas ocasiones. Este artículo pretende realizar una revisión bibliográfica sobre la tuberculosis ganglionar y hacer hincapié en que la TBC ha de ser tenida en cuenta como diagnóstico diferencial en las masas cervicales, que muchas veces se presentan con escasa sintomatología acompañante. En este artículo presentamos dos casos de TBC ganglionar diagnosticados en nuestro servicio en los últimos meses, ambos casos se manifestaron exclusivamente como masa cervical de crecimiento lento, sin síntomas pulmonares acompañante y fueron diagnosticados de TBC tras el estudio anatomopatológico resultante de la exéresis quirúrgica de la lesión.


The tuberculosis (TB) is an infect-contagious worldwide distribution disease caused by Mycobacterium Tuberculosis and other atypical Mycobacteria. Lymph node involvement is late, and its associated clinical manifestations are usually unspecifics, therefore the diagnosis of tuberculosis lymph node is often delayed and is an unexpected finding in numerous occasions. This article aims to carry out a literature review of lymph node tuberculosis and to emphasize that TB must be taken into account as differential diagnosis in cervical masses, which often occur with few associated symptoms. In this article we present two cases of lymph node TB diagnosed in our department in last months, both cases presented exclusively as cervical mass of slow growth, without any accompanying pulmonary symptoms and were diagnosed as TB after the surgical removal of the lesion and its histopathological study.


Subject(s)
Humans , Female , Child , Aged , Tuberculosis, Lymph Node/surgery , Tuberculosis, Lymph Node/diagnostic imaging , Tuberculosis, Lymph Node/pathology , Neck
18.
Rev. habanera cienc. méd ; 16(3): 387-394, may.-jun. 2017. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-901732

ABSTRACT

Introducción: Las formas de presentación de la tuberculosis (Tb) incluyen: la tuberculosis pulmonar, la miliar y la extrapulmonar. Fuera del pulmón, los sitios donde con mayor frecuencia se localiza la tuberculosis son, por orden de frecuencia: ganglios linfáticos, pleura, aparato genitourinario, huesos y articulaciones, meninges, peritoneo y pericardio. Objetivo: Presentar un caso interesante en la clínica de Tuberculosis extrapulmonar y Tuberculosis pulmonar. Presentación del caso: Paciente masculino de 65 años de edad, alcohólico crónico y fumador, empezó a presentar un aumento de volumen en la región lateral derecha del cuello que fue creciendo progresivamente; además de tos húmeda con expectoración blanquecina, disfagia a los alimentos sólidos, astenia, anorexia y pérdida de peso. Al examen físico se evidencian múltiples adenopatías cervicales supurativas, la mayor de 6cm y estertores crepitantes en tercio superior de hemitórax derecho. La prueba de Mantoux fue positiva y la radiografía de tórax sugestiva de TB pulmonar. El paciente fue egresado por alta a petición con tratamiento antituberculoso y antibiótico ambulatorio, los cuales fueron abandonados por parte del paciente. Es ingresado en segunda ocasión en el Servicio de Geriatría por ulceración de la lesión mayor del cuello donde fallece al tercer día por una sepsis generalizada. Conclusiones: La tuberculosis de los ganglios linfáticos es la presentación más común de la tuberculosis extrapulmonar. Esta enfermedad ataca principalmente a personas inmunodeprimidas y en el caso presentado el paciente tenia factores que podrían haber deprimido su sistema inmune como la edad, el alcoholismo crónico y el tabaquismo(AU)


Introduction: The forms of presentation of the tuberculosis (Tb) include: the pulmonary, miliaria and extrapulmonary tuberculosis. Outside of the lung, the where places with major frequency localizes tuberculosis are, by order of frequency: lymphatic ganglions, pleura, genitourinary system, bones and joints, meninges, peritoneum and pericardium. Objective: To present an interesting case in the clinic of extrapulmonary Tb and lung Tb. Case presentation: Masculine 65-years patient of age, chronic alcoholic and smoker. That began to present an increase of volume in the lateral right region of the neck that went growing progressively; besides humid cough with whitish expectoration, dysphagia to the solid foods, asthenia, anorexia and loss of weight. The physical examination made evident multiple cervical suppurative adenopathias, the major of 6cm and crepitating rasps at the superior third of the right hemi-thorax. The Mantoux proof was positive and the thorax X-ray suggested a pulmonary TB. The patient was discharged with a treatment against tuberculosis and ambulatory antibiotic, which were abandoned by the patient. He was entered in second occasion in the service of geriatrics for ulceration of the major injury of the neck and dies at the third day for a generalized sepsis. Conclusions: The tuberculosis of the lymphatic ganglions is the more common presentation of the extrapulmonary tuberculosis. Illness attacks principally to the persons with low defenses and in the presented case the patient had factors that could have depressed his immune system as the age, the chronic alcoholism and the smoking(AU)


Subject(s)
Tuberculosis, Lymph Node/complications , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/mortality , Case Reports
19.
Rev. chil. infectol ; 34(1): 55-59, feb. 2017. ilus
Article in Spanish | LILACS | ID: biblio-844445

ABSTRACT

In the 19th century scrofula or scrofulous adenitis was a frequent condition estimated by the finding of swollen cervical lymph nodes or scars, occurring in both sexes at all epochs of life, mainly in children. It was thought that it principally affected people with an inherited phlegmatic constitution that involved a scrofulous disposition or "diathesis". The disease would be triggered by environmental agents, bad habits or excesses in style of life. Besides injuring cervical lymph nodes, in some cases scrofula could compromise other groups of lymph nodes, bones, joints, lungs or other viscera. In some of its clinical presentations the disease could be healed while others were often lethal disorders. The finding of multiorgan compromise, caseation and "tuberculization" of the lesions originated discussion whether scrofula and tuberculosis were one or two different diseases and if they affected subjects with a common diathesis or people with a distinct scrofulous or tuberculous diathesis. Along the 19th century, before the discovery of Koch's bacillus, the notion of contagion as a cause of scrofula and tuberculosis was not predominant in Europe.


En el siglo XIX la escrófula era frecuente, estimada por la percepción de nódulos o cicatrices en el cuello. Paulatinamente se le empezó a denominar adenitis escrofulosa. Podía presentarse en personas de ambos sexos en todas las épocas de la vida; pero era más frecuente en la infancia. Se pensaba que afectaba principalmente a sujetos con una constitución flemática heredada que implicaba una susceptibilidad o diátesis escrofulosa. La enfermedad sería desencadenada por agentes ambientales, hábitos, o excesos en el estilo de vida. Aparte de los ganglios linfáticos cervicales, podía afectar otros grupos ganglionares, huesos, articulaciones, pulmones y otras visceras, atribuyéndosele diversas formas de presentación que variaban entre las potencialmente curables a las frecuentemente mortales. La afectación multiorgánica, la caseificación y la "tuberculización" de las lesiones originaron la discusión sobre si la escrófula y la tuberculosis eran una sola enfermedad o dos diferentes, y si se desencadenaban sobre una diátesis común o cada una sobre una diátesis específica escrofulosa o tuberculosa. En la mayor parte del siglo XIX, antes del descubrimiento del bacilo de Koch, la noción de contagio como causa de la escrófula y de la tuberculosis pulmonar no parecía predominar en países europeos.


Subject(s)
Humans , History, 19th Century , Tuberculosis, Lymph Node/history
20.
Article in English | WPRIM | ID: wpr-203545

ABSTRACT

Superior vena cava (SVC) syndrome refers to a medical emergency resulting from compression of the SVC. It requires early diagnosis and treatment, and is usually caused by malignant tumors; rarely, mediastinal tuberculous lymphadenitis can cause SVC syndrome. Here, we present a case study of an immunocompetent 61-year-old woman who presented with acute onset SVC syndrome and was diagnosed with tuberculous lymphadenitis on thoracotomy; the symptoms resolved with anti-tuberculosis therapy. This unusual case highlights the importance of the differential diagnosis in patients presenting with acute onset SVC syndrome; a timely diagnosis and appropriate treatment lead to complete recovery.


Subject(s)
Diagnosis , Diagnosis, Differential , Early Diagnosis , Emergencies , Female , Humans , Lymphadenitis , Middle Aged , Superior Vena Cava Syndrome , Thoracotomy , Tuberculosis , Tuberculosis, Lymph Node , Vena Cava, Superior
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