Granulomatous reticuloses and malignant lymphogranuloma.
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Amyloidosis↗
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Results for “Tuberculosis, Splenic”
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[Splenic vein obstruction due to tuberculous lymphadenitis in the splenic hilum].
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Aged↗
A radiological study of abdominal tuberculosis in a Saudi population, with special reference to ultrasound and computed tomography.
The radiological appearances of abdominal tuberculosis are presented, which includes peritoneal, liver, spleen and pancreatic disease, but excludes renal and musculoskeletal involvement. Twenty-three patients were studied, 12 of whom had TB peritonitis. Barium studies remain valuable in gastrointestinal tract disease but for peritoneal, splenic, hepatic and pancreatic disease, ultrasound and computed tomography are indicated. Their diagnostic value is further enhanced by guided aspiration and biopsy techniques.
Adolescent↗
Vaccination of guinea pigs with DNA encoding Ag85A by gene gun bombardment.
A DNA vaccine encoding Ag85A from Mycobacterium tuberculosis was administered to guinea pigs by epidermal gene gun bombardment and its protective efficacy was determined. Vaccination with Ag85A DNA twice significantly reduced the severity of pulmonary pathology and number of pulmonary colony-forming units (CFU) (p<0.01). When immunogenic synthetic Ag85A peptide was used as a booster, lung pathology was improved significantly and pulmonary CFU were reduced dramatically. Neither Ag85A DNA nor BCG Tokyo protected the guinea pigs from hematogenous spread of tubercle bacilli to the spleen because splenic granulomas without central necrosis were recognized. When the vaccinated guinea pigs were followed up for 7 months, the pulmonary lesions became fibrotic in guinea pigs vaccinated with Ag85A DNA plus Ag85A peptide, or BCG Tokyo, and no tubercle bacilli were detected. The protective efficacy of the tuberculosis Ag85A DNA vaccine was improved significantly by peptide boosting. It is concluded that dosage and peptide boosting are important in the induction of higher protective efficacy by a tuberculosis DNA vaccine.
Acyltransferases↗
Hemophagocytic syndrome and Burkholderia cepacia splenic microabscesses in a child with chronic granulomatous disease.
Hemophagocytic syndrome, splenic microabscesses and pulmonary cavitary lesions were presented in a 17-month-old boy with prolonged fever, hepatosplenomegaly and a history of tuberculous lymphadenitis. Clinical course mimicked tuberculosis. Blood cultures were negative. Ultrasound-guided, percutaneous aspiration from splenic microabscesses grew Burkholderia cepacia. He was treated successfully with trimethoprim-sulfamethoxazole. This child with chronic granulomatous disease had an unusual clinical manifestation of B. cepacia infection.
Abscess↗
Computed tomographic findings of abdominal tuberculosis--report of five cases.
Five patients with proven intra-abdominal tuberculosis were examined with computed tomography (CT) over a period of one year. This revealed hepatosplenomegaly in all five cases. Macroscopic nodules were noted in the liver and spleen in three cases. All three cases showed more severe involvement of the spleen over the liver. Other features were enlarged (para-aortic, para-caval, peripancreatic and mesenteric) nodes, ascites, stellate mesentery and thickened bowel wall. Incidental extra-abdominal findings included intrathoracic nodules, pleural effusion, pericardial effusion with constrictive pericarditis, bony osteomyelitis and psoas abscess. Follow-up CT was performed on four of the five cases and showed significant resolution of the above findings. In addition, one case showed calcification within a healing splenic nodule. The presence of macroscopic nodules detected on CT, especially in the spleen, is an unusual finding in prior reports. This paper attempts to account for its high local incidence and discusses the significance of other findings in the diagnosis of abdominal tuberculosis.
Adult↗
Distribution of mycobacteria grown in vivo in the organs of intravenously infected mice.
Suspensions of 35-day-old Mycobacterium tuberculosis H37Rv prepared from stirred liquid cultures and injected intravenously into CD-1 mice accumulated in the lungs at a significantly higher concentration that that seen with logarithmically growing cells. Mice were infected with logarithmic 8-day-old or stationary phase 35-day-old suspensions of H37Rv, and 24 hours later, the bacilli within pooled lung and splenic homogenates were recovered by differential centrifugation. The bacilli were then homogenized in Tween saline and injected intravenously into fresh mice. The partitioning of the 4 inocula into the lungs and spleens of the secondary recipients was compared to that for the original suspensions grown in vitro. There was a significant increase in the number of lung-adapted H37Rv that could again be recovered from the lungs of the secondary recipients compared to that observed for the corresponding splenic preparations. This effect was not due to bacterial clumping or to size differences in the organisms grown in vivo. Homogenation of H37Rv with normal lung increased the relative accumulation of viable bacilli in the lungs compared to the spleens of recipient mice.
Animals↗
Specific acquired resistance and activity of migration inhibition factor (MIF) in spleens of mice with chronic tuberculosis.
The antimycobacterial resistance of the host (as evaluated by mycobacterial counts in spleens) and the in vitro cell-mediated immunological mechanisms ((cellular immune reactivity) assayed by the activity of migration inhibition factor in splenic fragments) were compared in the course of experimental chronic tuberculosis infection. Mice, either unvaccinated or vaccinated with killed mycobacteria suspended in saline and then either untreated or treated with azathioprine, were used in the study. The treatment with azathioprine caused a relative depression of specific resistance accompanied by less pronounced inhibition of migration in vitro. Although a higher level of specific resistance was detected in mice vaccinated with non-living vaccine, no enhancement of cellular reactivity in vitro could be estimated in the splenic cells of these animlas. The participation of humoral mechanisms in mice vaccinated with the non-living vaccine plausibly explains the discrepancy. The results indicate furthermore, that the migration inhibition test reflects delayed hypersensitivity rather than other components of cellular immune reactivity.
Animals↗
Associations of iron overload in Africa with hepatocellular carcinoma and tuberculosis: Strachan's 1929 thesis revisited.
We analyzed data from the first study of iron overload in Africans, conducted between 1925 and 1928, to determine whether this common condition is associated with death from hepatocellular carcinoma and/or tuberculosis. In the original study, necropsies were performed on 714 adult blacks from southern Africa. Hepatic and splenic iron levels were measured semiquantitatively in 604 subjects and one of five iron grades was assigned. We examined death from hepatocellular carcinoma or from tuberculosis and the variables of age, sex, the presence of cirrhosis or other diagnoses that might be influenced by iron status, and tissue iron grades. Nineteen percent of men and 16% of women had the highest grade of hepatic iron. After adjustment for the presence of cirrhosis, hepatic iron grade was the variable most significantly associated with death from hepatocellular carcinoma (P = .021). The odds of death from hepatocellular carcinoma in subjects with the highest grade of hepatic iron was 23.5 (95% confidence interval, 2.1 to 225) times the odds in subjects with the three lowest grades. Splenic iron was the variable most significantly associated with death from tuberculosis (P <.0001). The odds of death from tuberculosis with the highest grade of splenic iron was 16.9 (4.8 to 59.9) times the odds with the two lowest grades. These findings suggest that iron overload in black Africans may be a risk factor for death from hepatocellular carcinoma and for death from tuberculosis.
Adult↗
Mycobacterial infection in natural killer T cell knockout mice.
To gain a better understanding of the pathological role of natural killer (NK) T cells in murine tuberculosis, NKT knockout (KO) mice (J(alpha)281(-/-)mice) were utilized. Eight-week-old NKT KO mice of BALB/c origin and wild-type (WT) mice were infected with Mycobacterium tuberculosis Kurono strain by the airborne route using an airborne infection apparatus, and their capacity to control mycobacterial growth, granuloma formation, and cytokine production were examined. The NKT KO mice developed granulomatous lesions in the lungs; there was no statistically significant difference in pulmonary granuloma size between NKT KO and WT mice (p<0.01). The average CFU values increased 3 weeks post-infection, but decreased 9 and 11 weeks post-infection, in the lungs of NKT KO mice. When stimulated with Kurono strain in vitro, splenic cells from NKT KO mice produced less IFN-gamma than did those from WT mice. Expression of mRNA for IL-2, IL-4, IL-6, IL-10 and IL-12 p40 was slightly lower in NKT KO mice compared with WT mice. Our data indicate that NKT cells play a detrimental role in late-phase mycobacterial infection, although Th1 cells are essential in early-phase mycobacterial infection.
Animals↗
Computed tomography in abdominal tuberculosis.
The diagnosis of abdominal tuberculosis is often difficult because of its protean clinical manifestations and non-specific laboratory investigations. In the abdomen, tuberculosis may affect the intestinal tract, lymph nodes, peritoneum and solid viscera in varying combinations. CT, with its ability to provide a comprehensive overview of abdominal structures, is the imaging modality of choice for evaluation of such patients. This pictorial review illustrates the spectrum of CT appearances of abdominal tuberculosis which includes intestinal, lymph nodal, peritoneal, mesenteric, hepatic, splenic and pancreatic disease.
AIDS-Related Opportunistic Infections↗
[Role of islacet (an extract from Island cethraria thalluses) in the complex therapy of experimental tuberculosis].
In vitro experiments showed that islacet produced an inhibitory effect on the growth of laboratory drug-sensitive Mycobacterium strains when used at a concentration of 25 microg/ml. A considerable reduction in death rates and a significant decrease in the mass index and in the indices of pulmonary lesion and bacterial isolation from splenic homogenates were observed on the model of generalized tuberculosis in mice and rabbits given islacet. In parallel with the higher efficiency of therapy using islacet, there was ConA- and PPD- stimulated proliferation of splenocytes and their production of interleukin-2 drastically inhibited in mice that had long received multidrug therapy (HRZ and HRE). Islacet was found to enhance the functional activity of phagocytes and that inhibited during the development of infection and under the influence of long-term (more than 1 month) etiotropic therapy: the generation of superoxide by murine peritoneal macrophages and rabbit neutrophils, as well as by the absorptive and digestive function of peritoneal macrophages.
Animals↗
Focal lesions of the spleen in patients with fever of unknown origin: sonographic patterns and diagnosis.
A review of ultrasonic scans performed for 811 patients admitted at the Abbassia Fever Hospital between 1990 through 1996 for investigation of fever undiagnosed for over 3 weeks revealed 28 cases of focal splenic lesions. They included lymphoma in sixteen cases, tuberculosis in six cases, echinococcal cysts in three, abscess in two, and infarction in one. Final diagnosis was obtained by correlating the ultrasonography and clinical findings, together with pathologic, bacteriologic, serologic and angiographic data.
Diagnosis, Differential↗
Etiology, clinical features and outcome of splenic microabscesses in HIV-infected patients with prolonged fever.
A prospective study was conducted to determine the etiology, clinical features, and outcome in a series of 32 consecutively enrolled HIV-infected patients with prolonged fever in whom high resolution (7.5 Mhz) sonography revealed multiple splenic microabscesses. Conventional (3.5 Mhz) sonography showed no splenic abnormalities in any patients. The diagnoses were: tuberculosis (14), visceral leishmaniasis (7), disseminated Mycobacterium avium complex infection (5), Salmonella spp. bacteremia (2), lymphoma (2), disseminated Rhodococcus equi infection (1), disseminated Candida krusei infection (1) and Pneumocystis carinii pneumonia (1). Twenty-eight patients were followed up for six months and four were lost to follow-up. In 16 patients with a clinical cure and microbiological eradication, the findings on follow-up high resolution sonography were normal, and in two patients the microabscesses persisted; ten patients died. In conclusion, the findings suggest splenic microabscesses may be a frequent condition in HIV-infected patients with prolonged fever, being an unspecific manifestation of the opportunistic diseases causing fever of unknown origin in this population. They cannot be detected by conventional abdominal sonography, whereas high resolution sonography is a useful technique for their detection and follow-up.
AIDS-Related Opportunistic Infections↗
Chemokine receptor expression and modulation by Mycobacterium tuberculosis antigens on mononuclear cells from human lymphoid tissues.
Chemokine receptor switching on lymphoid cells is an important factor regulating migration and homing, but little is known about the expression of such molecules during Mycobacterium tuberculosis infection in humans. We describe CCR2, CCR5 and CCR7 expression on human cells from blood, spleen and pulmonary hilar lymph nodes (PHLN) stimulated by M. tuberculosis antigens. CCR2 was not expressed by CD3+ cells regardless of the presence of antigen, but was highly expressed on CD14+ CD63+ monocytes/macrophages. CCR2 decreased on splenic monocytes/macrophages by nearly 50% in culture, independent of antigen, but remained high in blood and PHLN. CCR5 was low in CD3+ cells and was down-regulated by M. tuberculosis antigens on blood and splenic cells but not in PHLN. CCR5 was highly expressed on monocytes/macrophages and was down-regulated by M. tuberculosis antigens at 48 hr only in blood. Less than 15% of CD3+ cells from spleen and PHLN were CCR7+, whereas nearly 40% from blood expressed this receptor on primary isolation. However, CCR7 in PHLN increased in culture, independent of antigen. Monocytes/macrophages did not express CCR7. Thus, we characterize, for the first time, chemokine receptor expression and differential modulation by M. tuberculosis antigens on human mononuclear cells from spleen, blood and PHLN. Knowledge of chemokine receptor switching in human lymphoid tissue provides novel insight into mechanisms of the immune response to M. tuberculosis with potential effects on directing cell trafficking.
Adolescent↗
Sonographic diagnosis of congenital tuberculosis: an experience with four cases.
Abdominal sonography of four infants with pyrexia and hepatomegaly demonstrated multiple hypoechoeic hepatic and splenic foci, guided biopsies of which showed caseating granulomas with acid-fast bacilli. Evidence of tuberculosis in maternal endometrium and its exclusion in the contacts further confirmed a diagnosis of congenital tuberculosis. Clinical suspicion supplemented by careful sonography facilitated early detection and antemortem diagnosis of this potentially fatal disease.
Female↗
Fine-needle aspiration biopsy of spleen in diagnosis of generalized amyloidosis.
Fine-needle aspiration biopsy of the spleen was performed on 18 patients shown to have amyloid deposits in other organs and on 17 control patients being investigated for proteinuria. Of the 18 patients with amyloid disease smears of splenic aspirate were positive in all cases, renal biopsy was positive in 16 out of 16 cases, and rectal biopsy was positive in seven out of 11 cases. None of the splenic smears were positive in the 17 control patients and no amyloid was found in the kidney in 15 of these patients on whom renal biopsy was performed. Splenic aspirate biopsy seems to be a simple and safe procedure for the diagnosis of amyloidosis. It is as accurate as renal biopsy and more accurate than rectal biopsy.
Adolescent↗
Observations on the course and prognosis of sarcoidosis; with special consideration of its intrathoracic manifestations.
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Adolescent↗