ABSTRACT
SETTING: An out-patient clinic in a country with high rates of tuberculosis-human immunodeficiency virus (TB-HIV) co-infection. DESIGN: Cross-sectional analytical study of 123 adults with chronic cough and no previous anti-tuberculosis treatment. Demographic, clinical, chest X-ray (CXR) and GeneXpert® MTB/RIF data were collected. Proportions of TB diagnoses using both tests were calculated and compared using an unpaired t-test. RESULTS: Sixty-six patients (53.7%) were female and 35 (28.5%) tested positive for HIV; 21 (17.1%) were Xpert-positive, while 51 (42.5%) had CXR suggestive of TB (P = 0.0018), of whom only 15 (29.4%) were Xpert-positive. CXR was suggestive of pulmonary TB in 15 (71.4%) of the 21 patients with a positive Xpert test. CONCLUSIONS: The majority of the sputum smear-negative patients did not have TB on single Xpert testing. CXR gave an overestimate of sputum smear-negative TB cases.
Subject(s)
Mycobacterium tuberculosis/isolation & purification , Radiography, Thoracic , Sputum/microbiology , Tuberculosis, Pulmonary/diagnosis , Adult , Aged , Ambulatory Care , Antitubercular Agents/therapeutic use , Bacterial Proteins/genetics , Coinfection , Cross-Sectional Studies , DNA, Bacterial/isolation & purification , DNA-Directed RNA Polymerases , Drug Resistance, Bacterial/genetics , False Positive Reactions , Female , HIV Infections/diagnosis , HIV Infections/epidemiology , Humans , Male , Middle Aged , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/genetics , Predictive Value of Tests , Prevalence , Rifampin/therapeutic use , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/microbiology , Uganda/epidemiology , Young AdultABSTRACT
BACKGROUND: Vitamin B12 deficiency is associated with a wide spectrum of neuro-psychiatric manifestations. RESULTS: We report a case of a 44 year old female patient referred to the haematology unit with vitamin B12 deficiency presenting as an acute confusional state or delirium. Total resolution of the psychiatric symptoms occurred following parenteral vitamin B12 replacement therapy. CONCLUSION: This case report highlights one of the neuro-psychiatric presentations of vitamin B12 deficiency in a previously healthy individual.
