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Khil HS, Choi SI, Kim BK, Lee EJ, Lee SY, Kim JH, Jung WJ. Risk of tuberculosis after endoscopic resection and gastrectomy in gastric cancer: nationwide population-based matched cohort study. Surg Endosc 2024; 38:1358-1366. [PMID: 38114876 DOI: 10.1007/s00464-023-10610-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/26/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND This study aimed to investigate the association between gastrectomy and endoscopic resection for gastric cancer and the subsequent tuberculosis incidence. METHODS We conducted a nationwide matched cohort study using data from the Korea National Health Insurance Service from 2013 to 2019. We created two cohorts: patients who underwent gastrectomy and those who had endoscopic resection. Each patient was matched 1:1 with an unexposed individual based on index year, age, sex, income, and various comorbidities. The primary outcome was the incidence of tuberculosis during the follow-up period. RESULTS Our study comprised 90,886 gastrectomy patients and 46,759 endoscopic resection patients. The tuberculosis incidence was significantly higher in the gastrectomy group compared to its matched non-gastrectomy group (IRR 1.69, 95% CI 1.43-1.99, p < .001). In contrast, there was no significant difference in tuberculosis incidence between the endoscopic resection group and its matched non-resection group (IRR 0.95, 95% CI 0.75-1.19, p = 0.627). The Kaplan-Meier cumulative incidence also did not differ between the two groups. However, tuberculosis incidence significantly increased in the first year after endoscopic resection. CONCLUSION Gastrectomy for gastric cancer is associated with a higher incidence of subsequent tuberculosis, while no significant association was observed for endoscopic resection. However, tuberculosis incidence increases significantly during the first year after endoscopic resection.
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Affiliation(s)
- Hye Sung Khil
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Sue In Choi
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Byung-Keun Kim
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Eun Joo Lee
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Sang Yeub Lee
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Ji Hyun Kim
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Won Jai Jung
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea.
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Lahlou ND, Bakkali T, Zoulati M, Taoussi N, Benzakour Z, Lyazidi Y, Chtata H. [Tuberculosis aneurysm of descending thoracic aorta treated by covered stent graft : A case report]. Ann Cardiol Angeiol (Paris) 2023; 72:101614. [PMID: 37329821 DOI: 10.1016/j.ancard.2023.101614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/25/2023] [Accepted: 05/24/2023] [Indexed: 06/19/2023]
Abstract
Tuberculous aneurysm is a rare but lethal disease. It preferentially affects the aorta. The contamination occurs either secondarily to a tuberculosis site in contact with the aorta or by blood contamination. It presents an increased and unpredictable risk of rupture, hence the interest of urgent diagnostic and therapeutic management. His treatment was long based on surgery, but currently the endovascular approach is increasingly used. The treatment, whatever its type, will always be associated with a medical treatment for tuberculosis. We report the case of a patient with a descending thoracic aortic aneurysm considered tuberculous on the basis of epidemiological, clinical and biological arguments; who was treated by deployment of an endoprosthesis with good clinical and radiological evolution.
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Affiliation(s)
- Noured-Dine Lahlou
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc.
| | - Tarik Bakkali
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - Mohamed Zoulati
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - Nizar Taoussi
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - Zahra Benzakour
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - Youssef Lyazidi
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
| | - Hassan Chtata
- Service de chirurgie vasculaire, hôpital militaire d'instruction Mohammed V, Hay Riad, Rabat, Maroc
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3
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Huang H, Gao L, Li Y, Tan W, Wu H, Yuan Y, Liu C. Adrenal Tuberculosis: A Case Report and Literature Review. Urol Int 2023; 107:807-813. [PMID: 37075720 DOI: 10.1159/000529711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/06/2023] [Indexed: 04/21/2023]
Abstract
Adrenal tuberculosis (TB) is a rare disease, which is difficult to diagnose because of its atypical symptoms. We reported a 41-year-old female who was admitted to hospital due to a left adrenal tumor, which was found in health examination without any symptoms. Abdominal CT showed a mass in her left adrenal. The results of blood test were normal. A retroperitoneal laparoscopic adrenalectomy was carried out, and adrenal TB was finally pathologically diagnosed. Following this, examinations focusing on TB were conducted which revealed negative results except for T-cell enzyme-linked immunospot. After the operation, the hormone level was normal. However, a wound infection occurred, which was recovered after antituberculosis treatment. In conclusion, even if there is no evidence of TB, we should be alert when diagnosing adrenal masses. Examinations of pathology, radiography, and hormone play important roles in determining the definite diagnosis of adrenal TB.
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Affiliation(s)
- Hao Huang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China,
| | - Liang Gao
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - YaDong Li
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Tan
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Wu
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ye Yuan
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chuan Liu
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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4
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Samade R, Voskuil RT, Scharschmidt TJ. Two-stage TKA for tuberculosis septic arthritis of the knee masquerading as pigmented villonodular synovitis: A case report. Knee 2022; 38:30-35. [PMID: 35872480 DOI: 10.1016/j.knee.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 05/31/2022] [Accepted: 07/07/2022] [Indexed: 02/02/2023]
Abstract
A 25-year-old female presented with left knee pain following arthroscopic synovectomy for presumed pigmented villonodular synovitis (PVNS). Radiographs and magnetic resonance imaging demonstrated tricompartmental arthritic changes. She underwent a two-stage procedure first involving antibiotic spacer implantation, followed 1 week later by spacer removal and definitive total knee arthroplasty (TKA) once initial intraoperative culture results were negative. Subsequent cultures confirmed tuberculosis septic arthritis. Repeat evaluation 1 year postoperatively showed no complications and patient satisfaction with left knee function. This is a unique case report in the United States describing 1-year outcomes following staged TKA for tuberculosis septic arthritis masquerading as PVNS.
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Affiliation(s)
- Richard Samade
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Ryan T Voskuil
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - Thomas J Scharschmidt
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
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Yi S, Sheng L, Li W. Therapeutic effectiveness of tuberculous aneurysm and risk factors for mortality: a systematic review. Gen Thorac Cardiovasc Surg 2022; 70:515-525. [PMID: 35378674 PMCID: PMC9135858 DOI: 10.1007/s11748-022-01811-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/13/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study aimed to determine the therapeutic effectiveness of tuberculous aortic aneurysms (TBAAs) and the risk factors for mortality. METHODS We reviewed all case reports of TBAAs treated with open surgery or endovascular aneurysm repair (EVAR) from online database in 1996-2021. Only thoracic and abdominal aortic aneurysms were included. RESULTS Eighty cases of open surgery and 42 cases of EVAR were included. The 2-year mortality and perioperative mortality rates of open surgery were 11.3% and 10.0%, respectively. Emergent open surgery had a significantly higher mortality (25.0%) than non-emergent open surgery (6.7%). In the EVAR group, 2-year mortality, perioperative mortality, and TBAA-related mortality were 16.7%, 4.8%, and 10.0%, respectively. Patients with typical tuberculosis (TB) symptoms before EVAR had a significantly higher TBAA-related mortality (35.0%) than patients with no typical TB symptoms before EVAR (0%). In the open surgery group, the rate of TB recurrence (2.7% vs 2.4%) and aneurysm recurrence (8.1% vs 7.3%) were quite close between preoperative anti-TB-treated and postoperative anti-TB-treated cases. However, in the EVAR group, TB recurrence (8.7% vs 0%) and aneurysm recurrence (12.5% vs 6.25%) were more common in postoperative anti-TB-treated cases. CONCLUSION Open surgery was accompanied by higher perioperative mortality, whereas EVAR was followed with higher TBAA-related mortality. Emergent surgical choices of open surgery may be associated with high perioperative mortality. Typical TB symptoms before EVAR are a significant risk factor for mortality after EVAR. Early anti-TB treatment should be administered if EVAR is the surgical option.
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Affiliation(s)
- Shengwu Yi
- Zhejiang Hospital of Chinese Medicine, No. 54 Youdian Road, Hangzhou, Zhejiang, People's Republic of China
| | - Lingjie Sheng
- College of Health Science, Wuhan Sports University, No. 461 Luoyu Road, Wuhan, Hubei, People's Republic of China
| | - Wei Li
- Zhejiang Hospital of Chinese Medicine, No. 54 Youdian Road, Hangzhou, Zhejiang, People's Republic of China.
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6
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Othman SA, ElSharkawy TM, Alfaifi D, Aljehani Y. The Effectiveness of Vacuum-Assisted Closure Device in Managing Intramuscular Tuberculosis. Adv Skin Wound Care 2021; 34:330-333. [PMID: 33958522 DOI: 10.1097/01.asw.0000744328.95568.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Tuberculosis (TB) is endemic to some geographic areas such as Africa, Eastern Europe, Asia, Latin America, and the Caribbean. It is called the great mimicker because of its diverse and variable presentation and affects almost every organ in the body with different symptomatology. Often, TB causes empyema necessitans, the rarest forms of which are intramuscular and cutaneous. Here, the authors report a case of empyema necessitans and intramuscular TB, which was managed successfully with negative-pressure wound therapy. The treatment provided a good outcome and patient satisfaction compared with traditional invasive surgical options.
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Affiliation(s)
- Sharifah A Othman
- At the King Fahad Hospital, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia, Sharifah A. Othman, MBBS, is Surgery Resident, Thoracic Surgery Division; Tarek M. ElSharkawy, MD, is Pathology Consultant, Pathology Department; Doaa Alfaifi, MD, is Pathology Resident, Pathology Department; and Yasser Aljehani, MD, is Thoracic Surgery Consultant, Thoracic Surgery Division. Acknowledgment: The authors thank Dr Wasan Alalwan for collecting the patient's data. The authors have disclosed no financial relationships related to this article. Submitted May 28, 2020; accepted in revised form July 7, 2020
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7
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Hashmi JZ, Hashmi AZ, Anwar S, Ghafoor A, Haider Z, Zaheer F. Spleenic Abscess As A Complication Of Extrapulmonay Tuberculosis. J Ayub Med Coll Abbottabad 2019; 31:464-465. [PMID: 31535530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Tuberculosis continues to be a fatal infectious disease in developing countries. Despite the advances in medical sciences and introduction of potent therapeutic regimes tuberculosis has still managed to survive and prevail worldwide. It can affect many organs of body. Isolated splenic tuberculosis is uncommon in immunocompetent host and only some cases are reported internationally. Extrapulmonary tuberculosis with splenic involvement is also rare and only comes after lungs and liver. We present a case of patient presented with complaints of prolonged fever, cough and insidious onset of abdominal pain and sepsis. Exploratory laparotomy revealed spleenic abscess as incidental finding associated with tuberculous perforation of colon. She underwent double barrel colostomy and spleenectomy followed by intensive care unit admission. Measures such as awareness about the disease, early medical assistance and good compliance regarding treatment can produce positive results in combating tuberculosis and its complications.
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Affiliation(s)
| | | | - Shaheer Anwar
- Sheikh Khalifa Bin Zayed Al-Nayhan Medical College and Hospital, Lahore, Pakistan
| | | | - Zeeshan Haider
- Nishtar Medical University and Hospital Multan, Pakistan
| | - Faisal Zaheer
- Nishtar Medical University and Hospital Multan, Pakistan
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8
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MARTINI M, BESOZZI G, BARBERIS I. The never-ending story of the fight against tuberculosis: from Koch's bacillus to global control programs. J Prev Med Hyg 2018; 59:E241-E247. [PMID: 30397682 PMCID: PMC6196368 DOI: 10.15167/2421-4248/jpmh2018.59.3.1051] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 08/29/2018] [Indexed: 11/24/2022]
Abstract
Tuberculosis (TB) is one of the oldest diseases known to affect humanity, and is still a major public health problem. It is caused by the bacillus Mycobacterium tuberculosis (MT), isolated in 1882 by Robert Koch. Until the 1950s, X rays were used as a cheap method of diagnostic screening together with the tuberculin skin sensitivity test. In the diagnosis and treatment of TB, an important role was also played by surgery. The late Nineteenth century saw the introduction of the tuberculosis sanatorium, which proved to be one of the first useful measures against TB. Subsequently, Albert Calmette and Camille Guérin used a non-virulent MT strain to produce a live attenuated vaccine. In the 1980s and 1990s, the incidence of tuberculosis surged as a major opportunistic infection in people with HIV infection and AIDS; for this reason, a combined strategy based on improving drug treatment, diagnostic instruments and prevention was needed.
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Affiliation(s)
- M. MARTINI
- University of Genoa, Department of Health Sciences, Section of Medical History and Ethics, Genoa, Italy
- UNESCO CHAIR Anthropology of Health - Biosphere and Healing System, University of Genoa, Italy
| | - G. BESOZZI
- Centro di Formazione TB Italia Onlus
- Istituto Villa Marelli, Milano
| | - I. BARBERIS
- University of Genoa, Department of Health Sciences, Section of Medical History and Ethics, Genoa, Italy
- * Correspondence: Ilaria Barberis, University of Genoa, Department of Health Sciences, Section of Medical History and Ethics, largo R. Benzi 10 Pad 3, 16132 Genoa, Italy - Tel./Fax +39 010 353 85 02 - E-mail:
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9
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Al-Gameel G, Skaar M, Tvedskov TF, Kirk O, Andersen ÅB, Kroman N. [Breast tuberculosis is a rare cause of breast abscess]. Ugeskr Laeger 2018; 180:V02180091. [PMID: 30259841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Isolated secondary breast tuberculosis (TB) is an uncommon entity. This is a case report of a 27-year-old female who presented with a tumour in the breast. After four months with tedious examinations a positive polymerase chain reaction for TB was finally found, and the patient recovered after ten months of TB therapy and drainage of the abscess. One year later, a recurrence was seen after the patient had been breast feeding. Therapy was repeated, and more extensive surgery was performed with surgical excision of the abscess cavity, the fibrous tract to the pleura and resection of a pleural section. The patient achieved a full recovery afterwards.
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10
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Issoufou I, Harmouchi H, Efared B, Belliraj L, Ammor FZ, Lakranbi M, Ouadnouni Y, Smahi M. [What contribution for mediastinoscopy in non-tumor specific mediastinal lesions?]. Rev Pneumol Clin 2018; 74:242-247. [PMID: 30017753 DOI: 10.1016/j.pneumo.2018.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/14/2018] [Accepted: 05/19/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The aim of our study was to assess the interest of cervical mediastinoscopy in the management of benign mediastinal lymphadenopathy. METHOD We performed a single-center retrospective descriptive study over a period of 5 years (2013-2017) in the department of thoracic surgery of university hospital Hassan II of Fez. RESULTS During this period, a total of 137 cervical mediastinoscopies were performed among which 68 for a benign disease. This represents a frequency of 49.63 %. There were 22 men and 46 women with a mean age of 43.76 years±17.08. Chest CT showed isolated mediastinal lymphadenopathy in 52 %, associated with pulmonary images in 35 %. Cervical mediastinoscopy led to pathological diagnosis in 94 %. The pathological results showed a sarcoidosis in 51.5 %, tuberculosis in 41.2 % and a lymph node echinococcosis in 1 case. CONCLUSION Cervical mediastinoscopy remains a low risk modality in expert hands, which allows pathological diagnosis with excellent sensitivity, acceptable morbidity and no mortality in our experience.
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Affiliation(s)
- I Issoufou
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc.
| | - H Harmouchi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - B Efared
- Service d'anatomopathologie, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - L Belliraj
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - F Z Ammor
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - M Lakranbi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc
| | - Y Ouadnouni
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc; Faculté de médecine et de pharmacie, université Sidi Mohamed Ben Abdellah, Fès, Maroc
| | - M Smahi
- Service de chirurgie thoracique, CHU Hassan II, BP. 1893, km 2200, route de Sidi Harazem, Fès 3000, Maroc; Faculté de médecine et de pharmacie, université Sidi Mohamed Ben Abdellah, Fès, Maroc
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Affiliation(s)
- Ming-Tsung Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Neihu District, Taipei, 114, Taiwan, ROC
| | - Shih-En Tang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Neihu District, Taipei, 114, Taiwan, ROC.
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12
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Butt UI, Hameed B, Farooka MW, Ayyaz M, Chughtai A, Akbar MB. Tuberculosis of Gallbladder Mimicking Carcinoma. J Coll Physicians Surg Pak 2017; 27:S84-S85. [PMID: 28969733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/15/2017] [Indexed: 06/07/2023]
Abstract
Gallbladder is a rare site of tuberculous involvement. Less than 150 cases have been documented in the last 150 years. It may mimic malignancy. Histopathology examination is the mainstay of diagnosis. Gallstones and obstruction appear to be pre-disposing factors. Treatment involves localizing other sites and starting patient on anti-tuberculosis therapy. The report describes this rare site of involvement in an adult Pakistani man.
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Affiliation(s)
- Usman Ismat Butt
- Department of Surgery, Services Institute of Medical Sciences (SIMS), Services Hospital, Lahore
| | - Babar Hameed
- Department of Surgery, National Hospital and Medical Center, Lahore
| | | | - Mahmood Ayyaz
- Department of Surgery, Services Institute of Medical Sciences (SIMS), Services Hospital, Lahore
| | - Anila Chughtai
- Department of Histopathology, Chughtai Lab, 10-Jail Road, Main Gulberg, Lahore
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13
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Kagimoto A, Shibata S. [Resection of a Tuberculous Abscess of the Thoracic Wall]. Kyobu Geka 2017; 70:422-425. [PMID: 28595221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The patient was a 76-year-old man. Chest computed tomography revealed an abscess of the chest wall incidentally. Mycobacterium tuberculosis was detected by the aspiration of the abscess. Since the abscess cavity exhibited a larger trend in spite of 3 months of antituberculosis chemotherapy, surgical resection was performed. During the operation, indigo stain was injected thorough an aspiration tube to visualize the spread of the abscess. The abscess was completely resected with combined partial resection of the 7th, 8th, and 9th ribs, and the diaphragm. The patient has been well without recurrence of the lesion for 8 months after surgery with 3 months of adjuvant antituberculosis chemotherapy.
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Affiliation(s)
- Atsushi Kagimoto
- Department of Thoracic Surgery, Higashihiroshima Medical Center, Hiroshima, Japan
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14
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Jiayou L, Feng H, Bin W, Enhai C. [Report of two cases of primary mediastinal tuberculosis]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2017; 46:206-210. [PMID: 28752714 PMCID: PMC10397031 DOI: 10.3785/j.issn.1008-9292.2017.04.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Two cases of primary mediastinal lymphonode tuberculosis involved right bronchus were summarized in the report. Major clinical symptoms included cough and bloody sputum. Chest enhanced CT scan showed mediastinal lymph node enlargement with ring-shaped enhancement. Bronchoscopy suggested neoplasm in right bronchus. Diagnosis of tuberculosis was confirmed by histopathology in samples from lymph node puncture and brochoscopic biopsy. The clinical symptoms and medical imaging of patients were improved after transbrochoscopic interventional therapy and systemic chemotherapy.
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Affiliation(s)
- Luo Jiayou
- Department of Respiratory Medicine, Zhejiang University Huzhou Hospital, Huzhou 313000, China
| | - Hua Feng
- Department of Respiratory Medicine, Zhejiang University Huzhou Hospital, Huzhou 313000, China
| | - Wang Bin
- Department of Respiratory Medicine, Zhejiang University Huzhou Hospital, Huzhou 313000, China
| | - Cui Enhai
- Department of Respiratory Medicine, Zhejiang University Huzhou Hospital, Huzhou 313000, China.
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15
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Dahiya D, Kaman L, Rajendran J, Garg M. Tuberculosis of Gal-Blader Mimicking Malignancy - A Case Report. Pol Przegl Chir 2016; 88:287-289. [PMID: 27811346 DOI: 10.1515/pjs-2016-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Indexed: 11/15/2022]
Abstract
A correct preoperative diagnosis of gall-bladder tuberculosis is exceptionally unusual in the absence of pathognomic features both on clinical presentation and on imaging. Herein we present a case of 50 year female who was operated with a provisional diagnosis of gall-bladder malignancy and was found to have tuberculosis of gall-bladder on histopathology.
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16
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Niwa H, Nakajima Y, Arai T, Iuchi K, Shiraishi Y, Kikuchi K, Hasegawa S, Endo S. [LEGACIES OF SURGERY FOR TUBERCULOSIS AND SUCCESSION TO THE NEXT GENERATION]. Kekkaku 2016; 91:631-640. [PMID: 30646448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A symposium entitled "Legacies of surgery for tuberculosis and succession to the next generation" was held at the 89th annual meeting of The Japanese Society for Tuberculosis in Gifu. The purpose of the symposium was to look back at the history of surgery for tuberculosis and development of surgical techniques. The contribution of those techniques to the next generation was also discussed. Many unique and universal techniques such as segmentectomy, thoracoplasty, muscle flap plombage, greater omental plom- bage, open window thoracotomy, cavernostomy, and decortication have matured during a long history. Based on the development of antituberculous drugs, surgery seems to have a less important role. However, surgical techniques are still required for multi-drug resistant tuberculosis and non- tuberculous mycobacteriosis. Core techniques are apjlied in the surgery for many thoracic diseases, such as lung cancer, mycosis, pyothorax, and mesothelioma. This manuscript summarizes the presentations.
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Li H, Liu FY, Li XL, Zhu L, Zhou H. Clinical observation on pericardiocentesis and glucocorticoid in the treatment of tuberculous pericarditis. Eur Rev Med Pharmacol Sci 2016; 20:1130-1134. [PMID: 27049267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate peri-cardiocentesis and glucocorticoids in the treat-ment of the clinical curative effect of tubercu-lous pericarditis. PATIENTS AND METHODS Choose 128 cases of our hospital diagnosed as tuberculous peri-carditis patients as the research object, accord-ing to the treatment, were divided into group A (pericardium puncture + anti-tuberculosis (an-ti-TB) treatment of 26 cases) and group B (peri-cardium puncture +anti-tuberculosis (anti-TB) + glucocorticoid treatment of 30 cases), group C (anti-tuberculosis (anti-TB) + glucocorticoid therapy of 24 cases, and group D anti-tuberculo-sis (anti-TB) treatment of 48 cases, in the treat-ment of 8 weeks, 3 months, 6 months, 9 months, 12 months, 18 months by B ultrasonic and CT ex-amination to observe the efficacy of treatment. RESULTS At 8 weeks after treatment in group A, group B and group C and group D efficient were 61.54%, 93.33%, 54.17%, and 68.75%, respective-ly, group B, respectively, compared with group A, group C, and group D, had obvious statistical sig-nificance difference (p < 0.05); Groups of early and late treatment comparison difference have no sta-tistical significance (p > 0.05). CONCLUSIONS Tuberculous pericarditis in anti-TB treatment on the basis of using pericar-diocentesis and sugar cortical hormone treat-ment, can achieve an ideal effect.
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Affiliation(s)
- H Li
- Department of Cardiovascularology, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei, China.
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Abstract
An aortoesophageal fistula (AEF) is an extremely rare, potentially fatal condition, and aortic surgery is usually performed together with extracorporeal circulation. However, this surgical method has a high rate of surgical complications and mortality. This report describes an AEF caused by tuberculous esophagitis that was treated successfully using a two-stage operation. A 52-yr-old man was admitted to the hospital with severe hematemesis and syncope. Based on the computed tomography and diagnostic endoscopic findings, he was diagnosed with an AEF and initially underwent thoracic endovascular aortic repair. Esophageal reconstruction was performed after controlling the mediastinal inflammation. The patient suffered postoperative anastomotic leakage, which was treated by an endoscopic procedure, and the patient was discharged without any further problems. The patient received 9 months of anti-tuberculosis treatment after he was diagnosed with histologically confirmed tuberculous esophagitis; subsequently, he was followed as an outpatient and has had no recurrence of the tuberculosis or any further issues.
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Affiliation(s)
- Hwa Kyun Shin
- Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Chang Woo Choi
- Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jae Woong Lim
- Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Keun Her
- Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Kawamura M, Nakazawa S, Ueda N, Hirai T, Kishikawa H, Nishimura K. [A Case of Tubercular Prostatic Abscess Following Intravesical Bacillus Calmette-Guerin Therapy]. Hinyokika Kiyo 2015; 61:465-468. [PMID: 26699893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report a case of tubercular prostatic abscess. A 65-year-old man had undergone intravesical Bacillus Calmette-Guerin therapy for a non-muscle invasive bladder carcinoma. One year 8 months later, the prostate-specific antigen concentration in serum was elevated (18. 58 ng/ml). Results of magnetic resonance imaging (MRI) of the pelvis led us to suspect a prostatic abscess, and transurethral resection of the prostate for drainage was performed. A culture of fluid obtained from the latter procedure revealed a tubercular prostatic abscess. We administered the antituberculous agents, isoniazid (300 mg) and rifampicin(450 mg) daily, for 6 months. One year after surgery, the patient had no urinary symptoms or evidence of recurrence.
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Affiliation(s)
| | | | - Norichika Ueda
- The Department of Urology, Hyogo Prefectural Nishinomiya Hospital
| | - Toshiaki Hirai
- The Department of Urology, Hyogo Prefectural Nishinomiya Hospital
| | | | - Kenji Nishimura
- The Department of Urology, Hyogo Prefectural Nishinomiya Hospital
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Kilani T, Boudaya MS, Zribi H, Ouerghi S, Marghli A, Mestiri T, Mezni F. [Surgery for thoracic tuberculosis]. Rev Pneumol Clin 2015; 71:140-158. [PMID: 24894967 DOI: 10.1016/j.pneumo.2014.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 03/25/2014] [Accepted: 03/26/2014] [Indexed: 06/03/2023]
Abstract
Tuberculosis is mainly a medical disease. Surgery has been the unique therapeutic tool for a long time before the advent of specific antituberculous drugs, and the role of surgery was then confined to the treatment of the sequelae of tuberculosis and their complications. The resurgence of tuberculosis and the emergence of multidrug-resistant TB combined to immunosuppressed patients represent a new challenge for tuberculosis surgery. Surgery may be indicated for a diagnostic purpose in patients with pulmonary, pleural, mediastinal or thoracic wall involvement, or with a therapeutic purpose (drainage, resection, residual cavity obliteration). Modern imaging techniques and the advent of video-assisted thoracic surgery allowed a new approach of this pathology; the majority of diagnostic interventions and selected cases requiring lung resection can be performed through a mini-invasive approach. Patients proposed for aggressive surgery may be treated with the best results thanks to a good evaluation of the thoracic lesions, of the patients' nutritional, infectious and general status combined with a good coordination between the specialized medical team for an optimal preparation to surgery.
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Affiliation(s)
- T Kilani
- Hôpital Abderrahmane Mami, université Tunis El Manar, Ariana, Tunisie.
| | - M S Boudaya
- Hôpital Abderrahmane Mami, université Tunis El Manar, Ariana, Tunisie
| | - H Zribi
- Hôpital Abderrahmane Mami, université Tunis El Manar, Ariana, Tunisie
| | - S Ouerghi
- Hôpital Abderrahmane Mami, université Tunis El Manar, Ariana, Tunisie
| | - A Marghli
- Hôpital Abderrahmane Mami, université Tunis El Manar, Ariana, Tunisie
| | - T Mestiri
- Hôpital Abderrahmane Mami, université Tunis El Manar, Ariana, Tunisie
| | - F Mezni
- Hôpital Abderrahmane Mami, université Tunis El Manar, Ariana, Tunisie
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22
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Kimura H, Murakami K, Aoyama T, Koumoto I, Awane M, Kawai J, Hashimura T. [Adenocarcinoma of an augmented bladder 49 years after enterocystoplasty : a case report]. Hinyokika Kiyo 2015; 61:167-171. [PMID: 26037677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 69-year-old man visited our hospital presenting with bladder tamponade. The patient had undergone bladder augmentation using the ileocecum and the ascending colon for an atrophy bladder due to tuberculosis 49 years previously. Cystoscopy revealed an invasive bladder tumor in the anastomotic region of the bladder and the intestine. He underwent cystourethrectomy and ileal conduit (utilizing the previous ureteroileal anastomosis). A deliberate procedure of urinary tract diversion was required because of the severe postoperative adhesion by the augmentation. The pathological diagnosis showed adenocarcinoma. The tumor spread over the intestinal tract side and the deepest part reached the adventitia of the intestinal tract. The patient is receiving additional therapy of combined modality including chemotherapy.
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Affiliation(s)
- Hiroko Kimura
- The Department of Urology, Kansai Electric Power Hospital
| | - Kaoru Murakami
- The Department of Urology, Kansai Electric Power Hospital
| | | | - Izumi Koumoto
- The Department of Surgery, Kansai Electric Power Hospital
| | - Masaaki Awane
- The Department of Surgery, Kansai Electric Power Hospital
| | - Jun Kawai
- The Department of Pathology, Kansai Electric Power Hospital
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23
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Kholtobin DP, Kul'chavenia EV, Khomiakov VT. [Bladder tuberculosis stage 4: how to restore urination?]. Urologiia 2014:26-29. [PMID: 25807755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Reconstructive surgery for contracted bladder (bladder tuberculosis stage 4) was performed in 21 patients: women underwent cystectomy, and men underwent cystectomy and cystprostatectomy. The artificial bladder was formed using segment of the ileum by the Studer method with the implementation of ureteral-intestinal anastomosis by Nesbit or Wallace methods. Criteria for determining the bladder tuberculosis 4 stage, requiring the implementation of reconstructive surgery were as follows: bladder capacity of 100 ml or less (including general anesthesia); bladder volume--150 ml or less in the presence of vesicoureteral reflux. A good results were obtained in 17 (80.9%) patients. Results of 3 (14.2%) patients were regarded as satisfactory; one patient developed a stricture of ureterovaginal-reservoir anastomosis, which required re-anastomosis; 1 patient formed a stricture of membranous urethra, which recurred after optical urethrotomy and required the implementation of anastomotic urethroplasty; and 1 patient had difficulty urinating, requiring intermittent catheterization. Poor result was recorded in 1 (4.7%) patient who was diagnosed with chronic renal failure progression, despite the lack of evidence of retention of the urinary tract and vesicoureteral reflux in the presence of spontaneous urination, and satisfactory bladder capacity. This fact was attributable to the antiretroviral therapy for HIV infection.
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Bi H, Wang Y, Zhao Z, Xiong Q, Sun J, Zhan Y, Qi F, Hao X. [One-stage radical debridement and total hip arthroplasty for treatment of active tuberculosis of the hip]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2014; 28:938-941. [PMID: 25417302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the short-term effectiveness of one-stage radical debridement and total hip arthroplasty (THA) in the treatment of active tuberculosis of the hip. METHODS Between January 2006 and June 2011, one-stage radical debridement and THA were performed on 12 cases (12 hips) of active tuberculosis of the hip. There were 7 males and 5 females, aged 18-60 years (mean, 46.3 years). The disease duration ranged from 6 to 24 months (mean, 10.5 months). According to Babhulkar and Pande staging criteria, 5 cases were at stage III and 7 cases were at stage IV. One case had sinus, and 2 cases had previous pulmonary tuberculosis. Preoperative hip range of motion was (35.83 ± 9.25) degrees; hip Harris score was 36.83 ± 6.44. Erythrocyte sedimentation rate (ESR) was 45-90 mm/1 h (mean, 62.4 mm/l h); C-reactive protein (CRP) was 19-50 mg/L (mean, 33.6 mg/L). Perioperatively all the patients accepted the regular anti-tuberculous medication. RESULTS The results of histopathological examination and PCR detection were positive for tuberculosis bacillus. Postoperatively the incisions healed primarily. All the patients were followed up 25-60 months (mean, 40.8 months). The ESR and CRP returned to normal level with no liver injury. Tuberculosis recurrence occurred in 1 patient at 4 months after operation, which was cured after revision. X-ray film showed no prosthesis shift, prosthesis loosening, or sinus tract. At 18-24 months after operation, the bilateral sides had the same bone density, which was similar to that at the final follow-up. Hip range of motion was significantly improved to (107.08 ± 13.56)degrees (t = 14.571, P = 0.000). Hip Harris score was significantly increased to 88.00 ± 10.78 (t = 16.750, P = 0.000). COONCLUSION: A combination of one-stage radical debridement and THA is a safe method to treat active tuberculosis of the hip, which can relief symptoms and improve hip function, with low recurrence and satisfactory short-term effectiveness.
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Abstract
PANCREATIC tuberculosis (TB) is a rare disease and its diagnosis is difficult because of the lack of specific clinical manifestations. Computed tomography (CT) and magnetic resonance imaging (MRI) have some diagnostic values in this disease, but it is easy to misdiagnose pancreatic TB as a pancreatic tumor.1 In this article, we present a case of non-immunocompromised patient developing an isolated pancreatic TB, report the CT and MRI findings, and the surgical procedure for it.
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Affiliation(s)
- Shao-long Sun
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Feng Gao
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Dong-xu Cui
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Bao-sheng Wang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
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Zhou M, Ni Z, Xu J. [The experiences of debridement through external cervical incision in patients with tuberculous retropharyngeal abscess]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 27:669-670. [PMID: 24015640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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27
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Opanasenko MS, Konik BM, Klymenko VI, Demus RS, Tereshkovych OV, Kalenychenko MI, Bychkovs'kyĭ VB, Obrems'ka OK, Levanda LI, Kononenko VA, Kshanovs'kyĭ OE. [Possibilities of surgical treatment of patients with HIV/AIDS in conditions of phthysiosurgical hospital]. Klin Khir 2013:67-71. [PMID: 23888814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The results of surgical treatment of 158 patients in phthysiosurgical stationary, in whom HIV/AIDS was diagnosed, were presented. In the main group 103 (65.2%) patients were included, who were operated for tuberculosis of various localization. In 70 (44.3%) patients, suffering HIV/AIDS, videoscopy with pleural biopsy was performed, and in 50 (31.6%)--biopsy of lymphatic nodes for lymphadenopathy of occult genesis. The rate of postoperative complications was 4.4%. A priority of performance of videoscopic interventions in the patients, suffering HIV/AIDS, was substantiated.
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Taghipour-Zahir S, Baradaranfar MH, Zolfaghari AA. Primary tuberculosis of the adenoids in an 11-year-old male presenting with hearing loss: a case report. Pathologica 2013; 105:73-75. [PMID: 23946986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Hypertrophy of adenoids is usually caused by repeated throat infections, especially viral and bacterial infections, that in microscopic examination reveal reactive lymphoid follicular hyperplasia. Herein, we present an 11-year-old boy who developed hearing loss in his left ear three months before admission, and in direct examination the adenoids were hypertrophied. Histopathological study of the resected adenoid revealed caseating granulomatous inflammation. Based on histopathological and clinical findings, primary tuberculosis of adenoids was suggested which was confirmed by PCR.
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Affiliation(s)
- S Taghipour-Zahir
- Department of Pathology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Rejab H, Guirat A, Ellouze S, Trigui A, Mizouni A, Triki H, Boudaouara T, Beyrouti MI. Primitive gallbladder tuberculosis: a case report with review of the literature. Ann Ital Chir 2013; 84:1-3. [PMID: 23416311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Gallbladder tuberculosis is an exceedingly rare disease. A correct preoperative diagnosis of Gallbladder tuberculosis is difficult, and it may be confused with different gallbladder diseases. We present a new case of a patient who underwent surgery with the preoperative diagnosis of cholelithiasis. Diagnosis of gallbladder tuberculosis was obtained with the histological examination of the frozen section.
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Sharma S, Bansal R, Agrawal N, Khare A, Bharosay VV. Tuberculosis of the gall bladder clinically mimicking carcinoma--a case report. J Indian Med Assoc 2012; 110:402-403. [PMID: 23360047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Gall bladder tuberculosis is very rare and curable but, sometimes can be confused with the clinical diagnosis like carcinoma. A 32-year-old male presented with acute pain in right abdomen for one month and fever off and on for two months. CT scan (whole abdomen) showed features suggestive of lymphadenopathy although peroperatively no significant lymph node could be identified but there were multiple white patches on gastrohepatic ligament and neck of gall bladder probably which were identified as lymph nodes on scanning. On the basis of peroperative findings clinician diagnosed it as a case of carcinoma gall bladder and was subjected to cholecystectomy. On histopathological examination it turned out to be tuberculosis gall bladder. Therefore tuberculosis of gall bladder can mimic carcinoma clinically.
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Affiliation(s)
- Sangeeta Sharma
- Department of Pathology, Subharti Medical College, Meerut 250002
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Zhang N, Xu QZ, Fu XN, Sun W. Use of a pedicled omental flap in the treatment of chest wall tuberculosis. Ann Thorac Surg 2012; 93:1010-2. [PMID: 22365007 DOI: 10.1016/j.athoracsur.2011.08.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 08/24/2011] [Accepted: 08/24/2011] [Indexed: 11/18/2022]
Abstract
The most effective way to treat the chest wall tuberculosis is to fill the residual space with a muscle flap after complete resection of the lesion. However, in some situations a muscle flap cannot be used. The greater omentum has been widely used for reconstruction and the treatment of infections. We describe our technique of using a pedicled omental transposition flap in the management of chest wall tuberculosis for closing the dead space created by excision of the lesion.
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Affiliation(s)
- Ni Zhang
- Department of Thoracic Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
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Savu C, Surcel C, Mirvald C, Gîngu C, Hortopan M, Sinescu I. Atypical primary tuberculosis mimicking an advanced penile cancer. Can we rely on preoperative assessment? Rom J Morphol Embryol 2012; 53:1103-1106. [PMID: 23303041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Tuberculosis of penis is a very rare clinical entity. There are isolated reports of its presentation as a subcutaneous nodule with or without superficial ulcers and can be interpreted as advanced penile cancer. We present a case of penile tuberculosis that presented in our Center with a bulky penoscrotal formation treated in other center for the suspicion of Fournier gangrene.
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Affiliation(s)
- Carmen Savu
- Department of Intensive Care and Anesthesiology, Fundeni Clinical Institute, Bucharest, Romania
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Gupta PJ. Pilonidal sinus disease and tuberculosis. Eur Rev Med Pharmacol Sci 2012; 16:19-24. [PMID: 22338544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Pilonidal disease is a disease of young people, usually men, which can result in an abscess, draining sinus tracts, and moderate debility for some. It probably results from hair penetration beneath the skin, for reasons that are not totally clear. A pilonidal sinus in the sacrococcygeal region is associated with recurrent infection, abscess formation, cellulitis, and fistulae. The infection is usually chronic and non-specific. However, few reports of granulomatous infection like tuberculosis and actinomycosis in pilonidal sinus have been observed. The presentation of tuberculosis in these sinuses may have wide forms, with atypical and uncharacteristic clinical picture, making it difficult to make a diagnosis preoperatively. This paper discusses about pilonidal sinus disease and tubercular infiltration in these sinuses. The diagnosis of tuberculosis in pilonidal sinus disease is elusive, necessitating a high index of suspicion. The literature on the tubercular affliction of pilonidal sinus is scant. Novel diagnostic modalities such as adenosine deaminase levels and polymerase chain reaction (PCR) can be useful in doubtful situations. Physicians should obtain a thorough history focusing on risk behaviors for human immunodeficiency virus infection (HIV) and tuberculosis. Treatment comprises of standard regimen of antitubercular medication and a modest surgical approach towards the sinuses.
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Affiliation(s)
- P J Gupta
- Fine Morning Hospital and Research Center, Laxminagar, Nagpur, India.
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Akbulut S, Sogutcu N, Arikanoglu Z, Bakir S, Ulku A, Yagmur Y. Thyroid tuberculosis in southeastern Turkey: is this the resurgence of a stubborn disease? World J Surg 2011; 35:1847-52. [PMID: 21523497 DOI: 10.1007/s00268-011-1118-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND While tuberculosis (TB) has been found in many parts of the body, involvement of the thyroid gland is rare. In this study we describe the clinicopathological characteristics of seven patients with primary thyroid tuberculosis (TTB). METHODS This report is a retrospective case study of seven patients with thyroid tuberculosis who were treated surgically in our clinic between 2004 and 2010. Data collected from the cases included age, sex, clinical presentation, concurrent medical illness, initial diagnosis, and history of pulmonary tuberculosis. Testing used to establish the diagnosis of TTB included thyroid function tests, histopathological examination, a tuberculin skin test, and FNAC (fine needle aspiration cytology). Surgical procedures, antitubercular therapy, and follow-up data were also analyzed. RESULTS All seven cases were females between the age of 30 and 60 years (mean = 44.1 ± 9.5 years). Four cases had neck swelling and three had additional complaints of dysphagia and dyspnea. While total thyroidectomy was performed in six patients with multinodular goiter, a lobectomy was performed in one patient in whom a solitary thyroid nodule was detected. Histopathologic changes consistent with thyroid tuberculosis were detected in all patients. Thoracic X-ray, erythrocyte sedimentation rate (ESR) test, and tuberculin skin test (PPD) were performed and all patients were screened for other possible foci of infection. In conclusion, all seven cases were diagnosed with primary tuberculosis. While the lobectomy patient was administered a 6-month antitubercular treatment, the total-thyroidectomy patients did not receive any medical treatment postoperatively. During the postoperative follow-up period, which lasted between 6 and 53 months (mean = 37.3 ± 18.6 months), none of the patients had a recurrence of disease. CONCLUSION Tuberculosis should be considered in the list of differential diagnoses for thyroid abscesses and nodular lesions in people living in geographic regions with a high tuberculosis prevalence.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery, Diyarbakir Education and Research Hospital, Op. Dr. Seref Inaloz Caddesi, 21400 Diyarbakir, Turkey.
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35
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Li Y, Yao XP, Bai C, Huang Y, Wang Q, Zhao LJ, Dong YC, Teng HY, Li Q. [Therapeutic efficacy analysis of bronchoscopic interventional therapy on severe tuberculous main bronchial stenosis complicated with unilateral atelectasis]. Zhonghua Jie He He Hu Xi Za Zhi 2011; 34:454-458. [PMID: 21781520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To observe the therapeutic efficacy of bronchoscopic interventional therapy on severe tuberculous main bronchial stenosis or atresia complicated with unilateral atelectasis. METHODS Ninety patients with severe tuberculous main bronchial stenosis or atresia complicated with unilateral atelectasis, who had received bronchoscopic interventional therapy, were divided into group A and B according to whether stents had been implanted or not. Patients in group A had been treated with electrocautery, balloon dilatation and cryotherapy. Group B had been treated with metallic stent implantation on the basis of the above interventional management. In order to observe the effectiveness, the time needed for taking effect and restenosis rate were noted. The efficacy between patients with different disease courses, radiology, bronchoscopy and dyspnea index were evaluated before treatment and after the patients' conditions were stable. RESULTS Three months after treatment, the good response rate and the total effective rate of group B were higher than those of group A, 97% vs 42% (χ(2) = 29.595, P < 0.05), 100% vs 81% (χ(2) = 6.060, P < 0.05), respectively. The time needed for taking effect in group B was significantly shorter than that in group A, 0.25 month vs 1.6 month. The dyspnea indexes of both groups were significantly improved after treatment, but the improvement of group B was more significant than that of group A (u = -2.478, P < 0.05). The disease course of patients with different therapeutic efficacy was evaluated, and the median disease course was 2 months in good response efficacy patients, 3.5 months in improved patients, and 5 months in ineffective patients; the difference being significant between ineffective and good response efficacy patients (u = -3.079, P < 0.01). The restenosis rate of group B was significantly higher than that of group A, 72% vs 32% (χ(2) = 9.090, P < 0.01). The median restenosis time was 4 months in group A, and 6 months in group B. Bronchoscopy follow-up 12 months after the initial effective treatment showed that the good response rate and the total effective rate of group B were better than those of group A, 60% vs 29% (χ(2) = 10.559, P < 0.01), 88% vs 60% (χ(2) = 10.261, P < 0.01, respectively), and the total effective rate of main bronchial atresia patients in group B was significantly higher than that in group A, 90% vs 50% (Fisher's exact test, P < 0.05). There was no significant difference in effectiveness between severe stenosis and atresia patients in group A and B. CONCLUSION Electrocautery, balloon dilatation, cryotherapy and stent implantation were effective methods to treat severe tuberculous main bronchial stenosis or atresia complicated with unilateral atelectasis. Among them, the therapeutic efficacy was better and the symptoms improved more quickly in patients with stent implantation. The efficacy of stent implantation was better than that of conventional interventional therapy, but the incidence of restenosis was also higher. Following-up should be emphasized in this group of patients. Disease courses were associated with the therapeutic efficacy; longer disease course was related to worse therapeutic efficacy, and restenosis occurred earlier. So interventional therapy should be initiated earlier for bronchial tuberculosis with dyspnea, especially for that complicated by atelectasis.
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Affiliation(s)
- Yi Li
- Department of Respiratory Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
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Xue HB, Ma YZ, Chen X, Li HW, Guo LX. [Surgical treatment of lower lumbar tuberculosis with different operative procedures]. Zhongguo Gu Shang 2011; 24:394-398. [PMID: 21688536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To evaluate the surgical indications and clinical effectiveness of different operative procedures in the treatment of lower lumbar tuberculosis. METHODS From June 2001 to Oct 2008, 72 patients with lower lumbar tuberculosis were treated by different operative procedures. Including 38 males and 34 females, with an average age of 38.5 years old ranging from 16 to 70 years. The average duration of symptom was 6.8 months (ranging from 4 months to 2 years). A single vertebrae was involved in 10 patients,two contiguous vertebrae in 50 cases and three vertebrae in 12 cases. The average preoperative lordotic angle was 13.1 degree (ranging from -5.0 degrees to 34.0 degrees). Three different operative procedures included: (1) posterior debridement and posterolateral fusion and posterior instrumentation in 28 patients; (2) anterior radical debridement and anterior fusion and anterior instrumentation in 32 patients; (3) image-guided percutaneous drainage (PCD) of tuberculous abscesses in 12 patients. The selection of the procedure was made according to the degree of the lesions. The resolution of inflammatory process, bony fusion, correction of sagittal angles and JOA scores were used for evaluating the result of the surgery and the complications were analyzed. RESULTS All patients were followed up from 1.5 to 8.0 years (means 3.6 years). PCD was an effective treatment in 11 out of the 12 patients, one required surgical debridement and fusion. Among them, 57 (95%, 57/60) patients were treated by open operation showed successful bony fusion. The complications maily included common iliac vein injury in 3 patients, dural tear in 2 patients, they were all cured by intro-or postoperative treatment. The average immediate post-operative lordotic angle was 27.3 degree (35.0 degrees to 16.0 degrees), the average lordotic angle was 25.6 degree (33.0 degrees to 15.0 degrees) at final follow-up. Preoperatively and at final follow-up, JOA scores were respectively (15.2 +/- 3.4), (25.6 +/- 2.4) (P<0.01). CONCLUSION Different operative procedures should be selected to treat lower lumbar tuberculosis according to the degree of lesions. Aggressive surgical treatment was found helpful in the resolution of inflammatory process and correcting the loss of lordosis, preventing progression of kyphosis.
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Affiliation(s)
- Hai-bin Xue
- Orthopaedic Department, 309 Hospital of PLA, Beijing 100091, China.
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Wani I, Ommid M, Waheed A, Asif M. Tuberculous abdominal cocoon: original article. ULUS TRAVMA ACIL CER 2010; 16:508-510. [PMID: 21153942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Tuberculous abdominal cocoon is a rare disease, and diagnosis is seldom made preoperatively. The bowel is encased in a membrane in a cocoon-like fashion. Histopathology is confirmatory. METHODS This prospective case note review was a study of patients diagnosed with tuberculous abdominal cocoon from April 2005 - April 2008. There were 8 females and 3 males. RESULTS All patients had features of small bowel obstruction. All had laparotomy and the characteristic finding of absence of the greater omentum from the involved area and the absence of any stigmata of gut tuberculosis. Peeling of membrane is all that is required, and patients received anti-tubercular therapy postoperatively. In each case, evidence of tuberculosis on histopathology of membrane was present. CONCLUSION Tuberculous abdominal cocoon is a rare entity. Females are commonly affected. Surgery is the preferred treatment.
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Affiliation(s)
- Imtiaz Wani
- Department of Surgery, SMHS Hospital, Srinagar, Kashmir, India.
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Jiao AX, Liu XC. [The role of bronchoscopy in diagnosis and treatment of bronchial tuberculosis in children]. Zhonghua Er Ke Za Zhi 2010; 48:756-757. [PMID: 21176484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Tanaka N, Ito Y, Hori K, Endo N, Ota K. [Surgery for the chest wall tuberculous abscess; report of a case]. Kyobu Geka 2010; 63:922-925. [PMID: 20845707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The patient was a 70-year-old woman who visited our hospital due to right chest pain. Chest computed tomography (CT) and magnetic resonance imaging (MRI) revealed an abscess in the chest wall which was diagnosed as tuberculous abscess by a bacterial examination of needle aspiration. In spite of anti-tuberculosis chemotherapy, the abscess was ruptured on day 15 after starting treatment, and a radical resection of the abscess was performed after 10-days conservative treatment. Skin over the abscess and a part of right 7th and 8th rib were also resected. Postoperative anti-tuberculosis chemotherapy was added and no relapse was seen for 40 months postsurgery.
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Abstract
CONCLUSION The standard treatment for tuberculous otitis media (TOM) without complications consists of anti-tuberculosis (anti-TB) medication, with which we experienced good treatment outcomes. However, surgery is required for recovery of anatomy and hearing function. OBJECTIVE To determine the clinical characteristics of TOM that might optimize diagnosis and to evaluate the differences in clinical courses between patients treated with and without surgery. METHODS We analyzed 14 patients (16 ears) who had been diagnosed and treated for TOM. Radiologic findings, laboratory data, and audiometry results were also evaluated. Patients were divided into a chemotherapy group and a surgery group according to treatment modality. RESULTS Temporal bone CT (TBCT) showed total occupation of the tympanic cavity by soft tissue and little evidence of ossicular erosion. In the chemotherapy group, dry ears were obtained in all but one patient (14 ears) after treatment. Normalized tympanic membrane (TM) was found in 50% in the chemotherapy group and in 75% in the surgery group. The air-bone gap (ABG) changed from 40.3 +/- 2.5 dB to 47.0 +/- 19.2 dB in the chemotherapy group and from 35.2 +/- 7.6 dB to 30.2 +/- 11.4 dB in the surgery group. After treatment, ABG improved by > 10 dB in one ear in the chemotherapy group and in four ears in the surgery group.
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Affiliation(s)
- Minsu Kwon
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Nakamura K, Yamanaka T. [A case of abdominal tuberculosis relapsed after resection]. Kekkaku 2010; 85:553-557. [PMID: 20662252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Abdominal wall tuberculosis is rare. We report a case of abdominal wall tuberculosis that relapsed after surgery. A 40-year-old man without a past history of tuberculosis visited our hospital complaining of an abdominal wall mass. The mass was resected in the department of orthopedics of our hospital. No bacteriological or histological examination of the resected specimen was done. After 5 months, the patient found swelling of the axillary lymph node. CT revealed left axillary lymph node swelling and chest wall nodules of various sizes. As the pus aspirated from the left axillary lymph node was positive for PCR-TB, the patient was diagnosed with relapsed chest wall tuberculosis and tuberculous lymphadenopathy. Antituberculosis drugs (isoniazid, rifampicin, ethambutol and pyrazinamide) were administered, but resistance to both isoniazid and ethambutol were revealed afterward. So, isoniazid and ethambutol were replaced with levofloxacin and streptomycin. After 6 months of this therapy, the left axillary lymph node decreased remarkably and became scarred. Abdominal tuberculosis should be considered in cases of an abdominal wall mass, regardless of whether the patient has a history of tuberculosis. This case stresses the importance of postoperative anti-tuberculosis treatment, as well as the need for bacteriological and histological examinations of resected specimens.
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Affiliation(s)
- Kazuyoshi Nakamura
- Respiratory Department, Taragi Municipal Hospital, 4210 Taragi, Taragi-machi, Kuma-gun, Kumamoto 868-0598, Japan.
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Eguchi K, Kikuchi K, Nakayama M. [Surgery for tuberculosis--a ten-year experience]. Kekkaku 2010; 85:439-442. [PMID: 20560397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We reviewed our institutional experience of surgical cases of tuberculosis in the last decade. There were 42 surgical cases, including 26 cases of tuberculoma, 5 cases of tuberculous lymphadenitis, 4 cases of tracheobronchial tuberculosis, and 7 cases of tuberculous empyema. The most aim of the surgery for tuberculoma and lymphadenitis were to make differential diagnosis from malignant neoplasm. Sleeve resection was done in 3 cases of tracheobronchial tuberculosis and Montgomery T-tube placement was underwent for a case of tracheal stenosis. Radical surgery was indicated for 4 cases of empyema and open window thoracostomy for 3 cases. There was no major complication and operation-related death. The surgical indication for tuberculosis is very limited nowadays because of effective chemotherapy, however, surgery is still relevant in selected small groups of tuberculosis patients. Exchanging more information and alliance among physicians and thoracic surgeons will become more important for better tuberculosis treatment.
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Affiliation(s)
- Keisuke Eguchi
- Department of General Thoracic Surgery, Saitama Medical Center, 1981 Kamoda, Kawagoe-shi, Saitama 350-8550, Japan.
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Chen PY, Qiu LY, Wang YJ, Shi NC, Xu J. [Imaging diagnosis of synovial tuberculosis of sheath of wrist]. Zhongguo Gu Shang 2010; 23:373-375. [PMID: 20575296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To investigate the imaging features of synovial tuberculosis of sheath of wrist. METHODS Three patients of synovial tuberculosis of sheath of wrist underwent surgical operation from Oct. 2002 to Oct. 2009 included 2 males and 1 female, the age of 48, 67, 76 years respectivly. X-rays of 3 patients, CTs of 2 patients and MRI of 1 patient were retrospectively analyzed and the relevant literature were reviewed. RESULTS There were 3 cases with the soft tissue mass in the palm side of wrist, the section was unclear. There were no osteoporosis and no changes of bone destruction. There was 1 case with the punctate calcification in the soft tissue. MRI showed the embedded cystic mass of flexor tendon and "8" shape in carpal tunnel pressure, and showed abnormal signal (T1 low-signal, T2 slightly higher signal), a small part of the internal point showed high signal. CT showed the synovial membrane were obvious thickening and enhanced, corpus liberum in tendon sheath were no obvious strengthening. CONCLUSION Synovial tuberculosis of sheath of wrist has certain characteristics on radiographic image. The MRI has more clinical value than X-ray and CT.
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Affiliation(s)
- Pei-Yu Chen
- Department of Radiology, the People's Hospital of Zhuji City, Zhuji 311800, Zhejiang, China
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Crişan A, Tudorache V, Laza R, Nicodin A. [Mycobacterial mediastinal adenopathy]. Pneumologia 2010; 59:87-91. [PMID: 20695364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Tuberculosis is a frequent cause of prolonged fever. Mediastinal lymph node enlargement is an uncommon feature of intrathoracic tuberculosis in adults. The authors present the case of a 64 year old man who developed prolonged fever and was admitted to Clinical Hospital of Infectious Diseases and Pneumophtisiology Dr. Victor Babeş Timişoara during 06.04-15.04.2009. Diagnosis of mediastinal lymph node tuberculosis was established only after axillary thoracotomy and biopsy of tumoral mass, although the first results obtained after mediastinoscopy were negative. Dynamics of biological features, diagnostic pitfalls, differential diagnosis difficulties and peculiar aspects of evolution are presented. Mediastinal tuberculous adenopathy, without associated pulmonary involvement is a rare form of presentation among adults, generally evolving with sustained fever. Diagnosis of mediastinal tuberculosis is difficult due to non-specific clinical aspects and lack of characteristic radiographic features and so invasive diagnostic procedures gain importance (mediastinoscopy and biopsy).
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Affiliation(s)
- Alexandru Crişan
- Clinica II Boli Infecţioase, Universitatea de Medicină si Farmacie "Victor Babeş", Timişoara.
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Gui P, Fang R. [Surgical treatment of tuberculous abscess of the neck]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:162-163. [PMID: 20398521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Bobrov VM, Korobeĭnikova NM, Trifonov SI. [Tuberculous otitis media complicated by facial nerve paresis, sensorineural loss of hearing, and latent zygomaticitis. Case report]. Vestn Otorinolaringol 2010:70-72. [PMID: 20527092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Alabi BS, Afolayan EA, Aluko AA, Afolabi OA, Adepoju FG. Primary sinonasal tuberculosis in a Nigerian woman presenting with epistaxis and proptosis: a case report. Ear Nose Throat J 2009; 88:E1-E3. [PMID: 19750461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Tuberculosis is the second leading cause of death worldwide after human immunodeficiency virus/AIDS and is especially prevalent in developing countries. We report a case of primary sinonasal tuberculosis without pulmonary involvement, which is rare, in a 27-year old female Nigerian fish farmer. She had a 3-year history of right-eye proptosis, bilateral nasal masses, and epistaxis. Cranial computed tomography suggested an extensive sinonaso-orbital neoplastic lesion. We performed a right external frontoethmoidectomy. Histologically, the excised nasal polyps revealed tuberculosis. Six months of antituberculosis therapy provided satisfactory improvement. Sinonasal tuberculosis, despite its rarity, should be added to the differential diagnosis of nasal and paranasal sinus disorders, and histologic evaluation remains the hallmark of diagnosis. Therapy with a short-duration, multidrug combination, rather than the longer-duration treatment regimen hitherto used, could be quite valuable, especially in the setting of a developing country with poor patient compliance.
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Affiliation(s)
- B Sulyman Alabi
- Department of Otolaryngology, College of Health Sciences, University of Ilorin, Ilorin, Nigeria.
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Ilhan E. Fine needle aspiration biopsy and/or tissue biopsy for avoiding surgery complication in patients with peripancreatic tuberculosis. JOP 2009; 10:341-344. [PMID: 19454834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Abstract
Approximately 1.7 billion people are thought to be infected with Mycobacterium tuberculosis. The estimated mortality rate is 3 million people per year. Multidrug resistant-tuberculosis (MDR-TB) and extensively drug-resistant TB (XDR-TB) are serious problems that threaten global TB control. Patients who are inadequately treated remain chronic carriers and can spread the disease to family members and their communities. Treatment recommendations for TB include directly observed treatment and monitoring the patient's response to medications. Perioperative nurses must protect the patient and other health care workers when a patient with TB undergoes a surgical procedure.
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Mastronikolis NS, Papadas TA, Marangos M, Karkoulias KP, Tsamandas AC, Goumas PD. Tuberculosis of the parotid gland. Tuberk Toraks 2009; 57:84-88. [PMID: 19533444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Tuberculosis (Tbc) presented as an isolated parotid mass is rare. Preoperative diagnosis is difficult and the symptomatology is nonspecific. In the majority of the cases an initial diagnosis of a parotid tumor, often a pleomorphic adenoma, is made. We present a 35-year old woman with a six months duration right parotid lump. The mass was firm and nontender without ipsilateral cervical lymphadenopathy, suggesting a parotid neoplasm. The computerized tomography scan showed an intraparotideal tumor resembling a pleomorphic adenoma and thus the patient underwent to a superficial parotidectomy. Fine needle aspiration biopsy was performed but it was not diagnostic. Histological examination revealed an intraparotideal lymph node with changes of granulomatous lymphadenopathy type, like those demonstrated in the tuberculosis and sarcoidosis. Ziehl-Nielsen staining was negative, while the tuberculin skin test (PPD, 5 IU) was positive. The patient's treatment regimen consisted of a 2-month initial phase of isoniazid, rifampin, pyrazinamide and ethambutol followed by a 7 month continuation phase of isoniazid and rifampin. Postoperatively, there was only a mild paresis of the facial nerve resolved a week after. Parotid Tbc is very rare but should be considered as a differential diagnosis of parotid lumps. Fine needle aspiration biopsy (FNAB) is of outmost importance for diagnosis, since the treatment of this entity is primarily conservative. However, surgery could be both therapeutic and diagnostic, especially when other diagnostic examinations fail.
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