High-resolution CT findings of pulmonary tuberculosis in liver transplant patients.

AIM: To assess the high-resolution computed tomography (HRCT) findings in liver transplant patients diagnosed with pulmonary Mycobacterium tuberculosis infection. MATERIALS AND METHODS: The HRCT findings from 19 patients diagnosed with pulmonary tuberculosis infection after liver transplantation were reviewed. The patients included were 12 men and seven women, age range 23-65 years; mean age 57 years. The diagnosis was established with Mycobacterium tuberculosis detection in bronchoalveolar lavage, sputum, or biopsy. HRCT images were reviewed independently by two observers who reached a consensus decision. The HRCT findings were classified as (1) miliary nodules; (2) cavitation and centrilobular tree-in-bud nodules; (3) ground-glass attenuation and consolidation; and (4) mediastinal lymph node enlargement. RESULTS: The time between the transplantation and the diagnosis of pulmonary tuberculosis ranged from 7 to 153 days with an average of 79 days. The main HRCT pattern was cavitation and centrilobular tree-in-bud nodules (79%) followed by mediastinal lymph node enlargement (10.4%), ground-glass attenuation or consolidation (5.2%) and miliary nodules (5.2%). None of the patients presented pleural effusion. The cavitation and centrilobular tree-in-bud nodules pattern had upper lobe predominance, and ground-glass attenuation and consolidation pattern had middle lobe/lingular segment predominance. CONCLUSION: The main HRCT pattern of pulmonary tuberculosis in liver transplant patients was cavitation and centrilobular tree-in-bud nodules.

Hepatitis B Vaccination of Health Care Workers is Not Yet a Reality.

It is well documented that health care workers (HCW) have a higher prevalence of hepatitis B markers, and a higher risk of acquiring hepatitis than the general population does. In this study, we obtained the prevalence of vaccination against hepatitis B among HCW in a tertiary hospital, evaluated the reasons why hospital personnel did not use the vaccine, and we determined the prevalence of accidents which carried the potential of infection among the professional staff. HCW at possible risk were included in the study. The investigation showed that 39.3% of HCW were completely vaccinated, 12.9% received only partial vaccination, 8.4% were in the process of a vaccination series, 36.5% were never vaccinated, and 2.8% had passive immunization against hepatitis B virus. Lack of opportunity and difficulty in obtaining the vaccine were the main reasons given for non-vaccination. Of the non-vaccinated, 84.5% declared an intention to take the vaccine. Accidents with a potential for infection were observed in 57.9% of the population (sharp object accidents in 48.6%, accidents involving contact with blood or body fluids on mucous membranes in 27.6% and incision related accidents in 5.3%). The accidents were grouped into categories of risk of infection according to profession or medical specialty. Surgeons had the highest number of accidents. Strategies for vaccination campaign plans include an emphasis on the risks of exposure to the virus, discussion about the efficacy and safety of vaccination, and counselling to eliminate resistance to immunization.