TUBERCULOSIS

Selected abstracts:

1.            Den Boon S, Verver S, Marais BJ, Enarson DA, Lombard CJ, Bateman ED, Irusen E, Jithoo A, Gie RP, Borgdorff MW, Beyers N. Association between passive smoking and infection with Mycobacterium tuberculosis in children. Pediatrics. 2007 Apr;119(4):734-9.

Desmond Tutu TB Centre, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. denboons@kncvtbc.nl

OBJECTIVE: Tuberculosis and smoking are both significant public health problems. The association between passive smoking and Mycobacterium tuberculosis infection is not well documented. The objective of this study was to examine the influence of passive smoking on M. tuberculosis infection in children. METHODS: A community survey was conducted in 15% of addresses in 2 adjacent low-income suburbs in Cape Town, South Africa. All children (< 15 years of age) and their adult household members residing at these addresses were included in the study. Children underwent tuberculin skin testing. An induration of > or = 10 mm was considered to define M. tuberculosis infection. Passive smoking was defined as living in the household with at least 1 adult who smoked for at least 1 year. Random-effects logistic regression analysis was performed, and odds ratios were adjusted for age, presence of a patient with tuberculosis in the household, average household income, and clustering at the household level. RESULTS: Of 1344 children, 432 (32%) had a positive tuberculin skin test. Passive smoking was significantly associated with M. tuberculosis infection in the unadjusted analyses but not in the adjusted analyses. In the 172 households with a patient with tuberculosis, passive smoking was significantly associated with a positive tuberculin skin test but not in the 492 households without a patient with tuberculosis. CONCLUSIONS: Passive smoking is associated with M. tuberculosis infection in children living in a household with a patient with tuberculosis. More studies are needed to confirm this observation, but the possible association is a cause of great concern, considering the high prevalence of smoking and tuberculosis in most developing countries.

2.         Froissart A, Pagnoux C, Cherin P. Lymph node paradoxical enlargement during treatment for tuberculous spondylodiscitis (Pott's disease). Joint Bone Spine. 2007 May;74(3):292-5.

Service de Médecine Interne I, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75013 Paris, France.

INTRODUCTION: Paradoxical reactions during adapted antituberculous treatment are defined as a transient, clinical and/or radiological enlargement of pre-existent lesions or appearance of new ones. OBSERVATION: We report herein the case of a 62-year-old woman who suffered under treatment of Pott's disease from an enlargement of her para-vertebral abscess and disco-vertebral lesions, and a tuberculous paradoxical reaction characterized by the development of uni- then bilateral cervical lymph nodes. Outcome was favourable after drainage by percutaneous punction of the adenopathies and oral short course of corticosteroids, and the continuation of combined antituberculous therapy. CONCLUSION: Paradoxical reactions under adapted antituberculous treatment must be considered only after excluding an inadequate or irregular intake, or absorption of antituberculous drugs. This phenomenon is not rare, and has been reported even in ten to 15% of the patients not infected with the human immunodeficiency virus. The adjunction of a short course of corticosteroids may be necessary and rapidly efficient to control these reactions, in combination with surgical or percutaneous drainage of the enlarged lymph nodes, to avoid unfavourable and/or unaesthetic fistulisations.

3.         Marais BJ, Pai M. Recent advances in the diagnosis of childhood tuberculosis. Arch Dis Child. 2007 May;92(5):446-52. Review. 

Ukwanda Centre for Rural Health and the Department of paediatrics and Child Health, Desmond Tutu TB Centre, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. bjmarais@sun.ac.za

Children account for a major proportion of the global tuberculosis disease burden, especially in endemic areas. However, the accurate diagnosis of childhood tuberculosis remains a major challenge. This review provides an overview of the most important recent advances in the diagnosis of intrathoracic childhood tuberculosis: (1) symptom-based approaches, including symptom-based screening of exposed children and symptom-based diagnosis of active disease; (2) novel immune-based approaches, including T cell assays and novel antigen-based tests; and (3) bacteriological and molecular methods that are more rapid and/or less expensive than conventional culture techniques for tuberculosis diagnosis and/or drug-resistance testing. Recent advances have improved our ability to diagnose latent infection and active tuberculosis in children, but establishing a diagnosis of either latent infection or active disease in HIV-infected children remains a major challenge, particularly in high-burden settings. Although improved access to diagnosis and treatment is essential, ultimately the burden of childhood tuberculosis is determined by the level of epidemic control achieved in a particular community. Several recent initiatives, in particular the United Nations Millennium Developmental Goals, deal with the problem of poverty and disease in a holistic fashion, but global political commitment is required to support these key initiatives.

4.            Singh M, Kothur K, Dayal D, Kusuma S. Perinatal tuberculosis a case series. J Trop Pediatr. 2007 Apr;53(2):135-8.

Department of Pediatrics, Pediatric Pulmonology Unit, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India. meenusingh4@rediffmail.com

Perinatal tuberculosis is insufficiently understood and has been rarely reported even in areas endemic for the disease, and unless a high index of suspicion is maintained the diagnosis can be missed. Differentiation of congenital from early postnatally acquired tuberculosis is only of epidemiological importance. We hereby report one case of congenital tuberculosis and three cases of perinatal tuberculosis, and problems faced during investigation and management and emphasize need for improved screening of women at risk and sensitization of the medical community about this entity.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

16607.   Ahn JY, Chang JH, Kim KS, Kim WJ. Disseminated tuberculosis with multiple intracerebral tuberculomas in a patient with anorexia nervosa. Int J Eat Disord. 2007 Apr;40(3):288-91.

16608.   Alisjahbana B, van Crevel R. Improved diagnosis of tuberculosis by better sputum quality. Lancet. 2007 Jun 9;369(9577):1908-9. 

16609.   Andersen P, Doherty TM, Pai M, Weldingh K. The prognosis of latent tuberculosis: can disease be  predicted? Trends Mol Med. 2007 May;13(5):175-82. 

16610.    Bawa S, McNally J. A pain in the foot and a serious complication. J R Soc Med. 2007 Jun;100(6):284-5.

16611.    Bhargava P. Epididymal tuberculosis: presentations and diagnosis. ANZ J Surg. 2007 Jun;77(6):495-6.

16612.   Bong CN, Chen SC, Jong YJ, Tok TS, Hsu CF, Schouten EJ, Makombe SD, Yu JK, Harries AD. Outcomes of HIV-infected children with tuberculosis who are started on antiretroviral therapy in Malawi. Int J Tuberc Lung Dis. 2007 May;11(5):534-8. 

16613.  Brown M, Varia H, Bassett P, Davidson RN, Wall R, Pasvol G. Prospective study of sputum induction, gastric washing, and bronchoalveolar lavage for the diagnosis of pulmonary tuberculosis in patients who are unable to expectorate. Clin Infect Dis. 2007 Jun 1;44(11):1415-20.

16614.  Chaulet P. Learning about tuberculosis in medical schools. Int J Tuberc Lung Dis. 2007 Jun;11(6):592.

16615.  Cherian JV, Somasundaram A, Ponnusamy RP, Venkataraman J. Peripancreatic tuberculous lymphadenopathy. An impostor posing diagnostic difficulty. JOP. 2007 May 9;8(3):326-9.

16616.  De Backer AI, Mortele KJ, Van Den Heuvel E, Vanschoubroeck IJ, Kockx MM, Van de Vyvere M. Tuberculous adenitis: comparison of CT and MRI findings with histopathological features. Eur Radiol. 2007 Apr;17(4):1111-7.

16617.  Dubey A P, Sudha S, Parakh A. Peripheral gangrene: An uncommon manifestation of disseminated tuberculosis. Indian Pediat 2006, 43(3), 255-7.

16618.   Efferen LS. Tuberculosis and pregnancy. Curr Opin Pulm Med. 2007 May;13(3):205-11.

16619.   Garg RK, Singhal P. Primary tuberculosis of the tongue: a case report. J Contemp Dent Pract. 2007 May 1;8(4):74-80.

16620.   Gupta KB, Kumar A, Sen R, Sen J, Vermas M. Role of ultrasonography and computed tomography in complicated cases of tuberculous cervical lymphadenitis. Indian J Tuberc. 2007 Apr;54(2):71-8. 

16621.   Hanscheid T, Ribeiro CM, Shapiro HM, Perlmutter NG. Fluorescence microscopy for tuberculosis diagnosis. Lancet Infect Dis. 2007 Apr;7(4):236-7. 

16622.   Hirotani M, Yabe I, Hamada S, Tsuji S, Kikuchi S, Sasaki H. Abnormal brain MRI signals in the splenium of the corpus callosum, basal ganglia and internal capsule in a suspected case with tuberculous meningitis. Intern Med. 2007;46(8):505-9. 

16623.   Indumathi CK, Alladi A, Dinakar C, Rout PL. Tuberculosis of the breast in an adolescent girl: a rare presentation. J Trop Pediatr. 2007 Apr;53(2):133-4. 

16624.   Kamath MP, Bhojwani KM, Kamath SU, Mahabala C, Agarwal S. Tuberculous retropharyngeal abscess. Ear Nose Throat J. 2007 Apr;86(4):236-7.

16625.   Mofenson LM, Laughon BE. Human immunodeficiency virus, mycobacterium tuberculosis, and pregnancy: a deadly combination. Clin Infect Dis. 2007 Jul 15;45(2):250-3.

16626.   Nateghian A, Robinson JL, Fanning A. A child with headache, cough, weight loss, and seizure. Clin Infect Dis. 2007 May 15;44(10):1341-2, 1384-6.

16627.   Ozkutuk A, Terek G, Coban H, Esen N. Is it valuable to examine more than one sputum smear per patient for the diagnosis of pulmonary tuberculosis? Jpn J Infect Dis. 2007 May;60(2-3):73-5. 

16628.  Pai M. Alternatives to the tuberculin skin test: interferon-gamma assays in the diagnosis of Mycobacterium tuberculosis infection. Indian J Med Microbiol 2005;23(3): 151-8.

16629.   Quint JK, Elsheikh A, Yung B, Samuel J, Mukherjee DK. Respiratory disease in the ophthalmology department. Diagnosis: retinal vasculitis associated with tuberculoprotein hypersensitivity (Eales' disease). Thorax. 2007 Jun;62(6):520, 526.

16630.   Ranganathan S, Connell T, Curtis N. Interferon-gamma release assays in children--no better than tuberculin skin testing? J Infect. 2007 Apr;54(4):412-3; author reply 414-5.

16631.   Renard D, Morales R, Heroum C. Tuberculous meningovasculitis. Neurology. 2007 May 15;68(20):1745.

16632.   Shah S, Fickling W, Apps M. Gastrointestinal tuberculosis: an unusual presentation. Clin Gastroenterol Hepatol. 2007 Apr;5(4):A28.

16633.  Sahoo R, Vishak Acharya K, Kasturi D P, Lobo F D, Kini H. Second primary lung cancer with tuberculosis. Indian J Chest Dis All Sci 2006;48(1): 63-6.

16634.   Twine C, Coulston J, Tayton K. Bony lesions in BCG-vaccinated children: consider BCG osteitis. J Paediatr Child Health. 2007 Apr;43(4):307-9. 

16635.  Van Lierop AC, Prescott CA, Fagan JJ, Sinclair-Smith CC. Is diagnostic tonsillectomy indicated in all children with asymmetrically enlarged tonsils? S Afr Med J. 2007 May;97(5):367-70.

16636.  Veeregowda B M, Isloor S, Leena G, Rajsekhar M. Assessment of an enzyme linked immunosorbent assay for detection of bovine tuberculosis. J vet Public Hlth 2005, 3(2), 111-4.

16637.   Yilmazlar S, Bekar A, Taskapilioglu O, Tolunay S. Isolated intrasellar tuberculoma mimicking pituitary adenoma. J Clin Neurosci. 2007 May;14(5):477-81.

Vaccines:

16638.  Boelaert JR, Vandecasteele SJ, Appelberg R, Gordeuk VR. The effect of the host's iron status on tuberculosis. J Infect Dis. 2007 Jun 15;195(12):1745-53.  

Chemotherapy, Immunotherapy, Management & Drugs: 

16639.  Azali HY, Norly S, Wong LM, Tan KS, Safian NM. Liver abscess caused by tuberculosis and melioidosis. Asian J Surg. 2007 Apr;30(2):138-40. 

16640.  Potter B, Rindeleisch K, Kraus C K, Pharm D. Management of active tuberculosis. Indian J Clin Pract 2006; 16(11): 68-76.

16641.  Yew WW, Leung CC. Antituberculosis drugs and hepatotoxicity. Am J Respir Crit Care Med. 2007 Apr 15;175(8):858; author reply 858-9.