ABSTRACT
Data on the clinical presentation and outcomes of sarcoidosis patients with coronavirus disease 19 (COVID-19) are scarce. In this case series, we identified 5 out of 238 sarcoidosis patients who are enrolled in an ongoing longitudinal observational study who developed COVID-19 during the study period and follow their clinical course. Four patients recovered completely, whereas one patient expired during hospital admission. Our preliminary experience suggests that African American patients with chronic sarcoidosis treated with disease-modifying anti-rheumatic drugs (DMARDs) or anti-tumor necrosis factor (TNF) therapy do not seem to be at increased risk of respiratory or life-threatening complications from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with the general population, although at the present time, we advocate for maintaining a high level of vigilance and strict follow-up in this patient population.
ABSTRACT
The aim of this study was to determine the prevalence of drug-resistant tuberculosis (TB) and its associated risk factors. The susceptibilities of Mycobacterium tuberculosis isolates were tested against four first-line antituberculous drugs and were typed by spoligotyping. Spoligotyping of M. tuberculosis strains resulted in 95 different patterns that were divided into three evolutionary groups (1-3). Eighty-six (90%) of the isolates had unique patterns that were reported for the first time. Interestingly, 9.4% of the strains belonged to the Beijing family. Multidrug resistance (MDR) was seen in group 1 of the evolutionary scenario. All M. tuberculosis isolates belonging to the Beijing family were associated with a resistance pattern. MDR was much higher in bacteria isolated from Afghan TB patients residing in Iran.
Subject(s)
Drug Resistance, Multiple, Bacterial/drug effects , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/epidemiology , Adult , Afghanistan/epidemiology , Anti-Bacterial Agents/therapeutic use , Antibiotics, Antitubercular/therapeutic use , Drug Resistance, Multiple, Bacterial/genetics , Ethambutol/therapeutic use , Genotype , Humans , Iran/epidemiology , Isoniazid/therapeutic use , Microbial Sensitivity Tests , Middle Aged , Molecular Epidemiology , Mycobacterium tuberculosis/genetics , Prevalence , Rifampin/therapeutic use , Risk Factors , Streptomycin/therapeutic use , Tuberculosis, Multidrug-Resistant/genetics , Tuberculosis, Multidrug-Resistant/microbiologyABSTRACT
Primary immunodeficiencies (PIDs) are not solely diseases of childhood. We describe the clinical presentation and outcome for 55 adult patients with previously unrecognized PIDs. This series provides unique data regarding PIDs presenting in adulthood, and serves as a timely reminder that physicians must consider the diagnosis of PIDs in their adult patients. Using the experience gained from these patients, we outline key "warning signs" suggestive of an underlying PID. Only through increased physician awareness will patients with PIDs receive timely diagnosis and optimal management.
Subject(s)
Common Variable Immunodeficiency/diagnosis , Common Variable Immunodeficiency/immunology , Adolescent , Adult , Agammaglobulinemia/diagnosis , Agammaglobulinemia/genetics , Agammaglobulinemia/immunology , Aged , Ataxia Telangiectasia/diagnosis , Ataxia Telangiectasia/genetics , Ataxia Telangiectasia/immunology , Common Variable Immunodeficiency/genetics , Complement C1 Inactivator Proteins/deficiency , Complement C1 Inhibitor Protein , Diagnosis, Differential , Female , Genetic Diseases, X-Linked/diagnosis , Genetic Diseases, X-Linked/genetics , Genetic Diseases, X-Linked/immunology , Humans , Immunity, Cellular/genetics , Immunoglobulins/biosynthesis , Immunoglobulins/deficiency , Immunoglobulins/genetics , Iran , Job Syndrome/diagnosis , Job Syndrome/genetics , Job Syndrome/immunology , Leukocyte-Adhesion Deficiency Syndrome/diagnosis , Leukocyte-Adhesion Deficiency Syndrome/genetics , Leukocyte-Adhesion Deficiency Syndrome/immunology , Male , Middle Aged , Neutropenia/diagnosis , Neutropenia/genetics , Neutropenia/immunology , Retrospective Studies , Serpins/deficiency , Wiskott-Aldrich Syndrome/diagnosis , Wiskott-Aldrich Syndrome/genetics , Wiskott-Aldrich Syndrome/immunologyABSTRACT
The viability of Mycobacterium tuberculosis (MTB) in serial sputum specimens from persistently smear positive patients was evaluated. The assay was based on oxidation-reduction of Alamar Blue and Malachite Green dyes that change their color in response to MTB growth. A total of 280 sputum specimens from 40 persistently smear positive TB patients and 40 sputa from non-tuberculosis patients were digested, decontaminated and examined microscopically. To check the MTB viability, the sediments from decontaminated samples were inoculated into three culture media: Lowenstein-Jensen (LJ) slants, Alamar Blue and Malachite Green culture tubes. We found that out of 280 smear positive specimens, the LJ culture was positive in 124 (44%). The numbers of correctly identified S+/C+ cases by Alamar Blue and Malachite Green were 118 (95%) and 116 (93%), respectively. The mean time required for reporting the positive signal in Alamar Blue culture tubes was 9 versus 11 days by Malachite Green culture tubes. In the standard LJ culture media the average detection time was 27 days (P < 0.05). The sensitivity of LJ was 99%, Alamar Blue 95% and Malachite Green 93%. The specificity was 100%, 92% and 93%, respectively. The oxidation-reduction method is rapid, sensitive and inexpensive in monitoring the treatment response of patients with pulmonary TB. Thus, using this method can be of paramount importance, particularly in resource-constrained areas.
Subject(s)
Bacteriological Techniques , Colorimetry/methods , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiology , Antitubercular Agents/therapeutic use , Follow-Up Studies , Humans , Microscopy , Mycobacterium tuberculosis/cytology , Mycobacterium tuberculosis/growth & development , Mycobacterium tuberculosis/metabolism , Oxazines/metabolism , Oxidation-Reduction , Rosaniline Dyes/metabolism , Sensitivity and Specificity , Sputum/microbiology , Time Factors , Treatment Outcome , Xanthenes/metabolismABSTRACT
By oxidation-reduction assay, the viability of Mycobacterium tuberculosis in sputum specimens was evaluated. The technique is based on the Alamar Blue and Malachite Green dyes, which change their color in response to M. tuberculosis growth. The method is simple, permits visual reading of results, and is applicable for laboratories with limited resources.
