1/356. Pulmonary tuberculosis following successful treatment of pulmonary infection with mycobacterium kansasii.A case of pulmonary tuberculosis following successful treatment of pulmonary infection with mycobacterium kansasii is presented. The immunizing effect of an infection with M kansasii and and other nonspecific immune factors are discussed.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/356. Abnormal immunological response to mycobacterium tuberculosis antigens in a patient with chronic myelocytic leukemia and active tuberculosis.The pathogenic mechanisms of immunosuppression leading to susceptibility of mycobacterium tuberculosis (MT) infection in chronic myelocytic leukemia (CML) are not clear. To address this issue, we measured the proliferative response, variation of T cell subpopulations (CD4 , CD8 , TCR-V delta 2 and TCR-V beta 8 T cells) and the cytokine profile (IL-1 beta, IL-2, IL-4, IL-6, IL-10, TNF-alpha, IFN-gamma) after MT stimulation of peripheral blood mononuclear cells (PBMC) in a patient with concomitant CML and active pulmonary tuberculosis. The results were compared to four patients with active pulmonary tuberculosis and no other coexistent diseases. The immunologic response to phytohemagglutinin (PHA) was also evaluated. In contrast to controls, the CML PBMC failed to proliferate in response to MT antigens. Mycobacterium-reactive CD4 , V delta 2 and V beta 8 T cells did not expand after MT stimulation of the CML PBMC. In MT antigens-stimulated cultures from the CML patient, IL-2 was not produced and mild reduction of IL-1 beta and INF-gamma were observed. In contrast, IL-10 was markedly elevated in these cultures. Similarly, PHA-stimulated PBMC from the CML patient showed no expansion of CD4 and CD8 . T cells. In these cell cultures, INF-gamma concentration in supernatants was decreased and IL-10 was significantly elevated. This study suggests that patients with CML may present a profound immunosuppression of essential cellular and molecular immune effectors, a scenario which might contribute to the development of active tuberculosis. These findings further support the need of establishing immunotherapeutic modalities with potential value for myeloproliferative disorders.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
3/356. pulmonary artery fibrous bands: report of a case with extensive lung infarction and superinfection with coccidioides immitis, pseudomonas, and acid-fast bacilli.A 46-year-old woman presented with shortness of breath and frequent lower respiratory tract infections. A ventilation-perfusion scan showed markedly reduced perfusion of the right lung, and pulmonary arteriogram showed stenosis of the right pulmonary artery. A right pneumonectomy revealed dense white fibrous bands partially occluding the pulmonary artery branches and two large abscess cavities filled with pus in the upper and lower lobes. Microscopic examination revealed extensive necrosis of lung parenchyma, suppurative granulomatous inflammation with coccidioides immitis organisms and rare acid-fast bacilli. pulmonary artery fibrous bands were originally believed to be congenital; however, they are now known to be sequelae of thromboembolic phenomena.- - - - - - - - - - ranking = 0.83333333333333keywords = infection (Clic here for more details about this article) |
4/356. Severe anorexia nervosa associated with osteoporotic-linked femural neck fracture and pulmonary tuberculosis: a case report.We report a case study of a 38-year-old woman who had been suffering from anorexia nervosa (AN) since the age of 26. Before admittance to our clinic, she weighed 23.8 kg (at a height of 164 cm, 8.8 body mass index [BMI]) but still carried out strenuous physical activities. After good psychotherapeutic response and weight gain (34.4 kg), she accidentally fell and broke her femoral neck-favored as it was by osteoporosis. The X-ray taken before dynamic hip screw implantation coincidentally showed signs of pulmonary tuberculosis (TB), which could then be proven by computed tomography (CT) scans and cultures from a bronchoscopy. Other than lack of appetite and loss of weight, which we attributed to AN, there were no other clinical or biochemical indicators which could have pointed to an earlier TB diagnosis. As a result, the need for screening procedures is discussed. The manifestation of TB during the first weight gain after 12 years of severe malnutrition, during which there were no serious infections, seems to endorse former observations that AN patients appear to be "resistant" to some extent against infectious diseases, a "protection" which may be lost with convalescence and weight gain.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
5/356. mycobacterium tuberculosis infection masquerading as diffuse alveolar hemorrhage after autologous stem cell transplant.We report a fatal case of pulmonary tuberculosis masquerading as diffuse alveolar hemorrhage after autologous stem cell transplant.- - - - - - - - - - ranking = 0.66666666666667keywords = infection (Clic here for more details about this article) |
6/356. Transcontinental spread of multidrug-resistant mycobacterium bovis.Globally, the proportion of all cases of tuberculosis (TB) caused by drug-resistant strains is increasing. We report the case of a Canadian citizen who acquired a highly drug-resistant strain of mycobacterium bovis while visiting a relative with AIDS-related tuberculosis in spain. The origin of the strain was traced using spoligotyping, a polymerase chain reaction (PCR)-based fingerprint technology, and the European dna database. The level of primary drug resistance-all five first-line drugs and 19 of 21 second-line drugs-in this case was unprecedented in canada. Isolation of this strain from a Canadian citizen represents the first report of its appearance in this hemisphere. The infection was contained and combined medical-surgical treatment delivered.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
7/356. Potential association between calcified thoracic lymphadenopathy due to previous histoplasma capsulatum infection and pulmonary mycobacterium avium complex disease.BACKGROUND: Among patients with pulmonary disease due to mycobacterium avium complex (MAC) seen recently at our center, a substantial number have had extensive calcified mediastinal, hilar, and peribronchial lymphadenopathy, a finding historically inconsistent with pulmonary MAC disease. METHOD: We retrospectively studied the frequency of calcified lymphadenopathy in the chest and prevalence of known risk factors for MAC infection in 79 patients with pulmonary MAC disease who were referred to our hospital over a 1-year period. RESULTS: Calcified intrathoracic adenopathy was present in 25 of the 79 patients (32%). Residential histories revealed that 20 of the 25 patients (80%) with such calcified chest adenopathy reported living for substantial periods in the regions indigenous for histoplasma capsulatum. In contrast, the residences of patients without calcified chest adenopathy were more evenly distributed throughout the country. Nineteen of these 25 patients (76%) with calcified chest adenopathy had no known predisposing risk factor for the infection; in contrast, the proportion of patients with no calcified adenopathy who also had no identifiable classic risk factor tended to be lower (32/54, 59%). CONCLUSION: In this retrospective study, we observed that (1) a large number of patients with pulmonary MAC disease had no identifiable risk factor, (2) calcified chest adenopathy was present in one third of the patients, (3) the residential history of those with calcified adenopathy mirrored the endemic region of histoplasmosis, and, (4) conversely, those patients with pulmonary MAC who lived outside the histoplasmosis belt had no such adenopathy. Thus, we hypothesize that previous fungal infection may predispose the lungs of certain patients to subsequent invasion by MAC, presumably by airway distortion and/or parenchymal damage.- - - - - - - - - - ranking = 1.1666666666667keywords = infection (Clic here for more details about this article) |
8/356. Simultaneous infection with two strains of mycobacterium tuberculosis identified by restriction fragment length polymorphism analysis.Simultaneous infection with two different strains of mycobacterium tuberculosis has been demonstrated using phage typing. We report here the first case of mixed infection identified using IS6110-based genotyping of M. tuberculosis. The patient was diagnosed with pulmonary tuberculosis in February, 1991. The initial isolate of M. tuberculosis had two different genotype patterns (dark 7-band and light 14-band patterns). However, in a repeat isolate obtained several months later, only the 14-band pattern was visible. Exogenous reinfection and laboratory cross-contamination were unlikely because both genotype patterns were unique in the san francisco database which includes over 1300 isolates of M. tuberculosis. This case demonstrates the importance of identifying mixed infections in the study of the molecular epidemiology of tuberculosis. Mixed infections could be confused with exogenous reinfection or laboratory cross-contamination, and important epidemiologic connections could be missed.- - - - - - - - - - ranking = 1.6666666666667keywords = infection (Clic here for more details about this article) |
9/356. Endobronchial actinomycosis simulating endobronchial tuberculosis: a case report.We report a case of a 70-year-old woman who presented with mild exertional dyspnea and cough. Fiberoptic bronchoscopic findings revealed an endobronchial polypoid lesion with stenotic bronchus. The lesion was very similar to endobronchial tuberculosis. Histologic examination of the biopsy specimen demonstrated actinomyces infection. There was a clinical response to intravenous penicillin therapy. Primary endobronchial actinomycosis must be considered in the differential diagnosis of an endobronchial lesion, especially endobronchial tuberculosis in korea.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
10/356. Successful treatment of pulmonary mycobacterium xenopi infection in a natural killer cell-deficient patient with clarithromycin, rifabutin, and sparfloxacin.Isolation of mycobacterium xenopi from the respiratory tract may indicate pneumonia, often clinically indistinguishable from tuberculosis. Resistance to the classic antituberculous drugs renders the treatment of these infections problematic. We report on a case of cavernous pneumonia caused by M. xenopi in a 36-year-old male with natural killer cell deficiency but without severe immunodeficiency. He was successfully treated with a novel triple-drug combination comprising clarithromycin, sparfloxacin, and rifabutin. An impressive subsequent regression of pathological pulmonary changes was observed, and mycobacteria could no longer be detected. The therapeutic potential of clarithromycin and sparfloxacin in the treatment of M. xenopi infections is discussed.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
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