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At least 271 records · Page 15Linked to original sources
PubMed1966

Host-parasite relationships in experimental airborne tuberculosis. I. Preliminary studies in BCG-vaccinated and nonvaccinated animals.

Smith, D. W. (University of Wisconsin, Madison), E. Wiegeshaus, R. Navalkar, and A. A. Grover. Host-parasite relationships in experimental airborne tuberculosis. I. Preliminary studies in BCG-vaccinated and nonvaccinated animals. J. Bacteriol. 91:718-724. 1966.-Previous studies from this laboratory on immunogenicity and allergenicity of defatted mycobacterial vaccines involved subcutaneous challenge of guinea pigs and killing of the animals 6 weeks later to evaluate the amount of disease. This type of experiment has discontinued in this laboratory in favor of an airborne challenge type of experiment, with the advantages that animals can be challenged with small numbers of bacilli by a natural route, and the number of primary lesions, the rate of spread from those lesions, and the rate of bacillary multiplication can be used to evaluate protection. Experiments to determine uniformity of infection showed that a fair degree of uniformity resulted when seven guinea pigs were exposed simultaneously, and were studied 3 weeks later to determine numbers of primary lesions and bacilli in the tissues. A less satisfactory degree of uniformity was obtained when more animals were exposed at one time. BCG-vaccinated and nonvaccinated animals were studied to determine the earliest time and the optimal time for killing the animals to detect the effects of vaccination. In guinea pigs, the degree of protection assessed by lesion counts is time-dependent, but the degree of protection assessed by viable counts of bacilli in the tissues was relatively constant 3 to 12 weeks after infection. Mice vaccinated subcutaneously with BCG were not protected against infection at any interval between 2 and 19 weeks. Guinea pigs vaccinated subcutaneously with the same lot of vaccine were protected as judged by counts of viable bacilli in the tissues 3 weeks after infection.

Air↗
PubMed1994

Acute hypersplenism and thrombocytopenia: a new presentation of disseminated mycobacterial infection in patients with acquired immunodeficiency syndrome.

We describe 2 patients with acquired immunodeficiency syndrome who presented with acute or subacute splenomegaly and thrombocytopenia secondary to disseminated Mycobacterium avium complex (MAC). The patients were treated for immune thrombocytopenic purpura without success. Thrombocytopenia may be a prominent feature of MAC. Our experience suggests that disseminated MAC may present with acute splenomegaly and thrombocytopenia in these patients and that a high index of suspicion for disseminated tuberculosis is indispensable in order to avoid delay in diagnosis and treatment in patients presenting with rapidly progressive splenomegaly and thrombocytopenia.

AIDS-Related Opportunistic Infections↗
PubMed2005

Miliary tuberculosis not affecting the lungs but complicated by acute respiratory distress syndrome.

A 61-year-old woman was admitted with fever and headache of 10-day duration. She was found to have anemia, jaundice, and signs of meningitis. The erythrocyte sedimentation rate was increased and the tuberculin skin test was positive. A provisional diagnosis of miliary tuberculosis was made and antituberculous therapy was started, although no miliary lesions were seen on chest radiography. However, her condition rapidly deteriorated with diffuse opacification of both lungs and she died on the 7th hospital day. Postmortem examination revealed miliary tuberculosis in several organs but not in the lungs with acute respiratory distress syndrome accounting for the lung pathology. It should be noted that on rare occasions the lungs may not be involved by miliary tuberculosis.

Bone Marrow↗
PubMed2000

Generalized tuberculosis in the acquired immune deficiency syndrome.

OBJECTIVE: Generalized, or hematogenously disseminated, tuberculosis (TB) in patients with the acquired immune deficiency syndrome (AIDS) has been associated with a high incidence of cases remaining undiagnosed until postmortem. To better characterize generalized TB in the setting of AIDS, this report describes the clinical, laboratory, radiologic, and pathologic features of 20 fatal cases. DESIGN: The medical records, autopsy protocols, and histologic material from patients with AIDS and concomitant TB were reviewed. All patients were autopsied at a tertiary care medical center during the years 1985-1997. RESULTS: In 50% of our 20 cases, diagnosis was not made until postmortem. Signs and symptoms were few, including the absence of fever (temperature > or = 38 degrees C) in 55% of patients. Consistent laboratory abnormalities of a nonspecific nature were limited to hyponatremia (sodium <135 mmol/L) in 60%. Both peripheral and deep (thoracic and abdominal) lymphadenopathy, unusual in adults with TB, occurred in 45% and 95% of cases, respectively. In contrast to previous reports, all of the 6 cases of tuberculous meningitis presented as acute meningitis with a predominance of neutrophils in cerebrospinal fluid. Necrotizing encephalitis with extension of the acute inflammation into the superficial cortex was seen in all cases and tuberculous brain abscesses occurred in 50% of cases, a higher frequency than previously reported. Despite lung involvement in 90% of the cases, 33% of chest radiographs were interpreted as normal and disseminated mycobacterial disease was not suggested in the radiograph report in any of the other cases. Soft tissue abscesses in uncharacteristic locations such as the neck, mediastinum, and perirectal area occurred in these patients. Histologically, 95% of organs sampled showed inflammatory foci characterized by extensive necrosis with numerous neutrophils and/or karyorrhectic debris, numerous acid-fast bacilli, few or no epithelioid histiocytes, and no Langhans giant cells. CONCLUSION: Clinically and pathologically, generalized TB in the setting of AIDS is characterized by either unusual features or a lack of the typical features described for generalized TB in patients who do not have AIDS. This absence of classic features contributes to the high incidence of cases that remain undiagnosed until postmortem examination.

Acquired Immunodeficiency Syndrome↗
PubMed1988

An experimental model of chemotherapy on dormant tuberculous infection, with particular reference to rifampicin.

Mice were infected intravenously with a streptomycin (SM)-dependent strain of tubercle bacilli which had been starved of the antibiotic. The inoculum persisted in the spleen for a fairly long period, especially keeping almost the initial level of viable counts in the first few weeks. Isoniazid (INH) administration exerted little effect on such fate of the infection at a bactericidal dose to the same strain multiplying under the supply of SM. Rifampicin (RFP) was, however, highly effective in either case. Similar results were obtained in the corresponding in vitro experiments. The data suggest that this animal model is a convenient system for screening drugs effective on the dormant tuberculous infection.

Animals↗
PubMed1999

Successful treatment of spleen tuberculosis in a patient with human immunodeficiency virus infection.

Tuberculosis in human immunodeficiency virus (HIV)-infected patients may act as a cofactor that accelerates the clinical course of HIV infection, and, indeed, HIV-infected patients with tuberculosis have a reduced survival rate compared to those without tuberculosis. Diagnosis of tuberculosis in HIV-positive patients can be difficult because of nonspecific symptoms and the time required for the identification of mycobacteria by means of culture techniques. Recently, antiretroviral combination therapies have improved the outcome of several acquired immune deficiency syndrome (AIDS)-associated conditions. Unfortunately, the use of antiretroviral therapy for patients coinfected with HIV and Mycobacterium tuberculosis is still to be fully evaluated. The complexity of side-effects due to antituberculosis medication and drug interaction represent important issues and combining an effective anti-HIV treatment with antituberculosis therapy is still a clinical challenge. We discuss here a case of spleen tuberculosis in a human immunodeficiency virus-positive patient who had a successful response after a diagnostic splenectomy and medical treatment that included classical antituberculosis treatment associated with antiretroviral therapy without protease inhibitors.

AIDS-Related Opportunistic Infections↗
PubMed1999

[CT in diagnosis of tuberculosis of liver and spleen].

OBJECTIVE: To analyze CT findings of hepatospleeno-tuberculosis and to explore the characteristics for diagnosis and differential diagnosis of the disease. METHODS: CT scans were performed in fifteen patients. There were nine men and six women, the age ranging from 18 to 60 years old. All patients were diagnosed clinically, one of which was confirmed by pathology after surgery, two of which were confirmed by pathology through CT-guided biopsy. RESULTS: All cases were concurrent with two or more other tuberculosis. Disseminated milliary, small nodules and small saccular foci were present in livers of 8 cases and spleens of 5, and isolated low dense lesion in liver of 1 case, diffuse calcifications in liver and spleen of another 1. CONCLUSIONS: When disseminated milliary, small nodules and small saccular foci are found by CT in liver or spleen and tuberculous lesions are present in other tissues, diagnosis of liver and/or spleen tuberculosis should be considered.

Adolescent↗
PubMedDate not supplied

Laparoscopic intervention in resistant hepatosplenic tuberculosis presenting as pyrexia of unknown origin.

Hepatosplenic tuberculosis (HST), rarely encountered in surgical practice, is seen in-patients with disseminated tuberculosis. A 20-year-old female presenting with pyrexia of unknown origin (PUO) was subsequently diagnosed to have lymph-nodal tuberculosis with involvement of liver and spleen. Despite anti-tuberculosis treatment (ATT) for 3 months, clinical improvement did not occur and fever persisted. Laparoscopic splenectomy and drainage of the hepatic cold abscess were done with favorable results. Smear for acid fast bacilli (AFB), culture for Mycobacterium tuberculosis and histopathological examination (HPE) established the diagnosis of tuberculosis (TB).

Adult↗