Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis.
Transbronchial Cryobiopsy for Miliary Tuberculosis Mimicking Hypersensitivity Pneumonitis. Intern Med. 2020 Sep 19;: Authors: Nasu S, Kawahara K, Han Y, Okamoto N, Tamura Y, Suzuki H, Shiroyama T, Samejima Y, Kanai T, Noda Y, Tanaka A, Morishita N, Ueda K, Hashimoto S, Hirashima T, Nagai T Abstract Miliary tuberculosis is a potentially lethal type of tuberculosis that results from the hematogenous dissemination of Mycobacterium tuberculosis bacilli. We herein describe the case of a 34-year-old man that presented with a one-month history of cough and fever, while his sputum smear results were negative. Chest computed tomography revealed bilateral centrilobular ground-glass opacification (GGO), suggestive of hypersensitivity pneumonitis; thus, bronchoscopy was performed. Cryobiopsy specimens revealed necrotic granulomas. A re-examination of sputum after bronchoscopy identified Mycobacterium tuberculosis, and miliary tuberculosis was diagnosed. A cryobiopsy might be useful for diagnosing miliary tuberculosis pathologically, particularly when miliary nodules may be masked by GGO. PMID: 32963150 [PubMed - as supplied by publisher]
This report presents the case of a 10-month-old infant who had an unusual presentation of pulmonary tuberculosis with no cough, poor growth or documented temperature>38 C despite extensive right lung involvement with lung abscess formation and pleural effusions. Inflammatory markers were minimally deranged. The diagnosis of pulmonary tuberculosis was confirmed based on positive tuberculosis polymerase chain reaction test. The child made a successful clinical and radiological recovery upon completion of anti-tuberculosis drug regimen for six months. This report brings to light that it is crucial for clinicians to have a ...
Conclusion: According to the results of this study, infected infants with congenital CMV infection could identify at early stage by testing Guthrie cards (within 21 days of life). Furthermore, since there is a lack of CMV knowledge in our population, educating and effective counseling by obstetricians/gynecologists to the pregnant women are recommended. PMID: 32994908 [PubMed]
Conclusion: In addition to the specific anti-tubercular and adjuvant corticosteroid therapies for TBM, thalidomide can be used as a “salvage” antitubercular drug in cases that are unresponsive to corticosteroids.
HORSHAM, PA, September 30, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that the U.S. Food and Drug Administration (FDA) has approved SIMPONI ARIA® (golimumab) for patients 2 years of age and older for the treatment of active pJIA and has extended the PsA indication for this same patient population. “This latest FDA approval of SIMPONI ARIA for pediatric use in active pJIA and active PsA not only brings a new option to young patients living with these diseases but also adds to the growing body of evidence for this treatment,” said Mathai Mammen, M.D., Ph.D., Glob...
An 83-year-old Singaporean man presented to clinic for abdominal pain associated with loss of appetite and weight. He had a significant past medical history of hypertension, hyperlipidaemia, previously treated pulmonary tuberculosis, benign prostatic hyperplasia and peripheral vascular disease. His chronic medications included, aspirin, omeprazole, simvastatin and losartan. Otherwise, he did not have any fever, chills, vomiting, diarrhea, haematochezia, melena, change in bowel habits, cough, dyspnea, chest pain, headache, myalgia, joint pain, dizziness, odynophagia or dysphagia.
A 33-year-old Central American migrant worker developed productive cough, fevers, night sweats, and weight loss over the course of 1 month. A chest X-ray showed a left upper lung zone opacity with cavitation. Computed tomography (CT) of the chest showed extensive, centrilobular tree-in-bud opacities primarily in the left upper lobe with small areas of cavitation (see Fig. 1a). A sputum culture was positive for Mycobacterium tuberculosis, pan-susceptible to minimum inhibitory concentrations of first-line medications for pulmonary tuberculosis.
CONCLUSIONS PCT occurs most commonly in middle-aged women who have chronic pulmonary inflammatory processes such as bronchiectasis, atelectasis, and inflammation. Although there are no specific symptoms or direct imaging findings in these patients, our results showed that patients who have bronchiectasis, atelectasis, or recurrent pulmonary infection are at increased risk for PCT. PMID: 32913178 [PubMed - in process]
CONCLUSIONS: Esophageal tuberculosis is rare and frequently misdiagnosed due to the lack of diagnostic signs. There needs to be a high index of clinical suspicion among patients with dysphagia or retrosternal pain. Endoscopic biopsy and endoscopic ultrasound-guided FNA can help in achieving the correct diagnosis in esophageal tuberculosis. PMID: 32881605 [PubMed - as supplied by publisher]
We present the case of an immunocompetent patient whose illness began at age 49 with a cough, followed by purulent and hemoptoic sputum; bronchiectasis was diagnosed. Three years later, after hemoptysis, she underwent medial segmentectomy of the middle lobe and was asymptomatic for months. When tuberculosis was found in the pathology report, she was treated with 4HREZ2R2H2. Five years later her BK was 2+, thus receiving a new scheme of 4HREZ2R2H2, which did not succeed in obtaining negative results and the treatment was declared as a failure. After genotyping her Mycobacterium intracellulare culture, the patient received a...
DISCUSSION: Although CF prevalence is low in Malaysia, it is nevertheless an important diagnosis to be recognised as it is associated with increased morbidity. PMID: 32860386 [PubMed - as supplied by publisher]