RESUMEN
Data on the clinical presentation and outcomes of sarcoidosis patients with coronavirus disease 19 (COVID-19) are scarce. In this case series, we identified 5 out of 238 sarcoidosis patients who are enrolled in an ongoing longitudinal observational study who developed COVID-19 during the study period and follow their clinical course. Four patients recovered completely, whereas one patient expired during hospital admission. Our preliminary experience suggests that African American patients with chronic sarcoidosis treated with disease-modifying anti-rheumatic drugs (DMARDs) or anti-tumor necrosis factor (TNF) therapy do not seem to be at increased risk of respiratory or life-threatening complications from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with the general population, although at the present time, we advocate for maintaining a high level of vigilance and strict follow-up in this patient population.
RESUMEN
The aim of this study was to determine the prevalence of drug-resistant tuberculosis (TB) and its associated risk factors. The susceptibilities of Mycobacterium tuberculosis isolates were tested against four first-line antituberculous drugs and were typed by spoligotyping. Spoligotyping of M. tuberculosis strains resulted in 95 different patterns that were divided into three evolutionary groups (1-3). Eighty-six (90%) of the isolates had unique patterns that were reported for the first time. Interestingly, 9.4% of the strains belonged to the Beijing family. Multidrug resistance (MDR) was seen in group 1 of the evolutionary scenario. All M. tuberculosis isolates belonging to the Beijing family were associated with a resistance pattern. MDR was much higher in bacteria isolated from Afghan TB patients residing in Iran.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Adulto , Afganistán/epidemiología , Antibacterianos/uso terapéutico , Antibióticos Antituberculosos/uso terapéutico , Farmacorresistencia Bacteriana Múltiple/genética , Etambutol/uso terapéutico , Genotipo , Humanos , Irán/epidemiología , Isoniazida/uso terapéutico , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Epidemiología Molecular , Mycobacterium tuberculosis/genética , Prevalencia , Rifampin/uso terapéutico , Factores de Riesgo , Estreptomicina/uso terapéutico , Tuberculosis Resistente a Múltiples Medicamentos/genética , Tuberculosis Resistente a Múltiples Medicamentos/microbiologíaRESUMEN
Primary immunodeficiencies (PIDs) are not solely diseases of childhood. We describe the clinical presentation and outcome for 55 adult patients with previously unrecognized PIDs. This series provides unique data regarding PIDs presenting in adulthood, and serves as a timely reminder that physicians must consider the diagnosis of PIDs in their adult patients. Using the experience gained from these patients, we outline key "warning signs" suggestive of an underlying PID. Only through increased physician awareness will patients with PIDs receive timely diagnosis and optimal management.
Asunto(s)
Inmunodeficiencia Variable Común/diagnóstico , Inmunodeficiencia Variable Común/inmunología , Adolescente , Adulto , Agammaglobulinemia/diagnóstico , Agammaglobulinemia/genética , Agammaglobulinemia/inmunología , Anciano , Ataxia Telangiectasia/diagnóstico , Ataxia Telangiectasia/genética , Ataxia Telangiectasia/inmunología , Inmunodeficiencia Variable Común/genética , Proteínas Inactivadoras del Complemento 1/deficiencia , Proteína Inhibidora del Complemento C1 , Diagnóstico Diferencial , Femenino , Enfermedades Genéticas Ligadas al Cromosoma X/diagnóstico , Enfermedades Genéticas Ligadas al Cromosoma X/genética , Enfermedades Genéticas Ligadas al Cromosoma X/inmunología , Humanos , Inmunidad Celular/genética , Inmunoglobulinas/biosíntesis , Inmunoglobulinas/deficiencia , Inmunoglobulinas/genética , Irán , Síndrome de Job/diagnóstico , Síndrome de Job/genética , Síndrome de Job/inmunología , Síndrome de Deficiencia de Adhesión del Leucocito/diagnóstico , Síndrome de Deficiencia de Adhesión del Leucocito/genética , Síndrome de Deficiencia de Adhesión del Leucocito/inmunología , Masculino , Persona de Mediana Edad , Neutropenia/diagnóstico , Neutropenia/genética , Neutropenia/inmunología , Estudios Retrospectivos , Serpinas/deficiencia , Síndrome de Wiskott-Aldrich/diagnóstico , Síndrome de Wiskott-Aldrich/genética , Síndrome de Wiskott-Aldrich/inmunologíaRESUMEN
The viability of Mycobacterium tuberculosis (MTB) in serial sputum specimens from persistently smear positive patients was evaluated. The assay was based on oxidation-reduction of Alamar Blue and Malachite Green dyes that change their color in response to MTB growth. A total of 280 sputum specimens from 40 persistently smear positive TB patients and 40 sputa from non-tuberculosis patients were digested, decontaminated and examined microscopically. To check the MTB viability, the sediments from decontaminated samples were inoculated into three culture media: Lowenstein-Jensen (LJ) slants, Alamar Blue and Malachite Green culture tubes. We found that out of 280 smear positive specimens, the LJ culture was positive in 124 (44%). The numbers of correctly identified S+/C+ cases by Alamar Blue and Malachite Green were 118 (95%) and 116 (93%), respectively. The mean time required for reporting the positive signal in Alamar Blue culture tubes was 9 versus 11 days by Malachite Green culture tubes. In the standard LJ culture media the average detection time was 27 days (P < 0.05). The sensitivity of LJ was 99%, Alamar Blue 95% and Malachite Green 93%. The specificity was 100%, 92% and 93%, respectively. The oxidation-reduction method is rapid, sensitive and inexpensive in monitoring the treatment response of patients with pulmonary TB. Thus, using this method can be of paramount importance, particularly in resource-constrained areas.
Asunto(s)
Técnicas Bacteriológicas , Colorimetría/métodos , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/microbiología , Antituberculosos/uso terapéutico , Estudios de Seguimiento , Humanos , Microscopía , Mycobacterium tuberculosis/citología , Mycobacterium tuberculosis/crecimiento & desarrollo , Mycobacterium tuberculosis/metabolismo , Oxazinas/metabolismo , Oxidación-Reducción , Colorantes de Rosanilina/metabolismo , Sensibilidad y Especificidad , Esputo/microbiología , Factores de Tiempo , Resultado del Tratamiento , Xantenos/metabolismoRESUMEN
By oxidation-reduction assay, the viability of Mycobacterium tuberculosis in sputum specimens was evaluated. The technique is based on the Alamar Blue and Malachite Green dyes, which change their color in response to M. tuberculosis growth. The method is simple, permits visual reading of results, and is applicable for laboratories with limited resources.