ABSTRACT
A 6-year-old girl with a primary cutaneous form of Mycobacterium kansasii infection is presented. Disseminated infection and immune deficiency were excluded in our patient. She was successfully treated with surgical excision and oral erythromycin. Primary cutaneous M. kansasii is an exceedingly rare infection in children.
Subject(s)
Mycobacterium Infections, Nontuberculous/pathology , Mycobacterium kansasii/isolation & purification , Skin Diseases, Bacterial/pathology , Child , Elbow , Female , Humans , Mycobacterium Infections, Nontuberculous/microbiologyABSTRACT
OBJECTIVES: To determine the prevalence of M. tuberculosis isolates resistant to drugs in a general hospital and to assess its association with HIV infection. MATERIALS AND METHODS: Susceptibility analysis of all isolates of M. tuberculosis in a 4-year period (1990-1993). The proportion method was used to study the susceptibility to eight drugs. To assess the association of resistance with HIV infection a crossing was made of patients records who had M. tuberculosis recovered and that of patients with positive serology to HIV. RESULTS: Forty-two out of a total of 760 isolates (5.5%) were resistant to at least one drug, including isoniazid in 27 (3.3%), rifampin in 13 (1.6%), and pyrazinamide in 2 (0.2%). None of the isolates was resistant to ofloxacin. Twenty isolates (2.6%) were resistant to more than one drug and 9 (1.2%) were resistant to at least isoniazid and rifampin. Overall, 39% of resistance to one drug occurred in patients who had not received previous therapy with that drug. A greater incidence of resistant isolates was observed in HIV+ patients (7.3%) than in HIV- patients (4.6%), although this difference did not reach a statistical significance. CONCLUSIONS: Drug resistance rate in M. tuberculosis isolates in our hospital is still low and apparently not associated with HIV infection.
Subject(s)
Tuberculosis, Multidrug-Resistant/epidemiology , Hospitals, General , Humans , Microbial Sensitivity Tests , Mycobacterium tuberculosis/drug effects , Prevalence , Spain , Tuberculosis, Multidrug-Resistant/microbiologySubject(s)
Tuberculosis, Pulmonary/transmission , Adult , Child , Family , Humans , Parents , Spain/epidemiology , Tuberculosis, Pulmonary/epidemiologyABSTRACT
One hundred and nine adults recently diagnosed of active pulmonary tuberculosis (all of them with smear positive sputum) were selected. Their household contacts under fifteen years of age were studied. 73.1 por 100 of the children were tuberculin-positive, and 33.1 por 100 of these "reactors" had developed a pulmonary tuberculosis themselves. The bacillary density in the sputum of the source case was correlated to percentage of infected and ill children among his contacts. Neonatal vaccination with BCG showed a protective effect against the illness in children under eight years of age.
Subject(s)
BCG Vaccine/administration & dosage , Tuberculosis, Pulmonary/transmission , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Spain/epidemiology , Tuberculosis, Pulmonary/epidemiology , VaccinationABSTRACT
The clinical, microbiological, radiological and sonographical finding of 50 patients with tuberculosis and HIV infection are herewith described. 44 of the patients were men and 46 were intravenous drug addicts. Severe respiratory symptoms and peripheral pathological adenopathies were the most encountered manifestations. Those patients with tuberculosis and negative HIV titers (p less than 0.005) commonly showed lung miliary signs and mediastinal adenopathies when compared to others. Abdominal adenopathies evidenced by sonography were seen in 64.3% of the patients, of which only 2 out of the 27 HIV-positive-markers were of no tuberculous origin (p less than 0.0001). Sputum, urine and ganglia cultures were positive in more than 82%. 24 patients had pulmonary tuberculosis, 11 extra-pulmonary and 17 mixed. The response to treatment was good.
