EC PULMONOLOGY AND RESPIRATORY MEDICINE Literature Review Patient with Pulmonary Tuberculosis: A Literature Review (original) (raw)
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Tuberculosis: In and out of the airways
Journal of Hospital Medicine, 2008
A 23-year-old Chinese woman presented with worsening exertional dyspnea. Her medical history was notable for pulmonary tuberculosis treated at the age of 16. Over the past 3 years, she reported progressive respiratory symptoms resulting in marked exercise intolerance. She denied any fevers, cough, or weight loss. On examination, she had right-sided tracheal deviation but spoke comfortably. Her heart sounds were displaced and right-sided breath sounds nearly absent. Chest xray (Fig. 1) and subsequent CT revealed complete collapse of the right lung with associated hyperexpansion of the left lung and left-to-right mediastinal shift (Fig. 2, with an asterisk denoting the aortic arch; an arrow, the right main-stem bronchus, which would soon terminate; and arrowheads, the collapsed right lung). No lung masses or effusions were noted; active TB had been ruled out with AFB sputums. Bronchoscopy revealed a fibrotic and stenotic right main-stem bronchus (Fig. 3, with an asterisk denoting a patent left main-stem bronchus and an arrow denoting a stenotic right main-stem bronchus). Pulmonary manifestations of TB include
TB or not TB: update from the ERS Respiratory Infection Assembly 10
2010
Lower respiratory tract infections and tuberculosis represent some of the top health priorities in Europe. In the present report, the most recent advances in the field of disease control, clinical research and basic science of lower respiratory tract infections and tuberculosis are presented through analysis of some of the best abstracts presented at the 19th European Respiratory Society Congress in Vienna (Austria). Pathogenesis, diagnosis, treatment, prognostic factors and novel diagnostic techniques relevant for bacterial and viral infections, as well as new tools for the diagnosis of latent and active tuberculosis in different subgroups of patients, are discussed. The growing epidemiological threat represented by multidrug-resistant and extensively drug-resistant tuberculosis cases is presented and its impact analysed.
The management of pulmonary and lymph node tuberculosis notified in England and Wales in 1998
Clinical Medicine, 2003
The management of pulmonary and lymph node tuberculosis notified in England and Wales in 1998 LP Ormerod and RJ Prescott ABSTRACT -The management of 1,337 cases of pulmonary tuberculosis and 422 cases of lymph node tuberculosis reported to the 1998 national notification survey was compared with the recommended standards of treatment. Most patients (84%) were under the care of thoracic physicians. Culture confirmation was obtained in 67.5% of pulmonary cases and 52% of lymph node cases. Drug resistance was reported in 7%, ranging from 3.3% in white patients to 7.9-8.2% in other ethnic groups. Only a minority of non-white ethnic patients received the recommended fourdrug initial phase of therapy. Non-standard durations of initial and/or continuation therapy were used in 35% of cases on recommended drug combinations. Thirty-nine (2.9%) pulmonary cases were diagnosed only at post-mortem and a further 96 died before the end of the survey period, 55 (4.3%) due to tuberculosis. The outcome for pulmonary disease, with 80% cured or completing treatment, compare favourably with European outcome data. Although overall outcome data were satisfactory, more patients should have received a four-drug initial phase, with more combination tablet use and better compliance monitoring. Outcome monitoring will henceforth be based mainly on the continuous enhanced surveillance system introduced since 1999.
Clinical presentation of tuberculosis: a nine-year single-center experience
The European Research Journal
Objective. The aim of this study was to determine the clinical presentation of tuberculosis cases from our center for the last nine years. Methods. This study was set as descriptive and retrospective. The data was obtained from the hospital records. Subjects who had been diagnosed as tuberculosis and received treatment in our center between the years 2007 and 2015 were included. The cases were classified as newly diagnosed, relapse, transferred, and returning after default. Results. There were 276 (171 males and 105 females) patients with a mean age of 41.5 ± 19.2 years. Pulmonary involvement is the most common presentation and seen in 155 (56.2%) patients. Lymph node and pleura are the most common extrapulmonary involvements those are seen in 53 (19.2%) and 23 (8.3%) patients, respectively. Number of the cases seems to decreased after 2012. Most (85.1%) of the patients were newly diagnosed. Among the subjects, 55.2% of them had bacteriologic diagnosis, 35.1% had histopathologic diagnosis. Two subjects died during the treatment period whereas 274 of them completed the treatment program. Conclusions. Our results show that tuberculosis is seen mainly in the adult age group. While pulmonary involvement is the most common presentation, lymph node and pleura involvements are the most common extrapulmonary presentations. Number of the tuberculosis seems to decrease for the recent years. Strict preventive measures and treatment strategies should be administered.
Clinical spectrum of pulmonary and pleural tuberculosis: a report of 5,480 cases
European Respiratory Journal, 1996
The aim of the present study was to investigate the epidemiological, clinical, laboratory and radiological features of patients with active pulmonary tuberculosis (TB) (with or without pleural involvement) or with pleural TB (in the absence of radiological parenchymal disease). A systematic predetermined form, including 60 items regarding the above-mentioned features, was completed for 5,480 patients. Sputum smear and culture data, radiological findings, and additional extrapulmonary involvement were evaluated in the patients with pulmonary TB (n=5,094). Epidemiological features, and other clinical and laboratory characteristics were investigated in all patients (n=5,480). TB was more common among persons aged 20-39 yrs, males, and those living in large urban centres in our region. There were 4,268 newly detected patients (78%), and 1,212 active ex-patients (22%) who had history of previous antituberculosis treatment. Additional extrapulmonary involvement was found in 455 patients (9%). Sputum samples were smear-positive in 3,916 (79%), and culture-positive in 3,748 cases (76%). Most common radiological patterns were parenchymal infiltrate in 5,017 (99%), and cavitation in 3,363 (66%). Unusual radiological patterns were also noted, i.e. lower lung field TB (LLFTB) in 317 cases (6.2%), pneumothorax in 78 cases (1.5%), and miliary pattern in 66 cases (1.3%). In conclusion, because of the more frequent occurrence in the younger age group, it is considered that the prevalence of disease is still high and that the transmission of tubercle bacilli is not decreasing in our region. The highest risk group consisted of male subjects and those living in urban centres. The high percentage of active ex-patients suggests that new control programmes for tuberculosis are required in Turkey.
European Journal of Radiology, 2005
The relationship between tuberculosis and mankind has been known for many centuries, with the disease being one of the major causes of illness and death. During the early 1980s, there was a widespread belief that the disease was being controlled, but by the mid-1980s, the number of cases increased. This change in the epidemiological picture has several causes, of which the AIDS epidemic, the progression of poverty in developing countries, the increase in the number of elderly people with an altered immune status and the emergence of multidrug-resistant tuberculosis are the most important. Mainly due to this epidemiological change, the radiological patterns of the disease are also being altered, with the classical distinction between primary and postprimary disease fading and atypical presentations in groups with an altered immune response being increasingly reported. Therefore, the radiologist must be able not only to recognize the classical features of primary and postprimary tuberculosis but also to be familiar with the atypical patterns found in immuno-compromised and elderly patients, since an early diagnosis is generally associated with a greater therapeutic efficacy. Radiologists are, in this way, presented with a new challenge at the beginning of this millennium.
Tuberculosis: Current Diagnosis and Management
Elite Journal of Public Health, 2024
Tuberculosis is an airborne disease caused by the bacterium Mycobacterium tuberculosis (M. tuberculosis). Mycobacterium tuberculosis is carried in airborne particles, called droplet nuclei, of 1-5 microns in diameter. Infectious droplet nuclei are generated when persons who have pulmonary or laryngeal TB disease cough, sneeze, shout, or sing. Depending on the environment, these tiny particles can remain suspended in the air for several hours. Mycobacterium tuberculosis is transmitted through the air, not by surface contact. Transmission occurs when a person inhales droplet nuclei containing Mycobacterium tuberculosis, and the droplet nuclei traverse the mouth or nasal passages, upper respiratory tract, and bronchi to reach the alveoli of the lungs. Tuberculosis (TB) is a major cause of morbidity and mortality worldwide. It is estimated that 25% of the world's population are infected with Mycobacterium tuberculosis, with a 5-10% lifetime risk of progression into TB disease. Early recognition of TB disease and prompt detection of drug resistance are essential to halting its global burden. Culture, direct microscopy, biomolecular tests and whole genome sequencing are approved methods of diagnosis; however, their widespread use is often curtailed owing to costs, local resources, time constraints and operator efficiency. TB disease most commonly affects the lungs; this is referred to as pulmonary TB disease. Patients with pulmonary TB disease usually have a cough and an abnormal chest radiograph, and may be infectious. Although the majority of TB cases are pulmonary, TB can occur in almost any anatomical site or as disseminated disease.
International Journal of Medical Laboratory Research, 2020
Background: Globally, tuberculosis (TB) is one of the top 10 causes of death and India, is one among the leading contributors. This study was undertaken to assess the clinic-laboratory profile of the patients diagnosed with Pulmonary TB (PTB) and evaluate differences between dead and alive PTB patients. Material and methods: : This is a retrospective study, conducted in the patients diagnosed with PTB from January 2016 to December 2018. The clinical, hematological and biochemical parameters of the patients diagnosed with Pulmonary TB at the time of presentation to the tertiary care hospital was noted and compared among the age matched healthy individuals. We further looked for prognostic factors among the tuberculosis patients who died and survived. Results: A total of 209 patients were diagnosed with PTB during the study period. The prevalence of TB was higher in males. Most of the TB patients belonged to the age group 31-60 years. Among the PTB patients, cough with expectoration was the most common symptoms followed by fever and breathlessness. Nearly 50% patients had symptoms for less than 2 weeks. The right upper zone was the most common zone involved radiologically. When compared to healthy individuals, TB patients had significantly low haemoglobin, while there was raise in total leukocyte count, platelet count ESR, Blood urea, and LFT. The mortality in TB patients was associated with low haemoglobin, lower differential macrophage count and lower globulin. Conclusion: In our study population, PTB was common in males, and in age group of 31-60 years. Patients with Cough with expectoration with 2 weeks duration, anaemic, leucocytosis and raised ESR must be investigated extensively for Pulmonary TB. Patients (PTB) with were severe anaemia and lower differential macrophage count had higher mortality rate.
Aftermath of pulmonary tuberculosis: computed tomography assessment
Polish Journal of Radiology
Purpose: Pulmonary tuberculosis (PTB) has clinically significant sequelae, even after recommended treatment completion. It is important to recognise these sequelae for accurate assessment of severity and treatment planning, if indicated. Material and methods: We retrospectively analysed contrast-enhanced computed tomography (CT) scans of chest of 100 patients with previous history of treated pulmonary tuberculosis, excluding those with active pulmonary disease. CT findings were analysed based on parenchymal, airway, pleural, mediastinal, and vascular sequelae of PTB. Results: Parenchymal sequelae included fibrosis with architectural distortion and volume loss (90%), cavities (21%) (with aspergillomas noted in 19% of these cases), and tuberculomas (54%). Airway involvement was noted as bronchiectasis (77%) and bronchial stenosis (4%) but none with broncholithiasis. Mediastinal sequelae included lymph node calcification (74%), fibrosing mediastinitis (1%), and pericardial tuberculosis (2%). Pleural sequelae included pleural thickening (22%), with 40.9% of these patients showing calcifications, and one patient with chronic chylous pleural effusion. Vascular sequelae included Rasmussen aneurysms (4%), enlarged bronchial arteries (3%), and systemic bronchial collaterals in 1% of our patients. Conclusions: PTB has multiple appalling sequelae, which require due attention and appropriate treatment in symptomatic cases. Radiological evaluation forms an integral part in patient assessment and decision making.