Pulmonary tuberculosis

肺结核
  • 文章类型: Case Reports
    尽管通常是可以治疗和预防的,肺结核(PTB)是导致死亡的最常见感染因子之一。结核病的误诊经常导致不必要的诊断程序并推迟治疗的开始。
    肺结核(PTB)可以表现出各种异常的放射学和临床特征。结核病的误诊经常导致不必要的诊断程序并推迟治疗的开始。这里,我们描述了一名50岁的男性,他的放射学发现和非典型症状表现为癌性病变,导致最初诊断为肺癌.然而,肺病变的组织病理学和活检显示慢性肉芽肿性炎症伴干酪样坏死,确认PTB是真正的原因,没有进一步的恶性肿瘤指征。
    UNASSIGNED: Despite being generally treatable and preventative, pulmonary tuberculosis (PTB) is one of the most common infectious agents that cause death. Misdiagnosis of TB frequently leads to unwarranted diagnostic procedures and postpones the start of treatment.
    UNASSIGNED: Pulmonary tuberculosis (PTB) can present with various unusual radiological and clinical characteristics. Misdiagnosis of TB frequently leads to unwarranted diagnostic procedures and postpones the start of treatment. Here, we describe a 50-year-old man who presented with a cancerous-type lesion on radiological findings and atypical symptoms that led to an initial diagnosis of lung cancer. However, histopathology and biopsy of the lung lesion revealed chronic granulomatous inflammation with caseous necrosis, confirming PTB as the true cause, with no further indications of malignancy.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    由于预计老年人口的增长,预计肺癌和结核病的并发发病率将上升。奥希替尼和抗结核药物的联合治疗尚未建立。我们报告了一例老年患者同时服用奥希替尼和抗结核药物的成功治疗病例,一位89岁的女性,诊断为表皮生长因子受体(EGFR)突变的肺癌和肺结核。积累的证据是必要的,为肺癌和肺结核患者制定最佳的治疗策略。
    The concurrent incidence of lung cancer and tuberculosis is expected to escalate due to the projected growth in the older population. Combination therapy with osimertinib and antituberculosis drugs has not been well-established. We report a case of successful treatment involving the concomitant administration of osimertinib and antituberculosis drugs in an older patient, an 89-year-old female, diagnosed with epidermal growth factor receptor (EGFR)-mutant lung cancer and pulmonary tuberculosis. Accumulating evidence is warranted to develop an optimal treatment strategy for patients with lung cancer and tuberculosis.
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  • 文章类型: Case Reports
    背景:15岁以下儿童的结核病(TB)通常会导致气道压迫,中间支气管(BI)是最常见的部位。内镜摘除术可用于清除淋巴结并在严重病例中建立气道。刚性和柔性支气管镜检查都是合适的,鳄鱼钳因其提取组织的能力而备受青睐。最近的研究也探索了冷冻探针去核。
    方法:根据母亲和姐妹的XpertMTB/RIF阳性状态,诊断出一名HIV阳性男孩,在接受结核病治疗9个月后出现持续症状。他开始接受4种药物结核病治疗,但患儿仍有临床症状,胸部X线检查异常,结核病未确诊.进行了支气管镜检查,由于干酪样肉芽肿导致右侧中下叶塌陷,导致BI完全阻塞。冷冻疗法被用来重塑气道,和后续支气管镜检查证实专利BI。
    结论:虽然在这种情况下冷冻疗法在恢复气道通畅方面是有效的,缺乏对儿童使用的知识。
    BACKGROUND: Tuberculosis (TB) in children under 15 years often results in airway compression, with bronchus intermedius (BI) being the most common site. Endoscopic enucleations can be used to remove lymph nodes and establish an airway in severe cases. Both rigid and flexible bronchoscopy are suitable, with alligator forceps being preferred for its ability to extract tissue. Recent studies have also explored cryoprobe enucleation.
    METHODS: An HIV-positive boy with persistent symptoms after 9 months of TB treatment was diagnosed based on his mother\'s and sister\'s Xpert MTB/RIF positive status. He was started on 4-drug TB treatment, but the child remained clinically symptomatic with abnormal chest X-ray and unconfirmed TB. Bronchoscopy was performed, revealing complete obstruction of BI due to caseating granulomas causing collapse of the right middle and lower lobes. Cryotherapy was used to recanalize the airway, and follow-up bronchoscopy confirmed patent BI.
    CONCLUSIONS: While cryotherapy was effective in the restoration of airway patency in this case, there is a lack of knowledge about its use in children.
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  • 文章类型: Case Reports
    Lemierre综合征的特征是颈内静脉血栓性静脉炎和菌血症,主要来自厌氧生物。这种情况通常在最近的口咽感染后出现。年轻,健康人长期咽炎进展为败血症,肺炎,或侧颈僵硬应怀疑患有Lemierre综合征。识别颈内静脉血栓性静脉炎和在血液培养上发展厌氧性细菌生长通常用于确认诊断。治疗包括长期抗生素治疗,有时与抗凝药物一起使用。在这个案例报告中,我们描述了一名29岁男性结核分枝杆菌合并肺结核的独特病例,结核性脑膜炎,结核相关性急性缺血性卒中合并化脓性血栓性静脉炎.患者出现突然发作的感觉改变4小时。对大脑进行了磁共振成像,提示梗阻性脑积水伴脑室周围渗出.病人开始接受抗菌治疗,抗生素,抗凝剂,和全身性类固醇。患者出院时非常稳定。因此,至关重要的是,在提供及时和相关的诊断并推荐正确的治疗方案的同时,考虑这种非典型结核病表现的可能性。
    Lemierre\'s syndrome is characterized by internal jugular vein thrombophlebitis and bacteremia, primarily from anaerobic organisms. The condition usually arises after a recent oropharyngeal infection. Young, healthy people with prolonged pharyngitis that progresses into septicemia, pneumonia, or lateral neck stiffness should be suspected of having Lemierre\'s syndrome. Identifying internal jugular vein thrombophlebitis and developing anaerobic bacterial growth on blood culture are frequently used to confirm the diagnosis. Treatment consists of long-term antibiotic treatment, sometimes in conjunction with anticoagulant medication. In this case report, we describe the unique case of a 29-year-old male with Mycobacterium tuberculosis with pulmonary tuberculosis, tubercular meningitis, tuberculosis-related acute ischemic stroke with septic thrombophlebitis. The patient presented with sudden onset altered sensorium for 4 hours. Magnetic resonance imaging of the brain was done, which suggested obstructive hydrocephalus with periventricular ooze. The patient was started on antibacillary treatment, antibiotics, anticoagulants, and systemic steroids. The patient was vitally stable when he was discharged. Therefore, it is crucial to consider the likelihood of such atypical tuberculosis presentations while providing a prompt and relevant diagnosis and recommending the right course of therapy.
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  • 文章类型: Journal Article
    已知腹膜结核(TB)模拟晚期卵巢癌。在这个案例报告中,我们描述了在国际妇产科联合会(FIGO)阶段IC1伴有肺和腹膜TB的卵巢癌(子宫内膜样癌3级)的独特病例,术前怀疑是晚期卵巢癌和肺结核并存。一名68岁的妇女表现出突出的腹部肿块和发烧。实验室调查,成像,痰液分析表明在FIGOIIIC期可能诊断为卵巢癌,以腹膜播散和主动脉旁淋巴结转移为特征,并发肺结核进一步复杂化。手术治疗包括全腹全子宫切除术,双侧输卵管卵巢切除术,和部分网膜切除术.术中,肿瘤位于右卵巢,腹膜明显增厚,粘连提示腹膜结核。手术完成无明显并发症。术后组织病理学评估证实右侧卵巢3级子宫内膜样癌以及腹膜结核的证据。考虑到结核病的粘连程度,淋巴结清扫分期被认为具有挑战性,因此没有进行。在术后第2天开始抗结核治疗导致术前确定的肺结节和主动脉旁淋巴结肿大明显消退。表明它们的炎症源于结核病。尽管IC1期子宫内膜样癌3级患者通常主张术后化疗,但患者选择不进行化疗。因此,未给予辅助治疗,患者仍在密切观察.
    Peritoneal tuberculosis (TB) is known to mimic advanced ovarian cancer. In this case report, we describe a unique case of ovarian cancer (endometrioid carcinoma grade 3) at the International Federation of Gynecology and Obstetrics (FIGO) stage IC1 with pulmonary and peritoneal TB, which was suspected preoperatively to be a coexistence of advanced ovarian cancer and pulmonary TB. A 68-year-old woman presented with a prominent abdominal mass and fever. Laboratory investigations, imaging, and sputum analysis indicated a probable diagnosis of ovarian cancer at FIGO stage IIIC, characterized by peritoneal dissemination and para-aortic lymph node metastasis, which was further complicated by coexisting pulmonary TB. Surgical management included total abdominal hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy. Intraoperatively, the tumor was localized to the right ovary with significant peritoneal thickening and adhesions indicative of peritoneal TB. The surgery was completed without apparent complications. Postoperative histopathological evaluation confirmed grade 3 endometrioid carcinoma in the right ovary along with evidence of peritoneal TB. Given the extent of adhesions attributed to TB, lymph node dissection for staging was deemed challenging and was thus not pursued. Initiation of anti-TB treatment on postoperative day 2 resulted in marked regression of the preoperatively identified pulmonary nodules and para-aortic lymph node enlargement, suggesting their inflammatory origin from TB. Although postoperative chemotherapy is typically advocated for patients with stage IC1 endometrioid carcinoma grade 3, the patient opted against it. Consequently, no adjuvant therapy was administered and the patient remained under close observation.
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    文章类型: Journal Article
    肺结核(PTB)是大多数不发达国家和发展中国家的主要公共卫生问题。PTB影响患者的营养状况并影响体重指数(BMI)。存在组织炎症和自由基从活化的吞噬细胞爆发,导致氧化应激。本研究旨在评估新发现的肺结核患者中氧化应激与体重指数之间的关系。
    这是一项病例对照研究,旨在评估40例连续新诊断的PTB患者的氧化应激参数,例如一氧化氮(NO)和丙二醛(MDA),并与40例年龄匹配的健康对照进行比较。通过计算BMI来测量研究对象的营养状况。
    对照组的平均BMI为21.61±3.52Kg/m2,PTB患者的平均BMI为17.47±1.56Kg/m2,差异有统计学意义(p<0.0001)。PTB患者的MDA(7.65±0.65nmol/ml)和NO(36.12±1.07μmol/l)的平均水平明显高于对照组(MDA3.56±0.41nmol/ml和NO14.48±0.93μmol/l)。
    与对照组相比,在新诊断的PTB患者中观察到丙二醛和一氧化氮水平升高,表明PTB中存在氧化应激。这些患者的BMI明显低于对照组。因此,结论是PTB患者的氧化应激与BMI之间存在负相关关系,在国家结核病消除计划下,除了营养干预外,补充抗氧化剂可能有助于改善BMI并促进这些患者的更好恢复。
    UNASSIGNED: Pulmonary tuberculosis (PTB) is a major public health concern in most underdeveloped and developing countries. PTB affects the nutritional status of the patients and influences the body mass index (BMI). There is tissue inflammation and free radical burst from activated phagocytes resulting in oxidative stress. The present study was designed to assess the relationship between oxidative stress and body mass index in newly detected pulmonary tuberculosis patients.
    UNASSIGNED: This was a case-control study designed to assess oxidative stress parameters such as nitric oxide (NO) and malondialdehyde (MDA) in 40 consecutives newly diagnosed PTB patients and compared with 40 age-matched healthy controls. The nutritional status of the study subjects was measured by calculating the BMI.
    UNASSIGNED: The mean BMI was 21.61±3.52 Kg/m2 in controls and 17.47±1.56 Kg/m2 in PTB patients and the difference was statistically significant (p <0.0001). The mean levels of MDA (7.65±0.65 nmol/ml) and NO (36.12±1.07 μmol/l) were significantly higher in PTB patients compared to controls (MDA 3.56±0.41 nmol/ml and NO 14.48±0.93 μmol/l).
    UNASSIGNED: Increased levels of malondialdehyde and nitric oxide were observed in newly diagnosed PTB patients when compared to controls indicating oxidative stress in PTB. The BMI of these patients was significantly lower than the controls. Thus, it is concluded that there is an inverse relationship between oxidative stress and BMI in PTB patients and antioxidant supplementation in addition to nutritional intervention under the National Tuberculosis Elimination Program may help to improve the BMI and promote better recovery in these patients.
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  • 文章类型: Case Reports
    在评估电解质紊乱的同时识别肺部病理对于优化患者管理至关重要。在结核病流行地区工作的医生应将这种病理视为电解质失衡的差异。
    低钠血症,常见的电解质不平衡,可能源于各种潜在的病因,如利尿剂,腹泻,呕吐,充血性心力衰竭,肝脏和肾脏疾病。我们提供了一名74岁男子的病例报告,强调了肺结核(TB)与低钠血症的发展之间的关系。GeneXpert对患者痰液样本进行分析,发现潜在的活动性肺结核是低钠血症的原因。患者开始接受抗结核治疗,同时开始限制液体和补充钠以纠正电解质失衡。在接下来的3天里,患者表现出低钠血症消退的临床改善。该病例还强调了将TB视为低钠血症患者的潜在病因的重要性。尤其是在流行地区。进一步的研究是必要的,以探索连接肺结核和低钠血症的机制途径,帮助开发有针对性的治疗干预措施。
    UNASSIGNED: Identifying pulmonary pathology while evaluating electrolyte disorders is crucial for optimal patient management. Physicians working in endemic regions of tuberculosis should consider this pathology as a differential for electrolyte imbalances.
    UNASSIGNED: Hyponatremia, a common electrolyte imbalance, can arise from various underlying etiologies such as diuretics, diarrhea, vomiting, congestive heart failure, and liver and renal disease. We present a case report of a 74-year-old man highlighting the association between pulmonary tuberculosis (TB) and the development of hyponatremia. GeneXpert assay of the patient\'s sputum sample led to the identification of underlying active pulmonary TB as the cause of hyponatremia. The patient was started on anti-TB therapy, and concurrent fluid restriction and sodium supplementation were initiated to correct the electrolyte imbalance. Over the next 3 days, the patient demonstrated clinical improvement with the resolution of hyponatremia. This case also highlights the importance of considering TB as a potential etiology in patients presenting with hyponatremia, especially in endemic areas. Further research is warranted to explore the mechanistic pathways linking pulmonary TB and hyponatremia, aiding in the development of targeted therapeutic interventions.
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  • 文章类型: Case Reports
    背景:肺结核(PTB)在免疫受损人群中普遍存在,包括恶性血液病患者,人类免疫缺陷病毒感染,和慢性疾病。缺乏对急性早幼粒细胞白血病(APL)合并PTB的有效治疗。这些患者的预后极差。因此,研究应建立有效的治疗方案,以改善患者的生存和预后。
    方法:一名60岁男性,右侧胸部疼痛,发热4d,到我院门诊就诊。外周血涂片显示54%的母细胞。骨髓检查后,诊断为具有TNRC18-RARA融合基因的变异APL。胸部计算机断层扫描显示双侧肺炎伴双侧胸腔积液,双肺下叶部分肺不张,支气管肺泡灌洗液基因X-Pert检验阳性,指示PTB。卡里霉素,乙胺丁醇(EMB),和异烟肼(INH),因为他无法接受化疗,因为白细胞计数持续下降。在用卡利霉素治疗一周后,患者从发烧中康复并接受化疗。化疗非常有效,他的白细胞计数恢复正常。服用利福平五个月后,EMB和INH和化疗,患者出现肺炎和APL完全缓解.
    结论:我们报告了一例需要化疗的PTB患者,成功使用carrimamin和APL。
    BACKGROUND: Pulmonary tuberculosis (PTB) is prevalent in immunocompromised populations, including patients with hematologic malignancies, human immunodeficiency virus infections, and chronic diseases. Effective treatment for acute promyelocytic leukemia (APL) combined with PTB is lacking. These patients show an extremely poor prognosis. Therefore, studies should establish efficient treatment options to improve patient survival and prognosis.
    METHODS: A 60-year-old male with pain in the right side of his chest and a fever for 4 d visited the outpatient department of our hospital. Peripheral blood smear revealed 54% blasts. Following bone marrow examinations, variant APL with TNRC18-RARA fusion gene was diagnosed. Chest computed tomography scan showed bilateral pneumonitis with bilateral pleural effusions, partial atelectasis in the lower lobes of both lungs, and the bronchoalveolar lavage fluid gene X-Pert test was positive, indicative of PTB. Carrimycin, ethambutol (EMB), and isoniazid (INH) were administered since he could not receive chemotherapy as the WBC count decreased continuously. After one week of treatment with carrimycin, the patient recovered from fever and received chemotherapy. Chemotherapy was very effective and his white blood cells counts got back to normal. After being given five months with rifampin, EMB and INH and chemotherapy, the patient showed complete remission from pneumonia and APL.
    CONCLUSIONS: We report a case of PTB treated successfully with carrimycin with APL that requires chemotherapy.
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  • 文章类型: Case Reports
    毁损性肺综合征(DLS)是指不可逆和完全的肺组织破坏,常由于慢性或反复肺部感染。肺结核(PTB)是这种情况的主要原因,在PTB率高的地区尤其普遍。本报告描述了一名60岁的印度男性因不规则PTB治疗史而出现DLS的情况。病人主诉生咳,咯血,发烧,和呼吸困难。综合评估证实了诊断,促使抗结核治疗的重新开始。该病例报告强调了不规则PTB治疗导致严重肺损伤的挑战和后果。强调及时和一致的治疗在预防这种使人衰弱的结果方面的重要性。
    Destroyed lung syndrome (DLS) refers to the irreversible and complete destruction of lung tissue, often due to chronic or recurrent lung infections. Pulmonary tuberculosis (PTB) is a prominent cause of this condition, particularly prevalent in regions burdened by high PTB rates. This report delineates the case of a 60-year-old Indian male who presented with DLS as a consequence of a history of irregular PTB treatment. The patient complained of a productive cough, hemoptysis, fever, and dyspnea. A comprehensive evaluation confirmed the diagnosis, prompting the re-initiation of antitubercular therapy. This case report highlights the challenges and consequences of irregular PTB therapy leading to severe lung damage, emphasizing the significance of prompt and consistent treatment in preventing such debilitating outcomes.
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