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Effectiveness of Histopathological Examination of Ultrasound-guided Puncture Biopsy Samples for Diagnosis of Extrapulmonary Tuberculosis
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作者 GU Wen Fei SHI Xia +5 位作者 MA Xin YU Jun Lei XU Jin Chuan QIAN Cheng Cheng HU Zhi Dong ZHANG Hui 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2024年第2期170-177,共8页
Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Hea... Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics. 展开更多
关键词 extrapulmonary tuberculosis DIAGNOSIS BIOPSY Histopathological examination Puncture samples
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Primary extrapulmonary tuberculosis diagnosis warrants extraprecautious pulmonary tuberculosis exclusion workup
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作者 Sumanta Saha 《World Journal of Clinical Cases》 SCIE 2024年第18期3295-3297,共3页
This editorial article takes an opportunity to apprehend the diagnostic challenges of primary gastrointestinal tuberculosis(an uncommon extrapulmonary tuberculosis condition)utilizing the recently published case repor... This editorial article takes an opportunity to apprehend the diagnostic challenges of primary gastrointestinal tuberculosis(an uncommon extrapulmonary tuberculosis condition)utilizing the recently published case report of a young male with prolonged gastrointestinal symptoms and weight loss who received intermittent anti-tubercular treatment and underwent operative interventions to relieve gastric outlet obstruction.The diagnosis chiefly relied on high-end examinations,like computed tomography scans and histopathological evaluation of postoperatively resected bowel tissue,which wasn't preceded by an all-inclusive stepwise primary pulmonary tuberculosis exclusion approach that usually begins with a detailed tuberculosis-pertinent history acquisition.Given the geographic locations where the patient had been(and/or treated),pivotal consideration of tuberculosis-associated endemicities in those regions,like human immunodeficiency virus(HIV)infection,might have improved the case description.The obtainment of HIV-relevant histories,like intravenous drug use and sexual practice,are good places to start.The sputum bacteriology also seems imperative to rule out atypical Mycobacterium species infection because of its clinico-radiohistopathological resemblance with pulmonary Mycobacterium tuberculosis.Altogether,this editorial aims to underscore that primary extrapulmonary tuberculosis diagnosis should comprise an elaborative,comprehensive,systematic,and stepwise primary pulmonary Mycobacterium tuberculosis exclusion workup. 展开更多
关键词 extrapulmonary tuberculosis tuberculosis GASTROINTESTINAL Diagnosis Human immunodeficiency virus
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Evaluation of Xpert MTB/RIF for the Diagnosis of Extrapulmonary Tuberculosis in China 被引量:3
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作者 YUAN Mei LYU Yan +9 位作者 CHEN Su Ting CAi Chao LI Yuan ZHANG Zhi Guo LI Yun Xu DONG Ling Ling FU Yu Hong HUANG Hai Rong GAO Ji Min LI Wei Min 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2016年第8期599-602,共4页
We evaluate the performance of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis (EPTB) in China. The performance of Xpert was evaluated compared to the composite reference standard (CRS), drug suscep... We evaluate the performance of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis (EPTB) in China. The performance of Xpert was evaluated compared to the composite reference standard (CRS), drug susceptibility testing (DST), and imaging examination. The overall sensitivity and specificity of Xpert were 64.1% (195/304) and 100% (24/24), respectively, using CRS as the gold standard. The sensitivity was significantly higher than that of culture for pus (P〈0.05). The proportion of EPTB-positive cases diagnosed by imaging was two times more than that diagnosed using Xpert; however, 6 out of 19 cases may have been overdiagnosed by imaging. 展开更多
关键词 MTB CRS RIF Evaluation of Xpert MTB/RIF for the Diagnosis of extrapulmonary tuberculosis in China
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Evaluation of Xpert MTB/RIF Ultra for Diagnosis of Extrapulmonary Tuberculosis: A Retrospective Analysis in a Low-Tuberculosis Prevalence Setting
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作者 Annalisa Del Giudice Rossella Perna +10 位作者 Teresa Baldoni Francesco Scarano Annunziata De Rosa Agostina Pontarelli Mario De Marco Martha Alicia Falca Clelia Di Tella Luigi Atripaldi Sergio Alfonso Harari Andrea Bianco Roberto Parrella 《Journal of Tuberculosis Research》 2021年第3期219-229,共11页
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Extrapulmonary tuberculosis (EPTB) remains difficult to diagnose becaus... <b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Extrapulmonary tuberculosis (EPTB) remains difficult to diagnose because the clinical specimens to be examined are often paucibacillary</span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> and obtained with difficulty from inaccessible sites. </span><span style="font-family:Verdana;">An updated Xpert<sup></sup></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><sup><span style="white-space:nowrap;">&reg</span></sup></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> MTB/RIF Ultra (Ultra) test has been designed and licensed to improve sensitivity in the detection of Mycobacterium tuberculosis complex.</span></span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The aim of the present study is to evaluate the performance of Ultra assay for the clinical diagnosis of EPTB in </span><span style="font-family:Verdana;">a low tuberculosis prevalence country. </span><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"></span></b></span><span style="font-family:Verdana;"> A retrospective analysis was performed at “A.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">O dei Colli” of Naples on consecutive extrapulmonary specimens for EPTB across a three-year period. All different types of extrapulmonary specimens were tested for EPTB by smear microscopy, culture and Ultra assay in accordance with relevant guidelines. </span><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"></span></b></span><b> </b><span style="font-family:Verdana;">A total of 606 EPTB samples, 561 culture negative EPTB and 45 culture positive EPTB were included. Using culture as reference standard, the overall sensitivities and specificities of Ultra assay were 95.6% (95% CI 84.8</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">99.5) and 97.5% (95% CI 95.8</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">98.6) respectively. Sensitivity and specificity of Ultra for individual category of specimens w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> also</span><span style="color:red;"> </span><span style="font-family:Verdana;">performed. </span><span style="font-family:Verdana;"><b></b></span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"></span></b></span><span style="font-family:Verdana;"> In a </span><span style="font-family:Verdana;">low-tuberculosis prevalence setting, Ultra assay confirms to have a good performance in the diagnosis of EPTB for all different extrapulmonary samples.</span></span></span> 展开更多
关键词 extrapulmonary tuberculosis Molecular Diagnosis Mycobacterium tuberculosis Xpert® MTB/RIF Ultra
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Profile of Extra-Pulmonary Tuberculosis in Internal Medicine 被引量:1
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作者 Mouhamed Dieng Djiby Sow +8 位作者 Demba Diédhiou Michel Assane Ndour Boundia Djiba Mouhamed Almahy Niang Matar Ndiaye Oumar Boun Khattab Diouf Fatou Kiné Gadji Anna Sar Maïmouna Ndour Mbaye 《Open Journal of Internal Medicine》 2024年第1期64-73,共10页
Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the... Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the epidemiological, clinical, paraclinical and evolutionary aspects of extra pulmonary tuberculosis (EPT) at the Abass Ndao Hospital Center. Patients and Methods: This was a descriptive cross-sectional study conducted over a period of 11 years (January 1, 2010 to December 30, 2021). All patients with extrapulmonary tuberculosis hospitalized in the department of internal medicine during the recruitment period were included. Results: Fifty-two (52) patients were collected. The year 2019 recorded the most cases 23.08% (n = 20). The mean age of the patients was 40.56 ± 18.24 years. The age group 20 - 34 years 42.31% (n = 22) was the most represented. Females were in the majority 61.54% (n = 32) with a sex ratio (M/F) was 0.63. Housewives were in the majority 40.38% (n = 21). 60.87% of the cases (n = 14) came from a health facility. 38.46% of the cases had been infected. 21.74% (n = 9) were smokers. The reasons for consultation were dominated by fever (67.44%), AEG (62.79%) and cough (41.86%). Eighteen patients (40.91%) had fever. The mean time to consultation was 77.37 ± 90.3 days with extremes of 3 and 365 days. The median was 45 days. More than half of the patients 61.90% (n = 26) had anemia. Positive retroviral serology was noted in 21.43% of cases. All patients had a CRP greater than 6. More than half of the patients 51.92% (n = 27) had multifocal tuberculosis. The peritoneum 44.23% (n = 23) was the main organ affected. The average hospital stay was 9.8 ± 4.9 days with extremes of 1 and 19 days. All patients had received the protocol in force at the national level. Death was noted in 4 patients (9.52%). Conclusion: EPT is characterized in our context by a notorious diagnostic difficulty due to the multiplicity of clinical presentations, the complexity of explorations, and the problems of differential diagnosis notably with other granulomatosis, systemic lupus and cancers. This difficulty is reflected in the low rate of diagnosis with a paraclinical argument of certainty and in the long diagnostic delays. 展开更多
关键词 extrapulmonary tuberculosis EPIDEMIOLOGY DIAGNOSIS Senegal
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Unveiling the Threat: Case Reports of Extra-Pulmonary Tuberculosis among Sanctuary Chimpanzees
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作者 Emeline Chanove Yedra Feltrer +2 位作者 Antoine Collomb-Clerc Angela Ceballos-Caro Marina Spinu 《Advances in Infectious Diseases》 CAS 2024年第1期105-132,共28页
Primate sanctuaries across Africa play a pivotal role in the rescue and rehabilitation of confiscated and rescued wild primates, many of whom have had extensive contact with humans prior to their arrival and throughou... Primate sanctuaries across Africa play a pivotal role in the rescue and rehabilitation of confiscated and rescued wild primates, many of whom have had extensive contact with humans prior to their arrival and throughout the rehabilitation process, heightening the risk of disease transmission. While tuberculosis is not naturally occurring in free-living chimpanzees, it has been extensively observed in captive primates that have been in close proximity to humans or other captive primates infected with Mycobacterium tuberculosis. This case report delves into an outbreak of extra-pulmonary tuberculosis among juvenile chimpanzees within a sanctuary, detailing the associated diagnostic challenges and treatment approaches. The five cases had close contact with a caregiver infected with tuberculosis, subsequently transmitting the infection to other in-contact chimpanzees. Prolonged treatment, employing the human protocol of quadri-therapy (rifampicin, isoniazid, pyrazinamide, and ethambutol), followed by bi-therapy (rifampicin and isoniazid), resulted in complete resolution for all five cases. These cases underscore the critical importance of maintaining high levels of biosecurity, implementing effective quarantine measures, and adhering to strict hygiene practices when working with non-human primates. 展开更多
关键词 extrapulmonary tuberculosis tuberculosis CHIMPANZEES Zoonotic Risk BIOSECURITY Diagnosis Challenges
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Soft tissue tuberculosis detected by next-generation sequencing:A case report and review of literature
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作者 Yan-Gai He Ya-Hui Huang +5 位作者 Xiao-Lan Yi Kao-Liang Qian Ying Wang Hui Cheng Jun Hu Yuan Liu 《World Journal of Clinical Cases》 SCIE 2023年第3期709-718,共10页
BACKGROUND Soft tissue tuberculosis is rare and insidious,with most patients presenting with a localized enlarged mass or swelling,which may be factors associated with delayed diagnosis and treatment.In recent years,n... BACKGROUND Soft tissue tuberculosis is rare and insidious,with most patients presenting with a localized enlarged mass or swelling,which may be factors associated with delayed diagnosis and treatment.In recent years,next-generation sequencing has rapidly evolved and has been successfully applied to numerous areas of basic and clinical research.A literature search revealed that the use of next-generation sequencing in the diagnosis of soft tissue tuberculosis has been rarely reported.CASE SUMMARY A 44-year-old man presented with recurrent swelling and ulcers on the left thigh.Magnetic resonance imaging suggested a soft tissue abscess.The lesion was surgically removed and tissue biopsy and culture were performed;however,no organism growth was detected.Finally,Mycobacterium tuberculosis was confirmed as the pathogen responsible for infection through next-generation sequencing analysis of the surgical specimen.The patient received a standardized anti-tuberculosis treatment and showed clinical improvement.We also performed a literature review on soft tissue tuberculosis using studies published in the past 10 years.CONCLUSION This case highlights the importance of next-generation sequencing for the early diagnosis of soft tissue tuberculosis,which can provide guidance for clinical treatment and improve prognosis. 展开更多
关键词 Mycobacterium tuberculosis Soft tissue infection Next-generation sequencing extrapulmonary tuberculosis DIAGNOSIS Case report
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Tuberculous meningitis and miliary tuberculosis in Iran:A review
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作者 Sayyed Gholamreza Mortazavi-Moghaddam Abdol Sattar Pagheh +2 位作者 Ehsan Ahmadpour Alacsandra Barac Azadeh Ebrahimzadeh 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2022年第4期143-152,共10页
In recent years,the number of cases of extrapulmonary tuberculosis in Iran has increased.The goal of this study was to determine the epidemiological status,clinical symptoms,diagnostic methods,and treatment strategies... In recent years,the number of cases of extrapulmonary tuberculosis in Iran has increased.The goal of this study was to determine the epidemiological status,clinical symptoms,diagnostic methods,and treatment strategies of extrapulmonary tuberculosis in Iran,with a focus on tuberculosis meningitis and miliary tuberculosis.Between January 1,2000 and June 1,2021,1651 cases of tuberculosis meningitis and miliary tuberculosis were discovered in Iran.The prevalence of tuberculosis meningitis was higher in Sistan and Baluchestan,South Khorasan,and Mazandaran compared with other provinces.The most prevalent symptoms of tuberculous meningitis were fever,anorexia,headache,neck stiffness,loss of consciousness,and vomiting.The most commonly used procedures for diagnosing tuberculous meningitis were polymerase chain reaction and cerebrospinal fluid culture.The most prevalent clinical symptoms of miliary tuberculosis were fever,lethargy,weariness,and anorexia.In 70%of chest radiographs,a miliary pattern was visible.Bone marrow biopsy was used to diagnose miliary tuberculosis in 80%of patients,while bronchoalveolar lavage was used in 20%of cases.The conventional 6-month treatment approach for tuberculous meningitis and miliary tuberculosis was used for all of the participants in the investigations.Given the high prevalence of extrapulmonary tuberculosis patients in Iran and the devastating consequences of the disease,the researchers recommend that further study be done to prevent extrapulmonary tuberculosis in the general population. 展开更多
关键词 extrapulmonary tuberculosis Tuberculous meningitis Miliary tuberculosis Iran
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Case of bronchoesophageal fistula with gastric perforation due to multidrug-resistant tuberculosis
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作者 Chan Sung Park Kwang won Seo +2 位作者 Chang Ryul Park Yang Won Nah Jae Hee Suh 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2014年第12期253-258,共6页
Gastric perforation and tuberculous bronchoesophageal fistula(TBEF) are very rare complications of extrapulmonary tuberculosis(TB). We present a case of pulmonary TB with TBEF and gastric perforation caused by a multi... Gastric perforation and tuberculous bronchoesophageal fistula(TBEF) are very rare complications of extrapulmonary tuberculosis(TB). We present a case of pulmonary TB with TBEF and gastric perforation caused by a multidrug-resistant tuberculosis strain in a nonacquired immune deficiency syndrome male patient.The patient underwent total gastrectomy with Rouxen-Y end-to-side esophagojejunostomy and feeding jejunostomy during intravenous treatment with anti-TB medication, and esophageal reconstruction with colonic interposition and jejunocolostomy were performed successfully after a full course of anti-TB medication.Though recent therapies for TBEF have favored medication, patients with severe stenosis or perforation require surgery and medication with anti-TB drugs basedupon adequate culture and drug susceptibility testing. 展开更多
关键词 Bronchoesophageal fistula Gastric perforation Multidrug-resistant tuberculosis extrapulmonary tuberculosis TREATMENT
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Rectal cancer combined with abdominal tuberculosis: A case report
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作者 Pei-Gen Liu Xiang-Fan Chen Pan-Feng Feng 《World Journal of Clinical Cases》 SCIE 2022年第31期11523-11528,共6页
BACKGROUND It is very rare to suffer from colorectal adenocarcinoma and abdominal tuberculosis simultaneously.Even in a country such as China,where tuberculosis is still endemic,its diagnosis and treatment are challen... BACKGROUND It is very rare to suffer from colorectal adenocarcinoma and abdominal tuberculosis simultaneously.Even in a country such as China,where tuberculosis is still endemic,its diagnosis and treatment are challenging.This article describes in detail a case of rectal cancer complicated by abdominal tuberculosis and its pathological features.CASE SUMMARY We outline the case of a 71-year-old female who was admitted with intermittent blood in the stool over the past year.The patient was diagnosed with low rectal cancer and received neoadjuvant therapy.The patient then returned to the hospital for surgery,but diffusely distributed nodules were found during laparoscopic exploration.The diagnosis of rectal cancer with extensive metastasis was considered during the operation.There was no opportunity for radical surgery.Thus,nodules were taken for pathological examination,and the abdomen was closed.The histopathological diagnosis was tuberculous granuloma,and the patient was treated with standardized anti-tuberculosis drugs in a specialized hospital.Later,the patient again came to our hospital and underwent abdominoperineal resection.She was discharged 10 d after the operation in good clinical condition.CONCLUSION We aim to emphasize the importance of preoperative and postoperative pathological examination in diagnosis and treatment. 展开更多
关键词 Abdominal tuberculosis Rectal cancer extrapulmonary tuberculosis Peritoneal nodules Case report
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