ABSTRACT
La tuberculosis es una enfermedad infecciosa considerada un problema de salud pública ya que constituye una de las principales causas de morbimortalidad a nivel mundial; su forma clínica más frecuente es la tuberculosis pulmonar, sin embargo, esta enfermedad también puede afectar estructuras extrapulmonares cuyo diagnóstico generalmente es tardío debido a que los síntomas y signos son inespecíficos. En este artículo se presenta un caso clínico de tuberculosis extrapulmonar (miliar, sistema nervioso central e intestinal) en el Hospital Universitario de Puebla (AU)
Tuberculosis is an infectious disease considered a public health problem since it is one of the main causes of morbidity and mortality worldwide; the most common clinical form is pulmonary tuberculosis; however, this disease can also affect extrapulmonary structures whose diagnosis is generally late because the symptoms and signs are nonspecific. This article presents a clinical case of extrapulmonary tuberculosis (miliary, central nervous system and intestinal) at the University Hospital of Puebla (AU)
Subject(s)
Humans , Female , Aged , Tuberculosis, Miliary/diagnosis , Indicators of Morbidity and Mortality , Dental Service, Hospital , Tuberculosis, Extrapulmonary/diagnosis , Tuberculosis, Extrapulmonary/epidemiology , Mexico/epidemiology , Mycobacterium/pathogenicityABSTRACT
Introducción: La tuberculosis (TB) extrapulmonar es la afectación de cualquier órgano, sin compromiso pulmonar demostrado, como consecuencia de la diseminación hematógena/linfática del bacilo de Koch. Presentación de caso: Paciente en puerperio inmediato cursando cuadro clínico de gonalgia que se estudió con resonancia magnética que mostró lesión endomedular en región distal del fémur izquierdo. Se estudió con tomografía de tórax, abdomen y pelvis que evidenciaron otras lesiones a nivel esplénico, sin compromiso hepático ni pulmonar. Se realizó punción diagnóstica femoral con evidencia de granulomas con necrosis central. Se interpretó tuberculosis extrapulmonar y se inició tratamiento antifímico con mejora sintomática. Discusión: La TB extrapulmonar puede impactar a nivel de pleura, ganglios linfáticos, vías urinarias, sistema osteoarticular, sistema nervioso central y abdomen. En el embarazo, la prevalencia de TB extrapulmonar es baja. Conclusión: La TB femoral y esplénica concomitante en pacientes embarazadas es un hallazgo infrecuente por lo que su análisis resulta de gran importancia. Arribar al diagnóstico requiere un elevado índice de sospecha. El retraso diagnóstico conlleva a un aumento de la morbimortalidad
Introduction: Extrapulmonary tuberculosis (TB) is the involvement of any organ, without demonstrated pulmonary involvement, as a consequence of the hematogenous/lymphatic dissemination of the Koch bacillus. Case presentation: Patient in the immediate postpartum period with clinical symptoms of gonalgia that was studied with magnetic resonance imaging showing intramedullary lesion in the distal region of the left femur. A CT scan of the chest, abdomen and pelvis showed other lesions at the splenic level, without liver or lung involvement. A femoral diagnostic puncture was performed with evidence of granulomas with central necrosis. Extrapulmonary tuberculosis was interpreted and antifimic treatment was started with symptomatic improvement. Discussion: Extrapulmonary TB can impact the pleura, lymph nodes, urinary tract, osteoarticular system, central nervous system and abdomen. During pregnancy, the prevalence of extrapulmonary TB is low. Conclusion: Concomitant femoral and splenic TB in pregnant patients is a rare finding, which is why its analysis is of great importance. Arriving at a diagnosis requires a high index of suspicion. Delayed diagnosis leads to an increase in morbidity and mortalit
Subject(s)
Humans , Female , Adult , Pregnancy , Tuberculosis, Extrapulmonary/diagnosis , Mycobacterium tuberculosis , Argentina , Pleura , Splenomegaly , Biopsy , Diagnostic Imaging , Arthralgia , Diagnosis, Differential , Knee Joint/pathologyABSTRACT
Objective: Enlargement of the adrenal glands and variable adrenocortical function have been reported in patients with pulmonary tuberculosis and, in a few studies, in patients with extrapulmonary tuberculosis (EPTB). However, none of the studies have evaluated the course of the adrenal morphology in these patients. Subjects and methods: Prospective study including 37 patients with EPTB and 37 healthy age- and sex-matched controls. The adrenal function was evaluated by measurement of cortisol levels at baseline and after stimulation with ACTH (Acton Prolongatum) before and 6 months after antituberculosis treatment. The size of both adrenal glands was evaluated using 64-slice computed tomography (CT) scanning before and 6 months after treatment. The findings were compared with those in a group of healthy matched controls. Results: Clinical and biochemical parameters were comparable between groups. The mean baseline serum cortisol level was significantly lower in the EPTB group (397.1 ± 184.9 nmol/L) compared with the control group (696.3 ± 101.8 nmol/L). Compared with controls, patients with EPTB had significantly lower mean cortisol levels at baseline and 1 hour after ACTH, both before (397 ± 184.9 nmol/L and 750.7 ± 176.8 nmol/L, respectively) and after (529.7 ± 100.4 nmol/L and 1017.2 ± 119.7 nmol/L, respectively) antituberculosis treatment. Both the length and thickness of the right and left adrenal glands were greater in patients with EPTB than in controls but became comparable to those in controls after treatment completion. Conclusion: Patients with EPTB have an enlarged adrenal size and low baseline and stimulated serum cortisol levels. After treatment completion, cortisol levels increased significantly, and the adrenal size normalized in these patients.
Subject(s)
Hydrocortisone , Tuberculosis, Extrapulmonary , Humans , Prospective Studies , Antitubercular Agents/therapeutic use , Adrenocorticotropic Hormone , Adrenal Glands/diagnostic imagingABSTRACT
A tuberculose é uma doenças causada por uma bactéria denominada Mycobacterium tuberculoses ou Bacilo de Koch. Estima-se que a bactéria causadora tenha evoluído há 15.000 ou 20.000 anos, a partir de outras bactérias do gênero Mycobacterium.Esse relatório tem o objetivo de apresentar e descrever a situação epidemiológica e operacional da tuberculose no Estado de Goiás com os dados da base de dados referentes aos casos notificados atpe o ano de 2023. Foram utilizados as bases de ddos do Sistema de Informaçãoes de Agravos de Notificação (SINAN-NET), do Sistema de Informação de Tratamentos Especiais para Tuberculose (SITE-TB) e do Sistema de Notificação dos casos de Infecção Latente de Tuberculose (SILT)
Tuberculosis is a disease caused by a bacteria called Mycobacterium tuberculosis or Koch's Bacillus. It is estimated that the causative bacteria evolved 15,000 or 20,000 years ago, from other bacteria of the Mycobacterium genus. This report aims to present and describe the epidemiological and operational situation of tuberculosis in the State of Goiás with data from the database data referring to cases reported up to the year 2023. The databases of the Notifiable Diseases Information System (SINAN-NET), the Special Treatments Information System for Tuberculosis (SITE-TB) and the Notification System were used. of cases of Latent Tuberculosis Infection (SILT)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Tuberculosis/epidemiology , Tuberculosis/classification , Tuberculosis/mortality , Latent Tuberculosis/epidemiology , Tuberculosis, Extrapulmonary/epidemiologyABSTRACT
As it is an infrequent etiology, the diagnosis of perianal tuberculosis is challenging, especially in the absence of a pulmonary focus. TB should be considered in the differential diagnosis of perianal ulcers, fistulas, abscesses, mainly in non-healing and recurrent anal lesions. Treatment with anti-TB agents can provide complete recovery. Furthermore, these lesions are often diagnosed later after complete histopathological and mycobacterial results, where the benefit of avoiding morbid multiple surgeries by effective anti-TB treatment is lost. We reported a rare case of an immuno-competent patient with perianal TB, which was the first manifestation of the disease. A fit-and-well man in his 20s presented a large perianal abscess. Unexpectedly, his chest X-ray showed a rounded hyper-transparency in the left lung. The abscess was drained. Posterior investigation with culture analysis from pus swabs and sputum revealed the presence of Mycobacterium tuberculosis complex infection. After completing the 6 months of oral administration of anti-TB drugs, the patient was asymptomatic. By highlighting this unusual manifestation, we aim to improve clinicians' awareness of perianal TB, facilitating early recognition and appropriate management. (AU)
Subject(s)
Humans , Male , Adult , Perineum/injuries , Tuberculosis, Extrapulmonary/diagnosis , ImmunocompetenceABSTRACT
Tuberculosis (TB) is one of the leading causes of death by infectious diseases worldwide. Multidrug-resistant tuberculosis is a growing problem, especially in countries with high TB prevalence. Although the lungs are the organs most frequently affected by this disease, Mycobacterium tuberculosis can harm any organ, including the urogenital tract, causing extrapulmonary tuberculosis, which leads to a challenging diagnosis and consequent treatment delays. In this article, we present a case of orchiepididymitis caused by multidrug-resistant TB (MDR-TB) with a significantly delayed diagnosis, the proposed treatment according to the resistance profile, and the clinical outcomes.
Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Extrapulmonary , Tuberculosis, Multidrug-Resistant , Tuberculosis , Humans , Antitubercular Agents/therapeutic use , Tuberculosis/drug therapy , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/epidemiologyABSTRACT
Extrapulmonary tuberculosis is defined as that case of tuberculosis clinically diagnosed and confirmed by bacteriological studies that affects tissues and organs outside the lung parenchyma. Mexico is in third place among Latin American countries in terms of the incidence of pulmonary and extrapulmonary tuberculosis. Culture methods are still the gold standard for the diagnosis of extrapulmonary tuberculosis since they identify the species and susceptibility to drugs.
La tuberculosis extrapulmonar es aquella tuberculosis diagnosticada clínicamente y confirmada por estudios bacteriológicos que afecta a tejidos y órganos fuera del parénquima pulmonar. México es el tercer lugar en América Latina en incidencia de tuberculosis pulmonar y extrapulmonar. Los métodos de cultivo siguen siendo el método de referencia para el diagnóstico de tuberculosis extrapulmonar, ya que identifican la especie y la sensibilidad a los fármacos.
Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Extrapulmonary , Tuberculosis , Humans , Tuberculosis/diagnosis , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Lung , Mexico/epidemiologyABSTRACT
We report a case of constrictive pericarditis due to extrapulmonary tuberculosis associated with Human Immuno-deficiency Virus, complicated by cardiac tamponade that required surgical intervention in a drug user patient. The importance of early diagnosis and management is widely highlighted
El artículo presenta un caso de pericarditis constrictiva secundaria a tuberculosis extrapulmonar en un paciente con prueba positiva para virus de inmunodeficiencia humana (VIH) consumidor de sustancias psicoactivas, quien durante la hospitalización desarrolló un taponamiento cardíaco con requerimiento de intervención quirúrgica. Se plantea la discusión de la importancia de cada una de las pruebas solicitadas y el manejo adecuado en pacientes con dichas patologías
O artigo apresenta um caso de pericardite constritiva secundária à tuberculose extrapulmonar em paciente com teste positiva para vírus da imunodeficiência humana (HIV) e usuário de substâncias psicoativas que, durante a internação, desenvolveu tamponamento cardíaco com necessidade de intervenção cirúrgica. Discute-se a importância de cada um dos exames solicitados e o manejo ade-quado de pacientes com essas patologias
Subject(s)
Pericarditis, Constrictive , Cardiac Tamponade , HIV , Immunosuppression Therapy , Tuberculosis, ExtrapulmonaryABSTRACT
La Organización Mundial de la Salud (OMS) informa que ocurren 1.1 millones de casos de tuberculosis (TBC) en niños <15 años. En Chile se observa un aumento de casos en el tiempo. La pandemia por SARS-Cov2 ha implicado una disminución de la pesquisa y un retardo de la atención y diagnóstico de TBC. Se presenta dos casos clínicos de tuberculosis en adolescentes. El primero corresponde a un adolescente con una tuberculosis pulmonar de difícil y tardío diagnóstico, habiéndose descartado inicialmente TBC por estudio molecular y PPD no reactivo. El segundo caso corresponde a un adolescente con una tuberculosis pulmonar y extrapulmonar de diagnóstico tardío, de 8 meses de evolución, posterior a un cuadro leve de Covid.
The World Health Organization (WHO) reports that 1.1 million cases of tuberculosis (TB) occur in children <15 years of age. In Chile, an increase in cases is observed over time. The SARS-Cov2 pandemic has led to a decrease in screening and a delay in care and diagnosis of TB. Two clinical cases of tuberculosis in adolescents are presented. The first corresponds to an adolescent with TB of difficult and late diagnosis, having initially ruled out TB by molecular study and non-reactive PPD. The second case corresponds to an adolescent with pulmonary and extrapulmonary tuberculosis of late diagnosis, of 8 months of evolution, after a mild respiratory infection of Covid.
Subject(s)
Humans , Male , Female , Adolescent , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Extrapulmonary/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Empyema, Pleural/diagnostic imaging , Diagnosis, Differential , Delayed DiagnosisABSTRACT
A clinical experience of tuberculosis (TB) in 104 pediatric patients observed at the Hospital Regional de Valdivia (southern Chile), along a sixteen year period (1986 - 2001) is presented. Pulmonary TB was diagnosed in 88 cases, extrapulmonary TB in 19 cases and both localizations in three cases. Pulmonary TB was bacteriologically confirmed in 62.5% of cases, through either gastric aspirate or sputum samples. Gastric aspirate yielded 42.8% of positive cultures; two infants who presented central nervous system involvement, died. A case of congenital TB was observed in a 30 day old infant. There were no cases of AIDS in this experience. Pediatric TB has progressively decreased its incidence in our region, particularly the extrapulmonary localization, but still represents a challenging disease to clinicians.