ABSTRACT
A 76-year-old Japanese woman contracted a Mycobacterium tuberculosis (TB, Manila type) infection in Japan, despite never having traveled. However, her son was treated for TB in the Philippines 3 years before he stayed at her house. Spoligotyping allows us to identify the TB genotype and identify the route of infection.
ABSTRACT
BACKGROUND: Refugees and displaced populations after natural disasters have been vulnerable to tuberculosis. We report an active pulmonary tuberculosis case at a shelter and the subsequent contact investigation and review lessons learned from the 2011 Great East Japan Earthquake. METHODS: The contact investigation was conducted to identify latent tuberculosis infection among a total of 95 contact persons, including 78 evacuees at the shelter, who were exposed to the index tuberculosis patient. The association between exposure time of contacts to a patient with active tuberculosis and results of interferon-γ release assay (IGRA) was also examined. RESULTS: IGRA was positive in 9 (12.3%) of 73 evacuees at the shelter. Contacts who were exposed to active tuberculosis for more than 25 days were significantly more likely to be IGRA positive, compared with contacts exposed for less than 20 days. All of the 4 evacuees with latent tuberculosis infection who initiated treatment completed the regimen successfully. CONCLUSION: When a disaster strikes and many people are living in shelters, it is essential for health care personnel to first suspect tuberculosis and implement prevention and control in collaboration with referral hospitals and public health centers.
Subject(s)
Earthquakes , Tuberculosis/epidemiology , Tuberculosis/transmission , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Contact Tracing , Female , Humans , Infant , Infant, Newborn , Infection Control/methods , Interferon-gamma Release Tests , Japan/epidemiology , Male , Middle Aged , Tuberculosis/diagnosis , Tuberculosis/prevention & control , Young AdultSubject(s)
Disasters , Earthquakes , Mycobacterium tuberculosis/isolation & purification , Tuberculosis/transmission , Volunteers , Adult , DNA, Bacterial/analysis , Diagnosis, Differential , Female , Humans , Japan , Mycobacterium tuberculosis/genetics , Sputum/microbiology , Tomography, X-Ray Computed , Tuberculosis/diagnosisABSTRACT
Tuberculosis was diagnosed in a person who had stayed in a shelter after the 2011 Great East Japan Earthquake. A contact investigation showed that the prevalence of latent tuberculosis infection among other evacuees at the shelter was 20%. Our report underscores the importance of tuberculosis prevention and control after natural disasters.
Subject(s)
Earthquakes , Latent Tuberculosis/epidemiology , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Pulmonary/epidemiology , Adult , Aged , Aged, 80 and over , Child , Disasters , Female , Humans , Japan/epidemiology , Latent Tuberculosis/diagnosis , Latent Tuberculosis/transmission , Male , Middle Aged , Public Housing , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/transmissionABSTRACT
We report a case of chest wall abscess caused by Mycobacterium bovis BCG that arose as a complication 1 year after intravesical BCG instillation. We identified M. bovis BCG Tokyo 172 in the abscess by PCR-based typing of Mycobacterium tuberculosis complex and analysis of variable number of tandem repeats data.
Subject(s)
Abscess/diagnosis , Biological Therapy/adverse effects , Mycobacterium bovis/isolation & purification , Thoracic Wall/microbiology , Thoracic Wall/pathology , Tuberculosis/diagnosis , Abscess/microbiology , Abscess/pathology , Administration, Intravesical , Aged , Carcinoma/therapy , Humans , Male , Minisatellite Repeats , Molecular Typing , Polymerase Chain Reaction , Radiography, Thoracic , Tokyo , Tomography, X-Ray Computed , Tuberculosis/microbiology , Tuberculosis/pathology , Urinary Bladder Neoplasms/therapyABSTRACT
Home-related chronic hypersensitivity pneumonitis (HP) is sometimes difficult to discriminate because patients do not have an obvious history of antigen exposure. We report two HP cases which developed in an office area and in a home: a 47-year-old woman with acute-onset HP and a 72-year-old woman with chronic HP followed up as idiopathic pulmonary fibrosis following isolation of Cladosporium cladosporioides and Cladosporium herbarum, respectively. Lymphocyte stimulating activity and antibody titer to these fungi were increased in these patients. Since Cladosporium spp. and several other fungi are present ubiquitously in our living environment, it is difficult to eliminate the antigen from the patients' environment to control the disease. Cladosporium spp. can be key antigens in inducing chronic HP in the home environment.
Subject(s)
Alveolitis, Extrinsic Allergic/diagnosis , Alveolitis, Extrinsic Allergic/microbiology , Antigens, Fungal/adverse effects , Cladosporium , Environmental Exposure/adverse effects , Mycoses/complications , Alveolitis, Extrinsic Allergic/immunology , Biopsy , Cladosporium/immunology , Female , Humans , Lung/pathology , Middle Aged , Radiography, ThoracicABSTRACT
Angioimmunoblastic T-cell lymphoma (AILT) is a rare variant of nodal and aggressive lymphoma. It is sometimes difficult to distinguish AILT from reactive lymphoid hyperplasia from the histopathological aspect. We report a case of AILT which developed with bilateral pleural effusion. The effusion consisted predominately of small lymphoid cells. Analyses of the effusion showed trisomy 3, and rearranged bands of TCR beta gene. Flow cytometry showed a very small amount of CD10-positive cells. Although we could not further identify the tumor cells in this case, analysis of pleural effusion cells will increase our understanding of the pathogenesis and the pathophysiology of AILT.
Subject(s)
Immunoblastic Lymphadenopathy/complications , Lymphoma, T-Cell/complications , Pleural Effusion, Malignant/etiology , Aged, 80 and over , Chromosomes, Human, Pair 3/genetics , Gene Rearrangement/genetics , Genes, T-Cell Receptor beta/genetics , Humans , Immunoblastic Lymphadenopathy/diagnosis , Immunoblastic Lymphadenopathy/genetics , Immunoblastic Lymphadenopathy/immunology , Lymphoma, T-Cell/diagnosis , Lymphoma, T-Cell/genetics , Lymphoma, T-Cell/immunology , Male , Neprilysin/metabolism , Pleural Effusion, Malignant/pathology , Trisomy/geneticsABSTRACT
RATIONALE: Pulmonary alveolar microlithiasis is an autosomal recessive disorder in which microliths are formed in the alveolar space. OBJECTIVES: To identify the responsible gene that causes pulmonary alveolar microlithiasis. METHODS: By means of a genomewide single-nucleotide polymorphism analysis using DNA from three patients, we have narrowed the region in which the candidate gene is located. From this region, we have identified a gene that has mutations in all patients with pulmonary alveolar microlithiasis. MEASUREMENTS AND MAIN RESULTS: We identified a candidate gene, SLC34A2, that encodes a type IIb sodium phosphate cotransporter and that is mutated in six of six patients investigated. SLC34A2 is specifically expressed in type II alveolar cells, and the mutations abolished the normal gene function. CONCLUSION: Mutations in the SLC34A2 gene that abolish normal gene function cause pulmonary alveolar microlithiasis.
