Academic literature on the topic 'Tuberculous'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles

Select a source type:

Consult the lists of relevant articles, books, theses, conference reports, and other scholarly sources on the topic 'Tuberculous.'

Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.

You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.

Journal articles on the topic "Tuberculous"

1

N., Rajeshwari, and Savitha A. "Tuberculosis: a great masquerader." International Journal of Contemporary Pediatrics 7, no. 7 (June 24, 2020): 1651. http://dx.doi.org/10.18203/2349-3291.ijcp20202636.

Full text
Abstract:
Central nervous system tuberculosis caused by Mycobacterium tuberculosis is the most severe form of tuberculosis, accounting for 1% of all TB cases. Intracranial tuberculosis can present as Tuberculous meningitis, Tuberculous encephalopathy, Tuberculous vasculitis, CNS tuberculomas and Tuberculous brain abscess. Here authors present a case of a 10-year-old girl who presented with insidious onset of early morning vomiting, excessive sleepiness with classical neuroimaging findings of intracranial tuberculosis. Authors emphasise that intracranial tuberculoma should be considered in the differential diagnosis of any intracranial space-occupying lesion with or without pulmonary involvement.
APA, Harvard, Vancouver, ISO, and other styles
2

Hammi, Sanae, Naima Zimed, Khalid Bouti, and Jamal Eddine Bourkadi. "Paradoxical reactions during Antituberculosis therapy - A single-center prospective analysis." International Journal of Medicine and Surgery 2, no. 2 (December 26, 2015): 32–35. http://dx.doi.org/10.15342/ijms.v2i2.75.

Full text
Abstract:
[1] Hawkey CR, Yap T, Pereira J, Moore DA, Davidson RN, Pasvol G, et al. Characterization and management of paradoxical upgrading reactions in HIV-uninfected patients with lymph node tuberculosis. Clinical infectious diseases. 2005;40(9):1368-71. [2] Breton G. Syndrome inflammatoire de reconstitution immune (IRIS) associé à la tuberculose. Journal des Anti-infectieux. 2012;14(4):180-5. [3] Cheng V, Ho P, Lee R, Chan K, Woo P, Lau S, et al. Clinical spectrum of paradoxical deterioration during antituberculosis therapy in non-HIV-infected patients. European Journal of Clinical Microbiology and Infectious Diseases. 2002;21(11):803-9. [4] Al-Majed S. Study of paradoxical response to chemotherapy in tuberculous pleural effusion. Respiratory medicine. 1996;90(4):211-4. [5] Campbell I, Dyson A. Lymph node tuberculosis: a comparison of various methods of treatment. Tubercle. 1977;58(4):171-9. [6] Memish Z, Mah M, Mahmood SA, Bannatyne R, Khan M. Clinico‐diagnostic experience with tuberculous lymphadenitis in Saudi Arabia. Clinical microbiology and infection. 2000;6(3):137-41. [7] Choremis C, Padiatellis C, ZOU MLD, Yannakos D. Transitory exacerbation of fever and roentgenographic findings during treatment of tuberculosis in children. American review of tuberculosis. 1955;72(4):527. [8] Orlovic D, Smego J. Paradoxical tuberculous reactions in HIV-infected patients. The International Journal of Tuberculosis and Lung Disease. 2001;5(4):370-5. [9] Park I-S, Son D, Lee C, Park JE, Lee J-S, Cheong M-H, et al. Severe paradoxical reaction requiring tracheostomy in a human immunodeficiency virus (HIV)-negative patient with cervical lymph node tuberculosis. Yonsei medical journal. 2008;49(5):853-6. [10] Martinez V, Bricaire F. Réactions paradoxales. La Presse Médicale. 2006;35(1):1753-6. [11] Narita M, Ashkin D, Hollender ES, Pitchenik AE. Paradoxical worsening of tuberculosis following antiretroviral therapy in patients with AIDS. American journal of respiratory and critical care medicine. 1998;158(1):157-61. [12] Vidal CG, Garau J. Systemic steroid treatment of paradoxical upgrading reaction in patients with lymph node tuberculosis. Clinical infectious diseases. 2005;41(6):915-6. [13] Rakotoarivelo R, Vandenhende M-A, Michaux C, Morlat P, Bonnet F. Réactions paradoxales sous traitement antituberculeux chez des personnes non infectées par le VIH: quatre nouvelles observations et revue de la littérature. La Revue de médecine interne. 2013;34(4):202-8. [14] Cheng V, Yam W, Woo P, Lau S, Hung I, Wong S, et al. Risk factors for development of paradoxical response during antituberculosis therapy in HIV-negative patients. European Journal of Clinical Microbiology and Infectious Diseases. 2003;22(10):597-602. [15] Rao GP, Nadh BR, Hemaratnan A, Srinivas T, Reddy PK. Paradoxical progression of tuberculous lesions during chemotherapy of central nervous system tuberculosis: report of four cases. Journal of neurosurgery. 1995;83(2):359-62. [16] Fontanilla J-M, Barnes A, Von Reyn CF. Current diagnosis and management of peripheral tuberculous lymphadenitis. Clinical Infectious Diseases. 2011;53(6):555-62. [17] Guinchard A-C, Pasche P. Lymphadénite tuberculeuse cervicale et réaction paradoxale: diagnostic et traitement. ORL. 2012;356(34):1860-5. [18] Colebunders R, John L, Huyst V, Kambugu A, Scano F, Lynen L. Syndrome inflammatoire de reconstitution immunitaire de la tuberculose dans les pays à ressources limitées. Int J Tuberc Lung Dis. 2006;10(9):946-53. [19] Malone J, Paparello S, Rickman L, Wagner K, Monahan B, Oldfield E. Intracranial tuberculoma developing during therapy for tuberculous meningitis. Western Journal of Medicine. 1990;152(2):188. [20] Valdez LM, Schwab P, Okhuysen PC, Rakita RM. Paradoxical subcutaneous tuberculous abscess. Clinical infectious diseases. 1997;24(4):734-. [21] Bouchez B, Arnott G, Colover J. Paradoxical expansion of intracranial tuberculomas during chemotherapy. The Lancet. 1984;324(8400):470-1. [22] [Recommendations of the French Language Pneumology Society for tuberculosis management in France: consensus conference. Nice, France, 23 January 2004]. Revue des maladies respiratoires. 2004;21(3 Pt 2):S3-104. [23] Rabar D, Issartel B, Petiot P, Boibieux A, Chidiac C, Peyramond D. Tuberculomes et méningoradiculite tuberculeuse d’évolution paradoxale sous traitement. La Presse Médicale. 2005;34(1):32-4. [24] Chambers S, Record C, Hendrickse W, Rudge P, Smith H. Paradoxical expansion of intracranial tuberculomas during chemotherapy. The Lancet. 1984;324(8396):181-4. [25] Safdar A, Brown AE, Kraus DH, Malkin M. Paradoxical reaction syndrome complicating aural infection due to Mycobacterium tuberculosis during therapy. Clinical infectious diseases. 2000;30(3):625-7. [26] Hejazi N, Hassler W. Multiple intracranial tuberculomas with atypical response to tuberculostatic chemotherapy: literature review and a case report. Infection. 1997;25(4):233-9.
APA, Harvard, Vancouver, ISO, and other styles
3

Shah, Ira, and Naman S. Shetty. "Duration of anti-tuberculous therapy in children with persistent tuberculomas." SAGE Open Medical Case Reports 7 (January 2019): 2050313X1882309. http://dx.doi.org/10.1177/2050313x18823092.

Full text
Abstract:
The usual treatment duration of tuberculomas recommended is 1 year. While anti-tuberculous therapy is of absolute necessity for the treatment of central nervous system tuberculosis, no clear guidelines exist regarding the duration of therapy in case of persistent tuberculomas. We present a series of six cases of children with central nervous system tuberculosis who received anti-tuberculous therapy for a period varying between 23 and 32 months depending on the resolution of lesion seen in neuroradiological scans of the patients. Decrease in number and size of granuloma were noted in all patients while one patient showed complete resolution. After stopping anti-tuberculous therapy, the size of the granuloma remained the same, while in one patient an increase was noted. Thus, the duration of anti-tuberculous therapy in patients with tuberculoma may vary and may be required for longer time based on treatment response.
APA, Harvard, Vancouver, ISO, and other styles
4

Tanwar, Vikram Singh, Harpreet Singh, Nikhil Govil, Sameer Arora, and Ruchi Jagota. "Concurrent multiple intracranial and intramedullary tuberculoma: a rare form of neurotuberculosis." Journal of Advances in Internal Medicine 4, no. 1 (December 18, 2015): 25–27. http://dx.doi.org/10.3126/jaim.v4i1.14177.

Full text
Abstract:
Central nervous system tuberculosis is a serious form of tuberculosis. Tuberculous CNS involvement can occur in the form of TB meningitis, tuberculous Vasculitis, tuberculoma and rarely brain abscess. Tubercular granulomas generally solitary and occurs in the brain but it may be multiple and involve other areas such as spinal cord, epidural space and subdural space also. Tuberculoma in the spinal cord is rare. Concurrent occurrence of brain tuberculomas along with intramedullary spinal tuberculoma is even rarer. Only few cases have been reported in world literature. We are reporting a 28 years old female who presented with headache and progressive paraparesis in which imaging revealed intracranial and intramedullary tuberculoma and recovered completely with antitubercular therapy without any surgical intervention.Journal of Advances in Internal Medicine 2015;04(01):25-27
APA, Harvard, Vancouver, ISO, and other styles
5

Masood, Arslan, Gul Zaman Khan, Irfan Bashir, and Zubair Akram. "Parachute-Like Mitral Valve Tuberculoma: A Rare Presentation." Case Reports in Cardiology 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/1023924.

Full text
Abstract:
There have been anecdotal reports of tuberculous cardiac involvement, mainly in cases of military tuberculosis or immune deficient individuals. The spectrum of clinical presentations of tuberculous cardiac involvements includes incidental detection of single and multiple well-circumscribed tuberculomas, symptomatic obstructive lesions, AV conduction abnormalities, and even sudden death. We present a case of cardiac tuberculoma in an immune-competent person who presented with worsening dyspnea. The unique morphology of this mass posed an imaging challenge that required 4-dimensional (4D) echocardiography and cardiac magnetic resonance (CMR) detail to differentiate the mass from an anterior mitral leaflet (AML) aneurysm. Histological examination after surgical resection confirmed its tuberculous etiology.
APA, Harvard, Vancouver, ISO, and other styles
6

Vidal, José E., Adrián V. Hernández, Augusto C. Penalva de Oliveira, Alexandre de Leite Souza, Geraldine Madalosso, Paula R. Marques da Silva, and R. Dauar. "Cerebral tuberculomas in AIDS patients: a forgotten diagnosis?" Arquivos de Neuro-Psiquiatria 62, no. 3b (September 2004): 793–96. http://dx.doi.org/10.1590/s0004-282x2004000500010.

Full text
Abstract:
The human immunodeficiency virus (HIV) infection epidemics increased the prevalence, multi-drug resistance and disseminated forms of tuberculosis. The central nervous system (CNS) tuberculosis has high mortality and morbidity, and it is usually divided into diffuse (meningitis) and localized (tuberculoma and abscess) forms. We report three cases of cerebral tuberculomas in AIDS patients: one with definitive diagnosis, confirmed with histopathology, and two with probable diagnosis, based on clinical information, radiological images, Mycobaterium tuberculosis isolation out of the CNS and adequate response to antituberculous treatment. Further, we discuss diagnostic, therapeutic and prognostic issues of tuberculomas, with emphasis in the distinction from cerebral tuberculous abscesses. Despite of their infrequent presentation, tuberculomas should be considered in the differential diagnosis of cerebral expansive lesions in patients with AIDS.
APA, Harvard, Vancouver, ISO, and other styles
7

Muthukumar, Natarajan, Venkatachalam Sureshkumar, and Vengalathur Ganesan Ramesh. "En plaque intradural extramedullary spinal tuberculoma and concurrent intracranial tuberculomas: paradoxical response to antituberculous therapy." Journal of Neurosurgery: Spine 6, no. 2 (February 2007): 169–73. http://dx.doi.org/10.3171/spi.2007.6.2.169.

Full text
Abstract:
✓Spinal intradural extramedullary tuberculoma is a rare entity. Rarer still are extensive en plaque intradural extramedullary tuberculomas occurring concurrently with multiple intracranial tuberculomas as a paradoxical response to chemotherapy for tuberculosis (TB). The authors describe the case of a 21-year-old man who was treated for tuberculous meningitis. Three months after the episode of meningitis, while undergoing chemotherapy for TB, he developed features of thoracic myelopathy. Investigations revealed an extensive en plaque intradural extramedullary lesion spanning seven segments in the lower thoracic spine. Magnetic resonance imaging of the brain revealed multiple asymptomatic intracranial tuberculomas. Even after further treatment with antituberculous chemotherapy was initiated, the lesion failed to respond. The authors performed a laminectomy and excised the en plaque intradural extramedullary lesion. The patient’s condition responded well to this treatment. Although the appearance of intracranial tuberculoma as a paradoxical response to chemotherapy has been previously reported, no authors have reported on the development of an extensive en plaque intradural extramedullary tuberculoma in conjunction with asymptomatic multiple intracranial tuberculomas as a paradoxical response. In cases in which patients present with compressive myelopathy following therapy for tuberculous meningitis, it is important to consider in the differential diagnosis that intradural extramedullary tuberculoma may be a paradoxical response to chemotherapy. The authors’ experience and their review of the literature indicate that surgery has a definitive role to play in the management of spinal intradural extramedullary tuberculoma.
APA, Harvard, Vancouver, ISO, and other styles
8

Marais, Suzaan, Ronald Van Toorn, Felicia C. Chow, Abi Manesh, Omar K. Siddiqi, Anthony Figaji, Johan F. Schoeman, and Graeme Meintjes. "Management of intracranial tuberculous mass lesions: how long should we treat for?" Wellcome Open Research 4 (October 15, 2019): 158. http://dx.doi.org/10.12688/wellcomeopenres.15501.1.

Full text
Abstract:
Tuberculous intracranial mass lesions are common in settings with high tuberculosis (TB) incidence and HIV prevalence. The diagnosis of such lesions, which include tuberculoma and tuberculous abscesses, is often presumptive and based on radiological features, supportive evidence of TB elsewhere and response to TB treatment. However, the treatment response is unpredictable, with lesions frequently enlarging paradoxically or persisting for many years despite appropriate TB treatment and corticosteroid therapy. Most international guidelines recommend a 9-12 month course of TB treatment for central nervous system TB when the infecting Mycobacterium tuberculosis (M.tb) strain is sensitive to first-line drugs. However, there is variation in opinion and practice with respect to the duration of TB treatment in patients with tuberculomas or tuberculous abscesses. A major reason for this is the lack of prospective clinical trial evidence. Some experts suggest continuing treatment until radiological resolution of enhancing lesions has been achieved, but this may unnecessarily expose patients to prolonged periods of potentially toxic drugs. It is currently unknown whether persistent radiological enhancement of intracranial tuberculomas after 9-12 months of treatment represents active disease, inflammatory response in a sterilized lesion or merely revascularization. The consequences of stopping TB treatment prior to resolution of lesional enhancement have rarely been explored. These important issues were discussed at the 3rd International Tuberculous Meningitis Consortium meeting. Most clinicians were of the opinion that continued enhancement does not necessarily represent treatment failure and that prolonged TB therapy was not warranted in patients presumably infected with M.tb strains susceptible to first-line drugs. In this manuscript we highlight current medical treatment practices, benefits and disadvantages of different TB treatment durations and the need for evidence-based guidelines regarding the treatment duration of patients with intracranial tuberculous mass lesions.
APA, Harvard, Vancouver, ISO, and other styles
9

Marais, Suzaan, Ronald Van Toorn, Felicia C. Chow, Abi Manesh, Omar K. Siddiqi, Anthony Figaji, Johan F. Schoeman, and Graeme Meintjes. "Management of intracranial tuberculous mass lesions: how long should we treat for?" Wellcome Open Research 4 (October 31, 2019): 158. http://dx.doi.org/10.12688/wellcomeopenres.15501.2.

Full text
Abstract:
Tuberculous intracranial mass lesions are common in settings with high tuberculosis (TB) incidence and HIV prevalence. The diagnosis of such lesions, which include tuberculoma and tuberculous abscesses, is often presumptive and based on radiological features, supportive evidence of TB elsewhere and response to TB treatment. However, the treatment response is unpredictable, with lesions frequently enlarging paradoxically or persisting for many years despite appropriate TB treatment and corticosteroid therapy. Most international guidelines recommend a 9-12 month course of TB treatment for central nervous system TB when the infecting Mycobacterium tuberculosis (M.tb) strain is sensitive to first-line drugs. However, there is variation in opinion and practice with respect to the duration of TB treatment in patients with tuberculomas or tuberculous abscesses. A major reason for this is the lack of prospective clinical trial evidence. Some experts suggest continuing treatment until radiological resolution of enhancing lesions has been achieved, but this may unnecessarily expose patients to prolonged periods of potentially toxic drugs. It is currently unknown whether persistent radiological enhancement of intracranial tuberculomas after 9-12 months of treatment represents active disease, inflammatory response in a sterilized lesion or merely revascularization. The consequences of stopping TB treatment prior to resolution of lesional enhancement have rarely been explored. These important issues were discussed at the 3rd International Tuberculous Meningitis Consortium meeting. Most clinicians were of the opinion that continued enhancement does not necessarily represent treatment failure and that prolonged TB therapy was not warranted in patients presumably infected with M.tb strains susceptible to first-line drugs. In this manuscript we highlight current medical treatment practices, benefits and disadvantages of different TB treatment durations and the need for evidence-based guidelines regarding the treatment duration of patients with intracranial tuberculous mass lesions.
APA, Harvard, Vancouver, ISO, and other styles
10

Marais, Suzaan, Ronald Van Toorn, Felicia C. Chow, Abi Manesh, Omar K. Siddiqi, Anthony Figaji, Johan F. Schoeman, and Graeme Meintjes. "Management of intracranial tuberculous mass lesions: how long should we treat for?" Wellcome Open Research 4 (February 26, 2020): 158. http://dx.doi.org/10.12688/wellcomeopenres.15501.3.

Full text
Abstract:
Tuberculous intracranial mass lesions are common in settings with high tuberculosis (TB) incidence and HIV prevalence. The diagnosis of such lesions, which include tuberculoma and tuberculous abscesses, is often presumptive and based on radiological features, supportive evidence of TB elsewhere and response to TB treatment. However, the treatment response is unpredictable, with lesions frequently enlarging paradoxically or persisting for many years despite appropriate TB treatment and corticosteroid therapy. Most international guidelines recommend a 9-12 month course of TB treatment for central nervous system TB when the infecting Mycobacterium tuberculosis (M.tb) strain is sensitive to first-line drugs. However, there is variation in opinion and practice with respect to the duration of TB treatment in patients with tuberculomas or tuberculous abscesses. A major reason for this is the lack of prospective clinical trial evidence. Some experts suggest continuing treatment until radiological resolution of enhancing lesions has been achieved, but this may unnecessarily expose patients to prolonged periods of potentially toxic drugs. It is currently unknown whether persistent radiological enhancement of intracranial tuberculomas after 9-12 months of treatment represents active disease, inflammatory response in a sterilized lesion or merely revascularization. The consequences of stopping TB treatment prior to resolution of lesional enhancement have rarely been explored. These important issues were discussed at the 3rd International Tuberculous Meningitis Consortium meeting. Most clinicians were of the opinion that continued enhancement does not necessarily represent treatment failure and that prolonged TB therapy was not warranted in patients presumably infected with M.tb strains susceptible to first-line drugs. In this manuscript we highlight current medical treatment practices, benefits and disadvantages of different TB treatment durations and the need for evidence-based guidelines regarding the treatment duration of patients with intracranial tuberculous mass lesions.
APA, Harvard, Vancouver, ISO, and other styles
More sources

Dissertations / Theses on the topic "Tuberculous"

1

Nguyen, Thuy Van. "Utilisation des systèmes de surveillance pour évaluer les aspects particuliers de la tuberculose et de la résistance aux antituberculeux en France." Thesis, Paris 6, 2014. http://www.theses.fr/2014PA066283/document.

Full text
Abstract:
La tuberculose (TB) est encore aujourd’hui une cause majeure de morbidité et mortalité dans le monde. Sa maitrise a été rendue difficile par l’épidémie de VIH et la résistance au antituberculeux. La méningite tuberculose (MTB), est la forme la plus grave de TB et est un des indicateurs utilisés pour la politique vaccinale par le BCG. La multirésistance aux antituberculeux (MDR) qui pose des problèmes diagnostiques et thérapeutiques est surveillée depuis 1992 en France. En revanche, la mono-résistance à la Rifampicine (mono-RMP-R) qui représente une première étape vers la TB MDR est rarement étudiée et le devenir des malades est inconnu en France. Notre travail a été axé sur l’épidémiologie de la MTB et l’impact des modifications de stratégie vaccinale par le BCG. Nous avons pour cela utilisé deux systèmes de surveillance de la tuberculose en France : un réseau national de laboratoires coordonné par le centre national de référence des mycobactéries (CNR), et le système de la déclaration obligatoire (DO), coordonné par l’Institut de Veille Sanitaire (InVS). Nous avons également utilisé le réseau du CNR pour évaluer la monorésistance à la rifampicine dans la TB en France. Nous avons tout d’abord évalué le taux d’incidence de la tuberculose du système nerveux central à culture positive (TB SNC C+) en France en 2007 (année de modification de la politique vaccinale) et son évolution entre 1990 et 2007. En 2007, la TB SNC C+ représentait moins de 1% de tous les cas tuberculose à culture positive et son incidence était de 0,5/million d’habitants. La sensibilité du réseau du CNR était de 79,4%. Pour évaluer l’évolution de la TB SNC C+ entre 1990 et 2007, nous avons utilisé une sensibilité « moyenne » dérivée de la sensibilité du CNR pour l'année 2000 (75,6%) et celle pour l'année 2007 pour corriger le nombre de cas signalés dans chacune des 4 études (1990, 1995, 2000, 2007). Nous avons observé une diminution de 62% du nombre corrigé de TB SNC C+ en 17 ans (90 à 35 cas) et du taux d'incidence corrigé (de 1,6 à 0,55 cas par million d'habitants) (P < 0.001). Ensuite, nous avons mesuré l’impact des deux changements majeurs de la politique vaccinale par le BCG en 2006 (arrêt de la multipuncture) et 2007 (arrêt du BCG obligatoire), sur l’épidémiologie de la MTB chez les enfants <6 ans en France entre 2000 et 2011. Au total, 10 cas de MTB à culture positive et 17 cas de MTB possibles (culture négative ou inconnue) ont été identifiés, avec un taux d’incidence annuel variant de 0,16 à 0,66 cas/10 million habitants. En Ile de France où tous les enfants sont considérés « à risque » et donc devraient tous être vaccinés, ou dans les autres régions, où seuls les enfants à risque sont vaccinés depuis 2007, il n’existait aucune différence significative des taux d'incidence annuels pour chaque cohorte d’un an. Ces résultats renforcent la décision d'arrêter de la vaccination universelle par le BCG en 2007. Toutefois une surveillance étroite de la TB SNC dans les années à venir sera nécessaire pour évaluer l'impact long-terme de la nouvelle stratégie vaccinale. Finalement, nous avons mis en place par le biais du réseau des laboratoires du CNR une cohorte rétrospective des cas de TB mono-RMP-R diagnostiqués en France entre 2005 et 2010. Au total, 39 cas de TB mono-RMP-R (soit 0.12% des cas de TB) ont été recensés. Parmi tous ces patients, 19 cas (49%) avaient un antécédent de traitement de leur tuberculose, et 9 (23%) étaient infectés par le VIH. Les données sur le traitement et le devenir étaient disponibles pour 30 des 39 patients et seulement 20 (67%) ont été considérés guéris. Les traitements reçus tant en terme de drogues que de durée étaient hétérogènes. Ces résultats suggèrent qu’il faut améliorer la prise en charge des malades atteints de TB mono-RMP-R en France
Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide, partly because of drug resistance anf the HIV epidemics. Tuberculous meningitis (TBM) is the most severe form of the tuberculosis disease, and is one of the indicators used for the BCG vaccination policy. Multidrug resistant tuberculosis (MDR-TB), which poses diagnostic and therapeutic problems, has been monitored since 1992 in France. On the opposite, rifampicin mono-resistance (RMR) tuberculosis (TB) which represents a first step toward MDR-TB is rarely studied and the impact of rifampicin mono-resistance on patient’s outcome is unknown in France. Our work was focused on the epidemiology of MTB and the impact of changes in the BCG vaccination strategy. We used two systems implemented for the surveillance of TB in France: a nationwide laboratory network coordinated by the National Reference Centre (NRC) for Mycobacteria and Resistance of Mycobacteria to Anti-tuberculosis Drugs and the mandatory notification system of TB (MNS) coordinated by the National Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS). The NRC network was also used to evaluate Rifampicin mono-resistant tuberculosis in France. First, we assessed the incidence rate of culture-positive (C+) central nervous system tuberculosis (CNS TB) in France in 2007 (the year of the changing policy on BCG vaccination) and its time trend between 1990 and 2007. In 2007, CNS TB represented less than 1% of all culture-positive TB cases and its incidence was around 0.50 per million inhabitants. The 2007 sensitivity of the NRC was 79.4%. To assess the evolution of C+ CNS TB between 1990 and 2007, we used an average sensitivity derived from the 2000 sensitivity of the NRC (75.6%) and the sensitivity for the year 2007. The average sensitivity was used to correct the number of C+ CNS TB reported in four surveys (1990, 1995, 2000, 2007). There was a major decrease of 62% in the extrapolated number of C+ CNS TB in seventeen years (from 90 to 35 cases), and in the extrapolated incidence rate (from 1.6 to 0.55 cases per million inhabitants) (P < 0.001). Then, we measured the impact of two major changes in BCG vaccination policy in 2006 (disappearance of the multipuncture device for BCG) and 2007 (end of compulsory BCG vaccination) on the epidemiology of TBM in children under 6 years in France between 2000 and 2011. Overall, 10 culture-positive and 17 possible (negative-culture or unknown microbiological result) cases of TBM were identified, with an annual incidence rate varying from 0.16 to 0.66 cases / 10 million inhabitants. In Ile-de-France, where all children are considered “at risk” and therefore should all be vaccinated, and in the other regions where only at-risk children are considered for vaccination since 2007, no statistically significant differences in the annual incidences rates for each one-year age-group cohort could be observed. These results reinforce the 2007 decision to stop universal BCG vaccination. However, a close monitoring of CNS TB in the coming years will be needed to assess the long-term impact of the new vaccination policy. Finally, we built, through the NRC national network of laboratories, a retrospective cohort of RMR TB cases diagnosed between 2005 and 2010. A total of 39 cases with RMR TB were identified (0.12% of all TB culture positive cases). Among all patients, 19 (49%) had a previous history of TB treatment, and 9 (23%) were HIV-coinfected. Data about treatment and outcome were available for 30 of 39 patients and only 20 (67%) were considered as cured. Treatments received both in terms of drugs and duration were heterogeneous. These results suggest the need to improve the management of patients with RMR TB in France
APA, Harvard, Vancouver, ISO, and other styles
2

Kruger, Clarissa. "Non-tuberculous mycobacteria in tuberculosis epidemic settings in South Africa." Thesis, Cape Peninsula University of Technology, 2007. http://hdl.handle.net/20.500.11838/1489.

Full text
Abstract:
Thesis (MTech (Biomedical Technology))--Cape Peninsula University of Technology, 2007. .
Non-tuberculous mycobacteria (NTM) are often isolated from Human Immunodeficiency Virus (HIV) infected individuals, but there is very little information documented about the prevalence of NTM in community settings. An increase in NTM infection is also noted in HIV-negative people. Although it is as yet unknown whether the organisms cause desease in HIV-negative individuals or whether they are merely commensal organisms, their affect on HIV-positive individuals is unquestionable.
APA, Harvard, Vancouver, ISO, and other styles
3

Van, Toorn Ronald. "Childhood tuberculous meningitis : challenging current management strategies." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96750.

Full text
Abstract:
Thesis (PhD)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: Tuberculous meningitis (TBM) continues to be an important cause of mortality and neurological disability in resource-limited countries. Many questions remain about the best approaches to prevent, diagnose, and treat TBM, and there are still too fewanswers. The aim of this dissertation was to challenge current management strategies in childhood TBM. Accurate prediction of outcome in TBM is of critical importance when assessing the efficacy of different interventions. I conducted a retrospective cohort study of 554 children with TBM less than 13 years of age admitted to Tygerberg Children’s Hospital over a 20 year period (1985-2005) and reclassified all patients according to the criteria of all the currently available staging systems in childhood TBM (chapter 4). In this study, I found that the “Refined Medical Research Council (MRC) staging system after 1 week” had the highest predictive value of all TBM staging systems. It is created by subdivision of stage 2 (2a and 2b) of the existing MRC staging system. Additionally, I proposed and validated a simplified TBM staging system which is less dependent on clinical ability and neurological expertise than current staging systems. The simplified staging system was termed the “Tygerberg Children’s Hospital Scale” (TCH) and relies solely on the patient’s ability to visually fixate and follow and the motor response to pain on both sides. It demonstrated excellent predictive power of outcome after 1 week and did not differ significantly from the “Refined MRC staging system” in this regard. The optimal anti-TB drug regimen and duration of treatment for TBM is unknown. It has been suggested that intensive short-course (6 months) anti-TB therapy may be sufficient and safe. I conducted a prospective descriptive study of 184 consecutively treated children with TBM and found that short-course intensified anti-TB therapy aimed at treating TBM patients (anti-TBM therapy) is sufficient and safe in both HIV-uninfected and HIVinfected children with drug susceptible TBM (chapter 5). The overall study mortality of 3.8% at completion of treatment compares favourably with the median mortality rate of 33% (range 5-65%) reported in a recent review describing outcome in TBM treatmentstudies. TB-immune reconstitution inflammatory syndrome (IRIS) is a potentially life-threatening complication in HIV-infected children with TB of the central nervous system. Little is known about the incidence, case fatality, underlying immunopathology and treatment approaches in HIV-infected children with neurological TB-IRIS. In a case series, I found that neurological TB-IRIS should be considered when new neurological signs develop after initiation of antiretroviral therapy (ART) in children with TBM (chapter 6.1). Manifestations of neurological TB-IRIS include headache, seizures, meningeal irritation, a decreased level of consciousness, ataxia and focal motor deficit. I also discussed the rational for using certain treatment modalities, includingthalidomide. Neurological tuberculous mass lesions (tuberculomas and pseudo-abscesses) may develop or enlarge in children on anti-TBM treatment. These lesions respond poorly to therapy, and may require surgical excision, but may be responsive to thalidomide, a potent inhibitor of tumour necrosis factor-alpha (TNF-alpha). The optimal dose and duration of thalidomide therapy and the correlation with magnetic resonance imaging (MRI) is yet to be explored. The primary objective of our next study was to investigate whether serial MRI is useful in evaluating treatment response and duration of thalidomide therapy (chapter 6.2). A secondary objective was to determine the value of thalidomide in the treatment of these lesions. In a prospective observational study over three years, serial MRI was performed in 16 consecutive children compromised by TB pseudo-abscesses who were treated with thalidomide. The rapid clinical response of most patients suggests that thalidomide provides substantial clinical benefit in this clinical context. I also identified a MRI marker of cure that is evolution of lesions from early stage “T2 bright” with edema to “T2 black.” This finding could be useful in the future management of these patients. Transcranial Doppler imaging (TCDI) is potentially a valuable investigational tool in children with TBM, a condition often complicated by pathology relevant to Doppler imaging such as raised intracranial pressure (ICP) and cerebral vasculopathies. Serial TCDI was performed on 20 TBM children with the aim of investigating cerebral haemodynamics and the relationship between pulsatility index (PI) and ICP (chapter 6.3). In this study, I found that TCDI-derived pulsatility index (PI) is not a reliable indicator of raised ICP in children with tuberculous hydrocephalus which I attributed this to individual variation of tuberculous vascular disease, possibly compromising cerebral vascular compliance and resistance. The study did confirm the efficacy of medical therapy in children with tuberculous communicating hydrocephalus. In all cases, the ICP normalized within 7 days after initiation of acetazolamide and furosemide. In the same cohort of children with TBM I also measured cerebral blood flow velocities (BFV) in the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) on admission and after day 3 and 7. I found persistent high BFV in all the basal cerebral arteries suggesting stenosis due to vasculitis rather than functional vasospasm. Additionally, I found that complete MCA occlusion, subnormal mean MCA velocities (less than 40 cm/s) and a reduced PI (less than 0.4) correlated with radiological proven large cerebral infarcts. No side-to-side differences in MCA BFV or subnormal PI’s were detected in four TBM children with territory infarcts on admission. I attributed this to the occlusion of a limited number (one or two) of the 9 MCA perforators which has been shown not to affect the hemodynamics of the MCA. I concluded by highlighting the many questions that remain about the best approaches to prevent, diagnose, and treat TBM (chapter 2). In a second literature review, aimed at clinicians working in resource-limited countries, I describe novel approaches to the management of childhood TBM, including a treatment algorithm for tuberculous hydrocephalus, the role for short-course intensified anti-TBM treatment and home-based anti-TBM treatment (chapter 3). Even with the best diagnostic and treatment modalities, outcome in childhood TBM will remain poor if diagnosis is delayed. Our efforts should be on increased awareness and earlier diagnosis.
AFRIKAANSE OPSOMMING: Tuberkuleuse meningitis (TBM) bly ‘n belangrike oorsaak van mortaliteit en neurologiese ongeskiktheid in lande met beperkte hulpbronne. Baie vrae oor die beste benaderings tot voorkoming, diagnose en behandeling van TBM bly bestaan en daar is steeds te min antwoorde. Die doel van die verhandeling was om huidige behandelingstrategieë van tuberkuleuse meningitis (TBM) in kinders uit te daag. Akkurate voorspelling oor die uitkoms van TBM is van kritieke belang wanneer doeltreffendheid van verskillende ingrypings beoordeel word. Ek het ‘n retrospektiewe kohort studie van 554 kinders jonger as 13 jaar met TBM wat in Tygerberg Kinderhospitaal toegelaat is oor `n tydperk van twintig jaar (1985 tot 2005) uitgevoer en al die pasiënte volgens die kriteria van al die huidig beskikbare stadiëringsisteme vir kinder TBM geherklassifiseer (hoofstuk 4). Die waarde van die verskillende stadiëringsisteme in die voorspelling van neurologiese uitkoms is toe bepaal. In hierdie studie het ek bevind dat die “Verfynde Mediese Navorsings Raad (MNR) stadiëringsisteem na 1 week” die TBM stadiëringsisteem met die hoogste voorspellende waarde was om neurolgiese uitkoms te voorspel. Dit is geskep deur onderverdeling van stadium 2 (2a en 2b) van die bestaande gemodifiseerde MNR stadiëringsisteem. Daarbenewens het ek ’n vereenvoudigde stadiëringsisteem vir TBM wat minder afhanklik van kliniese vermoëns en neurologiese kundigheid sal wees as die bestaande stadiëringsisteme daargestel en getoets. Die vereenvoudigde stadiëringsisteem is die “Tygerberg Kinderhospitaal Skaal (TKH)” genoem en dit is slegs gebaseer op `n pasiënt se vermoë om visueel te fikseer en te volg en die motoriese respons tot pyn aan beide kante van die ligaam. Dit het uitstekende voorspellingswaarde gehad vir uitkoms na die eerste week van siekte en het in hierdie verband nie betekenisvol verskil van die “Verfynde MNR stadiëringsisteem” nie. Die optimale anti-TB middel regimen en duurte van behandeling vir TBM is onbekend. Sommige kenners stel voor dat ‘n intensiewe kort-kursus (6 maande) van anti-TB behandeling veilig en voldoende mag wees. Ek het ‘n prospektiewe beskrywende studie op 184 opeenvolgende kinders met TBM uitgevoer en bevind dat intensiewe kort-kursus anti-TB behandeling gemik op die behandeling van kinders met TBM (anti-TBM behandeling) in beide menslike immuniteitgebrekvirus (MIV)-ongeïnfekteerde en MIV-geïnfekteerde kinders met middel-gevoelige TBM voldoende en veilig was (hoofstuk 5 ). Die mortaliteit in my studie met voltooing van behandeling vergelyk gunstig met die mediane mortaliteit van 33% (reikwydte 5-65%) wat onlangs in ‘n oorsig van uitkoms in TBM gerapporteer is. TB immuun rekonstitusie inflammatoriese sindrome (IRIS) is ‘n potensieël lewensbedreigende komplikasie in MIV-geïnfekteerde kinders met TB van die sentrale senuwee sisteem (SSS). Min is oor die voorkoms, mortaliteit, onderliggende immunopatologie en behandelingsbenaderings in MIV-geïnfekteerde kinders met neurologiese TB-IRIS bekend. In `n gevalle-reeks het ek gevind dat neurologiese TB-IRIS oorweeg moet word as nuwe neurologiese tekens na aanvang van antiretrovirale terapie (ART) in MIV-geïnfekteerde kinders met TBM ontwikkel (hoostuk 6.1). Simptome en tekens van neurologies TB-IRIS behels hoofpyn, konvulsies, meningiale prikkeling, ‘n verlaagde vlak van bewussyn, ataksie en fokale motoriese uitval. Ons bespreek ook die rasionaal vir die gebruik van sekere behandelingsmodaliteite, insluitende thalidomied. Neurologiese tuberkuleuse massaletsels (tuberkulome en pseudo-absesse) mag ontwikkel of vergroot in kinders op anti-TBM behandeling. Hierdie letsels reageer swak op terapie, vereis soms chirurgiese verwydering, maar kan op talidomied behandeling reageer, ‘n kragtige inhibeerder van tumor nekrose faktor-alfa (TNF-α). Die optimale dosis en duurte van thalidomide behandeling en die korrelasie met magnetiese resonansbeelding (MRB) moet nog ondersoek word. Die primêre doel van my volgende studie was om te bepaal of seriële MRB van waarde is om die respons op behandeling te evalueer asook die duurte van talidomied behandeling. Die sekondêre doelwit was om die waarde van talidomied in die behandeling van hierdie letsels te bepaal. In ‘n prospektiewe waarnemingstudie wat oor 3 jaar gestrek het is seriële MRB uitgevoer op 16 opeenvolgende kinders met TB pseudo-absesse wat behandel is met talidomied (hoofstuk 6.2). Die spoedige kliniese verbetering van die meeste pasiënte dui daarop dat thalidomied `n aansienlike kliniese voordeel bied in hierdie kliniese konteks. Verder het ek `n MRB merker van genesing geïdentifiseer naamlik evolusie van die letsel van vroeë stadium “T2 helder” met edeem na “T2 swart”. Hierdie bevinding is van groot waarde in die toekomstige behandeling van TBM pasiënte wat hierdie komplikasie ontwikkel. Transkraniale Doppler beelding (TKDB) is potensieël `n waardevolle ondersoekmetode in kinders met TBM, `n toestand wat dikwels gekompliseer word deur patologie verwant aan Doppler beelding soos verhoogde intrakraniale druk (IKP) en serebrale vaskulopatieë. Seriële TKBD is op 20 TBM kinders uitgevoer om serebrale hemodinamika en die verband tussen die pulsatiele indeks (PI) en IKP te ondersoek (hoofstuk 6.3). In hierdie studie het ek gevind dat TKDB-afgeleide PI nie `n betroubare aanduiding van verhoogde IKD in kinders met tuberkuleuse hidrokefalus is nie en dit aan individuele variasies van tuberkuleuse vaskulêre siekte toegeskryf, wat serebrale vaskulêre toegeeflikheid en weerstand benadeel. Die studie het die doeltreffendheid van mediese behandeling in kinders met kommunikerende tuberkuleuse hidrokefalus bevestig. In alle gevalle het die IKP binne 7 dae na aanvang van asetosoolamied en furosemied genormaliseer. In dieselfde groep TBM kinders het ek die serebrale bloedvloei-snelhede (BVS) in die anterior serebrale arterie (ASA), middel serebrale arterie (MSA) en posterior serebrale arterie (PSA) met toelating en na dag 3 en 7 gemeet. Ek het volgehoue hoё BVS in al die basale arteries gevind wat op stenose sekondêr tot vaskulitis eerder as funksionele vasospasma dui. Daarbenewens het ek gevind dat volledige MSA afsluiting, subnormale gemiddelde MSA snelhede (minder as 40 sentimeter per sekonde) en `n verminderde PI (minder as 0.4) met radiologies-bewysde groot serebrale infarksies gekorreleer het. Geen kant-tot-kant verskille in MSA BVS of subnormale PI’s is in vier TBM kinders met kleiner infarksies met toelating bespeur nie. Ek skryf dit toe aan die afsluiting van `n beperkte aantal (een of twee) van die nege MSA perforators wat nie nie die hemodinamika van die MSA beïnvloed nie. Ek het afgesluit om al die vrae wat nog bestaan oor die beste benadering ten opsigte van voorkoming, diagnose and behandeling van TBM uit te wys (hoofstuk 2). In die tweede literatuuroorsig, wat gemik is op dokters wat werk in hulpbron-beperkte lande, beskryf ek nuwe benaderings tot die hantering van pediatriese TBM, insluitend `n behandelingsalgoritme vir tuberkuleuse hidrokefalus, die rol van kort- kursus versterkte anti-TB behandeling vir TBM en tuis-gebaseerede anti-TBM behandeling (hoofstuk 3). Selfs met die beste diagnostiese en behandelingsmodaliteite, is die uitkoms van kinder TBM swak indien diagnose vertraag word. Ons pogings moet daarom op groter bewustheid en vroeёr diagnose berus.
APA, Harvard, Vancouver, ISO, and other styles
4

Pedro, Heloisa da Silveira Paro. "Pesquisa do Mycobacterium sp. em uma população soropositiva para o HIV-1 do Noroeste Paulista /." São José do Rio Preto : [s.n.], 2008. http://hdl.handle.net/11449/94865.

Full text
Abstract:
Orientador: Andréa Baptista Rossit
Banca: Daisy Nakamura Sato
Banca: Silvia Helena Vendramine
Resumo: São José do Rio Preto (SJRP), localizada na região Noroeste do Estado de São Paulo, Sudeste do Brasil, é considerada Município prioritário pelo Programa Nacional de Controle da Tuberculose e da AIDS. O objetivo deste trabalho foi avaliar retrospectivamente pacientes infectados pelo HIV com pelo menos um isolamento de Mycobacterium sp., atendidos em unidades de saúde de referência de SJRP e região, bem como descrever seus aspectos clínicos e sócio-demográficos. Foram avaliados no período de janeiro de 2000 a dezembro de 2006, 198 indivíduos soropositivos para o HIV com culturas positivas no Instituto Adolfo Lutz de SJRP. Houve uma correlação positiva entre a tuberculose e o registro de detenção (p=0.021). O uso do tabaco reduziu o tempo de vida entre o diagnóstico e o óbito (p=0.05). Houve associação entre o isolamento de M. tuberculosis (MT) e os níveis de linfócitos TCD4+ bem como o achado difuso para RX de tórax (p=0.014 e 0.000, respectivamente). Aproximadamente 11% de todas as cepas de MT mostraram resistência a pelo menos uma droga, enquanto 3.1% foram multiresistentes. Micobactérias não tuberculosas (MNT) totalizaram 35.19% de todos os isolamentos e a maioria das espécies pertence ao complexo Mycobacterium avium (MAC; 22.3%), seguido por M. fortuitum (5.2%) e M.gordonae (3.1%). Conclui-se que a população HIV estudada tem alta prevalência de colonização por MNT. Em um país com extensão continental como o Brasil, o conhecimento das diferenças regionais na distribuição de MNT em populações infectadas pelo HIV pode contribuir para o controle e tratamento dessas infecções oportunistas.
Abstract: São José do Rio Preto city (SJRP), Northwestern São Paulo State, Southeast Brazil, is considered "priority" by the National Programs of Tuberculosis and AIDS Control. Our purpose was to retrospectively evaluate Mycobacterium sp. isolated from HIV-infected patients attending the HIV/TB reference health care units from SJRP and region, as well as to describe their clinical and socio-demographic aspects. One hundred and ninetyeigth HIV-seropositive individuals provided 287 positives cultures from January 2000 to December 2006. There was a positive correlation between tuberculosis and prison record (p=0.021) and tobacco use reduced the mean lifetime from tuberculosis diagnosis to obit (p = 0.05). TCD4+ levels and a diffuse chest X-ray finding were associated to Mycobacterium tuberculosis (MT) isolation (p = 0.014 and 0.000, respectively). Approximately eleven percent of all MT strains showed resistance to at least one drug while 3.1% were multidrug resistant. Non-tuberculous mycobacteria (NTM) totalized 35.19% of all species and the most frequently isolated ones were Mycobacterium avium complex (MAC; 22.3%), M. fortuitum (5.2%) and M. gordonae (3.1%). We conclude that the HIV-infected population studied has a high prevalence of NTM colonization. In a wide country like Brazil, regional differences on NTM distribution in HIV-infected individuals must be further evaluated in order to improve control and treatment of these opportunistic infections.
Mestre
APA, Harvard, Vancouver, ISO, and other styles
5

Nardy, Stella Maria Costa. "Contribuição para o estudo epidemiológico da meningite tuberculosa na Grande São Paulo." Universidade de São Paulo, 1986. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-19122017-123137/.

Full text
Abstract:
O presente trabalho estuda algumas características epidemiológicas de 241 casos de Meningite tuberculosa de pessoas residentes na Grande São Paulo, nos anos de 1982 e 1983. O levantamento de casos foi realizado no Centro de Investigações de Saúde e outras fontes oficiais de informação e complementado pela visitação domiciliária que representou um recurso inestimável para o esclarecimento dos dados. Os casos foram analisados por região de residência, aspectos individuais, núcleos familiares, história da doença, hospitalização, seqüência de tratamento e conhecimento sobre a doença. Os resultados identificam condições insatisfatórias de vida na maioria da população, demora no diagnóstico por falhas assistenciais, alta letalidade hospitalar e desconhecimento do modo de transmissão e prevenção da tuberculose pela maioria das pessoas entrevistadas. O grupo de menores de 5 anos de idade foi o mais comprometido pela ocorrência de seqüelas e, a maior letalidade oi na faixa de 7-12 meses. Ao final do estudo, houve 45,7 por cento de cura, 27,8 por cento de óbito, 13,3 por cento de abandono. Em 13,2 por cento dos casos, alguns permaneciam em observação e outros desconhecidos pelo sistema de controle de notificações.
The present paper studies some epidemiological characteristics of 241 cases of tuberculous miningitis in persons living in the Great São Paulo, State of São Paulo, Brazil, in 1982 and 1983. The survey of cases was worked out at the Center of Health Investigation; other official sources have been consulted, too, being work complemented by domiciliary visitings which represented an invaluable resource for data enlightenment. The cases were analysed taking into account region of dwelling, individual aspects, familiar nucleus, disease history, hospitalization, treatment follow-up and knowledge about the disease. Results identify unsatisfactory life conditions for the majority of the population under study; delay in diagnosing the disease due to failures in assistance; high rate of hospital lethality and lack of knowledge on how tuberculosis is transmitted and prevented by the majority of the persons interviewed with. The age group of children below five years was the one most implicated in as to the occurence of the highest rate of lethality was presented by children aged 7-12 months. At the end of the study, there were 45.7 per cent of healings; 27.8 per cent of deaths; 13.3 per cent of treatment abandonment. In 13.2 per cent of the cases, some persons continued under observation and others remained unknown by the Health System of notifications.
APA, Harvard, Vancouver, ISO, and other styles
6

Bezuidenhout, Juanita. "Cytokines and tuberculosis : an investigation of tuberculous lung tissue and a comparison with sarcoidosis." Thesis, University of Stellenbosch. Faculty of Health Sciences. Dept. of Biomedical Sciences, 2005. http://hdl.handle.net/10019.1/1453.

Full text
Abstract:
Thesis (PhD (Pathology. Anatgomical Pathology))--University of Stellenbosch, 2005.
The formation of granulomas at the site of antigen presentation in both tuberculosis and sarcoidosis is an essential component of host immunity for controlling inflammation. Granuloma formation is a complex process that also requires recruitment and activation of lymphocytes and macrophages to the site of infection and arrangement into a granuloma. It is dependant on the activation of especially IFNγ secreting CD4+ T cells, resulting in a Th1 profile. However, it is suggested that a persistently high IFNγ is responsible for the damage caused by granulomatous disease and that moderating cytokines, resulting in a Th0 profile, are necessary to down-regulate the IFNγ response to more appropriate levels later in the disease process, after the antigen has been effectively contained. I propose that: “Cytokine profiles determine clinical and histopathological phenotypes of disease. This thesis tests the hypothesis that it will be reflected by cytokine expression profiles in granulomas in different forms of tuberculosis and in sarcoidosis.” To examine this, biopsy tissue was obtained from patients with pulmonary cavitary tuberculosis, pleural tuberculosis in HIV sero-negative and sero-positive patients, and sarcoidosis. The diagnosis of tuberculosis or sarcoidosis was confirmed, granulomas were characterised as necrotic or non-necrotic, sarcoidosis cases were graded histologically and in situ hybridisation was performed for IL-12-, IFNγ-, TNFα- and IL-4-mRNA. In all patients with pleural tuberculosis, a Th0 profile was noted, while necrotic granulomas were more evident in HIV positive than HIV negative patients. There was a clear association between TNFα and necrosis in tuberculous granulomas that may be ascribed to the increased apoptotic activity of TNFα. An increase in IFNγ correlated with an increase in necrosis, supporting the theory that high IFNγ levels later in disease is detrimental. This effect may be enhanced by a strong presence of TNFα positive cells. An increase in both Th1 and Th2 cytokine mRNA in HIV positive patients supports the theory that an overproduction of cytokines may be a mechanism to compensate for the failure of another immune effector mechanism. Findings in pulmonary tuberculosis were similar to those in pleural tuberculosis. In all sarcoidosis cases the presence of a very strong Th1 and TNFα, but no Th0 response was confirmed. None of the differences in either the histological grading, or the clinical outcome of patients were reflected in the cytokine profile. It is possible that this profile does not reflect the histological grade of disease or that it may reflect various stages of disease. These findings support the theory that a strong Th1 presence later in disease, in conjunction with TNFα may induce fibrosis, as most of these cases showed signs of at least focal fibrosis. Numerous aspects, including a T helper response are involved in granulomatous inflammation. The earlier dogma of good, beneficial (Th1) versus evil, detrimental (Th2), is an oversimplification of a very complex process. It is clear that the effect of a cytokine depends at least partially on the stage of disease. The balance between the various cytokines, and the levels of these cytokines contribute to their role in resolution or disease progression. An early, pure Th1 response may be beneficial if effectively clearing the granuloma-inducing antigen. At this stage, a Th2 presence will be harmful as clearing of the antigen will not be as effective. In chronic disease where failure to remove the antigen results in progression of granulomas with subsequent necrosis and/or fibrosis, a proinflammatory Th1 response may be detrimental and minimising of this effect is needed. An overly strong presence of the various cytokines may also be detrimental, while lower levels will be beneficial.
APA, Harvard, Vancouver, ISO, and other styles
7

Marais, Suzaan. "Investigations into HIV-associated tuberculous meningitis." Doctoral thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/9304.

Full text
Abstract:
Includes bibliographical references.
[Background] Tuberculous meningitis (TBM) is a common form of tuberculosis in high TB incidence settings. However, the burden of disease and outcome in affected adults is unknown in Cape Town. The diagnosis of TBM is often challenging, particularly in HIV co-infected patients and no standardized clinical case definition exists. An emerging complication that contributes to poor outcome in HIV-associated TBM is neurological TB immune reconstitution inflammatory syndrome (TB-IRIS). [Methods] A consensus clinical TBM case definition was developed following a TBM meeting that I co-ordinated. I led two observational studies that determined the burden of HIV-associated TBM and neurological TB-IRIS at a district-level hospital in Cape Town. Patients with HIV-associated TBM were prospectively enrolled in a third cohort study to determine the clinical and immunological characteristics of paradoxical TBM-IRIS. [Results] TBM accounted for 57% of meningitis cases over a 6-months period; 88% of these patients were HIV-infected. At six months follow-up, mortality in HIV-associated TBM patients was 48%. Neurological TB-IRIS accounted for 21% of patients who presented with central nervous system (CNS) deterioration during the first year of antiretroviral therapy (ART) over a one-year period. TBM-IRIS developed in 47% of HIV-associated TBM patients and associated with extensive cerebrospinal fluid (CSF) inflammation both at TBM diagnosis and at TBM-IRIS presentation. Patients who did not develop TBM-IRIS, but who were culture-positive for Mycobacterium tuberculosis from CSF at TBM diagnosis, showed an immunological phenotype similar to TBM-IRIS patients; however neutrophils were increased in TBM-IRIS patients compared to culture-positive TBM-non-IRIS patients, both at TBM diagnosis and two weeks after ART initiation. [Conclusions] HIV-associated TBM is a common cause of meningitis with a poor outcome in Cape Town. TBM-IRIS is a frequent complication of ART in HIV-associated TBM patients. CSF Mycobacterium tuberculosis culture positivity drives an inflammatory response that manifests as TBM-IRIS in most, but not all TBM patients. Neutrophils associate closely with the CNS inflammation that characterizes TBM-IRIS. An intensified TB treatment regimen with increased CSF penetration early during TB treatment may lead to improved mycobacterial clearance from the CNS, which may result in improved outcome during TBM treatment and a reduced frequency of TBM-IRIS. We aim to test this hypothesis in future studies.
APA, Harvard, Vancouver, ISO, and other styles
8

Caws, Maxine Anna Maria. "The diagnosis and immunogenetics of tuberculous meningitis." Thesis, King's College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271415.

Full text
APA, Harvard, Vancouver, ISO, and other styles
9

Pedro, Heloisa da Silveira Paro [UNESP]. "Pesquisa do Mycobacterium sp. em uma população soropositiva para o HIV-1 do Noroeste Paulista." Universidade Estadual Paulista (UNESP), 2008. http://hdl.handle.net/11449/94865.

Full text
Abstract:
Made available in DSpace on 2014-06-11T19:27:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-03-14Bitstream added on 2014-06-13T20:16:36Z : No. of bitstreams: 1 pedro_hsp_me_sjrp.pdf: 1004378 bytes, checksum: d89276d95fd4738ef5918762497df5ea (MD5)
São José do Rio Preto (SJRP), localizada na região Noroeste do Estado de São Paulo, Sudeste do Brasil, é considerada Município prioritário pelo Programa Nacional de Controle da Tuberculose e da AIDS. O objetivo deste trabalho foi avaliar retrospectivamente pacientes infectados pelo HIV com pelo menos um isolamento de Mycobacterium sp., atendidos em unidades de saúde de referência de SJRP e região, bem como descrever seus aspectos clínicos e sócio–demográficos. Foram avaliados no período de janeiro de 2000 a dezembro de 2006, 198 indivíduos soropositivos para o HIV com culturas positivas no Instituto Adolfo Lutz de SJRP. Houve uma correlação positiva entre a tuberculose e o registro de detenção (p=0.021). O uso do tabaco reduziu o tempo de vida entre o diagnóstico e o óbito (p=0.05). Houve associação entre o isolamento de M. tuberculosis (MT) e os níveis de linfócitos TCD4+ bem como o achado difuso para RX de tórax (p=0.014 e 0.000, respectivamente). Aproximadamente 11% de todas as cepas de MT mostraram resistência a pelo menos uma droga, enquanto 3.1% foram multiresistentes. Micobactérias não tuberculosas (MNT) totalizaram 35.19% de todos os isolamentos e a maioria das espécies pertence ao complexo Mycobacterium avium (MAC; 22.3%), seguido por M. fortuitum (5.2%) e M.gordonae (3.1%). Conclui-se que a população HIV estudada tem alta prevalência de colonização por MNT. Em um país com extensão continental como o Brasil, o conhecimento das diferenças regionais na distribuição de MNT em populações infectadas pelo HIV pode contribuir para o controle e tratamento dessas infecções oportunistas.
São José do Rio Preto city (SJRP), Northwestern São Paulo State, Southeast Brazil, is considered “priority” by the National Programs of Tuberculosis and AIDS Control. Our purpose was to retrospectively evaluate Mycobacterium sp. isolated from HIV-infected patients attending the HIV/TB reference health care units from SJRP and region, as well as to describe their clinical and socio-demographic aspects. One hundred and ninetyeigth HIV-seropositive individuals provided 287 positives cultures from January 2000 to December 2006. There was a positive correlation between tuberculosis and prison record (p=0.021) and tobacco use reduced the mean lifetime from tuberculosis diagnosis to obit (p = 0.05). TCD4+ levels and a diffuse chest X-ray finding were associated to Mycobacterium tuberculosis (MT) isolation (p = 0.014 and 0.000, respectively). Approximately eleven percent of all MT strains showed resistance to at least one drug while 3.1% were multidrug resistant. Non-tuberculous mycobacteria (NTM) totalized 35.19% of all species and the most frequently isolated ones were Mycobacterium avium complex (MAC; 22.3%), M. fortuitum (5.2%) and M. gordonae (3.1%). We conclude that the HIV-infected population studied has a high prevalence of NTM colonization. In a wide country like Brazil, regional differences on NTM distribution in HIV-infected individuals must be further evaluated in order to improve control and treatment of these opportunistic infections.
APA, Harvard, Vancouver, ISO, and other styles
10

Bertrand, Maria Theresa Fonseca. "Anti-tuberculosis chemotherapy in the management of tuberculous pleural effusions : the effect of prednisolone on rifampicin pharmacokinetics." Thesis, University of Liverpool, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403214.

Full text
APA, Harvard, Vancouver, ISO, and other styles
More sources

Books on the topic "Tuberculous"

1

Tuberculous meningitis: Tuberculomas and spinal tuberculosis : a handbook for clinicians. 2nd ed. Oxford [England]: Oxford University Press, 1988.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
2

Fairbairn, Ian Paul. Investigations of a novel mechanism of anti-tuberculous immunity mediated by purinergic (P2X[inferior seven]) receptors. Birmingham: University of Birmingham, 2001.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
3

Hugolin. De la mort à la vie. Montréal: La Tempérance, 1995.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
4

Gauvreau, Joseph. Entretien au peuple: Un mal à combattre : la tuberculose. [Montréal]: Institut Bruchesi, 1995.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
5

Knopf, S. Adolphus. Tuberculosis, a preventable and curable disease: Modern methods for the solution of the tuberculosis problem. Toronto: McClelland & Goodchild, 1995.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
6

Bryce, P. H. Report on tuberculosis in Ontario. Toronto: [s.n.], 1986.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
7

Bryce, P. H. The duty of the public in dealing with tuberculosis. [S.l: s.n., 1986.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
8

Filho, Cláudio Bertolli. História social da tuberculose e do tuberculoso: 1900-1950. Rio de Janeiro, RJ: Editora Fiocruz, 2001.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
9

Knopf, S. Adolphus. La tuberculose, maladie du peuple: Comment la combattre. [Montréal?: s.n.], 1994.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
10

1959-, Harkin Timothy J., ed. Tuberculosis pearls. Philadelphia: Hanley & Belfus, 1996.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
More sources

Book chapters on the topic "Tuberculous"

1

Malhotra, Kiran Preet, and Dinkar Kulshreshtha. "Pathology of Tuberculosis of the Nervous System (Tuberculous Meningitis, Tuberculoma, Tuberculous Abscess)." In Tuberculosis of the Central Nervous System, 33–53. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-50712-5_4.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

McGuinness, Francis E. "Tuberculous Radiculomyelopathy and Myelitic Tuberculomas." In Clinical Imaging in Non-Pulmonary Tuberculosis, 27–42. Berlin, Heidelberg: Springer Berlin Heidelberg, 2000. http://dx.doi.org/10.1007/978-3-642-59635-3_3.

Full text
APA, Harvard, Vancouver, ISO, and other styles
3

Stehura, Michelle J., and Claire W. Michael. "Tuberculous Effusions." In Encyclopedia of Pathology, 504–6. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-33286-4_994.

Full text
APA, Harvard, Vancouver, ISO, and other styles
4

Martini, M., and A. Boudjemaa. "Tuberculous Osteomyelitis." In Tuberculosis of the Bones and Joints, 52–79. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-61358-6_9.

Full text
APA, Harvard, Vancouver, ISO, and other styles
5

Hand, Jonathan M., and George A. Pankey. "Tuberculous Otomastoiditis." In Tuberculosis and Nontuberculous Mycobacterial Infections, 309–12. Washington, DC, USA: ASM Press, 2017. http://dx.doi.org/10.1128/9781555819866.ch18.

Full text
APA, Harvard, Vancouver, ISO, and other styles
6

Vaid, Urvashi, and Gregory C. Kane. "Tuberculous Peritonitis." In Tuberculosis and Nontuberculous Mycobacterial Infections, 433–38. Washington, DC, USA: ASM Press, 2017. http://dx.doi.org/10.1128/9781555819866.ch26.

Full text
APA, Harvard, Vancouver, ISO, and other styles
7

Thijn, Cornelis J. P., and Jieldouw T. Steensma. "Tuberculous Osteomyelitis." In Tuberculosis of the Skeleton, 133–58. Berlin, Heidelberg: Springer Berlin Heidelberg, 1990. http://dx.doi.org/10.1007/978-3-642-74665-9_10.

Full text
APA, Harvard, Vancouver, ISO, and other styles
8

Thijn, Cornelis J. P., and Jieldouw T. Steensma. "Tuberculous Spondylitis." In Tuberculosis of the Skeleton, 13–56. Berlin, Heidelberg: Springer Berlin Heidelberg, 1990. http://dx.doi.org/10.1007/978-3-642-74665-9_5.

Full text
APA, Harvard, Vancouver, ISO, and other styles
9

Thijn, Cornelis J. P., and Jieldouw T. Steensma. "Tuberculous Arthritis." In Tuberculosis of the Skeleton, 57–64. Berlin, Heidelberg: Springer Berlin Heidelberg, 1990. http://dx.doi.org/10.1007/978-3-642-74665-9_6.

Full text
APA, Harvard, Vancouver, ISO, and other styles
10

Powell, Dwight A. "Tuberculous Lymphadenitis." In Tuberculosis, 99–107. New York, NY: Springer New York, 1988. http://dx.doi.org/10.1007/978-1-4684-0305-3_12.

Full text
APA, Harvard, Vancouver, ISO, and other styles

Conference papers on the topic "Tuberculous"

1

Gayoso, O. D., S. K. Salazar Gavino, O. A. Gayoso Liviac, K. B. Tafur, C. Casani, G. Zumaeta, E. S. Valdivia, et al. "Tuberculous Otomastoiditis Associated with Miliary Tuberculosis and Panhypopituitarism." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a4026.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

Lee, HS, GK Lee, HY Kim, S. Lee, K. Lim, and B. Hwangbo. "Response of Pulmonary Tuberculomas to Anti-Tuberculous Treatment According to the Culture Result of Tuberculoma Specimens." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a1683.

Full text
APA, Harvard, Vancouver, ISO, and other styles
3

Chinn, D. "A Rare Case of Tuberculous Osteomyelitis with Concomitant Pulmonary Tuberculosis." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a4029.

Full text
APA, Harvard, Vancouver, ISO, and other styles
4

LAVOR, DANIELE, and KELLE CAMBOIM. "TUBERCULOUS SACROILIITIS SECONDARY TO HEMATOGENOUS DISSEMINATION OF PULMONARY TUBERCULOSIS: CASE REPORT." In 36º Congresso Brasileiro de Reumatologia. São Paulo: Editora Blucher, 2019. http://dx.doi.org/10.5151/sbr2019-300.

Full text
APA, Harvard, Vancouver, ISO, and other styles
5

Masuda, Kimihiko, Masahiro Kawashima, Masahiro Shimada, Nobuharu Ohshima, and Shinobu Akagawa. "Diagnosis Of Tuberculous Pleurisy." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a4705.

Full text
APA, Harvard, Vancouver, ISO, and other styles
6

Moulaei, Nezar Ali, Abas Ali Niazi, Mehdi Nouralahzadeh, and Mosayeb Shahriyar. "Efficacy of Matrix Metalloproteinase-9 in Differentiating Tuberculous from Non-Tuberculous Pleural Effusion." In ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa3006.

Full text
APA, Harvard, Vancouver, ISO, and other styles
7

Chung, Wou Young, Yun Jung Jung, Ji Eun Park, Seug Soo Sheen, Keu Sung Lee, and Kwang Joo Park. "Tuberculosis Antigen Stimulated CXCR3 Ligand Assay for the Diagnosis of Tuberculous Lymphadenitis." In ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa3014.

Full text
APA, Harvard, Vancouver, ISO, and other styles
8

Ferreira Jr, Carlos U. G., Antônio C. Bulian Júnior, Crispim Cerutti Jr, Rogério I. Oliveira, Roger R. C. Médice, Frederico V. Toé, Thúlio M. Vago, Heidi S. N. Feitoza, Italo C. Jorge, and Thais B. Soto. "Tuberculous Sternal Osteomyelitis And Alcoholism." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a5455.

Full text
APA, Harvard, Vancouver, ISO, and other styles
9

Bilasco, Ancuta, Ramona Cirt, Szidonia Florea, Anca Draganescu, Magda Vasile, Camelia Kouris, Cristina Negulescu, and Monica Luminos. "GP70 Pulmonary miliary tuberculosis in a toddler after initial presentation with tuberculous meningitis." In Faculty of Paediatrics of the Royal College of Physicians of Ireland, 9th Europaediatrics Congress, 13–15 June, Dublin, Ireland 2019. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2019. http://dx.doi.org/10.1136/archdischild-2019-epa.136.

Full text
APA, Harvard, Vancouver, ISO, and other styles
10

Nishio, C., H. Konishi, T. Ochi, K. Oh, and H. Tomioka. "Clinical Significance of Isolation of Mycobacterium Tuberculosis Among Patients with Non-Tuberculous Mycobacteria." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a5179.

Full text
APA, Harvard, Vancouver, ISO, and other styles

Reports on the topic "Tuberculous"

1

Shen, Yanqin, Guocan Yu, Wuchen Zhao, and Yazhen Lang. Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous meningitis: A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2020. http://dx.doi.org/10.37766/inplasy2020.8.0045.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

Yu, Guocan, Yanqin Shen, Pengfei Zhu, and Da Chen. Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous pleurisy: A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2020. http://dx.doi.org/10.37766/inplasy2020.8.0047.

Full text
APA, Harvard, Vancouver, ISO, and other styles
3

Yu, Guocan, Fangming Zhong, Yanqin Shen, and Hong Zheng. Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2020. http://dx.doi.org/10.37766/inplasy2020.6.0045.

Full text
APA, Harvard, Vancouver, ISO, and other styles
4

Yu, Guocan, Yanqin Shen, Xudong Xu, and Lihua Lin. Nucleic acid amplification techniques for rapid diagnosis of non-tuberculous mycobacteria: A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2020. http://dx.doi.org/10.37766/inplasy2020.11.0076.

Full text
APA, Harvard, Vancouver, ISO, and other styles
5

Wynand J. Goosen, Wynand J. Goosen. Combating tuberculosis in African rhinoceros. Experiment, July 2018. http://dx.doi.org/10.18258/11547.

Full text
APA, Harvard, Vancouver, ISO, and other styles
6

Jayasimha, Sudhindra, and Anthony Devasia. Contemporary diagnosis of genitourinary tuberculosis. BJUI Knowledge, January 2021. http://dx.doi.org/10.18591/bjuik.0555.

Full text
APA, Harvard, Vancouver, ISO, and other styles
7

Miller, Joy M., and Martin A. Puckett. Annual US Air Force Tuberculosis Report, 1995. Fort Belvoir, VA: Defense Technical Information Center, May 1996. http://dx.doi.org/10.21236/ada309885.

Full text
APA, Harvard, Vancouver, ISO, and other styles
8

CHITATE, F., G. FOSGATE, and A. BOSHOFF. Namibia’s demonstration of freedom from bovine tuberculosis. O.I.E (World Organisation for Animal Health), October 2019. http://dx.doi.org/10.20506/bull.2019.nf.3014.

Full text
APA, Harvard, Vancouver, ISO, and other styles
9

Yu, Guocan, Yanqin Shen, Bo Ye, and Yan Shi. Diagnostic accuracy of Mycobacterium tuberculosis cell free DNA for tuberculosis: A protocol of systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2020. http://dx.doi.org/10.37766/inplasy2020.11.0101.

Full text
APA, Harvard, Vancouver, ISO, and other styles
10

Bryan Pasqualucci, Bryan Pasqualucci. Rapid Detection of Tuberculosis -SCSU-New Haven iGEM. Experiment, July 2016. http://dx.doi.org/10.18258/7393.

Full text
APA, Harvard, Vancouver, ISO, and other styles
We offer discounts on all premium plans for authors whose works are included in thematic literature selections. Contact us to get a unique promo code!

To the bibliography