TUBERCULOSIS  

January 2006

Some Selected Abstracts:

1.  

Gupta S, Shende N, Bhatia AS, Kumar S, Harinath BC. IgG subclass antibody response to mycobacterial serine protease at different stages of pulmonary tuberculosis. Med Sci Monit, 2005;11(2): CR585-588.
JB Tropical Disease Research Centre, Department of Biochemistry, Mahatma Gandhi Institute of Medical Sciences, Sevagram-442 102, Wardha, M.S., India, E-mail: jbtdrc_wda@sancharnet.in
Summary: Tuberculosis (TB) is a chronic bacterial infection caused by M. tuberculosis. Studies of antibody response in TB have focussed mainly on their usefulness as a diagnostic serological tool, with little attention given to analysis of antibodies at the isotype and subclass level in relation to disease pathogenesis. Hence the present study was done to analyse IgG subclass response at different stages of tuberculosis, in order to understand the immunological events associated with disease development.
Sera samples were collected from 104 subjects: 79 tuberculosis patients (fresh, relapse and chronic cases) and 25 healthy normals. IgG subclass antibody response was analysed by indirect plate peroxidase ELISA against previously reported mycobacterial serine protease (ES-31) antigen.
Fresh cases of tuberculosis showed increased IgG1 and IgG3 antibodies, while a few cases showed moderately increased IgG2. IgG1 and IgG3 were found to be elevated with increased bacillary load. Relapse and chronic cases showed increased IgG1 and IgG3, while positivity to IgG2 was decreased. Chronic cases showed a moderate increase in IgG4 antibody. Thus IgG1 and IgG3 were predominant in all forms of tuberculosis.

The elevated levels of IgG1 and IgG3 antibodies to mycobacterial serine protease in active tuberculosis observed in this study provide an additional marker for diagnosis of tuberculosis. Furthermore, the higher level of these antibodies with high bacillary load patients and in chronic cases of tuberculosis may provide valuable insight into their possible role in disease progression.
 

2.  

Marais BJ, Gie RP, Hesseling AH, Beyers N.Adult-type pulmonary tuberculosis in children 10-14 years of age. Pediatr Infect Dis J. 2005 Aug;24(8):743-4.

Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.

We report 8 children (10-14 years of age) who were diagnosed with tuberculosis at their local primary health care clinic from July to September 2004, after routine sputum testing was extended to all children older than 10 years of age with suspected tuberculosis. This case series emphasizes that older children develop adult-type cavitating disease, which can be diagnosed by sputum smear microscopy, in contrast to younger children for whom smear microscopy has very little diagnostic value.
 

3.  

Santa Saha-Roy, Niraj Shende, Satish Kumar and BC Harinath. Effectivity of crude versus purified mycobacterial secretory proteins as immunogen for optimum antibody production. Indian J of Experimental Biology, December 2005;43:1196-1198.

JB Tropical Disease Research Centre, Department of Biochemistry, Mahatma Gandhi Institute of Medical Sciences, Sevagram-442 102, Wardha, M.S., India, E-mail: jbtdrc_wda@sancharnet.in

Monospecific antibodies have been successfully utilized in antigen detection, which is better indicator of active infection. Mycobacterium tuberculosis excretory secretory (M tb ES) antigens such as ES 31, ES 41 and ES 43 (3l kDa, 41 kDa and 43 kDa protein, respectively) have been shown to be present in Mycobacterium tuberculosis H37Ra culture filtrate and are of diagnostic interest. To study the immunogenic potential of crude versus purified antigen, goat was immunized with M tb detergent soluble sonicate (DSS) antigen as well as purified antigen fraction (ESAS 7) containing ES 31 antigen. Both anti-DSS IgG antibody and anti ESAS 7 IgG antibody were found to be reactive with ES 31 antigen upto I ng concentration of antibody by ELISA. Crude DSS antigen was found to be quite effective in producing high titre antibodies and showed further high reactivity with other ES antigens (ES 41 and ES 43) of diagnostic interest.
 

4.

Venkatesh SK, Tan LK, Siew EP, Putti TC. Macronodular hepatic tuberculosis associated with portal vein thrombosis and portal hypertension. Australas Radiol. 2005 Aug;49(4):322-4.

Department of Diagnostic Radiology, National University of Singapore, Singapore.

Tuberculosis (TB) of the liver is usually associated with miliary spread. Macronodular TB of the liver is rare. A case of macronodular TB of the liver in a 31-year-old woman causing portal vein thrombosis and portal hypertension is presented. Ultrasound and CT appearances are described. There was coexistent ileo-caecal TB with extensive mesenteric and retroperitoneal lymphadenopathy. Macronodular TB should be considered in the differential diagnosis when a patient presents with multiple calcified masses in the liver with portal vein thrombosis and portal hypertension.
 

  Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

13553.   Akselband Y, Cabral C, Shapiro DS, McGrath P. Rapid mycobacteria drug susceptibility testing using Gel Microdrop (GMD) Growth Assay and flow cytometry. J Microbiol Methods. 2005 Aug;62(2):181-97.

13554.  Aleman M, de la Barrera SS, Schierloh PL, Alves L, Yokobori N, Baldini M, Abbate E, Sasiain MC. In tuberculous pleural effusions, activated neutrophils undergo apoptosis and acquire a dendritic cell-like phenotype. J Infect Dis. 2005 Aug 1;192(3):399-409.

13555.  Alisjahbana B, van Crevel R, Danusantoso H, Gartinah T, Soemantri ES, Nelwan RH, van der Meer JW. Better patient instruction for sputum sampling can improve microscopic tuberculosis diagnosis. Int J Tuberc Lung Dis. 2005 Jul;9(7):814-7.

13556.  Andersen P, Doherty TM. The success and failure of BCG - implications for a novel tuberculosis vaccine. Nat Rev Microbiol. 2005 Aug;3(8):656-62. Review.

13557.  Bas NS, Guzey FK, Emel E, Alatas I, Sel B. Paradoxical intracranial tuberculoma requiring surgical treatment. Pediatr Neurosurg. 2005 Jul-Aug;41(4):201-5.

13558.  Faris JE, Brown CD. Time tells the tale. Am J Med. 2005 Aug;118(8):840-2.

13559.  Fegan D, Butcher C, Rees C, Glennon J. Tuberculosis and abdominal pain. Intern Med J. 2005 Jul;35(7):437-8.

13560.  Figaji AA, Fieggen AG, Peter JC. Re: Endoscopic third ventriculostomy for chronic hydrocephalus after tuberculous meningitis [Jonathan A, Rajshekhar V. Surg Neurol 63 (2005) 32-35]. Surg Neurol. 2005 Jul;64(1):95.

13561.  Goyal NK, Saxena A, Chopra P. Complete resolution of a large intracardiac mass with medical treatment: an echocardiographic follow up. Heart. 2005 Aug;91(8):1046.

13562.  Gupta S, Shende N, Bhatia AS, Kumar S, Harinath BC. IgG subclass antibody response to mycobacterial serine protease at different stages of pulmonary tuberculosis. Med Sci Monit, 2005;11(2): CR585-588.

13563.  Hegde AN, Desai SB, Shivdasani B. Tuberculous pericardial abscess. Eur J Cardiothorac Surg. 2005 Jul;28(1):166.

13564.  Jakka S, Veena S, Rao AR, Eisenhut M. Cerebrospinal fluid adenosine deaminase levels and adverse neurological outcome in pediatric tuberculous meningitis. Infection. 2005 Aug;33(4):264-6.

13565.  Jolobe O. Meningitis is a common cause of convulsive status epilepticus. Arch Dis Child. 2005 Aug;90(8):878.

13566.  Laibl VR, Sheffield JS. Tuberculosis in pregnancy. Clin Perinatol. 2005 Sep;32(3):739-47. Review.

13567.  Lee IK, Liu JW. Tuberculous parotitis: case report and literature review. Ann Otol Rhinol Laryngol. 2005 Jul;114(7):547-51. Review.

13568.  Marais BJ, Gie RP, Hesseling AH, Beyers N. Adult-type pulmonary tuberculosis in children 10-14 years of age. Pediatr Infect Dis J. 2005 Aug;24(8):743-4.

13569.  Ozgul A, Baylan O, Taskaynatan MA, Kalyon TA. Poncet's disease (tuberculous rheumatism): two case reports and review of the literature. Int J Tuberc Lung Dis. 2005 Jul;9(7):822-4. Review.

13570.  Perrotti V, Petrone G, Rubini C, Fioroni M, Piattelli A. Tuberculosis of buccal mucosa. J Otolaryngol. 2005 Aug;34(4):274-6.

13571.  Raju R, Suneetha S, Sagili K, Meher Vani C, Saraswathi V, Satyanarayana AVV, Suneetha LM. Diagnostic role of the antibody response to the 38 kDa proteins and lipoarabinomannan of Mycobacterium tuberculosis. Indian J clin Biochem 2005, 20(1), 123-8.

13572.  Range N, Andersen AB, Magnussen P, Mugomela A, Friis H. The effect of micronutrient supplementation on treatment outcome in patients with pulmonary tuberculosis: a randomized controlled trial in Mwanza, Tanzania. Trop Med Int Health. 2005 Sep;10(9):826-32.

13573.  Santa Saha-Roy, Niraj Shende, Satish Kumar and BC Harinath. Effectivity of crude versus purified mycobacterial secretory proteins as immunogen for optimum antibody production. Indian J of Experimental Biology, December 2005;43:1196-1198.

13574.  Sharma SK, Mohan A, Sharma A, Mitra DK. Miliary tuberculosis: new insights into an old disease. Lancet Infect Dis. 2005 Jul;5(7):415-30. Review.

13575. Vijaya Lakshmi V, Sunil Kumar Surekha Rani H, Suman Latha G, Murthy KJR. Tuberculin specific T cell responses in BCG vaccinated children. Indian Pediat 2005, 42(1), 36-40.

  Pathogenesis:

13576.   Bosworth DM, Della Pietram A, Farrell RF, B EM. Streptomycin in tuberculous bone and joint lesions with mixed infection and sinuses. 1950. Clin Orthop Relat Res. 2005 Aug;(437):116-20.

13577.  Finlay DG, Szauter K, Raju GS, Snyder N. Tuberculous peritonitis. Am J Gastroenterol. 2005 Jul;100(7):1624-5.

13578.  Nash PT, Florin TH. Tumour necrosis factor inhibitors. Med J Aust. 2005 Aug 15;183(4):205-8. Review.

13579.  Olgac G, Yilmaz MA, Ortakoylu MG, Kutlu CA. Decision-making for lung resection in patients with empyema and collapsed lung due to tuberculosis. J Thorac Cardiovasc Surg. 2005 Jul;130(1):131-5.

13580.  Venkatesh SK, Tan LK, Siew EP, Putti TC. Macronodular hepatic tuberculosis associated with portal vein thrombosis and portal hypertension. Australas Radiol. 2005 Aug;49(4):322-4. 
  Vaccines:

13581.  Fine P. Stopping routine vaccination for tuberculosis in schools. BMJ. 2005 Sep 24;331(7518):647-8.

  Therapy:

13582.    Reichman LB, Mangura BT. And the beat goes on. Am J Respir Crit Care Med. 2005 Jul 1;172(1):140.

13583.  Seaworth BJ. It is too early to discount the contribution of isoniazid to the treatment of tuberculous meningitis. J Infect Dis. 2005 Jul 1;192(1):10-2.

13584.  Viveiros M, Martins M, Couto I, Kristiansen JE, Molnar J, Amaral L. The in vitro activity of phenothiazines against Mycobacterium avium: potential of thioridazine for therapy of the co-infected AIDS patient. In Vivo. 2005 Jul-Aug;19(4):733-6. 

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April 2006

Some Selected Abstracts:

1.  

Barreto ML, Cunha SS, Pereira SM, Genser B, Hijjar MA, Yury Ichihara M, de Brito SC, Dourado I, Cruz A, Santa'Ana C, Rodrigues LC. Neonatal BCG protection against tuberculosis lasts for 20 years in Brazil. Int J Tuberc Lung Dis. 2005 Oct;9(10):1171-3.
Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador-Bahia, Brazil. mauricio@ufba.br
Bacille Calmette-Guerin (BCG) efficacy against pulmonary disease is highly variable; until very recently there was no evidence of protection after 10 years. In the control arm of a trial of efficacy of revaccination of schoolchildren in Brazil we found substantial protection (39%; 95%CI 9-58) of neonatal BCG against all forms of tuberculosis (TB) 15-20 years after vaccination, much longer than previously believed. This confirms recent findings from an earlier trial, and must be considered in the design of trials of new TB vaccines and in policy decisions based on assumed lack of neonatal BCG protection with time.  
 

2.  

Bavdekar SB, Pawar M. Evaluation of an Internet delivered pediatric diagnosis support system (ISABEL) in a tertiary care center in India. Indian Pediatr. 2005 Nov;42(11):1086-91.
Department of Pediatrics, Seth GS Medical College and KEM Hospital, Parel, Mumbai 400 012, India. drsbavdekar@vsnl.com
BACKGROUND: Young graduates manning the emergency rooms in public hospitals often need guidance in diagnosing critically ill patients due to their limited clinical experience. Textbooks, manuals and several websites are of limited assistance, as they do not generate patient-specific advice. ISABEL diagnostic tool, an Internet-delivered pediatric diagnosis support system that provides such information has not been evaluated in developing countries. AIM: To study the sensitivity of the ISABEL diagnostic tool. MATERIAL AND METHOD: Records of patients admitted in the pediatric intensive care unit in a metropolitan hospital in India during January 2000-July 2002 were retrieved. Resident medical officers wrote key clinical and laboratory findings on the basis of admission notes and results of investigations carried out within 30 min of admission. The list of diagnoses generated by the diagnostic tool at the ISABEL site after submission of these terms was entered in a performa. The presence of final diagnosis in the list generated by the ISABEL was the outcome measure studied. RESULTS: Records of 200 subjects (boys 111, girls 89, aged 28 days-12 years) were analyzed. Congenital heart disease, respiratory tract infections, meningitis, tetanus and septicemia were the most frequently encountered diagnoses. The diagnostic tool missed 27 diagnoses (such as septicemia, tuberculosis and seizures) in 39 subjects providing a sensitivity of 80.5%. CONCLUSION: Even without any training offered to the users, ISABEL provided a reasonable sensitivity of 80.5%. The tool holds promise of being useful in the developing countries.
 

3.  

Bonnet M, Sizaire V, Kebede Y, Janin A, Doshetov D, Mirzoian B, Arzumanian A, Muminov T, Iona E, Rigouts L, Rusch-Gerdes S, Varaine F. Does one size fit all? Drug resistance and standard treatments: results of six tuberculosis programmes in former Soviet countries. Int J Tuberc Lung Dis. 2005 Oct;9(10):1147-54.
Medecins Sans Frontieres, Paris, France. maryline.bonnet@geneva.msf.org
SETTING: After the collapse of the Soviet Union, countries in the region faced a dramatic increase in tuberculosis cases and the emergence of drug resistance. OBJECTIVE: To discuss the relevance of the DOTS strategy in settings with a high prevalence of drug resistance. DESIGN: Retrospective analysis of one-year treatment outcomes of short-course chemotherapy (SCC) and results of drug susceptibility testing (DST) surveys of six programmes located in the former Soviet Union: Kemerovo prison, Russia; Abkhasia, Georgia; Nagorno-Karabagh, Azerbaijan; Karakalpakstan, Uzbekistan; Dashoguz Velayat, Turkmenistan; and South Kazakhstan Oblast, Kazakhstan. Results are reported for new and previously treated smear-positive patients. RESULTS: Treatment outcomes of 3090 patients and DST results of 1383 patients were collected. Treatment success rates ranged between 87% and 61%, in Nagorno-Karabagh and Kemerovo, respectively, and failure rates between 7% and 23%. Any drug resistance ranged between 66% and 31% in the same programmes. MDR rates ranged between 28% in Karakalpakstan and Kemerovo prison and 4% in Nagorno-Karabagh. CONCLUSION: These results show the limits of SCC in settings with a high prevalence of drug resistance. They demonstrate that adapting treatment according to resistance patterns, access to reliable culture, DST and good quality second-line drugs are necessary.
 

4.

Griffith R, Tengnah C. Public health 2: Criminal liability for spreading disease. Br J Community Nurs. 2005 Oct;10(10):475-8. Review. School of Health Science, Swansea University. richard.griffith@swan.ac.uk
Last month's article considered the role of the law in preventing the spread of infectious disease in cases such as tuberculosis and SARS where isolation, quarantine and treatment are effective in controlling the outbreak. Other forms of infectious disease that district nurses encounter--such as hepatitis B and C and the HIV virus that are spread through contact with blood or sexual intercourse--rely far more on the infected individual to act responsibly in preventing others from being infected. This month's article considers whether those who act recklessly and put others at risk of infection should be held criminally liable and prosecuted for their actions.
 

5.

Nicolls DJ, King M, Holland D, Bala J, del Rio C. Intracranial tuberculomas developing while on therapy for pulmonary tuberculosis. Lancet Infect Dis. 2005 Dec;5(12):795-801.
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA. dnicoll@emory.edu
We describe the case of a south Asian man who developed symptomatic intracranial tuberculomas while on therapy for pulmonary tuberculosis. The development or progression of intracranial tuberculomas during the course of appropriate antituberculous therapy has been recognised previously. We review the epidemiology, pathophysiology, diagnosis, and treatment of this paradoxical phenomenon. Although the aetiology of this reaction is unknown, it may be related to an enhanced immune response during the course of therapy. Routine brain imaging for all patients diagnosed with tuberculosis is not recommended; however, in patients presenting with new neurological findings, neuroimaging is clearly warranted. Stereotactic brain biopsy should be done whenever the diagnosis of an intracranial tuberculoma is in doubt. When intracranial tuberculomas become symptomatic, antituberculous therapy generally does not need to be changed. Corticosteroids are indicated in all symptomatic cases.
 

  Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

14123.   Banerjee S, Banerjee M. Diabetes and tuberculosis interface. J Indian medAss 2005; 103(6): 318-22,332-5.

14124.   Da Silva BB, Dos Santos LG, Costa PV, Pires CG, Borges AS. Primary tuberculosis of the breast mimicking carcinoma. Am J Trop Med Hyg. 2005 Nov;73(5):975-6.

14125.   Dhingra VK, Rajpal S, Bhalla P, Yadav A, Jain S k, Hanifm. Prevalence of initialdrug resistance to M. tuberculosis in new sputum positive RNTCPpatients. J Commun Dis 2003; 35(2):82-9.

14126.   Devi SB, Naorem S, Singh TJ, Singh Ksh B, Prasad L, Devi Th S. HIV and TB co-infection (a study from RIMS Hospital, Manipur). Journal, Indian Academy of Clinical Medicine. 2005 Jul-Sep; 6(3): 220-223 .

14127.   Dewey M, Eddicks S, Hamm B. Images in cardiology: Armoured heart. Heart. 2005 Oct;91(10):1256.

14128.   Dheda K, Booth H, Huggett JF, Johnson MA, Zumla A, Rook GA. Lung remodeling in pulmonary tuberculosis. J Infect Dis. 2005 Oct 1;192(7):1201-9.  Review.

14129.   Heininger U.  Diagnosing tuberculosis. Arch Dis Child. 2005 Nov;90(11):1104. Review.

14130.     Jai Bikhchandani, Malik VK, Kumar V, Sharma S. Hepatic tuberculosis mimicking carcinoma gall bladder . Indian Journal of Gastroenterology. 2005 Jan-Feb; 24(1): 25 .

14131.   Kakarala G, Rajan D. Rare presentation of osteoarticular tuberculosis. Acta Orthop Belg. 2005 Oct;71(5):626-7.

14132.   Lambie D, Campbell P, Strutton GM. Forgotten but not gone: urinary tract tuberculosis. Pathology. 2005 Oct;37(5):392-3. 

14133.   Marais BJ, Gie RP, Obihara CC, Hesseling AC, Schaaf HS, Beyers N.   Well defined symptoms are of value in the diagnosis of childhood pulmonary tuberculosis. Arch Dis Child. 2005 Nov;90(11):1162-5. 

14134.   Meyer D. Eye signs that alert the clinician to a diagnosis of AIDS. SADJ. 2005 Oct;60(9):386-7.

14135.   Pai M. Alternatives to the tuberculin skin test: interferon-gama assays in the diagnosis of mycobacterium tuberculosis infection. Indian Journal of Medical Microbiology. 2005 Jul; 23(3): 151-158.

14136.   Prasanthi K, Kumari AR . Efficacy of fluorochrome stain in the diagnosis of pulmonary tuberculosis co-infected with HIV . Indian Journal of Medical Microbiology. 2005 Jul; 23(3): 179-181.

14137.   Rodrigues J, Pinto R G W, Rodrigues S, Barreto G. A case ofbilateral tuberculous mastitis. J Cytol 2004; 21(3): 149-51.

14138.   Scherubl H, Zeitz M. Tuberculous colitis. Gut. 2005 Dec;54(12):1820. 

14139.   Swingler GH, du Toit G, Andronikou S, van der Merwe L, Zar HJ. Diagnostic accuracy of chest radiography in detecting mediastinal lymphadenopathy in suspected pulmonary tuberculosis. Arch Dis Child. 2005 Nov;90(11):1153-6.

14140.   Tripathi D G, Sriram N, Naik VK, Smita P, Seema A, Shakila G, Desai MW. Efficacy of immunochromatographic techniquesfor the serodiagnosis of tuberculosis. Indian J med Microbiol 2004; 22(2): 131-2.

14141.  Xia H. More innovative strategies needed to achieve the goal of tuberculosis elimination. Am J Public Health. 2005 Oct;95(10):1674-5.  

Pathogenesis:

14142.   Agarwal R, Gupta D. TB or TB plus vasculitis: Occam versus Hickam. J Intern Med. 2005 Dec;258(6):581; author reply 582-3. 

14143.   Chiang CY, Riley LW. Exogenous reinfection in tuberculosis. Lancet Infect Dis. 2005 Oct;5(10):629-36. Review.

14144.   Da Silva Telles MA, Chimara E, Ferrazoli L, Riley LW. Mycobacterium kansasii: antibiotic susceptibility and PCR-restriction analysis of clinical isolates. J Med Microbiol. 2005 Oct;54(Pt 10):975-9.

14145.   Mehta JB. New face of the old foe: central nervous system tuberculosis. South Med J. 2005 Oct;98(10):965-6. 

14146.   Vaerewijck MJ, Huys G, Palomino JC, Swings J, Portaels F. Mycobacteria in drinking water distribution systems: ecology and significance for human health. FEMS Microbiol Rev. 2005 Nov;29(5):911-34.  Review.

14147.  Van  den Berge M, de Marie S, Kuipers T, Jansz AR, Bravenboer B. Psoas abscess: report of a series and review of the literature. Neth J Med. 2005 Nov;63(10):413-6. 

 
Vaccines:

14148.     Kumar R, Dwivedi A, Kumar P, Kohli N. Tuberculous meningitis in BCG vaccinated and unvaccinated children. J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1550-4.

14149.   Lang T, Hill AV, McShane H, Shah R, Towse A, Pritchard C, Garau M.  New TB vaccine granted orphan drug status. BMJ. 2005 Dec 17;331(7530):1476. 

14150.   Lienhardt C, Zumla A. BCG: the story continues. Lancet. 2005 Oct 22-28;366(9495):1414-6. 

 

Therapy:

14151.    Baltussen R, Floyd K, Dye C. Cost effectiveness analysis of strategies for tuberculosis control in developing countries. BMJ. 2005 Dec 10;331(7529):1364. 

14152.   Celik US, Alabaz D, Yildizdas D, Alhan E, Kocabas E, Ulutan S. Cerebral salt wasting in tuberculous meningitis: treatment with fludrocortisone. Ann Trop Paediatr. 2005 Dec;25(4):297-302.

14153.   Chi BH, Fusco H, Sinkala M, Goldenberg RL, Stringer JS.  Cost and enrollment implications of targeting different source population for an HIV treatment program. J Acquir Immune Defic Syndr. 2005 Nov 1;40(3):350-5.

14154.   Falkensammer J, Behensky H, Gruber H, Prodinger WM, Fraedrich G. Successful treatment of a tuberculous vertebral osteomyelitis eroding the thoracoabdominal aorta: a case report. J Vasc Surg. 2005 Nov;42(5):1010-3.

14155.   Gibbs N. Saving 1 life at a time. Time. 2005 Nov 7;166(19):53-67. 

14156.   Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician. 2005 Nov 1;72(9):1761-8. Review.

14157.   Kordy FN, Al-Jumaah S, Al-Ghonaim A. Severe CD8 deficiency in a child with miliary tuberculosis. J Trop Pediatr. 2005 Oct;51(5):316-8. 

14158.   Lambert ML, Van der Stuyft P. Delays to tuberculosis treatment: shall we continue to blame the victim? Trop Med Int Health. 2005 Oct;10(10):945-6. 

14159.   Lee GS, Kim SJ, Park IY, Shin JC, Kim SP.  Tuberculous peritonitis in pregnancy. J Obstet Gynaecol Res. 2005 Oct;31(5):436-8; discussion 438.

14160.   Markel H. The medical detectives. N Engl J Med. 2005 Dec 8;353(23):2426-8. 

14161.  Onyebujoh P, Zumla A, Ribeiro I, Rustomjee R, Mwaba P, Gomes M, Grange JM.   Treatment of tuberculosis: present status and future prospects. Bull World Health Organ. 2005 Nov;83(11):857-65.  Review.

14162.   Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore). 2005 Nov;84(6):350-62.

14163.   Sheff B, Hayes DD. Connecting the DOTS to treat pulmonary TB. Nursing. 2005 Oct;35(10):24-5.  

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July 2006

Some selected abstracts:

1.  

Birkenmaier C, Reischl U, Stubinger B.Sterile abscess: a surprise diagnosis? Scand J Infect Dis. 2006;38(1):15-8.

Department of Orthopaedics, Ludwig-Maximilan-University Munich, Grosshadern Medical Center, Munich, Germany. christof@doctor-b.de

We present the case of an otherwise healthy female hairdresser of Brazilian origin who started to have pain and swelling in her left arm. An antecubital abscess was surgically treated at another institution and there was good initial wound healing. Swelling then recurred and fistulae appeared in the scar. Our diagnostic workup revealed an isolated intramuscular tuberculous abscess, which was successfully treated by an antituberculous drug regimen.
 

2.  

El Malki HO, Mohsine R, Benkhraba K, Amahzoune M, Benkabbou A, El Absi M, Ifrine L, Belkouchi A, Balafrej S.Thyroid tuberculosis: diagnosis and treatment. Chemotherapy. 2006;52(1):46-9. Epub 2005 Dec 9.

Surgical Department A, CHU Ibn Sina, Mohammed V University of Medicine and Pharmacy, Rabat, Morocco.

OBJECTIVE: It was the aim of this study to report clinical characteristics and treatment of thyroid tuberculosis (TT). METHODS: During 16 years, 2,426 patients have been operated on the thyroid in the surgical department 'A' in Ibn Sina Hospital, Rabat, Morocco. Anatomopathological results of the removed thyroid were analyzed for evidence of tuberculosis. RESULTS: Eight cases of TT were diagnosed. Five patients had a goiter and 3 patients had an isolated nodule of the thyroid. In one case, fine-needle aspiration cytology gave the diagnosis of TT. This patient had a complete drainage of the abscess. In all other patients, the diagnosis was given after surgery. All patients received additional antituberculous drugs for 6 months, and follow-up was satisfactory. CONCLUSION: TT does not have any consistent symptoms. Fine-needle aspiration is the best method for diagnosis and can result in the avoidance of surgery. Copyright 2006 S. Karger AG, Basel.
 

3.  

Harinath BC, Kumar S, Roy SS, Hirudkar S, Upadhye V, Shende N. A Cocktail of affinity purified antibodies reactive with diagnostically useful mycobacterial antigens ES-31, ES-43 and EST-6 for detecting presence of Mycobacterial tuberculosis. Diagn. Microbiol Infect. Dis. 2006;55(1): 65-68.

Jamnalal Bajaj Tropical Disease Research Centre, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra 442102, India. jbtdrc_wda@sancharnet.in

A cocktail of affinity-purified antibodies against diagnostically useful Mycobacterium tuberculosis H37Ra excretory-secretory protein antigens ES-31, ES-43, and EST-6 was explored for detection of circulating free and immune-complexed (IC) antigen in sera of patients with confirmed tuberculosis (TB) by sandwich enzyme-linked immunosorbent assay and compared with monospecific anti-ES-31 antibody. Out of 68 smear-positive TB cases studied, using cocktail antibody, a sensitivity of 97% (66/68) for immune-complexed cocktail antigen and 91% (62/68) for free cocktail-antigen detection was observed, compared to 91% (62/68) for immune-complexed ES-31 and 79% (54/68) for free ES-31 antigen when anti-ES-31 antibody was used alone. Thus, combinatorial use of antibodies showed improved sensitivity and was thus observed to be better than single antibody. The specificity was observed to be 99% for immune-complexed antigen using cocktail antibody. Furthermore, analysis of different groups of TB sera showed that circulating immune-complexed antigen is a sensitive marker than free antigen.
 

4.

Kartaloglu Z, Okutan O, Isitmangil T, Kunter E, Sebit S, Apaydin M, Ilvan A.Pyo-pneumothorax in patients with active pulmonary tuberculosis: an analysis of 17 cases without intrapleural fibrinolytic treatment. Med Princ Pract. 2006;15(1):33-8.

Department of Pulmonary Diseases, Gulhane Military Medical Academia Haydarpasa Training Hospital, Istanbul, Turkey. zkartaloglu@hotmail.com

OBJECTIVE: To review the medical records of patients with active pulmonary tuberculosis (TB) and pyo-pneumothorax (PPT). SUBJECTS AND METHODS: Medical records of 17 patients (14 male, 3 female, mean age 23.8 years, range 20-52) with PPT and active pulmonary tuberculosis at Gulhane Military Medical Academia Haydarpasa Training Hospital, Istanbul, Turkey, were reviewed from January 1998 to December 2002. The patients were treated with chest tube drainage and chemotherapy. Intrapleural fibrinolytic agents or irrigation was not performed. RESULTS: Pleural fluid samples were available in 14 patients and the mean levels of LDH, protein and glucose in the pleural fluid were 1,767 +/- 944 U/l, 5.2 +/- 1.4 g/dl and 31.7 +/- 22.6 mg/dl, respectively. Mycobacterium tuberculosis was detected in the pleural effusion of 3 patients. The duration of chest tube drainage was longer in cases who underwent open drainage (p = 0.014). At the end of the treatment period 10 patients developed pleural thickening, 4 of them underwent decortication and pneumonectomy was also done in 1 patient. The development of pleural thickening was related to the level of pleural fluid glucose (p = 0.04). CONCLUSION: This study shows that while taking care of patients with pulmonary TB the physician must be aware of the complication of PPT and that adequate chemotherapy and drainage must be duly performed.
 

5.

Surve TY, Malkani M, Mhatre A, Samdani VP.Congenital TB associated with asymptomatic maternal endometrial TB. Trop Doct. 2006 Jan;36(1):59-61.

The Department of Pediatrics, Grant Medical College and Sir J J Hospital, Byculla, Mumbai 400 008, India. talibsurve@rediffmail.com

 

Congenital TB has varied clinical manifestations, and may mimic septicaemia in neonates. Congenital TB is transmitted through the infected placenta via the umbilical vein or inhalation and ingestion of infected amniotic fluid. Endometrial TB usually manifests as infertility; however, congenital TB can be identified in the presence of asymptomatic maternal endometrial TB. We report a case of congenital TB associated with asymptomatic maternal endometrial TB to highlight the need for endometrial biopsy in such cases.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

14526.   Ashraf O. Hemoptysis, a developing world perspective. BMC Pulm Med. 2006 Jan 13;6:1.

14527.  Bikhchandani J, Malik VK, Kumar V, Sharma S. Hepatic tuberculosis mimicking carcinoma gall bladder. Indian J Gastroenterol. 2005;24(1):25.

14528.   Cengiz AB, Kara A, Kanra G, Secmeer G, Ceyhan M. Erythema nodosum in childhood: evaluation of ten patients. Turk J Pediatr. 2006 Jan-Mar;48(1):38-42.

14529.   Cheung HY, Siu WT, Yau KK, Yang GP, Li MK. Abdominal tuberculosis mimicking metastasis in a patient with carcinoma of the oesophagus. Asian J Surg. 2006 Jan;29(1):49-50.

14530.   Chopra H, Chopra V. Primary tuberculosis of the nose and paranasal sinuses:clinical case report of three cases and discussion. Indian J OtolarHead Neck Surg. 2005;57(2):154-7.

14531.   Corapcioglu F, Guvenc BH, Sarper N, Aydogan A, Akansel G, Arisoy ES. Peritoneal tuberculosis with elevated serum CA 125 level mimicking advanced ovarian carcinoma in an adolescent. Turk J Pediatr. 2006 Jan-Mar;48(1):69-72.

14532.   Desai CS, Josh AG, Abraham P, Desai DC, Deshpande RB, Bhaduri A, Shah SR. Hepatic tuberculosis in absence of disseminated abdominal tuberculosis. Ann Hepatol. 2006 Jan-Mar;5(1):41-3.

14533.   Faella FS, Pagliano P, Attanasio V, Rossi M, Rescigno C, Scarano F, Conte M, Fusco U. Factors influencing the presentation and outcome of tuberculous meningitis in childhood. In Vivo. 2006 Jan-Feb;20(1):187-91.

14534.   Gupta V, Gupta A, Sachdeva N, Arora S, Bambery P. Successful management of tubercular subretinal granulomas. Ocul Immunol Inflamm. 2006 Feb;14(1):35-40.

14535.   Hazra A, Laha B. Chemotherapy of osteoarticular tuberculosis. Indian J Pharmac. 2005;37(1): 5-12.

14536.   Immanuel C, Victor L, Silambu Chelvi K, Padmapriyadarsinic, Rehman F, Iliayas S, Swaminathan S. Serum neopterin levels in HIV infected patients with & without tuberculosis. Indian J med Res. 2005;121(4):220-5.

14537.   Khosrovaneh A, Camero LG, Briski LE, Khatib R. Chest wall soft tissue tuberculosis: a protracted course over a 10-year period. Scand J Infect Dis. 2006;38(2):129-30.

14538.   Kitajima K, Kaji Y, Imanaka K, Hayashi M, Kuwata Y, Sugimura K. Magnetic resonance imaging findings of tuberculous endometritis: a report of 2 cases. J Comput Assist Tomogr. 2006 Jan-Feb;30(1):62-4.

14539.  Koo V, Lioe TF, Spence RA. Fine needle aspiration cytology (FNAC) in the diagnosis of granulomatous lymphadenitis. Ulster Med J. 2006 Jan;75(1):59-64.

14540.   Li H, You C, Yang Y, He M, Cai B, Wang X, Ju Y. Intramedullary spinal tuberculoma: report of three cases. Surg Neurol. 2006 Feb;65(2):185-8; discussion 188-9.

14541. Mandal J, Singhi PD, Khandelwal N, Malla N. Evaluation of ELISA and dot blots for the serodiagnosis of neurocysticercosis, in children found to have single or multiple enhancing lesions in computerized tomographic scans of the brain. Ann Trop Med Parasitol. 2006 Jan;100(1):39-48.

14542.   Mittal R, Trikha V, Rastogi S. Tuberculosis of patella. Knee. 2006 Jan;13(1):54-6.

14543.  Muayqil T, Hussain MS, Saqqur M. A patient with neurosarcoidosis. Can J Neurol Sci. 2006 Feb;33(1):92-4.

14544.  Negi SS, Khan SFB, Gupta S, Pasha ST, Khare S, Lal S. Comparison of the conventional diagnostic modalities, bactec culture and polymerasechain reaction test for diagnosis of tuberculosis. Indian J med Microbiol 2005, 23(1), 29-33.

14545.  Netherland NA, Chen VK, Eloubeidi MA. Intra-abdominal tuberculosis presenting with acute pancreatitis: diagnosis by endoscopic ultrasound-guided fine-needle aspiration. Dig Dis Sci. 2006 Feb;51(2):247-51.

14546.  Oikonomou A, Mantatzis M, Ritis K, Kartalis G, Prassopoulos P. Multiple splenic macronodular tuberculomas: MRI characteristics under treatment. Int J Tuberc Lung Dis. 2006 Feb;10(2):233-4.

14547.   Pereira M, Tripathy S, Inamdar V, Ramesh K, Bhavsar M, Date A, Iyyer R, Acchammachary A, Mehendale S, Risbud A. Drug resistance pattern of Mycobacterium tuberculosis in seropositive and seronegative HIV-TB patients in Pune, India. Indian J med Res 2005, 121(4), 235-9.

14548.  Sethi A, Sareen D, Sabherwal A, Malhotra V. Primary parotid tuberculosis: varied clinical presentations. Oral Dis. 2006 Mar;12(2):213-5.

14549.  Shargie EB, Morkve O, Lindtjorn B. Tuberculosis case-finding through a village outreach programme in a rural setting in southern Ethiopia: community randomized trial. Bull World Health Organ. 2006 Feb;84(2):112-9.

14550.   Vaideeswar P, Pandit SP, Deshpande JR. Tuberculoma of the heart. Cardiovasc Pathol. 2006 Jan-Feb;15(1):55-6.

14551.   Wanchu A. Advances in serology for diagnosing TB in the HIV infected. Indian J chest Dis all Sci 2005, 47(1), 31-7.

14552.   Zhao X, Chen S, Deanda A Jr, Kiev J. A rare presentation of tuberculosis. Am Surg. 2006 Jan;72(1):96-7.

Therapy:

14553.   Dewan T, Sangal K, Premsagar IC, Vashishth S. Orbital tuberculoma extending into the cranium. Ophthalmologica. 2006;220(2):137-9.

14554.  Joazlina ZY, Wastie ML, Ariffin N. Computed tomography of focal splenic lesions in patients presenting with fever. Singapore Med J. 2006 Jan;47(1):37-41.

14555.   Kumar S. DOTS in pediatric tuberculosis. Indian Pediatr. 2006 Mar;43(3):275-6; author reply 276.

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October 2006

 

Some selected abstract:
1

Afzal A, Arshad M, Ashraf O. Psoas abscess secondary to Pott's disease--an unusual presentation in a young child. J Pak Med Assoc. 2006 Apr;56(4):191-2.

Medical College, Aga Khan University, Karachi. 

Psoas abscess in neonates and infants are rare. Primary psoas abscesses are said to be more common in young children. Limping, fever and abdominal pain has been described to be the way psoas abscesses usually present. The authors describe the unusual presentation and successful treatment of a young child with a unilateral psoas abscess secondary to advanced spondylodiscitis.
 
2

Bera S, Shende N, Kumar S, Harinath BC. Detection of antigen and antibody in childhood tuberculous                   meningitis. Indian Journal of Pediatrics, Aug 2006; 73:675-679.
Department of Biochemistry & Jamnalal Bajaj Tropical Disease Research Centre, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India.
Objective. Mycobacterium tuberculosis excretory secretory 31 kDa, a serine protease antigen (M. tb ES-31), prepared from Mycobacterium tuberculosis H[37]Ra culture medium has been shown to have potential in detecting tuberculosis. Precise diagnosis and management of tuberculous meningitis, in children in particular, is essential to curtail mortality and morbidity. Methods. In this study, M. tb ES-31 antigen, was used in Indirect ELISA to detect tuberculous IgG antibody, in sera and CSF samples while affinity purified anti ES-31 goat antibody was used in sandwich ELISA for detection of tuberculous antigen. In sixty-five samples each of CSF and sera from cases with neurotuberculosis and control with non-tuberculous diseases were collected from Kasturba Hospital, Sevagram. Results. Among the 20 patients suffering from neurotuberculosis the IgG antibody was detected in 17(85%) of CSF and 16(80%) of sera samples, while antigen was detected in 18 (90%) in CSF and 16 (80%) in sera. Overall specificity of the assay for both IgG antibody and antigen detection in CSF was 96% while in sera it was 94% for IgG antibody and 96% for antigen detection. Conclusion. This study showed the usefulness of mycobacterial serine protease antigen and its antibody in detecting neurotuberculosis.
 
3

Kalkan A, Serhatlioglu S, Ozden M, Denk A, Demirdag K, Yilmaz T, Kilic SS.  Paradoxically developed optochiasmatic tuberculoma and tuberculous lymphadenitis: a case report with 18-month follow up by MRI. South Med J. 2006 Apr;99(4):388-92.
Department of Infectious Diseases, Radiology, Immunology and Ophthalmology, Firat University Medical School, Elazig, TR23119 Turkey. akalkan61@hotmail.com
We report the first case ofextracranial tuberculous lymphadenitis which paradoxically developed during treatment of intracranial tuberculoma. Our patient, a 15-year-old girl who initially presented with meningitis and intracranial tuberculomas, developed extracranial tuberculomas during treatment for central nervous system tuberculosis. She was followed clinically with cerebrospinal fluid (CSF) studies and magnetic resonance imaging (MRI) at three monthly intervals. Within 18 months of specific antituberculous treatment, the patient had fully recovered. The course and response to therapy are discussed in light of the current literature.
 
4

Kim HJ, Lee HJ, Kwon SY, Yoon HI, Chung HS, Lee CT, Han SK, Shim YS, Yim JJ. The prevalence of pulmonary parenchymal tuberculosis in patients with tuberculous pleuritis. Chest. 2006 May;129(5):1253-8.
Division of Pulmonary and Critical Care Medicine, Department of Medicine and Lung Institute, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, South Korea.
STUDY OBJECTIVE: To examine the prevalence and characteristics of parenchymal tuberculous pleuritis in adult patients. DESIGN: Prospective cohort study. SETTING: Three hospitals affiliated with Seoul National University in South Korea. PATIENTS: All patients > 15 years old with a diagnosis of tuberculous pleuritis were enrolled prospectively between January 1, 2004, and October 31, 2004. INTERVENTIONS: Diagnostic thoracocentesis and CT of the chest were done for each patient. Acid-fast bacilli (AFB) smears and cultures for Mycobacterium tuberculosis were requested if patients produced any sputum. A board-certified radiologist reviewed the chest radiographs for the presence and characteristics of any lesions. MEASUREMENTS AND RESULTS: One hundred six patients with tuberculous pleuritis were enrolled (median age, 53 years; range 16 to 89 years). Among them, 33 patients (31%) had sputum or bronchial washing findings positive for AFB smears or for M tuberculosis by culture. Lung parenchymal lesions were observed in 91 of the patients (86%) using chest CT; 39 patients (37%) with parenchymal lesions had radiographic characteristics of active pulmonary tuberculosis. In total, 62 patients (59%) had bacteriologically or radiographically active pulmonary tuberculosis. In addition, 78 patients (74%) had features of reactivated pulmonary tuberculosis. CONCLUSIONS: Lung parenchymal lesions were more common in this series of patients with tuberculous pleuritis than has been reported in previous studies. The patients mostly had radiographic features of reactivated, rather than primary, tuberculosis.
 
5

Marais BJ, Gie RP, Schaaf HS, Beyers N, Donald PR, Starke JR. Childhood pulmonary tuberculosis: old wisdom and new challenges. Am J Respir Crit Care Med. 2006 May 15;173(10):1078-90. Review.
Department of Paediatrics and Child Health, Desmond Tutu Tuberculosis Centre, Faculty of Health Sciences, Stellenbosch University, P.O. Box 19063, Tygerberg 7505, South Africa. bjmarais@sun.ac.za
Childhood tuberculosis is neglected in endemic areas with resource constraints, as children are considered to develop mild forms of disease and to contribute little to the maintenance of the tuberculosis epidemic. However, children contribute a significant proportion of the disease burden and suffer severe tuberculosis-related morbidity and mortality, particularly in endemic areas. This review provides an overview of well-documented concepts and principles, and demonstrates how this "old wisdom" applies to current and future challenges in the field of childhood tuberculosis; the aim was to articulate some of the most pressing issues, to provide a rational framework for discussion, and to stimulate thought and further scientific study. The prechemotherapy literature that described the natural history of disease in children identified three central concepts: (1) the need for accurate case definitions, (2) the importance of risk stratification, and (3) the diverse spectrum of disease pathology, which necessitates accurate disease classification. The relevance of these concepts and their application to pertinent issues such as the diagnosis of childhood tuberculosis are discussed. The concepts are also linked to the basic principles of antituberculosis treatment, providing a simplified approach to the diagnosis and treatment of childhood tuberculosis that is independent of resource constraints. The main challenges for future research are highlighted and in conclusion it is emphasized that the infrastructure provided by the directly observed therapy, short-course strategy, combined with well-targeted interventions, slightly improved resources, and greatly improved political commitment, may lead to a dramatic reduction in tuberculosis-related morbidity and mortality among children.
 
6

Sah SP, Bhadani PP, Regmi R, Tewari A, Raj GA. Fine needle aspiration cytology of tubercular epididymitis and epididymo-orchitis. Acta Cytol. 2006 May-Jun;50(3):243-9.
Department of Pathology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. sah_sp@yahoo.com
OBJECTIVE: To study the role of fine needle aspiration cytology (FNAC) and ancillary studies in the diagnosis of tubercular epididymitis or epididymo-orchitis. STUDY DESIGN: Forty patients with tubercular epididymitis or epididymoorchitis diagnosed on FNAC underwent a detailed clinical workup, imaging and microbiologic studies before being started on antitubercular treatment (ATT). One patient underwent orchiectomy. RESULTS: Clinically, the disease presented in patients of all ages usually as a scrotal swelling or rarely as a scrotal sinus (3) or abscess (3) or as part of disseminated tuberculosis (2). Three patients gave a history of previous tuberculosis. Scrotal sonography confirmed the involvement of the epididymis, testis or spermatic cord in each case. FNAC was diagnostic in 27 aspirates (epithelioid cell granulomas with caseation) but nondiagnostic in the rest. Tubercular etiology was confirmed directly by detection of acid-fast bacilli (AFB) on FNA smears in 24 (60%) patients and urine samples in 11 and indirectly in 9 patients with negative AFB by using a combination of a positive Mantoux test (5 of 9), presence of caseating granulomas on FNA smears (7 of 9) and therapeutic response to ATT (9 of 9). CONCLUSION: FNA as a minimally invasive technique plays a prime role in the diagnosis of tubercular epididymitis and epididymoorchitis. It provides adequate material for cytologic and microbiologic examination and helps to avoid unnecesary orchiectomy.
 
7

Shome D, Honavar SG, Vemuganti GK, Joseph J. Orbital tuberculosis manifesting with enophthalmos and causing a diagnostic dilemma. Ophthal Plast Reconstr Surg. 2006 May-Jun;22(3):219-21.
Department of Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, LV Prasad Eye Institute, Hyderabad, India.
A 60-year-old woman with no known systemic disease was referred with a hard mass in the left orbit and enophthalmos of two months duration. Differential diagnoses of metastasis from an undetected scirrhous carcinoma and sclerosing nonspecific orbital inflammatory disease were considered and a biopsy was performed. Histopathology demonstrated granulomatous inflammation with fibrosis. Subsequent polymerase chain reaction was positive for Mycobacterium tuberculosis deoxyribonucleic acid. There was no evidence of systemic tuberculosis. The patient was treated with four-drug combination anti-tubercular therapy for 6 months. The mass regressed and there was no local recurrence at two years follow-up. Orbital tuberculosis generally manifests with proptosis or osteomyelitis. However, enophthalmos may be caused by the fibrosing variant. Biopsy with histopathologic and microbioloic evaluation is essential to distinguish it from other more common causes of an orbital mass with paradoxical enophthalmos such as metastatic scirrhous carcinoma and sclerosing nonspecific orbital inflammatory disease.
 

Diagnosis, diagnostics, Immunodiagnosis & Immunodiagnostics:

14893.  Beckford-Ball J. NICE guidelines to improve TB management and prevention. Nurs Times. 2006 May 9-15;102(19):19-20.

14894.  Campbell IA, Bah-Sow O. Pulmonary tuberculosis: diagnosis and treatment. BMJ. 2006 May 20;332(7551):1194-7. Review.   

14895.  Deogaonkar M, Das S. Isolated spinal intramedullary tuberculoma in a healthy immunocompetent adult. Int J Infect Dis. 2006 May;10(3):266-7.      

14896.  Duan SY, Zhang DT, Lin QC, Wu YH. Clinical value of CT three-dimensional imaging in diagnosing gastrointestinal tract diseases. World J Gastroenterol. 2006 May 14;12(18):2945-8.

14897.  Geisinger KR. Tubercular scrotal disease. Acta Cytol. 2006 May-Jun;50(3):241-2.

14898.  Khalid SK, Jassim O. Images in clinical medicine. Scrofula. N Engl J Med. 2006 May 4;354(18):e18.   

14899.  Meyer S, Struffert T, Gottschling S. Tuberculous meningitis. Lancet 2006 20;367(9523):1682.

14900.  Pommerville PJ, Zakus P, van der Westhuizen N, Kibsey PC. Tuberculosis of the bladder without previous renal infection. Can J Urol. 2006 Apr;13(2):3044-6.

14901.  Shome D, Honavar SG, Vemuganti GK, Joseph J. Orbital tuberculosis manifesting with enophthalmos and causing a diagnostic dilemma. Ophthal Plast Reconstr Surg. 2006 May-Jun;22(3):219-21.

14902.  Street I, Gillett D, Sawyer A, Weighill J. Laryngeal tuberculosis: not the usual suspect. Br J Hosp Med (Lond). 2006 Apr;67(4):212-3. Review.   

14903.  Todd B. The QuantiFERON-TB Gold Test: a new blood assay offers a promising alternative in tuberculosis testing. Am J Nurs. 2006 Jun;106(6):33-4, 37.    

Therapy:

14904.  Brody H. Confronting a colleague who covers up a medical error. Am Fam Physician. 2006 Apr 1;73(7):1272, 1274.

14905.  Cho KD, Cho DG, Jo MS, Ahn MI, Park CB. Current surgical therapy for patients with tuberculous abscess of the chest wall. Ann Thorac Surg. 2006 Apr;81(4):1220-6.

14906.  Cho YS, Lee HS, Kim SW, Chung KH, Lee DK, Koh WJ, Kim MG.   Tuberculous otitis media: a clinical and radiologic analysis of 52 patients. Laryngoscope. 2006 Jun;116(6):921-7.

14907.  Rajapakse CD, Shingadia D. Tuberculous pyomyositis of the left quadratus lumborum. Arch Dis Child. 2006 Jun;91(6):512

14908.  Wasay M.  Central nervous system tuberculosis and paradoxical response. South Med J. 2006 Apr;99(4):331-2.  

14909.  Zasloff M.  Fighting infections with vitamin D. Nat Med. 2006 Apr;12(4):388-90.  

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