A rare case of primary disseminated multi-drug resistant tuberculosis

Tuberculosis (TB) is the commonest cause of infection-related death globally. Disseminated tuberculosis (TB) is a life-threatening disease which results from the hematogenous spread ofMycobacterium tuberculosis. Genitourinary tuberculosis(GUTB) is usually caused as a result of the hematogenousspread of the mycobacteriaduring the initial infection. The patient's clinical presentation may vary from asymptomatic to non-specific symptoms related to the organ involved and may also overlap with urinary tract infections caused by other pathogens hence delaying the diagnosis. Here we report one such case where the vague symptoms of the patient and absence of respiratorysymptoms delayed the diagnosis of primary disseminated multi-drug resistant(MDR) tuberculosis.

Characteristics of lumbar canal stenosis patient at Koja district hospital year 2011-2021

Background:Since there are too many cases of lumbar canal stenosis in Indonesia. The aim of the study was to discover all the factors that influence the incidence of lumbar canal stenosis.Methods:This study used all cases of lumbar canal stenosis in Koja District Hospital in Jakarta from 2011 to 2021. This was a medical record-based retrospective study in which files of patients with the diagnosis of lumbar canal stenosis were reviewed. A descriptive analytic test was used to analyze results was presented in the form of a table.Results:There were 48 lumbar canal stenosis cases in male patients out of 66 total patients. Incidents of lumbar canal stenosis occurred more frequently in anatomical locations L4-5 than in other locations. There were 48 lumbar canal stenosis cases with anatomical locations L4-5 in 50 patients from 66 patients. Incidents of lumbar canal stenosis occur in people with obesity more frequently than in people without obesity. There were 48 lumbar canal stenosis cases in people with obesity patients out of 66 total patients. The incidence of lumbar canal stenosis with a moderate VAS score was greater than that with a mild or severe VAS score. There were 48 lumbar canal stenosis patients with a moderate vas score out of 66 patients. There were 59 lumbar canal stenosis patients who got surgery out of 66 patients, and 7 of them had no surgery. Lumbar canal stenosis more frequently occurred in men than women, with more frequent anatomical lesions in L4-L5, and more frequently in people with obesity than in people without obesity. Most of them had a moderate VAS score and got surgery.Conclusions:According to this study, males had more lumbar canal stenosis incidents than females.

Delayed diagnosis of disseminated tuberculosis in pregnancy: a case report

Miliary tuberculosis (TB) is a lethal form of TB, if left untreated. Miliary TB accounts for <2% of all cases of TB in immunocompetentindividuals. Intracranial tuberculoma is a rare manifestation ofMycobacterium tuberculosis(MTB), seen in only 1% of TB patients. It can occur as single or multiple lesions, most commonly located in the frontal and parietal lobes. Clinical features mimicthat of any space-occupying lesion in the brain.In pregnant women, diagnosis of TBmay be delayed by the non-specific nature of early symptoms and because they are often attributed to pregnancy.Here we report one such case where the diagnosis of TBwas delayed due to the non-specific nature of her symptoms in ante-natal period.

Endobronchial tuberculosis simulating a tumor: an interesting case report

Endobronchial tuberculosis(EBTB)is a special form of TB which is associated with significant morbidity and potential mortality. EBTBis the infection of tracheobronchial tree, and continues to remain challenging for clinicians to diagnose. The incidence of EBTBhas been reported to be 5.8% to 30% in people with pulmonary TB. 60-year-old male, chronic smoker presented with complaints of dyspnea, cough with expectoration and sore throat for 2 weeks. General examination showed patient to have pallor and respiratory system examination showeddecreased breath sounds in left infraaxillary region and bilateral crepitations. Routine blood investigations done showed decreased hemoglobin levels, elevated total leukocyte count, ESR. Sputum AFB was negative. Mantoux-15mm induration. Chest X-ray showed homogenous opacities over the left lower zone and elevated right diaphragm. CT thorax done showed a subsegmental peripheral soft tissue density 4.3×2.2 cm in the inferior lingula segment. Bronchoscopy showed whitish plaques over the anterior tracheal wall near carina and over left main bronchus. Endobronchial tissue growth seen occluding the lingula bronchus. Biopsy was taken and histopathology showed a granulomatous lesion, BAL Gene Xpert was positive for MTB. Patient was started on 3 tablets ATT. Clinicians need to be vigilant in patients who are AFB smear negative, with symptoms; bronchoscopy should be considered in those selected cases.

A study of correlation between prevalence of pulmonary artery hypertension with severity of bronchiectasis

Background:Pulmonary artery hypertension (PAH) dreadful complication in bronchiectasis. The 6thworld symposium on pulmonary hypertension have taken mPAPof 20 mmHg as normal. Not much studies have been done based on the current cut off values, so we have incorporated values based on the new guidelines and made following observations. Methods: Thisstudy was designed as an observational cross-sectional study consisting of 27 patients, who were admitted in Pulmonary medicine department. Results:Out of 27 study subjects 15 were female抯 and 12 were males. It was found that 70.3% had less than 5 segments involved and 29.6% had more than 5 segments involved. Mean value of PAH was 34.48�.06 mmHg. Analysis showed a significant correlation (r=0.67) between number of segments involved and incidence of pulmonary hypertension. Conclusions: Itis essential to evaluate the cardiac status of bronchiectasis patients at the time of diagnosis as cardiac manifestations are one of the dreadful complications.