scholarly journals DIFFERENCES BETWEEN PEDIATRIC PULMONARY AND EXTRA-PULMONARY TUBERCULOSIS: A WARNING SIGN FOR THE FUTURE

2014 ◽  
Vol 6 (1) ◽  
pp. e2014058 ◽  
Author(s):  
Ilker Devrim ◽  
Hüseyin Aktürk ◽  
Nuri Bayram ◽  
Hurşit Apa ◽  
Şener Tulumoğlu ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Pulmonary Involvement ◽  
Warning Sign ◽  
Extra Pulmonary Tuberculosis ◽  
Number Of Patients ◽  
Significant Difference ◽  
Extra Pulmonary ◽  
Tuberculosis In Children

Introduction: Tuberculosis (TB) remains a major global health problem affecting millions of people annually. Tuberculosis in children has unique features different from adults which makes the diagnosis to be more difficult. The spectrum of the symptoms of TB in children could vary from non-specific symptoms to severe clinical presentations.  In this study, we reviewed our experience at pediatric patients with active TB admitted in a tertiary hospital  and aimed to compare the epide­miological, clinical and microbiological features of  children with  the extra-pulmonary tuberculosis(EPTB) and pulmonary tuberculosis(PTB).Material and methods: Patients under 14 years of age diagnosed with active TB in our unit between December 2008 and September 2013 were included in the study. Data including demographic characteristics, clinical history, microbiology, imaging studies, medications and outcomes of the patients were collected from medical records.Results: A total of 129 cases of active TB were identified.  Ninety-two (78.6%) of the cases had Pulmonary Tuberculosis and 25 (21.4%) of the cases had Extra-pulmonary tuberculosis. The most common signs and symptoms on admission were fever in 40 cases (34.2%) and cough in 81 cases (69.2%). The number of patients without symptoms including fever, cough, malaise and weight loss were significantly higher in EXPTB (72.0%) group when compared with patients in PTB group (13.0%) (p<0.05). There was no significant difference between children with pulmonary and extra-pulmonary  tuberculosis by means of ratios of white blood cell count, c-reactive protein and erythrocyte sedimentation rate (p> 0.05). The detection rate of source in PTB group (42.4%) was significantly higher than the rate in  EPTB group (20.0%)( p=0.04). In the drug-resistant group, no source of infection could be established in 5 of 9 patients (55.5%).Conclusions: Extra-pulmonary tuberculosis diagnosis is more difficult than Pulmonary tuberculosis in children due to the various problems such as absence of associated pulmonary involvement,  lack of constitutional symptoms and negative tuberculosis exposure history compared to Pulmonary Tuberculosis. New strategies are required for improving the diagnosis of  Extra-pulmonary tuberculosis in children

scholarly journals Pulmonary involvement in patients presenting with extra-pulmonary tuberculosis: thinking beyond a normal chest x-ray

2014 ◽  
Vol 6 (1) ◽  
pp. 64 ◽  
Author(s):  
Samantha Herath ◽  
Christopher Lewis
Keyword(s):  
Public Health ◽  
Pulmonary Tuberculosis ◽  
Pulmonary Involvement ◽  
Extra Pulmonary Tuberculosis ◽  
Pulmonary Tb ◽  
X Ray ◽  
Normal Chest ◽  
Chest X Ray ◽  
Extra Pulmonary ◽  
Hiv Negative

INTRODUCTION: Recognition of pulmonary involvement in extra-pulmonary tuberculosis (TB) may be an important public health issue, as smear-negative pulmonary TB is responsible for about 17% of new infections. Pulmonary TB can be present despite a normal chest x-ray (CXR), even in human immunodeficiency virus (HIV)–negative patients. In this retrospective clinical audit, we reviewed a case series of HIV-negative patients with extra-pulmonary tuberculosis to identify the proportion with concurrent pulmonary TB despite an unremarkable CXR. METHODS: Clinical notes, microbiology results and CXR reports were reviewed from consecutive patients treated at Auckland City Hospital for extra-pulmonary TB from January 2007 to July 2010. RESULTS: Of the sample of 103 patients with extra-pulmonary TB, the majority of patients were born in an Asian country (n=70; 68%). The commonest presentation of extra-pulmonary TB was lymphadenopathy (n=51; 50%), followed by pleural (n=24; 23%) and bone (n=6; 6%) disease. Extra-pulmonary TB was diagnosed by biopsy or excision of the extra-pulmonary site in the majority (n=74; 72%), and by sputum testing alone in 26 (25%). The majority had CXR abnormalities (n=76; 74%). In the group with a normal CXR (n=27), 55% (n=15) had sputum cultures performed. In total, 18% (n=5) of patients with extra-pulmonary TB and a normal CXR had pulmonary TB, of whom two were smear positive. DISCUSSION: In patients with extra-pulmonary TB, sputum testing should be considered to detect concurrent pulmonary TB even if a CXR is normal, especially in immunosuppressed or symptomatic patients. This may aid diagnosis and determine infectivity and consequent public health action. KEYWORDS: Chest x-ray; sputum; tuberculosis; tuberculosis, pulmonary

scholarly journals Lupus vulgaris: a rare presentation of tuberculosis

2017 ◽  
Vol 5 (6) ◽  
pp. 2813
Author(s):  
Nasreen Ali ◽  
Sunil Kumar Agarwalla ◽  
Niranjan Mohanty ◽  
Pulok Ranjan Mallick
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lupus Vulgaris ◽  
Rare Presentation ◽  
Extra Pulmonary Tuberculosis ◽  
Medical College ◽  
Pain Abdomen ◽  
Paediatric Department ◽  
Extra Pulmonary ◽  
Tuberculosis In Children

70-80% of tuberculosis in children is pulmonary tuberculosis and the rest belong to the group of extra pulmonary tuberculosis, of which cutaneous TB is relatively uncommon. Here, we present a case of 10year old boy who was admitted in emergency paediatric department of MKCG medical college with complains of pain abdomen. On further examination and investigation was diagnosed as a case of Lupus vulgaris with SAIO.

scholarly journals Sociocultural and host factors related to extra-pulmonary tuberculosis in rural Bangladesh: A case control study

2016 ◽  
Vol 41 (2) ◽  
pp. 59-66
Author(s):  
Md Rizwanul Karim ◽  
Md. Ashraful Alam ◽  
Shaikh Abdullah Al Mamun ◽  
Md. Anisur Rahman
Keyword(s):  
Risk Factors ◽  
Pulmonary Tuberculosis ◽  
Case Control Study ◽  
Clinical Information ◽  
Pulmonary Involvement ◽  
Case Control ◽  
Extra Pulmonary Tuberculosis ◽  
History Of ◽  
Extra Pulmonary ◽  
Control Study

Bangladesh ranks sixth among higher TB burden countries. Extra-pulmonary TB contributes 12% of all tuberculosis cases in 2008. Risk factors for EPTB in Bangladesh are hypothesized to be different from pulmonary tuberculosis as seen in other high-burden countries. A case control study was conducted to compare the sociodemographic, household condition and lifestyle characteristics between extra pulmonary and pulmonary tuberculosis. This case control study was conducted in thirteen sub districts of Pabna, Shirajgonj and Cox’s Bazar districts from January to June 2013. The samples were classified as either extra pulmonary tuberculosis EPTB (cases) or pulmonary tuberculosis PTB (controls). A total of 490 participants including 245 extra pulmonary tuberculosis (cases) and 245 pulmonary tuberculosis (controls), who were being enrolled in DOTS treatment for last six months, were interviewed for epidemiological and clinical information using a standardized questionnaire. Children, adolescent and younger adults had four-time higher risk of being manifested with extra pulmonary tuberculosis [Adjusted odds ratio (AOR) 3.97; 95% Confidence Interval (CI) 1.10 to 14.35] and (AOR 4.50; 95% CI 1.48 to 13.72). Respondents, who lived in their own houses showed three times more chance of getting extra pulmonary disease (AOR 3.11; 95% CI 1.15 to 8.39). Extra pulmonary tuberculosis was seven to eight times more likely to occur among those whose resided in bedrooms ventilated with one (p= .001) or more windows (p =.004) and having window shutter made of glasses or wood slit raised the probability of getting extra pulmonary involvement by twenty times. Households using grain husk and leaves as cooking fuel revealed seven times higher chance of being manifested as extra pulmonary tuberculosis (P <.001). Extra pulmonary cases were three times more common among respondents, who had no history of exposure with known tuberculosis cases than those who had frequent exposure history (AOR 3.01; 95% CI 1.24 to 7.34). Extra pulmonary tuberculosis was found 1.5 times more common among BCG vaccinated respondents than pulmonary tuberculosis (AOR 1.66; 95% CI 1.06 to 2.58). Younger age, house ownership, bedroom ventilation, fuel material used for cooking, contact history and BCG vaccination status might be the important risk factors for the extra pulmonary manifestation of tuberculosis relative to pulmonary tuberculosis.

scholarly journals The Assessment of Vitamin D Serum Level in Patients With Pulmonary and Extra-Pulmonary Tuberculosis in Karaj, Iran, During 2017-2018.

2020 ◽  
Vol 8 (4) ◽  
pp. 147-150
Author(s):  
Alireza Soleimani ◽  
Mohammad Hossein Dehghan Tarzejani ◽  
Shirin Shams Hakimi ◽  
Niloofar Alishiri ◽  
Roya Torabizadeh
Keyword(s):  
Vitamin D ◽  
Pulmonary Tuberculosis ◽  
Hypovitaminosis D ◽  
Related Factors ◽  
Extra Pulmonary Tuberculosis ◽  
Study Results ◽  
Significant Difference ◽  
Study Population ◽  
Extra Pulmonary

Background: It is important to determine the type of tuberculosis and its related factors in order for effectively treating a disease and reducing its side effects in the society. Objective: This study aimed to determine vitamin D level in patients with pulmonary and extra-pulmonary tuberculosis in Karaj, Iran in 2017-2018. Materials and Methods: In this observational study, 102 patients suffering from pulmonary and extra-pulmonary tuberculosis disease were availably selected in Karaj, Iran in 2017-2018. They were examined and, then, their vitamin D level were assessed and compared according to the type of tuberculosis. Results: The study results showed that vitamin D level was normal in 39.2% of the case study population, but it was abnormal in 60.8% of it (18.6% deficiency and 42.2% insufficiency). Vitamin D deficiency was 15.8% in pulmonary tuberculosis patients and it was 22.2% in extra-pulmonary tuberculosis ones, showing no significant difference (P>0.05) statistically. Conclusion: According to the obtained results, hypovitaminosis-D was detected in more than half of the patients with pulmonary and extra pulmonary tuberculosis, which was not associated with the type of tuberculosis. Seemingly, the patients needed the same amount of – or even more – food, medical supplements, sports, and sunlight compared to healthy people.

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