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Orv Hetil. 2000 Sep 3;141(36):1981-3.
[The role of bacteriology in the treatment of tuberculosis; the Hungarian program]

[Article in Hungarian]

Fodor T.

Mycobacteriologiai Referencia Laboratorium, Orszagos Koranyi TBC es Pulmonologiai Intezet, Budapest.

A positive result of the bacteriological examination of Mycobacterium tuberculosis is signal to start treatment. The response to antituberculosis chemotherapy in patients with positive bacteriology is best evaluated by repeated examinations. The recommendation of the Hungarian National Tuberculosis Programme for the initial intensive phase of chemotherapy of previously untreated patients is based on the frequency of primoresistance determined by the National Reference Laboratory. The treatment of multidrug resistant tuberculosis can be supported by the result of previous susceptibility test and/or by the outcome of multicenter validated Bactec 460 susceptibility test of second-line antimicrobial drugs. The presence of a mutation within a gen is predictive of rifampicin resistance of M. tuberculosis. The results are available within 48 h. 92.4% of rifampicin resistant and nearly 100% of pyrazinamid resistant isolates in the Reference Laboratory were resistant to isoniazid. On the other hand streptomycin resistant strains were susceptible to amikacin in a rate of 38:1. Some rifampicin resistant strains are susceptible to rifabutin. The Reference Laboratory observed among the first that some ofloxacin resistant strains are susceptible to ciprofloxacin. It was the first which demonstrated effectivity of amikacin in the treatment of pulmonary tuberculosis. It was drawn attention to the importance of the PAS infusion therapy of multidrug resistant tuberculosis cases by observing bacteriological conversion.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11031835&dopt=Abstract

Rev Esp Salud Publica. 2000 Jul-Aug;74(4):361-6.
[Prevalence of tuberculosis infection prevalence in a provincial prison]

[Article in Spanish]

Martin V, Brugos M, Valcarcel I.

Area de Medicina Preventiva y Salud Publica, Escuela de Enfermeria, Universidad de Leon. dfivmnileon.es

BACKGROUND: Tuberculosis in prisons is a serious public health problem. In those penitentiaries with a high prevalence of co-infection by M. tuberculosis and HIV infection, the treatment of the tubercular infection can be an important tool for prevention and control. Ascertaining the prevalence of tubercular infection, the access and adherence to the treatment of tubercular infection in a prison population without a history of treatment of tubercular disease or infection could be of great interest in order to assess the efficacy of this measure. METHODS: A cross study was made of the population confined at 28 June 1999 in a Penitentiary with a programme of prevention and control of tuberculosis, based on the directly observed therapy (DOT) of the patients, on early diagnosis and the treatment of the tubercular infection. The treatment of the tubercular infection was prescribed following individualised counselling, reaching an agreement with the patient as to the modality of treatment (DOT, daily or twice-weekly check-up). The clinical histories of the patients were reviewed in order to determine the prevalence of patients infected by M. tuberculosis, of those who had completed treatment and of those who were still undergoing treatment of tubercular infection. The Eidus-Hamilton test was performed in the case of patients under treatment for tubercular infection in order to evaluate compliance. RESULTS: Of the 219 inmates, 127 (58%) presented criteria of tubercular infection. Treatment of the tubercular infection was indicated in 113 people of whom 29 refused (25.7%). Of the 84 patients who initiated treatment for their tubercular infection, 22 (26.2%) abandoned it, 39 (46.4%) had finalized the treatment, and 23 (27.4%) were still undergoing treatment. Of the latter, 95.7% showed positive to the Eidus-Hamilton test. 48% of those infected by M. tuberculosis, either had finalized or were undergoing the treatment against tubercular infection correctly. CONCLUSION: The prevalence of tubercular infection observed in this group is very high. Acceptable levels of access and adherence to the treatment of tubercular infection have been observed, which translates into a high level of treatment coverage of this infection in the population studied.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11031844&dopt=Abstract

J Comp Pathol. 2000 Aug-Oct;123(2-3):96-103.
Immunophenotypical characterization of the lymphocyte infiltrate in caprine pulmonary tuberculosis.

Seva J, Hernandez D, Bernabe A, Pallares FJ, Navarro JA.

U.D. Histologia y Anatomia Patologica, Facultad de Veterinaria, Universidad de Murcia, Apdo. Correos 4021, Murcia, 30071, Spain.

A study was made of the immunophenotype of the lymphocytes associated with natural caprine pulmonary tuberculosis at four stages of the disease. Regardless of the stage, CD4(+)and CD8(+)T lymphocytes predominated in lung and mediastinal lymph node lesions, but gamma/delta T and B (IgM(+)) cells were seen only rarely. At the primary complex stage, CD4(+)cells outnumbered CD8(+)cells. At the stage of generalized tuberculosis, however, and still more at the post-primary stage, CD8(+)cells outnumbered CD4(+)cells. At the final stage (tuberculous pneumonia), CD4(+)and CD8(+)cells were present in low but approximately equal numbers. 2000 Harcourt Publishers Ltd.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11032661&dopt=Abstract

Jpn J Ophthalmol. 2000 Sep 1;44(5):576.
A Case of Tuberculous Uveitis Complicated by Myelodysplastic Syndrome.

Aomatsu I I, Isano K, Iizuka S, Mori T, Ohara HM, Ishii Y.

Department of Ophthalmology, Meiwa Hospital, Meiwa, Japan

Background: Recently, the incidence of tuberculosis in compromised hosts has increased.Case: A 52-year-old man suffering from myelodysplastic syndrome (MDS) had pulmonary tuberculosis. On June 22, 1996, we found a disc-sized choroidal lesion with milky appearance on the paramacular in his right eye. After 1 month, a similar choroidal lesion was found near the disc in the same eye. In spite of chemotherapy for MDS and antituberculosis medications, those choroidal lesions gradually enlarged. In November, satellite lesions were found around them. Some retinal exudates and hemorrhage were also detected in both eyes. He died on April 6, 1997. We found Langhan's giant cells in the choroid on the specimen of his eyes. So we judged the choroidal lesions to be tuberculous uveitis.Conclusion: This case showed choroidal tuberculosis and choroidal miliary tuberculosis in the same eye that were resistant to medications. We thought resistance to medication was due to destruction of the immune system by MDS.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11033161&dopt=Abstract [PubMed - as supplied by publisher]

J Emerg Med. 2000 Oct;19(3):245-8.
Chronic paronychia, osteomyelitis, and paravertebral abscess in a child with blastomycosis.

Muniz AE, Evans T.

Department of Emergency Medicine, Medical College of Virginia of Virginia Commonwealth University, Richmond, Virginia 23298-0401, USA.

Blastomycosis is an unusual fungal infection in children. It is often a chronic infection characterized by granulomatous and suppurative lesions. Clinical manifestations include either pulmonary findings or disseminated disease. Disseminated blastomycosis usually begins with a lung infection that spreads to the skin, bones, and central nervous system. This is a case report of a child with chronic blastomycosis presenting with chronic paronychia, fever, cough, malaise, and back pain. The child underwent surgical drainage of a paravertebral abscess and administration of intravenous amphotericin B. He was discharged in good condition on oral therapy with ketoconazole. The literature on blastomycosis, with particular emphasis on clinical presentations and management, is reviewed. When the history and physical examination suggest a chronic granulomatous or disseminated disease, such as tuberculosis, the physician must include blastomycosis in the differential.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11033269&dopt=Abstract

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