Assessment of concurrent infection with bovine viral diarrhoea virus (BVDV) and Mycobacterium bovis: A herd-level risk factor analysis from Northern Ireland.

Bovine viral diarrhoea virus (BVDV) is a significant pathogen of cattle, leading to severe economic and animal-welfare impacts. Furthermore, the pathogen has been associated with impacting the progression or spread of other pathogens (e.g. Mycobacterium bovis, the causative agent of bovine tuberculosis (bTB)). During this study we investigated (i) risk factors for BVDV at a herd-level and (ii) whether there was any association between BVDV and herd-level bTB risk. The data for this study were gathered from a voluntary BVDV control programme in Northern Ireland (2013-2015) based on the identification of virus positive animals through tissue tag testing of calves. We assigned a herd-level BVDV status to 2827 participating herds, where a herd was assumed "infected" if one or more animals tested positive for BVDV. Two model suites were developed. Firstly, we assessed risk factors for BVDV herd status using multivariable logit random-effects modelling, aggregating to the calendar year level (2013-2015; n=4828; model 1). Secondly, we aggregated data across the three years of the study to give an overall status for the whole study period (n=2827; logistic model 2). Risk factors included year, herd-type, herd size, number of births, inward trade moves, calf mortality, and region. Furthermore, the herd-level bovine tuberculosis status (based on the single intradermal comparative cervical tuberculin (SICCT) test outcomes, or confirmation at post-mortem), or the size of bTB breakdowns (number of SICCT test positive animals), of herds was also investigated to assess whether there was an association (co-infection) with herd BVDV status. The final models suggested that BVDV herd status was positively associated with increased levels of calf mortality, herd size, number of births, the number of BVDV tests undertaken and the number of animals introduced to the herd. There was a significant univariable positive association between BVDV status, and SICCT breakdown risk, breakdown size and confirmed bTB status in model 2. However, there was no evidence of significant associations between bTB status (using SICTT status, confirmed status or herd breakdown size) and BVDV status in final multivariable models when controlling for other significant confounders. These results provide information for action for the future control and eradication of BVDV in Northern Ireland, though these data provide little support for the hypothesised association between BVDV and bTB status at herd-level. Further animal-level analyses are necessary to investigate whether there is support for a BVD-bTB co-infection association, including the impact of co-infection on the severity of infection.

Milk yield and reproductive performance of Holstein cows testing positive for bovine tuberculosis.

The objective of this study was to determine if high milk-yielding Holstein cows testing positive for bovine tuberculosis (bTB) are affected in their reproductive performance and milk yield. For this purpose, 1044 healthy cows and 105 bTB reactor cows were used. Tuberculosis reactor cows were from four large commercial dairy operations from the same region which were transferred from their barns to an isolated dairy facility. Cows free from this disease were placed in the same barn as the bTB reactor cows but in an isolated division and served as control animals. The analysis of variance with a general linear model for binary data showed that the reproductive performance of bTB reactors was impaired; overall pregnancy per artificial insemination differed (P < 0.05) between bTB reactor and non-reactor cows (16.9 vs. 20.7%). Cows that were TB reactors required 4.7 ± 2.9 services per pregnancy compared with 4.3 ± 2.8 for control cows (P > 0.05). The intervals between calving and conception were similar between bTB reactors (154 ± 78 days) and control animals (150 ± 80 days). Control cows tended (P = 0.08) to produce more milk than bTB reactors over a 305-day lactation (10,684 ± 1720 vs. 10,345 ± 1736; mean ± SD). Serum metabolites indicative of nutritional stress did not differ between bTB reactor and non-reactor cows. It was concluded that both reproductive performance and milk yield decreased marginally in bTB reactor cows, which explains the reluctance of milk producers to get rid of these animals.

Evaluation of the single cervical skin test and interferon gamma responses to detect Mycobacterium bovis infected cattle in a herd co-infected with Mycobacterium avium subsp. paratuberculosis.

This study reports the performance of the single intradermal tuberculin (SIT) test and the interferon-gamma (IFN-γ) assay for Mycobacterium bovis in a cattle herd with high prevalence of paratuberculosis (PTB). A total of 58/350 animals were selected for necropsy based on one or more of the following criteria: positive to SIT, IFN-γ, a breeding cow that seroconverted to PTB and showed signs compatible with a wasting disease. Infection status was determined by post mortem diagnostic tests that included histopathology examination, mycobacterial cultures and PCR identification for M. bovis and Mycobacterium avium subsp. paratuberculosis (MAP). In 7/58 animals primary tuberculosis (TB) lesions, affecting only the retropharyngeal and/or mediastinal lymph nodes, were found; 3/7 animals were found SIT positive. PTB was confirmed in 35/58 animals, of which 30 had seroconverted and 14 had typical clinical signs. 45/58 animals were IFN-γ(+) using the most stringent criterion (cut-off point ≥ 0.05); however, IFN-γ test was only positive in 33 animals when using a higher threshold (cut-off point ≥ 0.1). Three animals co-infected also showed extensive TB and diffuse PTB lesions. These results show that the combined use of SIT and IFN-γ, as interpreted using official guidelines, detected all confirmed cases of TB. Individually, the sensitivity of the SIT was inadequate to diagnose TB-positive animals with an advanced stage of PTB. The large number of IFN-γ(+) animals with no visible TB lesion could be due, in part, to some protection conferred by prior infection with MAP.

[Zoonotic tuberculosis in Argentina]. / La tuberculosis zoonótica en la Argentina.

There are significant achievements in the control of animal tuberculosis (tB) in Argentina. the percentage of bovines with apparent tB lesions at the slaughterhouse inspection decreased from 6.7% to 0.6% between 1969 and 2011. on the other hand, the mean percentage of human tB cases due to M. bovis among all those bacteriologically confirmed, was in Santa Fe, an agro-industrial province, 2.3% in the period 1977-2001. It fell to 1.6% by 2011. In the Cetrángolo Hospital (Buenos Aires), it was 0.34% in the period 2001-2005, and 0.36% in 2006-2011. At the Muñiz Hospital, these percentages decreased from 1.75% in 1971 to 0.22% in 2006. Frequency of HIV infection among M. bovis cases varied from 5.9% in santa Fe to 11.1% and 20.5% respectively, in Cetrángolo and Muñiz Hospitals (a reference institution for aids) in Buenos Aires. According to these data M. bovis infection predominates in agro-industrial/ rural areas, showing a slow decrease there as well as in Buenos Aires. Co-infection with HIV is more frequent among patients with M. bovis that in all cases of tB. The situation of M. bovis in Argentina is here compared with that in USA and in several European and Latin American countries. Trends followed by tB in cattle, in humans, and the percentages of M. bovis among them, are not always closely related to move towards the common goal of eradicating tB; the employment of appropriate strategies and the strengthening of control measures are critical in both programs.

La tuberculosis zoonótica en la Argentina / Zoonotic tuberculosis in Argentina

Existen importantes logros en el control de la tuberculosis (TB) animal en la Argentina. Los porcentajes de bovinos con lesiones TB halladas en mataderos disminuyeron de 6.7% a 0.7% entre 1969 y 2011. En salud pública, el porcentaje promedio de TB por M. bovis sobre el total de los casos confirmados bacteriológicamente, fue en Santa Fe -provincia agro industrial- 2.3% en el período 1977-2001 y 1.6% entre 2002 y 2011. En Buenos Aires, en el Hospital Cetrángolo, ese porcentaje fue 0.34% (2001-2005) y 0.36% (2006-2011). En el Hospital Muñiz disminuyó de 1.75% en 1971 a 0.22% en 2006. La frecuencia de HIV entre los casos de M. bovis varió de 5.9% en Santa Fe a 11.1% y 20.5% respectivamente en los Hospitales Cetrángolo y Muñiz de Buenos Aires. En conjunto, la infección por M. bovis es más importante en las zonas rurales/ agro industriales, con un lento descenso, también observado en Buenos Aires. La coinfección por HIV es más frecuente en pacientes con M. bovis que en el conjunto de los casos de TB. Comparando la situación de la Argentina con la de EE.UU. y países de Europa y América Latina, se observa que las tendencias de la TB en el ganado, en humanos y la frecuencia relativa del M. bovis en salud pública, no siempre siguen una relación estrecha. Para avanzar hacia la meta común de erradicación de la TB, el empleo de estrategias adecuadas y el fortalecimiento de las medidas de control son fundamentales para ambos programas.

There are significant achievements in the control of animal tuberculosis (TB) in Argentina. The percentage of bovines with apparent TB lesions at the slaughterhouse inspection decreased from 6.7% to 0.6% between 1969 and 2011. On the other hand, the mean percentage of human TB cases due to M. bovis among all those bacteriologically confirmed, was in Santa Fe, an agro-industrial province, 2.3% in the period 1977-2001. It fell to 1.6% by 2011. In the Cetrángolo Hospital (Buenos Aires), it was 0.34% in the period 2001-2005, and 0.36% in 2006-2011. At the Muñiz Hospital, these percentages decreased from 1.75% in 1971 to 0.22% in 2006. Frequency of HIV infection among M. bovis cases varied from 5.9% in Santa Fe to 11.1% and 20.5% respectively, in Cetrángolo and Muñiz Hospitals (a reference institution for aids) in Buenos Aires. According to these data M. bovis infection predominates in agro- industrial/ rural areas, showing a slow decrease there as well as in Buenos Aires. Co-infection with HIV is more frequent among patients with M. bovis that in all cases of TB. The situation of M. bovis in Argentina is here compared with that in USA and in several European and Latin American countries. Trends followed by TB in cattle, in humans, and the percentages of M. bovis among them, are not always closely related. To move towards the common goal of eradicating TB, the employment of appropriate strategies and the strengthening of control measures are critical in both programs.

La tuberculosis zoonótica en la Argentina / Zoonotic tuberculosis in Argentina

Existen importantes logros en el control de la tuberculosis (TB) animal en la Argentina. Los porcentajes de bovinos con lesiones TB halladas en mataderos disminuyeron de 6.7% a 0.7% entre 1969 y 2011. En salud pública, el porcentaje promedio de TB por M. bovis sobre el total de los casos confirmados bacteriológicamente, fue en Santa Fe -provincia agro industrial- 2.3% en el período 1977-2001 y 1.6% entre 2002 y 2011. En Buenos Aires, en el Hospital Cetrángolo, ese porcentaje fue 0.34% (2001-2005) y 0.36% (2006-2011). En el Hospital Muñiz disminuyó de 1.75% en 1971 a 0.22% en 2006. La frecuencia de HIV entre los casos de M. bovis varió de 5.9% en Santa Fe a 11.1% y 20.5% respectivamente en los Hospitales Cetrángolo y Muñiz de Buenos Aires. En conjunto, la infección por M. bovis es más importante en las zonas rurales/ agro industriales, con un lento descenso, también observado en Buenos Aires. La coinfección por HIV es más frecuente en pacientes con M. bovis que en el conjunto de los casos de TB. Comparando la situación de la Argentina con la de EE.UU. y países de Europa y América Latina, se observa que las tendencias de la TB en el ganado, en humanos y la frecuencia relativa del M. bovis en salud pública, no siempre siguen una relación estrecha. Para avanzar hacia la meta común de erradicación de la TB, el empleo de estrategias adecuadas y el fortalecimiento de las medidas de control son fundamentales para ambos programas.(AU)

There are significant achievements in the control of animal tuberculosis (TB) in Argentina. The percentage of bovines with apparent TB lesions at the slaughterhouse inspection decreased from 6.7% to 0.6% between 1969 and 2011. On the other hand, the mean percentage of human TB cases due to M. bovis among all those bacteriologically confirmed, was in Santa Fe, an agro-industrial province, 2.3% in the period 1977-2001. It fell to 1.6% by 2011. In the Cetrángolo Hospital (Buenos Aires), it was 0.34% in the period 2001-2005, and 0.36% in 2006-2011. At the Muñiz Hospital, these percentages decreased from 1.75% in 1971 to 0.22% in 2006. Frequency of HIV infection among M. bovis cases varied from 5.9% in Santa Fe to 11.1% and 20.5% respectively, in Cetrángolo and Muñiz Hospitals (a reference institution for aids) in Buenos Aires. According to these data M. bovis infection predominates in agro- industrial/ rural areas, showing a slow decrease there as well as in Buenos Aires. Co-infection with HIV is more frequent among patients with M. bovis that in all cases of TB. The situation of M. bovis in Argentina is here compared with that in USA and in several European and Latin American countries. Trends followed by TB in cattle, in humans, and the percentages of M. bovis among them, are not always closely related. To move towards the common goal of eradicating TB, the employment of appropriate strategies and the strengthening of control measures are critical in both programs.(AU)

Lumbo-sacral spine disease due to bovine tuberculosis in a patient with concurrent pulmonary disease.

Lumbo-sacral spinal disease due to bovine tuberculosis (TB) in a patient with concurrent pulmonary disease is rare. We report this unpredicted finding in an immunocompetent patient and discuss the natural history in an area of low prevalence.

Coinfection of a cow with Bovine leukemia virus and Mycobacterium bovis.

Bovine leukosis associated with infection with the delta retrovirus Bovine leukemia virus (BLV) is endemic in many cattle herds in the United States. Infection has been associated with immunosuppression and decreased productivity. Cases of tuberculosis in cows due to infection with Mycobacterium bovis reemerged in Michigan in 1998, and despite intensive eradication attempts, new cases of bovine tuberculosis are sporadically identified. The present report details a coinfection with BLV and M. bovis in a Holstein cow from Michigan that presented as part of a bovine tuberculosis screening program. Peripheral and visceral lymph nodes of this animal were markedly enlarged, homogeneously pale white, and bulged on the cut surface. The submandibular, mesenteric, and caudal mediastinal lymph nodes contained multifocal to coalescing caseogranulomas that ranged from 1 to 5 cm in diameter. Histologically, dense sheets of monomorphic populations of neoplastic lymphocytes obliterated the normal architecture of all lymph nodes. Caseogranulomas were characterized by central pools of amorphous degenerate eosinophilic and occasionally mineralized granular debris surrounded by thick rims of epithelioid macrophages, occasional Langhan's type giant cells, and fibrosis. Polymerase chain reaction assay was positive for BLV. Cultures of affected lymph nodes yielded growth of M. bovis.

Co-Infection of cattle with Fasciola hepatica and Mycobacterium bovis- immunological consequences.

Fasciola hepatica, the liver fluke, is a common parasite of cattle in much of the world. Previously, we have shown that cattle infected with F. hepatica have altered responsiveness (delayed type hypersensitivity reaction and cytokine responses) to M. bovis BCG infection. We hypothesized that co-infection with F. hepatica would, likewise, alter the immune response of cattle to virulent M. bovis infection, with possible implications for disease diagnosis and disease progression. Our previous work with F. hepatica/M. bovis BCG-infected cattle demonstrated a reduction in interferon (IFN)-gamma responsiveness in co-infected animals. Similar findings are reported here with virulent M. bovis following aerosol infection. The epidemiological significance of these findings, also, require exploration, particularly in view of the considerable resources devoted to the diagnosis and eradication of bovine tuberculosis, and the high prevalence of F. hepatica infection in areas where eradication has proved difficult.

Clinical demodicosis in African buffalo (Syncerus caffer) in the Kruger National Park.

We investigated the relationship between prevalence and severity of clinical signs of Demodex cafferi infection in free-ranging African buffalo (Syncerus caffer) and other factors such as age, sex, pregnancy status, and concomitant infections with bovine tuberculosis (BTB), Rift Valley fever (RVF), and brucellosis (BA). Approximately half of 203 buffalo examined in this study had clinical signs of demodicosis (cutaneous nodules); younger age classes had the highest prevalence and severity of lesions (chi(2)=21.4, df=6, P=0.0015). Nodules were generally limited to the head and neck region, but in severe cases were present over the entire animal. We found no significant association between clinical severity of the Demodex infection and gender, pregnancy status, or infection with BTB, RVF, or BA.

Effect of paratuberculosis on the diagnosis of bovine tuberculosis in a cattle herd with a mixed infection using interferon-gamma detection assay.

Interferon-gamma (IFN-gamma) detection assay is being applied as an ancillary test to tuberculin tests in the diagnosis of bovine tuberculosis to detect the maximum number of infected animals. Among possible factors influencing the performance of tuberculosis-diagnostic tests, paratuberculosis, a widespread disease in Spain and other European countries, has been pointed out as a cause of false positive reactions. Still, its effect on the sensitivity of these tests in cattle has yet to be fully characterized. The impact of paratuberculosis in the apparent sensitivity of IFN-gamma assay was studied in a bullfighting cattle herd with a mixed tuberculosis-paratuberculosis infection, using culture of Mycobacterium bovis and Mycobacterium avium paratuberculosis as the gold standard to determine the infection status of every animal. A total of 218 animals were slaughtered and sampled for bacteriology after blood sampling. IFN-gamma assay showed a lower apparent sensitivity in animals with a mixed infection (50%) compared to all animals suffering tuberculosis (78.3%). This finding indicates that the presence of paratuberculosis in tuberculosis-infected herds could imply a serious impairment in the sensitivity of IFN-gamma detection test.

Disseminated Bacillus Calmette-Guerin infection after BCG vaccination.

The BCG is administered to all the newborns at birth in Iran. Systemic adverse reactions to BCG vaccine such as osteomyelitis and disseminated BCG infection are rare. This is a retrospective study of 15 cases <72 months who were admitted with systemic syndrome compatible with disseminated mycobacterial disease during 2004-07. Disseminated BCG disease occurred in eight children younger than 6-months old and 12 patient younger than 12-months old. Twelve patients were male. Nine of 15 patients had well known primary immune deficiency disorders including severe combined immunodeficiency, chronic granulomatous disease; cell mediated immune defect and HIV infection. Nine (60%) cases had good response to four anti-mycobacterial drug therapy and interferon gamma. Disseminated BCG disease is a rare but devastating complication of BCG vaccination that should be considered in the appropriate clinical setting. Severe immune-compromised infants are at greatest risk and they respond poorly to standard therapies.

Mycobacterium bovis shedding patterns from experimentally infected calves and the effect of concurrent infection with bovine viral diarrhoea virus.

Concurrent infection of cattle with bovine viral diarrhoea virus (BVDV) and Mycobacterium bovis is considered to be a possible risk factor for onward transmission of bovine tuberculosis (BTB) in infected cattle and is known to compromise diagnostic tests. A comparison is made here of M. bovis shedding (i.e. release) characteristics from 12 calves, six experimentally co-infected with BVDV and six infected with M. bovis alone, using simple models of bacterial replication. These statistical and mathematical models account for the intermittent or episodic nature of shedding, the dynamics of within-host bacterial proliferation and the sampling distribution from a given shedding episode. We show that while there are distinct differences among the shedding patterns of calves given the same infecting dose, there is no statistically significant difference between the two groups of calves. Such differences as there are, can be explained solely in terms of the shedding frequency, but with all calves potentially excreting the same amount of bacteria in a given shedding episode post-infection. The model can be thought of as a process of the bacteria becoming established in a number of discrete foci of colonization, rather than as a more generalized infection of the respiratory tract. In this case, the variability in the shedding patterns of the infected calves can be explained solely by differences in the number of foci established and shedding being from individual foci over time. Should maximum exposure on a particular occasion be a critical consideration for cattle-to-cattle transmission of BTB, cattle that shed only intermittently may still make an important contribution to the spread and persistence of the disease.

Low-dose Mycobacterium bovis infection in cattle results in pathology indistinguishable from that of high-dose infection.

To understand the relevance of aerogenic transmission for bovine tuberculosis, it is important to study cattle experimentally infected with low doses of Mycobacterium bovis that result in pathology of the lower respiratory tract resembling that of most naturally infected cattle. In this study, we have compared and contrasted granuloma distribution and formation from cattle infected with low doses (1-1000 colony-forming units (cfu)) of M. bovis over 24 weeks. We also studied the expression of the cytokine IFN-gamma in lymph nodes by immunohistochemistry (IHC) as well as by ELISA from in vitro-stimulated peripheral blood cells. Our results confirmed that 50% of cattle infected with only 1cfu of field strain (AF2122/97) M. bovis developed advanced granulomas in thoracic lymph nodes. The degree of lesion advancement and granuloma distribution was similar between the lowest dose group (1cfu) and the highest of the 4 groups (1000cfu). The number of acid-fast bacilli identified within the granulomas was also similar among all groups. IFN-gamma expression was not significantly correlated with the infective dosage in either granuloma IHC or ante-mortem ELISA. These studies confirm that within the same time period, the smallest possible infective dose, properly administered, can produce pathology indistinguishable from a dose 1000-fold greater.

Assessment of diagnostic tools for eradication of bovine tuberculosis in cattle co-infected with Mycobacterium bovis and M. avium subsp. paratuberculosis.

The intradermal tuberculin (IDTB) test and the interferon-gamma (IFN-gamma) assay are used worldwide for detection of bovine tuberculosis in cattle, but little is known about the effect of co-infecting agents on the performance of these diagnostic tests. This report describes a field trial conducted in a cattle herd with dual infection (bovine tuberculosis and paratuberculosis) during 3.5 years. It has been based on a strategic approach encompassing serial parallel testing (comparative IDTB test, the IFN-gamma assay and serology of paratuberculosis) that was repeated 8 times over the period, and segregation of animals into two herds. The IDTB test detected 65.2% and the IFN-gamma test detected 69.6% of the Mycobacterium bovis culture-positive cattle. However, the IDTB test performed better during the first part of the trial, while the IFN-gamma test was the only method that detected infected animals during the following three samplings. The number of false positive reactors with the IDTB and/or the IFN-gamma tests was remarkably high compared to other reports, and could be caused by cross-reactivity with M. avium subsp. paratuberculosis. Also, the M. bovis isolates from cattle and wildlife from the same property were characterised using molecular techniques to disclose an epidemiological link. The IDTB test may not be appropriate to eradicate bovine tuberculosis in herds with dual mycobacterial infections. This report highlights the need to use several diagnostic techniques for the accurate detection of M. bovis infected animals in these herds.

Development of Vgamma2Vdelta2+ T cell responses during active mycobacterial coinfection of simian immunodeficiency virus-infected macaques requires control of viral infection and immune competence of CD4+ T cells.

Vgamma2Vdelta2+ T cells play a role in antimicrobial responses. It is unknown whether adaptive Vgamma2Vdelta2+ T cell responses during active mycobacterial coinfection of human immunodeficiency virus-infected humans can be generated during effective antiretroviral treatment. Here, simian immunodeficiency virus (SIV)mac-infected macaques previously exposed to bacille Calmette-Guerin (BCG) were reinfected with BCG, were treated either with tenofovir or tenofovir plus indinavir, and were assessed for the development of Vgamma2Vdelta2+ T cell responses during active BCG coinfection. A restored capacity of Vgamma2Vdelta2+ T cells to undergo major expansions and pulmonary migration during active BCG coinfection was detected after simultaneous BCG reinfection and treatment with tenofovir of the SIVmac-infected macaques. Interestingly, a restored expansion of Vgamma2Vdelta2+ T cells in the SIVmac/BCG-coinfected macaques was detectable, even though antiretroviral treatment was initiated 1 month after BCG reinfection. Importantly, the restored expansion of Vgamma2Vdelta2+ T cells coincided with increases in numbers of purified protein derivative-specific interferon- gamma -producing CD4+ T cells and increases in the magnitude of their proliferative responses. In contrast, the SIVmac-infected control macaques exhibited diminished responses of Vgamma2Vdelta2+ T cells and mycobacterium-specific CD4+ T cells during active BCG coinfection. Our results suggest that the development of adaptive immune responses of phosphoantigen-specific Vgamma2Vdelta2+ T cells during active mycobacterium/HIV coinfection requires control of viral infection and immune competence of peptide-specific CD4+ T cells.

Molecular and histopathologic evidence for systemic infection by Mycobacterium bovis in a patient with tuberculous enteritis, peritonitis, and meningitis: a case report.

Mycobacterium bovis infection has been reported in several patients with AIDS in other countries. The prevalence of tuberculosis in Taiwan is higher than the World Health Organization standard. However, reports of M. bovis infection are rare. A 47-year-old male had the habit of drinking uncooked fresh deer's blood and unpasteurized deer's milk. He suffered from acute abdominal pain and underwent emergency laparotomy. Pathology demonstrated tuberculosis enteritis with colon perforation. The molecular diagnosis by nested polymerase chain reaction assay and single-strand conformation polymorphism assay showed M. bovis infection in the small intestine, mesenteric lymph nodes, and cerebrospinal fluid (CSF). Our results suggest that the most likely portal of entry of M. bovis is the gastrointestinal rather than the respiratory tract. Ingested M. bovis from unpasteurized deer's milk probably entered the mucosal macrophages of the intestine and then the draining mesenteric lymph nodes. As immunity declined, bacilli from the mesenteric lymph nodes disseminated to other organs and into the CSF.

Tubeculosis generalizada por Mycobacterium Bovis en un paciente inmunocompetente (presentación de un caso y revisión de la bibliografía) / Generalized tuberculosis by Mycobacterium bovis in a immunocompetent patient (case report and bibliographic review)

El Mycobacterium bovis es una variedad del complejo M. tuberculosis que afecta principalmente al ganado vacuno. Raramente puede producir tuberculosis pulmonar y extrapulmonar en el hombre. Presentamos el caso de una paciente de 72 años, con serología negativa para HIV y sin otras evidencias de inmunosupresión que se internó por tuberculosis pulmonar miliar, ósea y cutánea por M. bovis. El diagnóstico se confirmó por el examen directo y cultivo del esputo y la biopsia de piel. Al ingreso presentaba severa afectación de su estado general, pero luego de tres meses de tratamiento antituberculoso su evolución clínica y radiológica fue favorable. Analizamos la incidencia, las características del bacilo y las vías de contagio. Este es un caso poco frecuente de tuberculosis generalizada por M. bovis en un paciente inmunocompetente

Granuloma development in cattle after intratonsilar inoculation with Mycobacterium bovis.

OBJECTIVE: To examine the temporal development of tuberculous lesions in cattle inoculated with Mycobacterium bovis. ANIMALS: 15 mature crossbred cows obtained from a herd with no history of M bovis infection. PROCEDURE: Inoculation of cattle was done by intratonsilar instillation of 1.48 X 10(5) to 5.4 X 10(7) colony-forming units of M bovis strain 2045T. At 3 to 4 hours, 4 weeks, 6 weeks, and 8 weeks after inoculation, tissues were examined for gross and microscopic lesions and processed for isolation of M bovis. RESULTS: Retropharyngeal lymph nodes from cattle examined 4 weeks after inoculation contained microgranulomas consisting of aggregates of macrophages with few neutrophils. Retropharyngeal lymph nodes from all cattle examined 6 and 8 weeks after inoculation contained multiple, large, coalescing granulomas consisting of central areas of necrosis with mild fibrosis, numerous macrophages, lymphocytes, plasma cells, multinucleated giant cells, and neutrophils. Three of 8 cattle examined 6 or 8 weeks after inoculation had lesions in nonretropharyngeal sites with morphologic characteristics similar to that seen in retropharyngeal lymph node granulomas from cattle examined 4 weeks after inoculation. CONCLUSION: Granulomas can develop in draining lymph nodes of cattle in as little as 4 weeks after inoculation via intratonsilar instillation of M bovis. Intralesional morphologic changes between 4 and 6 weeks after inoculation indicate an increase in cellular chemotaxis and differentiation. Dissemination of bacteria to distant sites most likely was by lymphatic and hematogenous routes after establishment of the primary infection in retropharyngeal lymph nodes.