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1.
Int J Mycobacteriol ; 13(3): 314-319, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-39277895

RESUMEN

BACKGROUND: Tuberculosis (TB) remains a significant global health concern, with extrapulmonary manifestations, including central nervous system involvement, posing substantial morbidity and mortality. While medical treatment with anti-TB drugs is the mainstay of therapy, certain TB-related cerebral complications, such as hydrocephalus, abscesses, and large symptomatic tuberculomas, may require surgical intervention. This study aimed to evaluate the outcomes of surgical management in patients with TB-related cerebral disorders. METHODS: A retrospective analysis was conducted on 24 patients who underwent surgical intervention for TB-related cerebral disorders, including tuberculomas, hydrocephalus, and abscesses, at a tertiary care center between 2005 and December 2020. Demographic data, clinical presentations, radiological findings, surgical techniques, and treatment outcomes were analyzed. RESULTS: The study cohort had a mean age of 35.8 ± 13.6 years, and the majority (62.5%) were male. Underlying immunodeficiency, primarily HIV infection, was present in 75% of the patients. The most common presenting symptoms were headache (83.3%), focal neurological deficits (75%), and altered mental status (54.2%). Radiological findings revealed 13 (54.2%) tuberculomas, 8 (33.3%) instances of hydrocephalus, and 3 (12.5%) abscesses. VP shunt inserted in 8 (33.3%) cases. Microscopic craniotomy performed in 7 (29.16%) cases. Aspiration through burr hole was done in 3 (12.5%) cases and stereotactic biopsy was performed in 6 (25%) cases. After 12 months of follow-up, favorable outcome achieved in 18 cases (75%) and the mortality occurred in 2 patients (8.3%). Surgical interventions included lesion resection (n = 10), stereotactic biopsy (n = 7), and ventriculoperitoneal (VP) shunt placement (n = 7). At 12-month follow-up, 18 (75%) patients had a favorable outcome, defined as clinical improvement or stabilization. Unfavorable outcomes were observed in 6 (25%) patients, including 2 deaths. CONCLUSION: Surgical management, in conjunction with appropriate anti-TB medical therapy, may be a valuable component of the comprehensive treatment approach for select patients with TB-related cerebral disorders. The favorable outcome rate observed in this study suggests that timely and tailored surgical intervention can contribute to improved patient outcomes. However, larger, prospective, multicenter studies are needed to further elucidate the role and long-term efficacy of surgical management in this patient population.


Asunto(s)
Hidrocefalia , Humanos , Masculino , Estudios Retrospectivos , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Hidrocefalia/cirugía , Hidrocefalia/etiología , Resultado del Tratamiento , Antituberculosos/uso terapéutico , Absceso Encefálico/cirugía , Absceso Encefálico/microbiología , Absceso Encefálico/tratamiento farmacológico , Tuberculosis del Sistema Nervioso Central/cirugía , Tuberculosis del Sistema Nervioso Central/complicaciones , Tuberculosis del Sistema Nervioso Central/tratamiento farmacológico , Tuberculoma Intracraneal/cirugía , Tuberculoma Intracraneal/tratamiento farmacológico , Tuberculoma Intracraneal/complicaciones , Tuberculosis/cirugía , Tuberculosis/complicaciones , Tuberculosis/tratamiento farmacológico , Centros de Atención Terciaria , Encefalopatías/cirugía , Encefalopatías/microbiología , Adolescente
2.
J Formos Med Assoc ; 123(7): 818-820, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38494361

RESUMEN

Tracheobronchial tuberculosis is one of the conditions causing long segment tracheal stenosis and is a clinically challenging scenario. This report describes a successful tracheal reconstruction in a 44-year-old man with long-segment post-tuberculosis tracheobronchial stenosis, utilizing a stented cryopreserved aortic allograft. The procedure was necessitated by the failure of conventional treatments. The stenotic segment was resected and replaced with a cryopreserved aortic allograft, supported by a metallic stent to maintain airway patency. Post-surgery, the patient experienced resolution of dyspnea without major complications. Currently, at 33 months post-operation, the patient enjoys an enhanced quality of life with effective breathing, speaking, swallowing abilities, and has resumed normal daily activities, with regular bronchoscopic follow-ups. This report demonstrates a novel approach for managing challenging tuberculosis-induced long segment airway stenosis.


Asunto(s)
Criopreservación , Stents , Estenosis Traqueal , Humanos , Masculino , Estenosis Traqueal/cirugía , Estenosis Traqueal/etiología , Adulto , Procedimientos de Cirugía Plástica/métodos , Aorta/cirugía , Aloinjertos , Broncoscopía , Tuberculosis/complicaciones , Tuberculosis/cirugía , Calidad de Vida
3.
Surg Endosc ; 38(3): 1358-1366, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38114876

RESUMEN

BACKGROUND: This study aimed to investigate the association between gastrectomy and endoscopic resection for gastric cancer and the subsequent tuberculosis incidence. METHODS: We conducted a nationwide matched cohort study using data from the Korea National Health Insurance Service from 2013 to 2019. We created two cohorts: patients who underwent gastrectomy and those who had endoscopic resection. Each patient was matched 1:1 with an unexposed individual based on index year, age, sex, income, and various comorbidities. The primary outcome was the incidence of tuberculosis during the follow-up period. RESULTS: Our study comprised 90,886 gastrectomy patients and 46,759 endoscopic resection patients. The tuberculosis incidence was significantly higher in the gastrectomy group compared to its matched non-gastrectomy group (IRR 1.69, 95% CI 1.43-1.99, p < .001). In contrast, there was no significant difference in tuberculosis incidence between the endoscopic resection group and its matched non-resection group (IRR 0.95, 95% CI 0.75-1.19, p = 0.627). The Kaplan-Meier cumulative incidence also did not differ between the two groups. However, tuberculosis incidence significantly increased in the first year after endoscopic resection. CONCLUSION: Gastrectomy for gastric cancer is associated with a higher incidence of subsequent tuberculosis, while no significant association was observed for endoscopic resection. However, tuberculosis incidence increases significantly during the first year after endoscopic resection.


Asunto(s)
Resección Endoscópica de la Mucosa , Neoplasias Gástricas , Tuberculosis , Humanos , Estudios de Cohortes , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/complicaciones , Endoscopía/efectos adversos , Gastrectomía/efectos adversos , Tuberculosis/epidemiología , Tuberculosis/etiología , Tuberculosis/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Resección Endoscópica de la Mucosa/efectos adversos
4.
Acta Orthop Belg ; 89(1): 152-155, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37295000

RESUMEN

We describe the case of a 78-years-old male with dyspnea, inappetence and weight loss over a period of two weeks. The CT scan suggested disseminated tuberculosis and T5-T6 spondylodiscitis. During hospitalization, he developed a left shoulder pain where a reverse total shoulder arthroplasty was implanted 11 years ago. Open debridement and lavage with retention of the implant was performed first and intraveinous antibiotics were administered. 3 months after surgery the patient developed a painful sinus track at the incision site. Resection of the fistula tract, soft tissue debridement and removal of the implants were performed before restarting chemotherapy. As the incidence of reverse total shoulder arthroplasty continues to increase throughout the world, periprosthetic joint infection (PJI) will probably raise as well. Diagnosing and treatment of shoulder PJI with atypical germs remains a challenge and explantation seems to be the safer surgical option to avoid recurrent surgeries on patient with increasing comorbidities.


Asunto(s)
Artritis Infecciosa , Artroplastía de Reemplazo de Hombro , Infecciones Relacionadas con Prótesis , Articulación del Hombro , Tuberculosis , Humanos , Masculino , Anciano , Artroplastía de Reemplazo de Hombro/efectos adversos , Resultado del Tratamiento , Infecciones Relacionadas con Prótesis/etiología , Infecciones Relacionadas con Prótesis/terapia , Infecciones Relacionadas con Prótesis/diagnóstico , Artroplastia , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/cirugía , Antibacterianos/uso terapéutico , Tuberculosis/tratamiento farmacológico , Tuberculosis/cirugía , Artritis Infecciosa/cirugía , Estudios Retrospectivos , Desbridamiento , Reoperación
5.
Ann Cardiol Angeiol (Paris) ; 72(4): 101614, 2023 Oct.
Artículo en Francés | MEDLINE | ID: mdl-37329821

RESUMEN

Tuberculous aneurysm is a rare but lethal disease. It preferentially affects the aorta. The contamination occurs either secondarily to a tuberculosis site in contact with the aorta or by blood contamination. It presents an increased and unpredictable risk of rupture, hence the interest of urgent diagnostic and therapeutic management. His treatment was long based on surgery, but currently the endovascular approach is increasingly used. The treatment, whatever its type, will always be associated with a medical treatment for tuberculosis. We report the case of a patient with a descending thoracic aortic aneurysm considered tuberculous on the basis of epidemiological, clinical and biological arguments; who was treated by deployment of an endoprosthesis with good clinical and radiological evolution.


Asunto(s)
Aneurisma , Aneurisma de la Aorta Torácica , Implantación de Prótesis Vascular , Tuberculosis , Humanos , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Stents , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Aneurisma/cirugía , Tuberculosis/cirugía , Resultado del Tratamiento
6.
Urol Int ; 107(8): 807-813, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37075720

RESUMEN

Adrenal tuberculosis (TB) is a rare disease, which is difficult to diagnose because of its atypical symptoms. We reported a 41-year-old female who was admitted to hospital due to a left adrenal tumor, which was found in health examination without any symptoms. Abdominal CT showed a mass in her left adrenal. The results of blood test were normal. A retroperitoneal laparoscopic adrenalectomy was carried out, and adrenal TB was finally pathologically diagnosed. Following this, examinations focusing on TB were conducted which revealed negative results except for T-cell enzyme-linked immunospot. After the operation, the hormone level was normal. However, a wound infection occurred, which was recovered after antituberculosis treatment. In conclusion, even if there is no evidence of TB, we should be alert when diagnosing adrenal masses. Examinations of pathology, radiography, and hormone play important roles in determining the definite diagnosis of adrenal TB.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Laparoscopía , Tuberculosis , Humanos , Femenino , Adulto , Laparoscopía/métodos , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/cirugía , Adrenalectomía/métodos , Espacio Retroperitoneal , Tuberculosis/cirugía
7.
Eur Ann Otorhinolaryngol Head Neck Dis ; 139(6): 351-356, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-35778340

RESUMEN

OBJECTIVES: Systematic review of the scientific literature dedicated to treatment modalities and results for aural tuberculosis published since the start of the 21st century. MATERIAL AND METHODS: Search of the Medline, Cochrane and Embase databases for the period 2000 - 2020. Selection of articles in English, French and Spanish devoted to clinical cases and series documenting treatment of auricular tuberculosis. Extraction of data on pre-established files documenting treatment modalities and results. Reading of articles by two authors. Analysis performed according to SWiM guidelines, evaluating cure, tuberculosis-related death, treatment-related complications, improvement in facial palsy, and hearing sequelae rates. RESULTS: One hundred and twenty eight articles: 118 case reports (159 patients) and 10 cohorts (177 patients) from 42 countries were analyzed. Female/male sex ratio was 1.2 with ages ranging from 1 month to 87 years. Medical treatment consisted in 5 to 24 months' antitubercular antibiotic treatment using 2 to 8 antibiotics. Mastoidectomy, tympanoplasty and facial nerve decompression were associated to medical treatment in 64.7%, 17.4% and 6.2% of cases, respectively. Overall rates of cure, death, treatment-related complications, facial sequelae and hearing sequelae were 96.8%, 2%, 9.5%, 35.8% and 75.5%. In case reports, BCG vaccination did not appear to protect against facial palsy and severe intracranial complications (P>0.6). There was no significant correlation (P>0.3) between death and the clinical variables tested, and facial nerve decompression did not appear to influence outcome for facial function (P=0.4). CONCLUSION: Medical treatment is very effective but not without risk of death, complications and sequelae. It is the same as for pulmonary tuberculosis. Indications for and benefit of major auricular surgery during medical treatment deserve further studies.


Asunto(s)
Parálisis de Bell , Parálisis Facial , Tuberculosis , Humanos , Masculino , Femenino , Parálisis Facial/etiología , Tuberculosis/complicaciones , Tuberculosis/tratamiento farmacológico , Tuberculosis/cirugía , Nervio Facial , Parálisis de Bell/tratamiento farmacológico , Timpanoplastia/efectos adversos , Antibacterianos/uso terapéutico
8.
Knee ; 38: 30-35, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35872480

RESUMEN

A 25-year-old female presented with left knee pain following arthroscopic synovectomy for presumed pigmented villonodular synovitis (PVNS). Radiographs and magnetic resonance imaging demonstrated tricompartmental arthritic changes. She underwent a two-stage procedure first involving antibiotic spacer implantation, followed 1 week later by spacer removal and definitive total knee arthroplasty (TKA) once initial intraoperative culture results were negative. Subsequent cultures confirmed tuberculosis septic arthritis. Repeat evaluation 1 year postoperatively showed no complications and patient satisfaction with left knee function. This is a unique case report in the United States describing 1-year outcomes following staged TKA for tuberculosis septic arthritis masquerading as PVNS.


Asunto(s)
Artritis Infecciosa , Artroplastia de Reemplazo de Rodilla , Sinovitis Pigmentada Vellonodular , Tuberculosis , Adulto , Antibacterianos , Artritis Infecciosa/diagnóstico , Artritis Infecciosa/cirugía , Artroplastia de Reemplazo de Rodilla/efectos adversos , Femenino , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/patología , Articulación de la Rodilla/cirugía , Sinovectomía , Sinovitis Pigmentada Vellonodular/complicaciones , Sinovitis Pigmentada Vellonodular/diagnóstico , Sinovitis Pigmentada Vellonodular/cirugía , Tuberculosis/complicaciones , Tuberculosis/patología , Tuberculosis/cirugía
10.
Gen Thorac Cardiovasc Surg ; 70(6): 515-525, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35378674

RESUMEN

OBJECTIVE: This study aimed to determine the therapeutic effectiveness of tuberculous aortic aneurysms (TBAAs) and the risk factors for mortality. METHODS: We reviewed all case reports of TBAAs treated with open surgery or endovascular aneurysm repair (EVAR) from online database in 1996-2021. Only thoracic and abdominal aortic aneurysms were included. RESULTS: Eighty cases of open surgery and 42 cases of EVAR were included. The 2-year mortality and perioperative mortality rates of open surgery were 11.3% and 10.0%, respectively. Emergent open surgery had a significantly higher mortality (25.0%) than non-emergent open surgery (6.7%). In the EVAR group, 2-year mortality, perioperative mortality, and TBAA-related mortality were 16.7%, 4.8%, and 10.0%, respectively. Patients with typical tuberculosis (TB) symptoms before EVAR had a significantly higher TBAA-related mortality (35.0%) than patients with no typical TB symptoms before EVAR (0%). In the open surgery group, the rate of TB recurrence (2.7% vs 2.4%) and aneurysm recurrence (8.1% vs 7.3%) were quite close between preoperative anti-TB-treated and postoperative anti-TB-treated cases. However, in the EVAR group, TB recurrence (8.7% vs 0%) and aneurysm recurrence (12.5% vs 6.25%) were more common in postoperative anti-TB-treated cases. CONCLUSION: Open surgery was accompanied by higher perioperative mortality, whereas EVAR was followed with higher TBAA-related mortality. Emergent surgical choices of open surgery may be associated with high perioperative mortality. Typical TB symptoms before EVAR are a significant risk factor for mortality after EVAR. Early anti-TB treatment should be administered if EVAR is the surgical option.


Asunto(s)
Aneurisma de la Aorta Abdominal , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Tuberculosis , Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/efectos adversos , Procedimientos Endovasculares/efectos adversos , Humanos , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Tuberculosis/etiología , Tuberculosis/cirugía
11.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 36(1): 122-126, 2022 Jan 15.
Artículo en Chino | MEDLINE | ID: mdl-35038810

RESUMEN

OBJECTIVE: To review the characteristics and applications of different implantation in cervical tuberculosis surgery and the research progress of the new implantation. METHODS: By consulting relevant domestic and foreign research literature on cervical tuberculosis, the classification, advantages, disadvantages, and prospects of implantations were analyzed and summarized. RESULTS: The incidence of cervical tuberculosis has increased recently and has a high disability rate. Currently, the implantation in the surgical treatment of cervical tuberculosis are mainly divided into bone materials, metal materials, and bioactive materials; the above materials have their own advantages and disadvantages, for example, the amount of autologous bone is limited, the complications of allogeneic bone are common, and the bone fusion effect of metal materials is poor. With the development of science and technology, the implantation are also more diverse. CONCLUSION: The choice of the implantation affects the bone fusion directly, furthermore, it affects the effectiveness of cervical tuberculosis, the development of new implantation provides a variety of options for the treatment of cervical tuberculosis.


Asunto(s)
Fusión Vertebral , Tuberculosis , Trasplante Óseo , Vértebras Cervicales/cirugía , Humanos , Cuello , Trasplante Autólogo , Resultado del Tratamiento , Tuberculosis/cirugía
12.
Ann Vasc Surg ; 79: 437.e1-437.e6, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34644643

RESUMEN

BACKGROUND: Bacillus Calmette-Guerin (BCG) is a live, attenuated strain of Mycobacterium bovis that is used in the treatment of non-muscle invasive bladder cancer (NMIBC). Vascular complications, including mycotic aneurysms, after BCG therapy are exceedingly rare. In this patient population, the diagnosis of mycotic aneurysms can be delayed or missed due to their non-specific clinical and radiologic presentation. Literature review reveals management of mycotic aneurysms attributable to BCG therapy is widely varied.2,5-8,12,15 CASE REPORT: We report a patient who presented with mycotic aneurysm formation secondary to BCG treatment for bladder cancer that was repaired with in-line reconstruction utilizing cryoartery and buttressed with omental flap. We suggest this as an alternative treatment to in-line prosthetic graft or extra-anatomic reconstruction.


Asunto(s)
Aneurisma Infectado/cirugía , Aneurisma de la Aorta/cirugía , Arterias/trasplante , Vacuna BCG/efectos adversos , Mycobacterium bovis/patogenicidad , Epiplón/cirugía , Colgajos Quirúrgicos , Tuberculosis/cirugía , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Injerto Vascular , Administración Intravesical , Anciano , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/microbiología , Aneurisma de la Aorta/diagnóstico , Aneurisma de la Aorta/microbiología , Vacuna BCG/administración & dosificación , Criopreservación , Humanos , Masculino , Resultado del Tratamiento , Tuberculosis/diagnóstico , Tuberculosis/microbiología , Neoplasias de la Vejiga Urinaria/inmunología , Neoplasias de la Vejiga Urinaria/patología
13.
Auris Nasus Larynx ; 49(6): 1093-1097, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34657776

RESUMEN

Thyroid tuberculosis is a rare disease, very few cases have been reported. It is difficult to diagnose because of no typical characteristics. We report on a patient who underwent surgery for suspected thyroid carcinoma, but who was then diagnosed with thyroid tuberculosis. The patient was a woman in her 70s. She had been diagnosed with chronic renal failure and had been on peritoneal dialysis. She complained of fever and a painful left anterior neck swelling. Computed tomography showed thyroid tumor with cervical lymph node swelling, ultrasound-guided fine needle aspiration cytology was suspected for papillary thyroid carcinoma. We performed surgery to confirm the diagnosis and determine treatment. Procedures for thyroid carcinoma were followed, including left lobectomy of the thyroid gland, central lymph node dissection and right cervical lymph node resection. Pathological examination found no malignant findings in the thyroid tissue but did find a granulation layer even in the right cervical lymph node. Tuberculosis-specific IFN-γ assay was positive, we diagnosed thyroid and cervical lymph node tuberculosis. Postoperatively, the neck pain and fever improved, she was treated as an outpatient with antituberculosis drugs therapy. Thyroid tuberculosis must be considered in patients with immunocompromised, such as this patient, who was on peritoneal dialysis.


Asunto(s)
Carcinoma Papilar , Fiebre de Origen Desconocido , Neoplasias de la Tiroides , Tuberculosis , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/diagnóstico por imagen , Femenino , Fiebre de Origen Desconocido/etiología , Fiebre de Origen Desconocido/cirugía , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Metástasis Linfática , Cáncer Papilar Tiroideo/complicaciones , Cáncer Papilar Tiroideo/diagnóstico por imagen , Cáncer Papilar Tiroideo/cirugía , Neoplasias de la Tiroides/complicaciones , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Tuberculosis/cirugía
14.
Rev. otorrinolaringol. cir. cabeza cuello ; 81(4): 551-558, dic. 2021. ilus, graf, tab
Artículo en Español | LILACS | ID: biblio-1389806

RESUMEN

La tuberculosis (TBC) es una de las patologías infecciosas que más muertes ha producido a nivel mundial, sobrepasando al virus de inmunodeficiencia humana (VIH). En Chile a pesar de la baja incidencia de la patología, aun no es posible llegar a su erradicación. La TBC es una enfermedad que habitualmente compromete el pulmón, sin embargo, en ocasiones compromete otros sitios del organismo, siendo la ubicación en cabeza y cuello una de las más importantes. Las manifestaciones clínicas son variadas y el curso de estas puede ser larvado, simulando otras patologías de mayor frecuencia en el ámbito otorrinolaringológico y transformando su diagnóstico en un desafío mayor. En este artículo se presentan tres casos clínicos diagnosticados y manejados en nuestra en región, además de una revisión de la literatura disponible en relación a la presentación clínica, orientación diagnóstica y tratamiento de la patología.


Tuberculosis is one of the infectious diseases which has produced more deaths around the world, even more than human immunodeficiency virus. In Chile, despite of the low incidence, there is still not possible to eradicate it. Tuberculosis is a disease which commonly compromises lungs, however, in some occasions involves another site of the organism, been the location in head and neck one of the most important. The clinical features are diverse and the natural history of those can be masked, for this reason it can simulate another more frequent disease in otolaryngology field, making the diagnosis a real challenge. In this article, we present three clinical cases diagnosed and treated in our region, besides, a review of the available literature related with the clinical presentation, diagnosis orientation and treatment of this pathology.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Tuberculosis/diagnóstico , Tuberculosis/terapia , Tuberculosis/cirugía , Traqueostomía/métodos , Tomografía Computarizada por Rayos X/métodos
15.
J Surg Res ; 267: 384-390, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34225051

RESUMEN

BACKGROUND: Lung resection surgery can be a complementary therapy for managing tuberculosis (TB) complications, but access is lacking in high-burden areas. The referral process for surgical evaluation is not well described. This study aimed to elucidate the TB surgery referral process in Peru. METHODS: A qualitative study was conducted using focus groups and interviews of health care providers from the Peruvian National TB Program. A semi-structured interview guide was developed with local partners. Focus groups and individual interviews were recorded and transcribed. Thematic analysis was used to reconstruct the referral process and identify barriers as well as areas for improvement. RESULTS: A total of 12 sessions were recorded (7 interviews and 5 focus groups; 36 participants total). The main themes identified were: (1) Surgical referral workflow, (2) Unstandardized selection criteria for surgery, (3) Limited inter-institutional communication, and (4) Material barriers to surgical management. CONCLUSION: Health care providers involved in the referral process of surgical management of tuberculosis in Lima reported a hierarchical referral workflow. Interinstitutional communication may be a critical interventional point to improve a patient's quality of care during the referral process.


Asunto(s)
Tuberculosis , Grupos Focales , Personal de Salud , Humanos , Investigación Cualitativa , Derivación y Consulta , Tuberculosis/cirugía
16.
Adv Skin Wound Care ; 34(6): 330-333, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33958522

RESUMEN

ABSTRACT: Tuberculosis (TB) is endemic to some geographic areas such as Africa, Eastern Europe, Asia, Latin America, and the Caribbean. It is called the great mimicker because of its diverse and variable presentation and affects almost every organ in the body with different symptomatology. Often, TB causes empyema necessitans, the rarest forms of which are intramuscular and cutaneous. Here, the authors report a case of empyema necessitans and intramuscular TB, which was managed successfully with negative-pressure wound therapy. The treatment provided a good outcome and patient satisfaction compared with traditional invasive surgical options.


Asunto(s)
Músculos/anomalías , Terapia de Presión Negativa para Heridas/normas , Tuberculosis/cirugía , Adulto , Diseño de Equipo , Humanos , Masculino , Músculos/microbiología , Terapia de Presión Negativa para Heridas/instrumentación , Terapia de Presión Negativa para Heridas/estadística & datos numéricos , Cicatrización de Heridas/fisiología
17.
Indian J Tuberc ; 68(2): 272-278, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33845964

RESUMEN

Thyroid tuberculosis is a rare disease. Its incidence is low even in countries where prevalence of pulmonary tuberculosis is high (0.1-0.4%). In literature, there are only a few cases which were diagnosed as thyroid tuberculosis. It can be explained by a high resistance of the thyroid gland to infectious processes. However, the prevalence of tuberculosis has increased worldwide and thyroid involvement can be a primary manifestation of the disease. The incidence of extrapulmonary tuberculosis has been showing a progressive increase in the recent years(Barnes and Weatherstone, 1979). The most frequent clinical presentation is a solitary thyroid nodule that may present as a cystic nodule. It may also present as thyroid abscess with pain, fever and other non-specific signs and symptoms. ATT results in complete cure therefore it is important to differentiate it from other form of thyroiditis. Patients are usually euthyroid, but cases of hypothyroidism and hyperthyroidism are described. For accurate diagnosis of thyroid tuberculosis, clinical and radiological features are nonspecific and histological examination is required for confirmation of diagnosis. PCR may help in diagnosis. The authors encounter 3 cases of thyroid tuberculosis in last 5 year which are described in this article. The aim of this study is to review all the cases published in literature to describe clinical presentation, appropriate diagnostic method and possible treatment options of the disease.


Asunto(s)
Glándula Tiroides , Tuberculosis/diagnóstico , Humanos , Tiroidectomía , Tuberculosis/cirugía
18.
Pediatr Infect Dis J ; 39(12): e466-e469, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33214408

RESUMEN

Bacillus Calmette-Guérin (BCG)-associated osteomyelitis is a rare adverse event following BCG vaccination, and there have been no previous reports of BCG-associated cervical spondylitis. Here, we describe the case of a 3-year-old immunocompetent girl who developed BCG-associated cervical spondylitis and was successfully treated by prompt surgical drainage of the abscess and administration of isoniazid and rifampicin for 9 months without sequelae.


Asunto(s)
Vértebras Cervicales/microbiología , Mycobacterium bovis , Osteomielitis/microbiología , Espondilitis/microbiología , Tuberculosis/patología , Absceso/microbiología , Absceso/cirugía , Antituberculosos/administración & dosificación , Antituberculosos/uso terapéutico , Vacuna BCG/administración & dosificación , Vacuna BCG/inmunología , Vértebras Cervicales/patología , Preescolar , Femenino , Humanos , Inmunocompetencia , Isoniazida/administración & dosificación , Isoniazida/uso terapéutico , Osteomielitis/patología , Osteomielitis/terapia , Rifampin/administración & dosificación , Rifampin/uso terapéutico , Espondilitis/patología , Espondilitis/terapia , Tuberculosis/tratamiento farmacológico , Tuberculosis/prevención & control , Tuberculosis/cirugía
19.
Zhongguo Gu Shang ; 33(10): 912-5, 2020 Oct 25.
Artículo en Chino | MEDLINE | ID: mdl-33107252

RESUMEN

OBJECTIVE: To compare clinical effect of movable external fixation and fusion fixation for the treatment of elbow tuberculosis. METHODS: From October 2013 to June 2019, 52 patients with elbow tuberculosis treated with standard antituberculosis therapy were divided into movable external fixation group and fusion fixation group according to treatment methods. In group A, there were 25 patients, including 11 males and 14 females, aged from 24 to 75 years old with an average of (42.81± 9.01) years old; the courses of diseases ranged from 2 to 9 months with an average of (3.96±1.45) months. In group B, there were 27 patients, including 15 males and 12 females, aged from 23 to 77 years old with an averageof (44.08±7.44) years old; the courses of diseases ranged from 2 to 7 months with an average of (3.88±1.67) months. All patients were performed focus debridement. Intraoperative blood loss, operative time were compared between two groups. VAS score before operation, 2 weeks and 12 months after operation were applied to evaluate pain relieve;Mayo elbow performance score (MEPS) before operation, 1 and 12 months after operation were used to evaluate clinical effect;changes of erythrocyte sedimentation rate (ESR) and Creactive protein, CRP) before operation, 3 weeks after antituberculosis therapy, 1 week and 6 months after operation were compared between two groups. RESULTS: All patients were followed up from 12 to 20 months with an average of (13.50±4.85) months. No mixed infection and recurrence of tuberculosis occurred. There were no statistical differences in intraoperative blood loss and operative time(P>0.05). There was difference in postoperative VAS score at 2 weeks between movable external fixation group (5.15±0.95) and fusion fixation group (4.04±0.84)(P<0.01);while no difference in postoperative VAS score at 12 months between two groups (P>0.05). No difference in ESR and CRP level between two groups before and after operation (P>0.05). Postoperative Mayo score at 1 and 12 months in movable external fixation group were (78.15±7.83) and (90.19±7.13);in fusion fixation group were (70.40±7.61) and (82.60±8.38);there were differences in Mayo score at different time points between two groups(P<0.01). CONCLUSION: For elbow tuberculosis, movable external fixation and fusion fixation have equal effect in operative time, amount of bleeding and control of tuberculosis infection indicator. Movable external fixation need earlier functional exercise, not conducive to pain relief at early stage, which may be better than fusion fixation, it is worth clinical promoting.


Asunto(s)
Articulación del Codo , Fijadores Externos , Tuberculosis , Codo , Articulación del Codo/cirugía , Femenino , Fijación de Fractura , Humanos , Lactante , Masculino , Resultado del Tratamiento , Tuberculosis/tratamiento farmacológico , Tuberculosis/cirugía
20.
Zhonghua Er Ke Za Zhi ; 58(10): 824-827, 2020 Oct 02.
Artículo en Chino | MEDLINE | ID: mdl-32987462

RESUMEN

Objective: To explore the effectiveness and safety of holmium laser treatment via flexible bronchoscopy in children with tracheobronchial tuberculosis (TBTB). Methods: The clinical data of 40 children with TBTB admitted in Qilu Children's Hospital of Shandong University from February 2016 to June 2019 were retrospectively analyzed. According to the treatment approach, they were divided into conventional treatment group (20 cases) and holmium laser treatment group (20 cases). The sex, age, course of disease and lesion location before treatment, and the time till relief of atelectasis and airway obstruction after treatment were compared between the two groups with t test and χ2 test. Results: Among the 40 cases, 24 were males and 16 females, and 35 had lymph node fistula (87.5%) and 5 had granulation proliferation (12.5%). There was no statistically significamt difference between the conventional group and laser group in sex (male ratio: 50%(10/20) vs. 75%(15/20), χ2=2.66, P=0.10), age ((3.2±2.2) years vs. (2.2±1.8) years, t=1.41, P=0.16), course of disease (<1 month ratio: 30%(6/20) vs. 35%(7/20), χ2=0.11, P=0.73), lesion location (single lesion ratio: 45%(9/20) vs. 60%(12/20), χ2=0.90, P=0.34). The effectiveness was evaluated after 3 months, and the total effective rate were 100% in laser group and 40% in conventional group, the difference was significant (χ²=25.34, P<0.01). No serious adverse events occurred in the two groups during the observational period. Conclusions: Holmium laser treatment via bronchoscopy is an effective way to remove the tuberculosis foci in the trachea, which can reduce the incidence of further related complications, and could be applied in clinical approach.


Asunto(s)
Broncoscopía , Terapia por Láser , Láseres de Estado Sólido , Tuberculosis , Niño , Femenino , Holmio , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Estudios Retrospectivos , Tuberculosis/cirugía
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