Isoniazid-Resistant Cavitary Tuberculosis in a Physician Following Isoniazid Prophylaxis

2002 ◽  
Vol 23 (10) ◽  
pp. 622-625
Author(s):  
Tobi B. Karchmer ◽  
John D. Phipps ◽  
Eve T. Giannetta ◽  
Barry M. Farr
Keyword(s):  
Chest Radiograph ◽  
Soft Tissue Density ◽  
X Ray ◽  
Single Drug ◽  
Resistant Tuberculosis ◽  
Tuberculin Skin Test Conversion ◽  
Chest X Ray ◽  
Drug Prophylaxis ◽  
Isoniazid Prophylaxis ◽  
Active Disease

Abstract Single-drug prophylaxis is recommended after tuberculin skin test conversion, but not when there is active disease on chest radiograph because resistance develops frequently. Isoniazid-resistant tuberculosis developed in a physician receiving prophylaxis despite “faint left upper lobe soft tissue density” on chest radiograph. Ignoring active disease on chest x-ray renders this strategy counterproductive and cost ineffective. '(Infect Control Hosp Epidemiol 2002;23:622-625).

Hubungan antara Luas Lesi pada Foto Toraks Penderita TB Paru Dewasa yang Memiliki Riwayat Diabetes Melitus dengan Indeks Massa Tubuh di Rumah Sakit Hasan Sadikin Bandung

2016 ◽  
Vol 1 (3) ◽  
pp. 138-144
Author(s):  
Ina Edwina ◽  
Rista D Soetikno ◽  
Irma H Hikmat
Keyword(s):  
Chest Radiograph ◽  
Chi Square ◽  
Pulmonary Tb ◽  
X Ray ◽  
Consecutive Sampling ◽  
Close Relationship ◽  
Chi Square Test ◽  
Chest X Ray ◽  
The Relationship ◽  
Diabetes Melitus

Background: Tuberculosis (TB) and diabetes mellitus (DM) prevalence rates are increasing rapidly, especially in developing countries like Indonesia. There is a relationship between TB and DM that are very prominent, which is the prevalence of pulmonary TB with DM increased by 20 times compared with pulmonary TB without diabetes. Chest X-ray picture of TB patients with DM is atypical lesion. However, there are contradictories of pulmonary TB lesion on chest radiograph of DM patients. Nutritional status has a close relationship with the morbidity of DM, as well as TB.Objectives: The purpose of this study was to determine the relationship between the lesions of TB on the chest radiograph of patients who su?er from DM with their Body Mass Index (BMI) in Hasan Sadikin Hospital Bandung.Material and Methods: The study was conducted in Department of Radiology RSHS Bandung between October 2014 - February 2015. We did a consecutive sampling of chest radiograph and IMT of DM patients with clinical diagnosis of TB, then the data was analysed by Chi Square test to determine the relationship between degree of lesions on chest radiograph of pulmonary TB on patients who have DM with their BMI.Results: The results showed that adult patients with active pulmonary TB with DM mostly in the range of age 51-70 years old, equal to 62.22%, with the highest gender in men, equal to 60%. Chest radiograph of TB in patients with DM are mostly seen in people who are obese, which is 40% and the vast majority of lesions are minimal lesions that is equal to 40%.Conclusions: There is a signifcant association between pulmonary TB lesion degree with BMI, with p = 0.03

Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography

2018 ◽  
Vol 35 (10) ◽  
pp. 1032-1038 ◽  
Author(s):  
Aaron S. Weinberg ◽  
William Chang ◽  
Grace Ih ◽  
Alan Waxman ◽  
Victor F. Tapson
Keyword(s):  
Pulmonary Embolism ◽  
Chest Radiograph ◽  
High Probability ◽  
Hemodynamic Instability ◽  
X Rays ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Low Probability ◽  
Clinically Significant

Objective: Computed tomography angiography is limited in the intensive care unit (ICU) due to renal insufficiency, hemodynamic instability, and difficulty transporting unstable patients. A portable ventilation/perfusion (V/Q) scan can be used. However, it is commonly believed that an abnormal chest radiograph can result in a nondiagnostic scan. In this retrospective study, we demonstrate that portable V/Q scans can be helpful in ruling in or out clinically significant pulmonary embolism (PE) despite an abnormal chest x-ray in the ICU. Design: Two physicians conducted chart reviews and original V/Q reports. A staff radiologist, with 40 years of experience, rated chest x-ray abnormalities using predetermined criteria. Setting: The study was conducted in the ICU. Patients: The first 100 consecutive patients with suspected PE who underwent a portable V/Q scan. Interventions: Those with a portable V/Q scan. Results: A normal baseline chest radiograph was found in only 6% of patients. Fifty-three percent had moderate, 24% had severe, and 10% had very-severe radiographic abnormalities. Despite the abnormal x-rays, 88% of the V/Q scans were low probability for a PE despite an average abnormal radiograph rating of moderate. A high-probability V/Q for PE was diagnosed in 3% of the population despite chest x-ray ratings of moderate to severe. Six patients had their empiric anticoagulation discontinued after obtaining the results of the V/Q scan, and no anticoagulation was started for PE after a low-probability V/Q scan. Conclusion: Despite the large percentage of moderate-to-severe x-ray abnormalities, PE can still be diagnosed (high-probability scan) in the ICU with a portable V/Q scan. Although low-probability scans do not rule out acute PE, it appeared less likely that any patient with a low-probability V/Q scan had severe hypoxemia or hemodynamic instability due to a significant PE, which was useful to clinicians and allowed them to either stop or not start anticoagulation.

scholarly journals Therapeutic effect of cycloserine combined with anti-tuberculosis drugs in the treatment of multidrug-resistant tuberculosis

2022 ◽  
Vol 20 (2) ◽  
pp. 419-424
Author(s):  
Yang Zhao ◽  
Mabin Si ◽  
Zhihui Li ◽  
Xiulei Yu
Keyword(s):  
Ct Scan ◽  
Multidrug Resistant ◽  
Chest Ct ◽  
Case Detection Rate ◽  
X Ray ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Before And After ◽  
Mdr Tb ◽  
Chest X Ray

Purpose: The present study analyzes the comprehensive therapeutic effect of cycloserine, in combination with anti-tuberculosis drugs using chest X-ray and chest CT (computed tomography) scan techniques. Methods: A total of 90 patients, diagnosed with multidrug resistant tuberculosis (MDR TB) were subjected to chest x-ray and CT scan before and after treatment in the two groups. Different views such as sagittal, coronal, lung window and multiplanar imaging of mediastinal window were taken. Some parameters such as case detection rate (CDR) in chest X-ray and CT scan and comprehensive curative effect were observed in two groups. Further, the changes in chest CT signs in addition to absorption of focus, cavity closure and changes in CT extra pulmonary signs were also observed. Results: The clinical profile of the patients and the course of disease were statistically insignificant (p > 0.05). Total effectiveness rate and case detection rate (CDR) values exhibited a significant difference between the groups (p < 0.05). Lung consolidation, nodules and cavities significantly improved in both groups before and after the treatment (p < 0.05). Both groups showed significant improvements in extrapulmonary signs in CT scan (p < 0.05) after the treatment. Conclusion: Based on the study outcomes, the CT scan method has good potentials for diagnosing and treating MDR TB at the early stages. Further, it can clarify the signs and outcomes of the disease at early stages, thus providing the medical fraternity a great opportunity to cure the disease.

scholarly journals Identifying drug-resistant tuberculosis from chest X-ray images using a simple convolutional neural network

2021 ◽  
Vol 2071 (1) ◽  
pp. 012001
Author(s):  
J Ureta ◽  
A Shrestha
Keyword(s):  
Neural Network ◽  
Convolutional Neural Network ◽  
Binary Classification ◽  
Health Concern ◽  
Drug Resistant ◽  
X Rays ◽  
Drug Resistant Tuberculosis ◽  
X Ray ◽  
Resistant Tuberculosis ◽  
Chest X Ray

Abstract Tuberculosis(TB) is one of the top 10 causes of death worldwide, and drug-resistant TB is a major public health concern especially in resource-constrained countries. In such countries, molecular diagnosis of drug-resistant TB remains a challenge; and imaging tools such as X-rays, which are cheaply and widely available, can be a valuable supplemental resource for early detection and screening. This study uses a specialized convolutional neural network to perform binary classification of chest X-ray images to classify drug-resistant and drug-sensitive TB. The models were trained and validated using the TBPortals dataset which contains 2,973 labeled X-ray images from TB patients. The classifiers were able to identify the presence or absence of drug-resistant Tuberculosis with an AUROC between 0.66–0.67, which is an improvement over previous attempts using deep learning networks.

scholarly journals Evaluation and Follow-Up of Infectious Tuberculosis at the University of Ottawa

1995 ◽  
Vol 6 (5) ◽  
pp. 239-243 ◽  
Author(s):  
Ziad A Memish ◽  
Raymonde Hickey ◽  
Ian Gemmill
Keyword(s):  
Early Detection ◽  
Skin Testing ◽  
Health Department ◽  
Contact Tracing ◽  
X Ray ◽  
Purified Protein Derivative ◽  
Chest X Ray ◽  
The University ◽  
Isoniazid Prophylaxis

A case of active infectious pulmonary tuberculosis (tb) in a recent immigrant to Canada was identified at the University of Ottawa. The student was attending classes regularly and coughing for six months before the diagnosis of infectious pulmonarytbwas made. Investigation carried out by the Ottawa-Carleton Health Department identified 871 student contacts. Of the 871 contacts, 773 (89%) were available for testing and follow-up. Initial skin testing with purified protein derivative (ppd) was positive in 149 contacts. Of the 602 contacts testing negative initially 399 (66%) returned for 12-week retesting. Eleven skin test converters were identified. All 160 contacts with positiveppdhad negative chest x-ray and were given isoniazid prophylaxis for six months. The estimated cost of the process of contact tracing, testing, follow-up and treatment was $34,036. Although pre-immigration screening policies fortbdo exist, additional pre- and postimmigration measures could help in the early detection of activetband the prevention of its spread.

scholarly journals Evaluation of risk factors associated with the development of MDR- and XDR-TB in a tertiary care hospital: a retrospective cohort study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10826
Author(s):  
Amna Saifullah ◽  
Tauqeer Hussain Mallhi ◽  
Yusra Habib Khan ◽  
Muhammad Shahid Iqbal ◽  
Nasser Hadal Alotaibi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous Treatment ◽  
Care Hospital ◽  
X Ray ◽  
Factors Associated ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Chest X Ray

Background Drug resistant tuberculosis (DR-TB) infringes substantial burden in terms of longer treatment duration, morbidity and mortality. Timely identification of patients at risks of DR-TB will aid individualized treatment. Current study was aimed to ascertain several factors associated with DR-TB among patients attending a tertiary care hospital. Methods This retrospective study was conducted among patients with confirmed diagnosis of DR-TB and drug susceptible TB (DS-TB) seeking medical care from a tertiary care hospital during 2014–2019. The types of DR-TB included were rifampicin resistant tuberculosis (RR-TB), Multidrug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB). Appropriate statistical methods were implied to evaluate the factors associated with DR-TB. Results Out of 580 patients, DS-TB was diagnosed in 198 (34.1%) patients while DR-TB was present in 382 patients. Of resistance cases, RR-TB, MDR-TB and XDR-TB were diagnosed in 176 (30.3%), 195 (33.6%) and 11 (1.9%) patients, respectively. Significant differences (P < 0.05) in demographics and clinico-laboratory characteristics were observed between patients with DS-TB and DR-TB. Logistic regression analysis revealed age ≤38 years (OR: 2.5), single marital status (OR: 11.1), tobacco use (OR: 2.9), previous treatment (OR: 19.2), treatment failure (OR: 9.2) and cavity on chest X-ray (OR: 30.1) as independent risk factors for MDR-TB. However, XDR-TB was independently associated with age group of ≤38 years (OR: 13.6), students (OR: 13.0), previous treatment (OR: 12.5), cavity on chest X-ray (OR: 59.6). The independent risk factors associated with RR-TB are age ≤38 years (OR: 2.8), females (OR: 5.7), unemployed (OR: 41.5), treatment failure (OR: 4.9), previous treatment (OR: 38.2) and cavity on chest X-ray (OR: 4.3). ROC curve analysis accentuate the excellent predictive accuracy of all logistic regression models as shown by AUC (0.968, P < 0.001) for MDR-TB, AUC (0.941, P < 0.001) for XDR-TB and AUC (0.962, P < 0.001) for RR-TB. Conclusions Current study demonstrates a sizeable extent of resistant cases among pulmonary TB patients. This study presaged significant risk of DR-TB among females, young adults, unemployed, smokers, patients with previous treatment failure and cavitation on chest X-ray. Timely identification of high risk patients will give pronounced advantages regarding appropriate choices of prevention, treatment and disease control.

scholarly journals Hubungan antara Pola Resistensi OAT Lini Pertama dan Gradasi Gambaran Foto Toraks Penderita TB Paru MDR

2019 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Pramanindyah Bekti Anjani ◽  
Soedarsono Soedarsono
Keyword(s):  
Drug Resistance ◽  
Chest Radiograph ◽  
Outpatient Clinic ◽  
Multi Drug Resistance ◽  
Resistance Pattern ◽  
First Line ◽  
X Ray ◽  
Resistance Patterns ◽  
Mdr Tb ◽  
Chest X Ray

Background: Tuberculosis (TB) is a disease which has long been known and is still a cause of death in the world. The emergece of the drug resistance in TB treatment, particularly Multi drug-Resistance Tuberculosis (MDR TB) become a significant public health problem in many countries. The diagnosis of MDR TB based on culture results. In some cases radiographic feature with severe abnormalities consideres as MDR TB. From this phenomenon, there is no research that connects the resistance pattern of first line ATD with chest x-ray feature in patients with MDR TB. Methods: The research design are analytical observational with cross-sectional study conducted in outpatient clinic of MDR TB in Dr. Soetomo hospital. Subjects were patients who are following a theraphy program in outpatient clinic of MDR TB in Dr. Soetomo hospital from 2012 to 2014 who meet the inclusion and exclusion criteria. A total of 65 patients. Result: the result of this study showed that of all patterns of resistance, most of the MDR TB patients were classified as having severe chest radiograph. 27 patients with RH resistance patterns, there were 14(51.9%) who had a chest radiograph are classified as severe. 5 patients with RHS resistance patterns, 2(60%) vwho had a chest radiograph are classified as severe. 13 patients RHES resistance patterns, 8(61.5%) who had a chest radiograph are classified as severe. 20 patients with RHE resistance patterns, 14(70%) who had a chest radiograph are classified as severe. Conclusion: There were no significant association between resistance pattern of first line ATD and chest x-ray feature in patient with MDR TB.

scholarly journals A tüdő nekrotizáló sarcoid granulomatosisa

2021 ◽  
Vol 162 (38) ◽  
pp. 1541-1547
Author(s):  
Noémi Zombori-Tóth ◽  
Katalin Ugocsai ◽  
Árpád Vincze ◽  
József Furák ◽  
László Tiszlavicz ◽  
...  
Keyword(s):  
Standard Form ◽  
Spontaneous Remission ◽  
Rare Entity ◽  
Soft Tissue Density ◽  
Thoracoscopic Resection ◽  
Granulomatous Angiitis ◽  
X Ray ◽  
Bilateral Hilar Lymphadenopathy ◽  
Function Test ◽  
Chest X Ray

Összefoglaló. A nekrotizáló sarcoid granulomatosis a granulomatosus pulmonalis angitisek közé tartozó, ritka kórkép. Egyesek a sarcoidosis variánsának, mások primer pulmonalis vasculitisnek tartják. A kórkép klinikai és patológiai jellegzetességeit két eset bemutatásával ismertetjük. A 20 éves nőbeteg sürgősséggel került pulmonológiai osztályra száraz köhögés, jobb oldali, mély belégzéssel összefüggő mellkasi fájdalom és láz miatt, a 63 éves férfi beteget pedig pneumoniát követő kontroll-mellkasröntgenfelvételen látott elváltozás kivizsgálása során észlelték. Az autoimmun panel vizsgálata, a mikrobiológiai tesztek mindkét betegnél negatívnak bizonyultak, a légzésfunkciós vizsgálat és a bronchoszkópos vizsgálat nem talált eltérést. A mellkas-CT-felvételen lágyrész-denzitású nodulusok látszottak egyoldali dominanciával, a folyamatot nem kísérte a hilusi nyirokcsomók szimmetrikus megnagyobbodása. A nodulusok szövettani vizsgálata vált indokolttá, melyet videoasszisztált torakoszkópos tüdőreszekciós mintavétellel biztosítottak. Mikroszkóposan a tüdőparenchymában gócos nekrózisokat, a környezetükben el nem sajtosodó epitheloid sejtes granulomatosus gócokat, az átfutó artériákban pedig granulomatosus arteritist láttak; a klinikai adatok figyelembevételével a tüdő nekrotizáló sarcoid granulomatosisa diagnózisát állították fel. A tüdőbetegség mindkét betegnél egy év alatt spontán regrediált. Az irodalom adatait és az eseteket összegezve, a tüdő nekrotizáló sarcoid granulomatosisában mikrobiológiai vizsgálatokkal nem igazolható tüdőfertőzés, és az immunológiai kivizsgálás sem tár fel szisztémás autoimmun betegséget; a diagnózis a klinikai kép és a képalkotó vizsgálatok alapján indikált szövettani vizsgálattal állítható fel. A betegség szteroidkezelésre jól reagál, de előfordul spontán regresszió is, az utóbbira láttunk példát. Bár az entitás átmenetet képez a nekrotizáló vasculitisek és a sarcoidosis között, egyre több érv szól amellett, hogy a sarcoidosis spektrumába tartozik. Orv Hetil. 2021; 162(38): 1541–1547. Summary. Necrotizing sarcoid granulomatosis is a rare entity currently classified as a subtype of granulomatous pulmonary angiitis. It is considered to be either a variant of sarcoidosis or a primary pulmonary angiitis. Two cases are demonstrated to present its clinical and pathological features. A 20-year-old female patient was admitted to the department of pulmonology with dry cough, right-sided chest pain during hyperventilation and fever. A 63-year-old male patient was observed with a right-sided lesion on chest X-ray after pneumonia. In both cases, autoimmune panel examination, microbiology tests, spirometry function test and bronchoscopy were unremarkable. Chest CT scans have revealed nodules with soft-tissue density without bilateral hilar lymphadenopathy. In order to clarify the diagnosis, video-assisted thoracoscopic resection (biopsy) was performed. Microscopically, parenchymal focal necrosis with adjacent to non-caseating granulomas and granulomatous angiitis were detected. In both cases, spontaneous remission occurred within a year. Histological examination – integrated with clinical data and radiological tests’ results – is the gold standard form of evaluation to confirm necrotizing sarcoid granulomatosis; furthermore, exclusion of pneumonia and autoimmune diseases are also required. The disease responds well to corticosteroids; moreover, spontaneous remission is often reported, as it happened in both cases. Necrotizing sarcoid granulomatosis is a transition between necrotizing vasculitides and sarcoidosis; although more and more evidence appears supporting the fact that necrotizing sarcoid granulomatosis may belong to the spectrum of sarcoidosis. Orv Hetil. 2021; 162(38): 1541–1547.

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