Extrapulmonary Nontuberculous Mycobacteriosis in a Lung Transplant Recipient / Micobacteriosis no tuberculosa extrapulmonar en un receptor de transplante de pulmón

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Silicotuberculosis with oesophagobronchial fistulas and broncholithiasis: a case report.

A 76-year-old woman was admitted to the hospital four times from November 2007 to June 2009. In this complex case, the patient had silicosis complicated by broncholithiasis, oesophagobronchial fistulas, and relapsed tuberculosis. She had worked as a stone crusher for 3 years and was exposed to a large amount of quartz dust. Barium oesophagography, gastroesophageal endoscopy, and biopsy suggested oesophageal-related chronic inflammation and ulceration, which may have caused the repeated oesophagobronchial fistulas. Bronchoscopy revealed a free broncholithiasis in the left mainstem bronchus. The patient was admitted a fourth time because of silicotuberculosis relapse. After 9 months of antituberculosis treatment, the patient recovered and was still clinically well at the time of this writing.

Silicotuberculosis with Esophagobronchial Fistula and Broncholithiasis.

A 69-year-old woman was admitted to hospital 4 times from November 2007 to June 2009. The patient had silicosis complicated by broncholithiasis, esophagobronchial fistula, and relapsed tuberculosis. She had worked as a stone crusher for 3 years and was exposed to a large amount of quartz dust. Barium esophagography, gastroesophageal endoscopy, and biopsy suggested esophageal-related chronic inflammation and ulcer, which probably caused the repeated esophagobronchial fistulas observed. Bronchoscopy revealed a free broncholithiasis in the left main bronchus. The patient was readmitted a fourth time, for the relapse of silicotuberculosis. After 9 months of antituberculous therapy, she was doing well until the recent last follow-up visit.

A rare adverse reaction to ethambutol: drug-induced haemolytic anaemia.

Anti-tuberculosis drugs seldom cause serious haematological side effects. However, among these drugs, isoniazid and rifampicin, especially when administered intermittently, may very rarely be linked to acute autoimmune haemolytic anaemia. Ethambutol (EMB) can cause dose-related retrobulbar neuritis. In this paper, we present the first reported case of acute fatal autoimmune haemolytic anaemia due to EMB.

Farewell, king coal!

Coal mining provided the power for the industrial development of the West, at great cost to the health of the workforce and, from industrial pollution, of the population. Medical appreciation of the diseases of miners was slow to develop and has been marked by controversy relating to the roles of coal and quartz and the causation of emphysema. Research by the MRC and the British coal industry resolved these issues as the industry itself declined. However, from the research has come an understanding of the influence of inhalation of different inhaled pollutants on human health that has been applied to predicting and preventing possible hazards of developing nanotechnologies.

[Silicotuberculosis]. / La silicotuberculose.

OBJECTIVE: Tuberculosis is a serious and common complication of silicosis. The aim of this study is to describe the epidemiological, clinical, radiological and progressive aspects of this pathological entity. PATIENTS AND METHODS: The study concerns 23 cases of silicotuberculosis which were collected at the service of respiratory diseases at CHU Ibn Rochd of Casablanca, Morocco during 12years (2003-2015). RESULTS: All patients were men. They were 7 diggers, 5 rock crushers, 7 miners and 4 masons. The mean duration of silica exposure was 11years. The symptomatology was dominated by dyspnea and persistent bronchial syndrome. Imagery showed tumor-like opacities in all cases, associated with mediastinal calcified lymphadenopathy in 9 cases, with micronodules in 8 cases and an excavated opacity in 2 cases. The diagnosis of tuberculosis was confirmed by isolation of the Koch's bacillus in sputum in 13% of cases in the bronchial aspirate in 52% and culture in sputum post-bronchoscopy in 13%. The bronchial biopsies confirmed the diagnosis in 2 cases. Tuberculosis had complicated silicosis 9years on average after the cessation of exposure to silica in 65% of cases. The antituberculous treatment was started in all patients with good clinical outcome in 22 cases. We had deplored a case of death by acute respiratory failure. CONCLUSION: Silicosis increases the risk of tuberculosis, hence the importance of TB screening in all patients with silicosis.

Conspicuous disease: The surveillance of silicosis in South Africa, 1910-1970.

Scholarly understanding of the nature of the science around silicosis has been strongly influenced, in recent years, by the idea that the mine doctors were responsible for hiding an epidemic, on the mines and in the countryside. In this paper, I try to show that the opposite was in fact the case, and that the science and government institutions for the regulation of silicosis and tuberculosis in white and black male workers were distinctively elaborated, and very largely successful in tracking and controlling the disease. This singular visibility, funded by the mines, stands in marked contrast with disease in general in South Africa, and forms a major part of the explanation for the very strong association of silicosis with mine work.

The pathologist's view of silicosis in 1930 and in 2015. The Johannesburg Conference legacy.

The 1930 International Labour Office Conference on silicosis in Johannesburg was a turning point in the history of silicosis and in the recognition of the associated pathologic patterns. Since 1930, pneumoconioses such as silicosis have become much rarer in developed countries and can now be diagnosed at an early stage based on clinical and radiologic criteria. However, in spite of these advances, pathologists must remember to look for silica in tissues, particularly when clinical and radiologic findings are more uncertain. Furthermore, nowadays pathologists essentially observe silicotic lesions as incidental findings adjacent to lung cancers. In addition to identifying the characteristic lesions, pathologists must also try to identify their causative agent, in the case of crystalline silica firstly by using polarized light examination, followed as appropriate by more sophisticated devices. Finally, pathologists and clinicians must always keep in mind the various implications of exposure to silica compounds in a wide range of diseases.

From the 1930 International Johannesburg conference on silicosis, to "tables" of occupational diseases, France, 2000 onward: A comparative reading.

Through the concept of "thought collectives" in particular, Ludwik Fleck was a pioneer in demonstrating how much scientific knowledge is inherently made up of social and historical material. In this article, I propose to follow a Fleckian path by comparing the proceedings of the 1930 International Labour Office Conference on silicosis in Johannesburg on the one hand, and on the other the content of the debates that took place in France in the 2000s to revise the "tables" of occupational diseases which define the compensation rules for salaried workers in the French general (as well as the farm) health insurance scheme. The text offers an analysis of the striking similarities between these two distant sources, pointing out particularly the repetitiveness of ignorance and knowledge, and the nature of what can be admitted as a body of "evidence" in medico-legal issues such as the definition and compensation of occupational diseases.

"Acute" silicosis at the 1930 Johannesburg Conference on silicosis and in its aftermath: Controversies over a distinct entity later recognized as silicoproteinosis.

BACKGROUND: Very rapidly progressive "acute silicosis" was observed prior to the 1930 International Labour Office Conference on silicosis, but its clinical significance and pathologic relationship to classic silica caused pneumoconiosis were not settled. METHODS: Textual analysis of the 1930 Conference proceedings identified data relevant to rapidly progressive silicosis. Standard bibliographic searches identified relevant biomedical literature dating from before and after the Conference. RESULTS: The 1930 Johannesburg Conference contained descriptions of acute silicosis, especially in the abrasive powders industry, but acute silica-related lung disease did not conform to a three-stage disease model in which tuberculosis supra-infection caused advanced disease, a model accepted at the Conference. Over following decades, additional reports appeared of rapidly progressive silicosis, unrelated to tuberculosis. Pulmonary alveolar proteinosis was identified only in 1958. CONCLUSIONS: Adoption by the 1930 Johannesburg Conference of a classification scheme into which acute rapidly progressive disease unrelated to tuberculosis fitted poorly may have impeded the understanding of acute silicosis and its importance.

Complicated silicotuberculosis in a South African gold miner: A case report.

We present a case of complicated silicotuberculosis in a former gold miner with a sufficiently heavy silica dust exposure to cause International Labor Organization grade 2/2 silicosis after a cumulative exposure duration of 11 years. We describe a cascade of complications-active pulmonary tuberculosis despite recent isoniazid prophylactic therapy, non-tuberculous mycobacterial disease, chronic airways obstruction, and spontaneous pneumothorax-and the difficulties, which arose, in diagnosis and management of such combined disease. We highlight three implications of such cases: the need to understand the interaction of silicosis and tuberculosis in this setting, the importance of maintaining continuity of care in the management of these conditions in miners and former miners, and control of silica dust exposure as a primary form of prevention of tuberculosis.

Establishment of rat model of silicotuberculosis and its pathological characteristic.

OBJECTIVE: To establish different stages of silicosis rat model complicated with tuberculosis infection, and compare the pathological characteristics and analyze the impact of silicosis on tuberculosis infection. METHODS: SD rats were subjected to intratracheal administration of silica with non-exposure method at the 1st, 30th, or 60th day. At the 50th day, the rats were injected with the suspension of H37Rv (a virulent standard strain of Mycobacterium tuberculosis) via tail-vein. After 40 days post-infection, rats were sacrificed, the lung tissues were isolated, and paraffin was embedded and sectioned. The sections were treated using HE staining for structure observation, acid fast stain of Ziehl-Neelsen for bacterial detection, and Warthin-Starry silver staining for displaying the distribution of dust particles. The bacterial load was quantified by colony counting. RESULTS: Primary to tertiary silicosis could be discovered at the 30th, 60th, and 90th day of post-infection. The rats could be infected by injection of M. tuberculosis via tail vein, with tuberculosis load and the degree of lung tissue lesions positively correlated with silicosis. CONCLUSION: The rat model of silicotuberculosis was established successfully, which facilitated understanding the 'cross-talk' of silicosis and tuberculosis during the process they drive each other.

Silicosis pulmonar: hallazgos radiológicos en la tomografía computarizada / Silicosis: computed tomography findings

La silicosis es una enfermedad pulmonar ocupacional, causada por la inhalación de sílice, que afecta a un amplio abanico de profesiones. Existen varias formas clínicas. La silicosis aguda, que resulta de la exposición a cantidades muy grandes de sílice en un período inferior a 2 años. La silicosis crónica simple, el tipo más frecuente que podemos ver en la actualidad, resulta de la exposición a bajas cantidades de sílice durante un período de entre 2 y 10 años. La silicosis crónica complicada, con conglomerados silicóticos. En muchos casos el diagnóstico se realiza por los datos epidemiológicos y radiológicos, sin confirmación histológica. Es importante conocer las distintas manifestaciones radiológicas de la silicosis para diferenciarla de otras enfermedades pulmonares y reconocer sus posibles complicaciones concomitantes. El objetivo de este trabajo es describir los hallazgos radiológicos, típicos y atípicos, de la silicosis y sus complicaciones en la TC de tórax helicoidal y de alta resolución (TCAR) (AU)

Silicosis is an occupational lung disease, which is caused by the inhalation of silica and affects a wide range of jobs. There are many clinical forms of silicosis: acute silicosis, results from exposure to very large amounts of silica dust over a period of less than 2 years. Simple chronic silicosis, the most common type that we see today, results from exposure to low amounts of silica between 2 and 10 years. Chronic silicosis complicated, with silicotic conglomerates. In many cases the diagnosis of silicosis is made according to epidemiological and radiological data, without a histological confirmation. It is important to know the various radiological manifestations of silicosis to differentiate it from other lung diseases and to recognize their complications. The objective of this work is to describe typical and atypical radiological findings of silicosis and their complications in helical and high resolution (HRCT) thorax CT (AU)

[Misdiagnosis of pneumoconiosis or silicotuberculosis in China: a pooled analysis of 1178 cases].

OBJECTIVE: To investigate the situation and causes of misdiagnosis of pneumoconiosis or silicotuberculosis in China by pooled analysis, and to provide a reference for the clinical diagnosis of pneumoconiosis in China and reduce the misdiagnosis rate. METHODS: A computer search was performed to collect the studies on the misdiagnosis of pneumoconiosis or silicotuberculosis published in China from 1985 to 2013. The obtained data were subjected to pooled analysis to investigate the causes of misdiagnosis and seek the measures for reducing misdiagnosis. RESULTS: Fifty-nine studies involving 1178 cases of misdiagnosed pneumoconiosis or silicotuberculosis were collected. There were 13 causes of misdiagnosis, and the most common one was the poor ability of identification due to inadequate experience in reading chest X-ray films (45.93%), followed by neglect of patient's occupational history (44.99%). Other causes of misdiagnosis included complex X-ray findings that are difficult to judge (29.03%), poor quality of chest radiographs (23.09%), and lack of regular health supervision (19.95%). CONCLUSION: Inadequate experience of physicians is the main cause of misdiagnosis of pneumoconiosis or silicotuberculosis. To reduce misdiagnosis of the disease, measures should be taken to enhance the training and evaluation of knowledge and skills of diagnosis and differential diagnosis of pneumoconiosis among physicians.