Asunto(s)
Tamizaje Masivo/métodos , Refugiados , Tuberculosis/diagnóstico por imagen , Adolescente , Niño , Preescolar , Control de Enfermedades Transmisibles , Europa (Continente) , Migración Humana , Humanos , Lactante , Recién Nacido , Países Bajos , Tuberculosis/epidemiología , Tuberculosis/prevención & controlAsunto(s)
Control de Enfermedades Transmisibles , Tamizaje Masivo , Refugiados/estadística & datos numéricos , Tuberculosis , Adulto , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , Tamizaje Masivo/organización & administración , Modelos Organizacionales , Países Bajos/epidemiología , Evaluación de Procesos y Resultados en Atención de Salud , Tuberculosis/diagnóstico , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Tuberculosis/transmisiónRESUMEN
The incidence of tuberculosis in the Netherlands has dropped dramatically over the past 50 years. With declining experience of tuberculosis, misdiagnosis can easily happen. Laryngeal tuberculosis often presents as a tumorous mass that may initially be mistaken for cancer. As laryngeal tuberculosis is usually highly infectious, this poses a risk to the patient as well as his/her contacts including healthcare providers. We describe three patients with (suspected) laryngeal tuberculosis and discuss potential pitfalls. Pivotal for a correct diagnosis are thorough history-taking, physical examination and relatively simple radiological and laboratory tests. Risk groups have been identified for tuberculosis and this can provide a clue. Differentiation between tuberculosis and cancer can be difficult, and the two diseases may concur. Even in low-incidence settings for tuberculosis, knowledge of the disease remains necessary as it is curable and further spread can be prevented with simple measures.
Asunto(s)
Neoplasias Pulmonares/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Tuberculosis Pulmonar/diagnóstico , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Faringitis/diagnóstico , Faringitis/etiología , Prueba de Tuberculina , Tuberculosis Pulmonar/epidemiologíaRESUMEN
Eighteen isolates of a nonchromogenic, slowly growing, non-tuberculous species of the genus Mycobacterium were cultured from respiratory specimens obtained over the last eight years from 17 patients in the Netherlands. These isolates were grouped because they revealed a unique 16S rRNA gene sequence and were related to Mycobacterium xenopi. None of the 17 patients met the American Thoracic Society diagnostic criteria for non-tuberculous mycobacterial disease, which distinguishes the novel isolates from the related species, M. xenopi. A polyphasic taxonomic approach, including identification by biochemical and phenotypical analysis, hsp65 gene sequencing and PCR restriction enzyme pattern analysis, and sequence analyses of the rpoB gene and 16S-23S internal transcribed spacer supported the separate species status of the novel isolates. The name Mycobacterium noviomagense sp. nov. is proposed for the novel strains. The type strain is NLA000500338(T) (=DSM 45145(T)=CIP 109766(T)). A more distinctive taxonomy of NTM is a prerequisite for the assessment of their clinical relevance.