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PubMed1993

[The clinical observation of 247 tuberculosis cases in Oral Maxillofacial region]

This paper presents a report of clinical observation on tuberculosis of oral and maxillofacial region in 247 patients.Of these which diagnosed by histopathology.94 cases are from mucous membrane of oral cavity,108 subjects from lymph nodes,27 ones from parotid gland,15 persons from facial dermis and 3 from jaw.Among 247 patients.154 cases were male and 93 female.The youngest was 2 years old and the eldest one was 71 of age and the mean age was 32 years old.The shortest course of disease was 15 days and the longest was 30 years,the mean course of time was two and half years.The rate of clinical diagnosis accord with pathology was 41.3%,most error diagnosis were to suspect inflammation,tumors and ulcer.In addition,the etiology,the clinical manifestion,diagnosis and therapies of oral and maxillofacial tuberculosis were analyzed.

Journal Article↗
PubMed2005

BCG Moreau Rio de Janeiro: an oral vaccine against tuberculosis--review.

The vaccine Bacillus of Calmette Guérin (BCG) was originally developed in France as an oral vaccine against tuberculosis. The oral use of this vaccine was replaced by the parenteral route in almost all countries after the Lubeck disaster. In contrast, Brazil retained the oral delivery of the vaccine until the mid-seventies when it was replaced by the intradermal route. This change in route of delivery was mainly secondary to pressure by medical practitioners based on the poor responses of oral immunized subjects to purified protein derivative (PPD) skin tests. Even after the change of route of delivery, Ataulpho de Paiva Foundation continued making the oral vaccine. Currently, BCG Moreau has been described as one of the most immunogenic and with fewer side effects than other BCGs. The genomics, proteomics and vaccine trials for oral BCG Moreau Rio de Janeiro are currently under investigation. In this review, we intend to describe the history of BCG Moreau Rio de Janeiro in Brazil.

BCG Vaccine↗
PubMedDate not supplied

[Therapy of tuberculosis today: to prescribe is not enough. A case report].

Tuberculosis is a re-emerging disease not only in developing but also in industrialized countries. The multidrug resistance of Mycobacterium tuberculosis is an increasing problem, mainly due to the poor compliance of the patients on drug regimens. The authors discuss the case of a 28-year-old male affected by pulmonary tuberculosis who did not improve after a 3-month period of oral tuberculosis treatment. The switch to intravenous therapy was rapidly followed by clinical and microbiological improvement. The patient subsequently admitted that he had not complied with oral treatment because after healing he would be sent back to prison. This case demonstrates that, even in the hospital setting, noncompliance to antitubercular therapy is not unfrequent, as demonstrated by other case reports. The authors discuss a great amount of literature that strongly supports the introduction of directly observed therapy for the treatment of all tuberculosis patients.

Administration, Oral↗
PubMed1987

Activity of ciprofloxacin and other fluorinated quinolones against mycobacteria.

The new fluorinated quinolones display interesting but variable activity against mycobacteria. Almost all compounds tested (ciprofloxacin, ofloxacin, enoxacin, norfloxacin, difloxacin, CI-934, A-56620, and megalone) inhibit Mycobacterium tuberculosis at achievable serum concentrations, with ciprofloxacin and ofloxacin most active by weight (minimal inhibitory concentration at which growth of 90 percent of strains is inhibited is equal to 1 microgram/ml or less). The growth of Mycobacterium kansasii, Mycobacterium xenopi, and Mycobacterium fortuitum is also well inhibited by these agents in the same range of concentrations. Activity against the Mycobacterium avium complex is method-dependent, with growth of perhaps one third of the strains isolated from patients with the acquired immune deficiency syndrome inhibited by ciprofloxacin. Determination of individual drug efficacy data in experimental mycobacterial infections is not a practical goal. However, combination therapy studies are in progress using murine models of both M. tuberculosis and M. avium challenges. Ofloxacin has been used with some success in human patients with pulmonary tuberculosis. Oral administration may be an important advantage, and, when used in combination with other active agents, the new quinolones may have a useful role in treating mycobacterial infections.

Anti-Bacterial Agents↗
PubMed2004

Tuberculosis: medical management update.

Tuberculosis (TB) is an infectious chronic disease. After decades of steadily declining prevalence, the disease has reemerged in the last 5 years. Symptoms of TB are mild and not specific and can be classified as either systemic or localized to target organs. Microscopic examination of the sputum remains an inexpensive and rapid way to identify highly infectious patients. Four different antimicrobial agents-rifampin, ethambutol, pirazinamide, and isoniazid-form the basis of currently recommended antituberculosis therapy. Tuberculosis could be an occupational risk for health care workers. Dentists must be involved in the health promotion and early detection of TB.

Adult↗
PubMed1998

Isolated cervical tuberculosis in patients with HIV infection.

OBJECTIVE: Tuberculosis isolated to the head and neck region is common in patients with HIV infection. However, the management of isolated head and neck tuberculosis has not been reported in the literature. This study was done to describe the characteristics of tuberculosis isolated to the head and neck region in patients infected with HIV and to detect differences in presentation and diagnostic management based on the status of HIV infection at presentation. METHODS: A retrospective study was performed including 38 patients infected with HIV who were seen with tuberculosis isolated to the head and neck region at two tertiary care centers during a 10-year period. These patients were divided into two groups on the basis of the HIV status at presentation, which indirectly reflects the level of immunosuppression. Group 1 included 11 patients (29%) with AIDS at presentation. Group 2 included 27 patients (71%) with HIV infection but not AIDS. RESULTS: The cervical lymphatics were the most common site for isolated head and neck tuberculosis (89%), with the supraclavicular nodes most often involved (53%). Extralymphatic involvement was less common (11%), but involved a variety of anatomic locations (skin, spinal cord, larynx, parotid). The presenting history and physical examination had a low sensitivity for tuberculosis in patients with HIV infection, mainly because of the presence of multiple confounding factors. Purified protein derivative testing was highly sensitive for tuberculosis in patients with HIV infection alone (61 %); however, its usefulness was diminished in patients with AIDS (14%; p=0.03). Fine-needle aspiration biopsy was 94% sensitive for diagnosing tuberculosis and was not affected by the status of HIV infection. Surgical biopsy was the gold standard for diagnosing tuberculosis but was associated with chronically draining fistulas in a significant number of cases (14%). CONCLUSIONS: These data suggest that tuberculosis should be considered in the differential diagnosis of all head and neck lesions in patients infected with HIV, even in the absence of pulmonary involvement. Purified protein derivative testing should be done liberally in these patients, with realization that the sensitivity of purified protein derivative testing is reduced in patients with AIDS. Fine-needle aspiration biopsy should be the key diagnostic test in this patient population, with open surgical biopsy reserved for highly suspicious cases in which other measures were not diagnostic.

Adult↗
PubMed1996

Probable BCG osteomyelitis of the hard palate: a case report.

A 4-year-old child with probable multifocal BCG osteomyelitis is reported. The lesions in the skull, clavicula, humerus, ribs, fibula, calcaneus, metatarsus, and hard palate were mainly osteolytic and healed rapidly with antituberculotic therapy. This is the first time that involvement of the hard palate has been described.

Antibiotics, Antitubercular↗
PubMed2001

Tuberculous osteomyelitis of the mandible: a case report.

Osteomyelitis of jaws caused by infection with Mycobacterium tuberculosis is uncommon, especially in children. We present a case of tuberculous osteomyelitis in a young child. Its clinical presentation, with features similar to a dento-alveolar abscess, underline the importance of considering it in the differential diagnosis of jaw lesions. We discuss of the diagnostic techniques, management and preventive measures, and stress the importance of history taking during clinical examination.

Antitubercular Agents↗