STUDY ON SOME ASPECTS OF PATHOGENESIS OF RHODOCOCCUS EQUI IN MICE

In order to study some aspects of pathogenesis of Rhodococcus equi, 60 white Swiss mice were used. They were randomly divided into 2 groups. The 1s' group (40 animals) was inoculated subcutaneously with a dose of 4x10° CFU .of R.equi while the 2nd group was kept as a control. Four animals from the 1st group and 2 animals from the 2nd group were sacrified at day, 1,2,4,8,12,16,20,24,28 and 30 postinoculation (P.I) Six animals of 1stgroup were died during the first and second days P.I. Microscopical examination showed acute to subacute suppurative inflammation in the liver, lung and spleen at I to 4 days PI. While pyogranulomatous lesions and epithelioid granuloma were seen in liver, lungs and spleen at 4 to 24 days PI R.equi was isolated liver, lungs, spleen, kidney and brain in the first day PI. The bacteria persisted in the spleen from and brain up to 20th day, in the liver up to 24" day while in the lungs, and kidney bacterial isolation continuous till 28th day PI.

RURAL HOSPITAL CORRELATION OF CLINICAL PRESENTATION, HISTOPATHOLOGY, AND POLYMERASE CHAIN REACTION FOR GENITAL TUBERCULOSIS DIAGNOSIS

In India, vaginal tuberculosis (FGTB) is a common cause of infertility, but diagnosis is difficult because of the form of the disease of people in need. Traditional diagnostic methods include the detection of rapid bacilli acid in endometrial or peritoneal biopsy, epithelioid granuloma biopsy, or a positive Expert type in biopsy, although this is only available in a small percentage of cases, leaving patients many are not available. Diagnosis of GTB by PCR along with histopathological findings leads to high sensitivity and specificity. So, both diagnostic and operative laparoscopy and hysteroscopy are the modalities essential for management of genital TB in infertile women. This review discusses various diagnostic modalities including endometrial or peritoneal biopsy to detect epithelioid granuloma on microscopy, role of PCR for GTB and correlation of two for early diagnosis of genital tuberculosis so that management will be started at early stage which can prevent patient from getting permanent damage to organs. Tuberculosis being endemic in counties likes India; it is often a leading cause of infertility. Early diagnosis is crucial because, by the time patient reports with infertility, already the damage has started and reverting tubal patency is almost impossible. Early diagnosis typically fails in developing countries, primarily because there are no pathognomonic signs of the disease and either poor sensitivity or procedurally invasive diagnostic methods are in use.

The clinical analysis of pulmonary lymphoepithelioma-like carcinoma with epithelioid granuloma: Fourteen cases and literature review.

e20545 Background: Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare subtype of non-small cell lung cancer associated with Epstein-bar virus (EBV) infection. Even less reported were those with Epithelioid granuloma (EG) and were frequently misdiagnosed. Current study aimed at investigating the clinical presentation, pathological characteristics and treatments of PLELC complicated with EG to improve our understanding of this disease. Methods: Data was collected from January 2013 to December 2017. A total of 105 patients were diagnosed as PLELC, in which 14 patients were with EG. Their clinical features, pathological characteristics and treatment were analyzed. Results: The 14 patients with EG (13.3%) in our group were followed-up 15 months (10-31 months).The median age was 48.5 year-old (38-67 year-old) and 85.7% were under the age of 60, meanwhile females had a slightly higher proportion than males (1.8:1). Most patients were at early stage (71.4%) with nonspecific manifestations such as cough, expectoration and lack of rich-lewis phenomenon. EG were often located in tumor or beside the tumor (71.4%), others were located in lymph node. It was all negative in specific stain of pathology and all positive in situ hybridization of EBV-encoded RNA (EBER). In our study, two patients received palliative chemotherapy with the duration of progression-free survival in 8 and 10 months, respectively. Twelve patients underwent surgical resection including ten with adjuvant or neo-adjuvant chemotherapy. Three patients had disease relapsed in 8, 13 and 25 months after surgery, respectively. None of them had tuberculosis occurring, progression or relapse, even if anti-tuberculosis therapy were not taken. Conclusions: PLELC complicated with EG, a rare phenomenon, was lack of rich-lewis phenomenon and specific clinical characteristic compared with those without EG. The formation of EG may be caused by immunological hypersensitivity to tumor cell or EBV infection instead of tuberculosis. It was important for us to make an exact pathological diagnosis, and attention should be paid to obtain samples by biopsy and make differential diagnosis. PLELC complicated with EG could receive multimodality therapy such as chemotherapy and surgery. However, anti-tuberculosis therapy was not necessary.

Cytopathological patterns of tuberculous lymphadenitis: an analysis of 126 cases in a tertiary care hospital

Background: Tuberculous lymphadenitis is one of the most common causes of lymphadenopathy in developing countries. Fine needle aspiration cytology (FNAC) has important role in the diagnosis of tuberculous lymphadenitis. The objective of this study was to evaluate the cytopathological patterns of tuberculous lymphadenitis and to correlate with Ziehl-Neelsen (ZN) staining.Methods: FNAC of 126 cases diagnosed as tuberculous lymphadenitis over a period of three years were reviewed. FNAC findings were categorized into three patterns: pattern A- epithelioid granuloma without caseous necrosis, pattern B- epithelioid granuloma with caseous necrosis, pattern C- caseous necrosis without epithelioid granuloma. Chi-square test was done to correlate cytopathological pattern and acid fast bacilli (AFB) positivity.Results: Tuberculous lymphadenitis was most frequent in the age group of 21-30 years (40.5%). Most common lymph node involved was cervical lymph node (82.53%). The most common pattern observed was Pattern B- Epithelioid granuloma with caseous necrosis in 53.17% cases. Overall AFB positivity was seen in 34.92% cases. Maximum AFB positivity was seen in Pattern C- Caseous necrosis without epithelioid granuloma in 81.81% cases. Serum adenosine deaminase (ADA) was elevated in 66.66% patients.Conclusions: FNAC is safe and cost effective diagnostic tool for the diagnosis of tuberculous lymphadenitis. Ziehl-Neelsen stain for Acid fast bacilli and Serum ADA can be used as an adjunctive tool for the diagnosis of tuberculous lymphadenitis.

Lupus Vulgaris: A Rare Case of Cutaneous Tuberculosis

Lupus vulgaris is an extremely chronic, progressive form of cutaneous tuberculosis. The earliest description of lupus vulgaris was given by Erasmus Wilson in 1865. It usually occurs through contagious extension of the disease from underlying affected tissue or hematogenous or lymphatic spread. A 55 years male, non diabetic, non hypertensive, non smoker, got himself admitted into Dermatology and Venereology Department of DMCH with the complaints of multiple ulcerated lesions over the left lower thigh and upper leg including knee for 8 years. Histological sections of skin revealed multiple epithelioid granuloma, multinucleated giant cells and infiltration of lymphocytes with areas of fibrosis and ESR was 80 in 1st hour. The patient was treated with anti tubercular therapy and cured completely. DOI: http://dx.doi.org/10.3329/bmj.v41i2.18811 Bangladesh Medical Journal 2012 Vol. 41 No. 2: 57-58