scholarly journals Tuberculose Urinária: Graves Complicações Podem Ocorrer com um Diagnóstico Tardio

2015 ◽  
Vol 28 (3) ◽  
pp. 382 ◽  
Author(s):  
Inês Sanches ◽  
Cláudia Pinto ◽  
Mário Sousa ◽  
Aurora Carvalho ◽  
Raquel Duarte ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis Complex ◽  
Extrapulmonary Tuberculosis ◽  
Infectious Agent ◽  
Percutaneous Nephrostomy ◽  
Tuberculosis Complex ◽  
Ureteral Stenosis ◽  
Genitourinary Tuberculosis ◽  
Therapeutic Measures ◽  
Sterile Pyuria ◽  
Tract Infections

Genitourinary tuberculosis is the third most common form of extrapulmonary tuberculosis, comprising 4 - 17% of extrapulmonary forms. The authors describe the case of a patient with recurrent urinary tract infections, without isolation of an infectious agent and without symptomatic resolution, despite antibiotic treatment. Imaging exams showed left ureteral stenosis with moderate hydronephrosis. The attempt of retrograde catheterization was impossible so we opted for percutaneous nephrostomy to renal relief. Microbiological urine<br />analysis colleted by that way was positive for Mycobacterium tuberculosis complex. The patient started therapy with classical quadruple therapy and underwent nephrostomy for catheter placement. Despite therapeutic measures the patient required nephrectomy due to nonfunctioning kidney. Genitourinary tuberculosis is a diagnosis that should be considered in the presence of a persistent sterile pyuria.

scholarly journals Genitourinary Tuberculosis: A Rare Cause of Obstructive Uropathy in Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Emily H. Adhikari ◽  
Elaine L. Duryea ◽  
Martha W.F. Rac ◽  
Jeanne S. Sheffield
Keyword(s):  
Pregnancy Outcomes ◽  
Early Recognition ◽  
Obstructive Uropathy ◽  
Extrapulmonary Tuberculosis ◽  
Percutaneous Nephrostomy ◽  
Foreign Born ◽  
Imaging Studies ◽  
Genitourinary Tuberculosis ◽  
Prompt Treatment ◽  
In Pregnancy

Background. A rare but morbid form of extrapulmonary tuberculosis (TB), genitourinary TB is an important cause of obstructive uropathy and is likely underdiagnosed in pregnancy.Case. A 30-year-old primigravida undergoing treatment for active pulmonary TB presented with anuria at 13-14-weeks gestation. Bilateral ureteral strictures above the level of the ureterovesicular junctions were seen on imaging studies. Given her pulmonary disease, her obstructive uropathy was attributed to genitourinary TB. Bilateral percutaneous nephrostomy tubes were placed during pregnancy with successful ureteral reimplantation postpartum.Conclusion. Genitourinary TB should be considered as an etiology of urinary tract pathology during pregnancy, especially in foreign-born and immunocompromised persons. Early recognition resulting in prompt treatment can prevent further deterioration of maternal renal function and optimize pregnancy outcomes.

scholarly journals Detection of Mycobacterium tuberculosis complex by nested polymerase chain reaction in pulmonary and extrapulmonary specimens

2013 ◽  
Vol 39 (6) ◽  
pp. 711-718 ◽  
Author(s):  
Adriana Antônia da Cruz Furini ◽  
Heloisa da Silveira Paro Pedro ◽  
Jean Francisco Rodrigues ◽  
Lilian Maria Lapa Montenegro ◽  
Ricardo Luiz Dantas Machado ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Mycobacterium Tuberculosis ◽  
Mycobacterium Tuberculosis Complex ◽  
Extrapulmonary Tuberculosis ◽  
Laboratory Data ◽  
Target Sequence ◽  
Tuberculosis Complex ◽  
Chain Reaction ◽  
Nested Polymerase Chain Reaction ◽  
Polymerase Chain

OBJECTIVE: To compare the performance of nested polymerase chain reaction (NPCR) with that of cultures in the detection of the Mycobacterium tuberculosis complex in pulmonary and extrapulmonary specimens.METHODS: We analyzed 20 and 78 pulmonary and extrapulmonary specimens, respectively, of 67 hospitalized patients suspected of having tuberculosis. An automated microbial system was used for the identification of Mycobacterium spp. cultures, and M. tuberculosis IS6110 was used as the target sequence in the NPCR. The kappa statistic was used in order to assess the level of agreement among the results.RESULTS: Among the 67 patients, 6 and 5, respectively, were diagnosed with pulmonary and extrapulmonary tuberculosis, and the NPCR was positive in all of the cases. Among the 98 clinical specimens, smear microscopy, culture, and NPCR were positive in 6.00%, 8.16%, and 13.26%, respectively. Comparing the results of NPCR with those of cultures (the gold standard), we found that NPCR had a sensitivity and specificity of 100% and 83%, respectively, in pulmonary specimens, compared with 83% and 96%, respectively, in extrapulmonary specimens, with good concordance between the tests (kappa, 0.50 and 0.6867, respectively).CONCLUSIONS: Although NPCR proved to be a very useful tool for the detection of M. tuberculosis complex, clinical, epidemiological, and other laboratory data should also be considered in the diagnosis and treatment of pulmonary and extrapulmonary tuberculosis.

scholarly journals Mycobacterium tuberculosis complex detected by modified fluorescent in situ hybridization in lymph nodes of clinical samples

2011 ◽  
Vol 6 (01) ◽  
pp. 58-66 ◽  
Author(s):  
Juan Rodriguez-Nuñez ◽  
Francisco J Avelar ◽  
Francisco Marquez ◽  
Bruno Rivas-Santiago ◽  
Cesar Quiñones ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Lymph Node ◽  
Mycobacterium Tuberculosis Complex ◽  
Extrapulmonary Tuberculosis ◽  
Clinical Samples ◽  
Tuberculosis Complex ◽  
Tissue Samples ◽  
Negative Results ◽  
Modified Dna ◽  
Pna Fish

Introduction:  Lymph node tuberculosis (TB) is the leading cause of extrapulmonary tuberculosis and is the most frequently identified type in Aguascalientes, Mexico. Conventional diagnosis has serious limitations for rapid detection of extrapulmonary tuberculosis in clinical samples. Here PCR and modified FISH have been tested as complementary diagnosis methods for extrapulmonary tuberculosis. Methodology: The specific insertion sequence IS6110 for Mycobacterium tuberculosis complex was used to perform PCR and build DNA and PNA FISH probes (20bp). PCR and modified DNA and PNA FISH assays were performed to evaluate 41 lymph node paraffin-embedded tissue samples, in comparison with the histopathology diagnosis, which was considered the gold standard (22 positive and 19 negative). Results: In comparison with histopathology diagnosis PCR showed 62.5 % sensitivity and 77.8 % specificity (χ2 = 4.583 p < 0.05). Modified DNA FISH showed 71.4% sensitivity and 84.6% specificity (χ2 = 11.21 p < 0.05). PNA FISH showed 66.7% sensitivity and 60.0% specificity (χ2 = 2.93 p > 0.05). Ziehl Neelsen stain was positive in only four cases of 22 lymph node samples positive to histopathology.  In contrast, PCR and modified DNA FISH were positive in 20 cases of the same group. The negative cases were coincident in all tests.Conclusions: PCR and DNA FISH showed a significant increase in the number of cases detected and also showed higher sensitivity and specificity compared with data reported by traditional methodology. In developing countries, these techniques could help to complement the early diagnosis and timely treatment of extrapulmonary tuberculosis.

scholarly journals Comparative Evaluation of the New Gen-Probe Mycobacterium tuberculosis Amplified Direct Test and the Semiautomated Abbott LCx Mycobacterium tuberculosis Assay for Direct Detection of Mycobacterium tuberculosis Complex in Respiratory and Extrapulmonary Specimens

1998 ◽  
Vol 36 (12) ◽  
pp. 3601-3604 ◽  
Author(s):  
Claudio Piersimoni ◽  
Annapaola Callegaro ◽  
Claudio Scarparo ◽  
Valeria Penati ◽  
Domenico Nista ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Mycobacterium Tuberculosis Complex ◽  
Direct Detection ◽  
Extrapulmonary Tuberculosis ◽  
Nucleic Acid Amplification ◽  
Tuberculosis Complex ◽  
Predictive Values ◽  
Clinical Specimens ◽  
Respiratory Specimens ◽  
Level Of Agreement

Two commercial assays that detect Mycobacterium tuberculosis complex (MTB) in clinical specimens by rRNA target amplification (AMTDII) and ligase chain reaction (LCx) were evaluated. The tests were applied to 457 respiratory (n = 273) and extrapulmonary (n = 184) specimens collected from 357 patients. The results were compared with those of acid-fast staining and culture. The combination of culture and clinical diagnosis was considered to be the “gold standard.” Seventy specimens were from patients with pulmonary tuberculosis and 28 specimens were from patients with extrapulmonary tuberculosis. After resolution of discrepant results, the overall sensitivities, specificities, and positive and negative predictive values for respiratory specimens were 92.8, 99.4, 98.5, and 97%, respectively, for AMTDII and 75.7, 98.8, 96.4, and 90.5%, respectively, for LCx. With extrapulmonary specimens, the overall sensitivities, specificities, and positive and negative predictive values were 78.6, 99.3, 95.6, and 96.2%, respectively, for AMTDII and 53.6, 99.3, 93.7, and 92.1%, respectively, for LCx. The level of agreement between AMTDII and LCx assay results was 78.2%. We conclude that although both nucleic acid amplification methods are rapid and specific for the detection of MTB in clinical specimens, AMTDII is significantly more sensitive than LCx with both respiratory (P = 0.005) and extrapulmonary (P = 0.048) specimens.

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