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Intestinal tuberculosis [keywords]
- [Crohn's disease or intestinal tuberculosis: A diagnostic challenge.] [JOURNAL ARTICLE]
- Arch Pediatr 2014 Aug 25.
Distinguishing intestinal tuberculosis from Crohn disease is difficult and can result in misdiagnosis, especially when active pulmonary infection is absent. A 13-year-old girl was admitted to our hospital with a 2-month history of watery diarrhea, abdominal pain, and 12-kg weight loss. Based on clinical, radiological, endoscopic, and histological findings, she was initially misdiagnosed as having Crohn disease and treated with glucocorticosteroids, with a poor response after 4 weeks. Intestinal tuberculosis was then suspected. Improvement was observed during the 1st week of antituberculous treatment. The differentiation of intestinal tuberculosis from Crohn disease may be very difficult in some patients. A positive response to antituberculous treatment associated with clinical, endoscopic, and histological features argue in favor of the diagnosis of intestinal tuberculosis.
- Infectious diseases in Poland in 2012. [Journal Article]
- Przegl Epidemiol 2014; 68(2):177-85.
The aim of the study is to assess the epidemiological situation for infectious and parasitic diseases in Poland in 2012.The main source of data for this study are statistical overviews contained in the annual bulletins "Infectious Diseases in Poland in 2012" and "Immunizations in Poland in 2012" (NIPH-NIH, Warsaw 2013) and data contained in the articles presented in this issue of Przegląd Epidemiologiczny. Information on deaths due to infectious and parasitic diseases registered in Poland in 2012 and earlier years is based on the data of the Department for Demographic Research of Central Statistical Office.Upper respiratory tract infection classified as "influenza and influenza-like illness" were reported in 2012 in a total number of 1 460 037 cases. In comparison with 2011, it was an 26.2% increase of incidence, and as compared to the median of 2006-2010 of 286.1%. In 2012, with still the clear predominance of salmonellosis among intestinal bacterial infections, downward trend in the incidence of intestinal infections of this etiology persisted. In 2012 reported number of intestinal infections caused by Salmonella was, 8 267 (21.5/100 000), which represents incidence decrease of 4.5%. Foodborne infections of viral etiology were reported in 39462 cases (102.4/100 000). Most frequent were caused by rotaviruses - 23 692 (61.5/100 000). In 2012, there were 4 684 reported cases of pertussis (12.2/100 000), which means an increased incidence compared with the previous year by 180%. In 2012, there was an increase in the number of cases of mumps by 7.5% (from 2 585 to 2 779 cases), and of rubella by 46.0%, but compared to the median of the years 2006 to 2010 it was a decrease of 52.9%. In 2012, there was not any case of congenital rubella. Number of measles cases was 70 (0.18/100 000). In 2012, there was an increase in the number of cases of invasive disease caused by H. influenzae from 31 in 2011 to 36 in 2012. Number of infections caused by Streptococcus pneumoniae remained in 2012 as compared to 2011, on almost the same level: 436 in 2012 and 430 in 2011. However, there was a 36% increase in the number of sepsis cases caused by this organism. The incidence of tuberculosis in total (all forms of TB) in 2012 decreased compared to the previous year from 22.0 to 19.6 /100000, and pulmonary tuberculosis from 20.5 to 18.2. In 2012, were reported 1 093 cases of HIV infections (2.84/100 000), compared with the previous year, it was a fall in incidence of 2.4%. 21 cases of malaria occurred in people, who infection acquired abroad in malaria endemic areas. In 2012, there were no cases of diphtheria, poliomyelitis, rabies and viral haemorrhagic fevers outside of dengue, of which 5 cases of infections acquired in endemic areas were reported to National Sanitary Inspection. Total number of people who died in Poland in 2012 due to infectious and parasitic diseases, was 2 774. The share of deaths from these causes in the total number of deaths was 0.72%, and the mortality rate - 7.2/100 000. Out of all those deaths 41.1% were due to sepsis.
- Clinical problem-solving. A gut instinct. [Case Reports, Clinical Conference, Journal Article]
- N Engl J Med 2014 Aug 7; 371(6):560-4.
- The detergent fraction is effective in the detection of IgG anti-Strongyloides stercoralis in serum samples from immunocompromised individuals. [JOURNAL ARTICLE]
- Parasitol Int 2014 Aug 2.
Human strongyloidiasis is an intestinal helminthiasis that can be fatal particularly in cases of immunosuppression. The aim of this study is to assess the diagnostic accuracy of the detergent fraction (D), purified from total saline extract (SE) of Strongyloides venezuelensis, in the detection of anti-Strongyloides stercoralis IgG antibodies in serum samples from individuals coming from endemic areas for strongyloidiasis and presenting immunocompromised conditions: human immunodeficiency virus (HIV(+)), diabetes mellitus type 2, cancer, tuberculosis and alcoholism. Serum samples from 93 individuals were analyzed by ELISA, as follows: Group 1: 30 immunocompromised individuals with strongyloidiasis; Group 2: 33 immunocompromised individuals without strongyloidiasis and Group 3: 30 healthy individuals. The total saline extract (SE) and detergent fraction (D) showed a sensitivity of 73.33 and 83.33%, and specificity of 82.15 and 86.36%, respectively. The detergent fraction was effective to detect anti-S. stercoralis IgG antibodies in immunocompromised individuals with strongyloidiasis and may be applied as an important tool in the immunodiagnosis of human strongyloidiasis related to immunosuppression.
- Intestinal Co-infection of Tuberculosis and CMV can Cause Massive Lower GI Bleeding in a Patient with HIV. [JOURNAL ARTICLE]
- J Surg Sci 2013 Dec 1; 1(1):12-15.
Tuberculosis (TB) and HIV are considered pandemic by the World Health Organization (WHO). It has been reported that HIV infection is one of the major risk factors for the development of TB, increasing the incidence by up to 1,000 times, but it often has an atypical presentation. The incidence of extrapulmonary TB is increasing, largely among HIV patients. The diagnosis of intestinal TB is a challenge because of its chronic and nonspecific presentation which often mimics other diseases, and requires a high clinical suspicion to timely diagnose. Massive lower gastrointestinal bleeding due to intestinal TB was once an uncommon complication of TB, but recent reports indicate an increased incidence especially in developing countries. We suspect that co-infection with cytomegalovirus colitis contributes to the massive hemorrhage from intestinal TB. Surgical intervention is the recommended management for intestinal TB complicated by lower gastrointestinal bleeding. Accordingly, it is important for HIV patients to be screened and treated for TB to prevent this complication. Although the diagnosis is a challenge, it is important to consider intestinal TB as a cause of gastrointestinal bleeding in the HIV positive patients.
- Mycobacterium marinum Infection in Japanese Forest Green Tree Frogs (Rhacophorus arboreus). [JOURNAL ARTICLE]
- J Comp Pathol 2014 Jul 18.
Four Japanese forest green tree frogs (Rhacophorus arboreus) were presented with emaciation, abdominal distention and ulcerative and nodular cutaneous lesions affecting the brisket, limbs, digits and ventral abdomen. Another three frogs had been found dead in the same tank 1 year previously. Necropsy examination of these seven frogs revealed splenomegaly and hepatomegaly, with multiple tan-yellow nodular foci present in the liver, spleen, heart, lungs, ovaries and kidneys. Microscopically, five frogs had necrosis and surrounding granulomatous inflammation in the liver, spleen, kidneys, lungs, intestine and ovaries, with numerous acid-fast bacilli in the areas of necrosis. Two frogs had granulomatous lesions in the lungs, liver, spleen, heart, coelomic membrane, stomach and intestinal wall. These lesions had no or minimal necrosis and few acid-fast bacilli. Mycobacterium spp. was cultured from three frogs and identified as Mycobacterium marinum by colony growth rate and photochromogenicity and DNA sequencing. This is the first report of M. marinum infection in Japanese forest green tree frogs.
- Abdominal tuberculosis masquerading as intestinal lymphangiectasia. [Case Reports, Journal Article]
- Trop Gastroenterol 2013 Oct-Dec; 34(4):285-6.
- Differential diagnosis of intestinal tuberculosis from Crohn's disease and primary intestinal lymphoma in China. [JOURNAL ARTICLE]
- Saudi J Gastroenterol 2014 July-August; 20(4):241-247.
Background/Aims: There are many similarities and overlaps in clinical, radiological, endoscopic, and histological features among intestinal tuberculosis (ITB), Crohn's disease (CD), and primary intestinal lymphoma (PIL), and the differential diagnosis of ITB can be very challenging for clinicians. Patients and Methods: The clinical, radiologic, endoscopic, and pathological data of 213 patients were analyzed retrospectively. According to the diagnostic criteria and exclusive criteria of ITB, CD, and PIL, 83 patients were recruited and divided into three groups, including 30 cases in the ITB group, 38 cases in the CD group, and 15 cases in the PIL group, and the medical data and statistical analysis were recorded. Results : Rural patients with abdominal pain as the first symptom and with transverse ulcer and caseating granulomas were more common in the ITB group than the CD group, whereas urban patients with stool change as the first symptom, moderate or severe anemia, thickening of intestinal wall, rectal involvement, skipping distribution, prominent lymphoid aggregates, and irregular glands were more common in CD group than ITB group (P < 0.05). Young patients (age < 30 years) with fever, weakness, fatigue, abdominal mass, intestinal perforation, and emergent operation were more common in ITB group than PIL group, whereas thickening of intestinal wall, malignant lymphocytes, limited distribution, and involvement of small intestine occurred more in PIL group than ITB group (P < 0.05). Conclusion : The differential diagnosis of ITB from CD and PIL can be made by a combination of clinical manifestation, endoscopy, and pathological examinations.
- Tuberculosis infection causing intestinal perforations in 2 patients with systemic lupus erythematosus. [Journal Article]
- J Clin Rheumatol 2014 Aug; 20(5):287-90.
Patients with systemic lupus erythematosus (SLE) have a higher incidence rate of tuberculosis and a more frequent extrapulmonary involvement than the general population. We present 2 SLE patients who developed gastrointestinal tuberculosis complicated with intestinal perforation, a rare but serious complication that could be confused with lupus-associated intestinal vasculitis. Opportunistic infections such as tuberculosis must be suspected in SLE patients with abdominal symptoms on immunosuppressive therapy because its early recognition could prevent catastrophic complications such as intestinal perforation and subsequent peritonitis.
- Parasitic Diseases as the Cause of Death of Prisoners of War during the Korean War (1950-1953). [Journal Article]
- Korean J Parasitol 2014 Jun; 52(3):335-7.
To determine the cause of death of prisoners of war during the Korean War (1950-1953), death certificates or medical records were analyzed. Out of 7,614 deaths, 5,013 (65.8%) were due to infectious diseases. Although dysentery and tuberculosis were the most common infectious diseases, parasitic diseases had caused 14 deaths: paragonimiasis in 5, malaria in 3, amoebiasis in 2, intestinal parasitosis in 2, ascariasis in 1, and schistosomiasis in 1. These results showed that paragonimiasis, malaria, and amoebiasis were the most fatal parasitic diseases during the early 1950s in the Korean Peninsula. Since schistosomiasis is not endemic to Korea, it is likely that the infected private soldier moved from China or Japan to Korea.