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Effectiveness of Histopathological Examination of Ultrasound-guided Puncture Biopsy Samples for Diagnosis of extrapulmonary tuberculosis

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Biomedical and Environmental Sciences 2024年第2期37卷 170-177页

作者： GU Wen Fei SHI Xia MA Xin YU Jun Lei XU Jin Chuan QIAN Cheng Cheng HU Zhi Dong ZHANG Hui Shanghai Public Health Clinical Center Fudan UniversityShanghai 201508China School of Laboratory Medicine and Life Science Wenzhou Medical UniversityWenzhou 325000ZhejiangChina Department of Laboratory Medicine Zhejiang Putuo HospitalZhoushan 316100ZhejiangChina Zhongshan Hospital Fudan UniversityShanghai 200032China

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 *** 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%),*** 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%),*** examination showed the highest sensitivity but lowest ***,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 *** with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower *** combination of histopathology with Xpert showed the best performance characteristics.

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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World Journal of Clinical Cases 2024年第18期12卷 3295-3297页

作者： Sumanta Saha Department of Women's and Children's Health Dunedin Public HospitalDunedin 9016New Zealand

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 *** 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 *** 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 *** obtainment of HIV-relevant histories,like intravenous drug use and sexual practice,are good places to *** sputum bacteriology also seems imperative to rule out atypical Mycobacterium species infection because of its clinico-radiohistopathological resemblance with pulmonary Mycobacterium ***,this editorial aims to underscore that primary extrapulmonary tuberculosis diagnosis should comprise an elaborative,comprehensive,systematic,and stepwise primary pulmonary Mycobacterium tuberculosis exclusion workup.

关键词： extrapulmonary tuberculosis tuberculosis Gastrointestinal Diagnosis Human immunodeficiency virus

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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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Journal of tuberculosis Research 2021年第3期9卷 219-229页

作者： Annalisa Del Giudice Rossella Perna 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 UOC Microbiologia e Virologia Hospital Cotugno AORN Ospedali dei Colli Naples Italy UOC Respiratory Infectious Diseases Unit Hospital Cotugno AORN Ospedali dei Colli Naples Italy Department of Medical Sciences San Giuseppe Hospital MultiMedica IRCCS and Department of Clinical Sciences and Community Health University of Milan Milan Italy Department of Translational Medical Sciences University of Campania “L. Vanvitelli”/Hospital Monaldi Naples Italy

Background: extrapulmonary tuberculosis (EPTB) remains difficult to diagnose because the clinical specimens to be examined are often paucibacillary and obtained with difficulty from inaccessible sites. An updated Xper... 详细信息

Background: Extrapulmonary tuberculosis (EPTB) remains difficult to diagnose because the clinical specimens to be examined are often paucibacillary and obtained with difficulty from inaccessible sites. An updated Xpert® MTB/RIF Ultra (Ultra) test has been designed and licensed to improve sensitivity in the detection of Mycobacterium tuberculosis complex. The aim of the present study is to evaluate the performance of Ultra assay for the clinical diagnosis of EPTB in a low tuberculosis prevalence country. Methods: A retrospective analysis was performed at “A. 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.

关键词： extrapulmonary tuberculosis Molecular Diagnosis Mycobacterium tuberculosis Xpert® MTB/RIF Ultra

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Unveiling the Threat: Case Reports of Extra-Pulmonary tuberculosis among Sanctuary Chimpanzees

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Advances in Infectious Diseases 2024年第1期14卷 105-132页

作者： Emeline Chanove Yedra Feltrer Antoine Collomb-Clerc Angela Ceballos-Caro Marina Spinu Department of Infectious Diseases University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca Romania International Primate Health and Welfare Group (IPHWG) Madrid Spain NeuroX Institute and Brain Mind Institute School of Life Sciences Swiss Federal Institute of Technology (EPFL) Lausanne Switzerland Malaria and Emerging Parasitic Diseases Laboratory National Centre for Microbiology Instituto de Salud Carlos III Madrid Spain

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.

关键词： extrapulmonary tuberculosis tuberculosis Chimpanzees Zoonotic Risk Biosecurity Diagnosis Challenges

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Profile of Extra-Pulmonary tuberculosis in Internal Medicine

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Open Journal of Internal Medicine 2024年第1期14卷 64-73页

作者： Mouhamed Dieng Djiby Sow Demba Diédhiou Michel Assane Ndour Boundia Djiba Mouhamed Almahy Niang Matar Ndiaye Oumar Boun Khattab Diouf Fatou Kiné Gadji Anna Sar Maïmouna Ndour Mbaye Clinique Médicale II H&ocircpital Aristide Abass Ndao Université Cheikh Anta Diop Dakar Sénégal

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

关键词： extrapulmonary tuberculosis Epidemiology Diagnosis Senegal

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Rectal cancer combined with abdominal tuberculosis: A case report

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World Journal of Clinical Cases 2022年第31期10卷 11523-11528页

作者： Pei-Gen Liu Xiang-Fan Chen Pan-Feng Feng Department of General Surgery Central Hospital of Panzhihua CityPanzhihua 617000Sichuan ProvinceChina Department of Pharmacy Affiliated Hospital 2 of Nantong UniversityNantong 226000Jiangsu ProvinceChina

BACKGROUND It is very rare to suffer from colorectal adenocarcinoma and abdominal tuberculosis *** in a country such as China,where tuberculosis is still endemic,its diagnosis and treatment are *** article describes in detail a case of rectal cancer complicated by abdominal tuberculosis and its pathological *** SUMMARY We outline the case of a 71-year-old female who was admitted with intermittent blood in the stool over the past *** patient was diagnosed with low rectal cancer and received neoadjuvant *** patient then returned to the hospital for surgery,but diffusely distributed nodules were found during laparoscopic *** diagnosis of rectal cancer with extensive metastasis was considered during the *** was no opportunity for radical ***,nodules were taken for pathological examination,and the abdomen was *** histopathological diagnosis was tuberculous granuloma,and the patient was treated with standardized anti-tuberculosis drugs in a specialized ***,the patient again came to our hospital and underwent abdominoperineal *** was discharged 10 d after the operation in good clinical *** We aim to emphasize the importance of preoperative and postoperative pathological examination in diagnosis and treatment.

关键词： Abdominal tuberculosis Rectal cancer extrapulmonary tuberculosis Peritoneal nodules Case report

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Tuberculous meningitis and miliary tuberculosis in Iran:A review

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Asian Pacific Journal of Tropical Medicine 2022年第4期15卷 143-152页

作者： Sayyed Gholamreza Mortazavi-Moghaddam Abdol Sattar Pagheh Ehsan Ahmadpour Alacsandra Barac Azadeh Ebrahimzadeh Infectious Diseases Research Center Birjand University of Medical SciencesBirjandIran Department of Parasitology and Mycology Faculty of MedicineTabriz University of Medical SciencesTabrizIran Clinic for Infectious and Tropical Diseases Clinical Centre of Serbia11000BelgradeSerbia

In recent years,the number of cases of extrapulmonary tuberculosis in Iran has *** 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 *** January 1,2000 and June 1,2021,1651 cases of tuberculosis meningitis and miliary tuberculosis were discovered in *** prevalence of tuberculosis meningitis was higher in Sistan and Baluchestan,South Khorasan,and Mazandaran compared with other *** most prevalent symptoms of tuberculous meningitis were fever,anorexia,headache,neck stiffness,loss of consciousness,and *** most commonly used procedures for diagnosing tuberculous meningitis were polymerase chain reaction and cerebrospinal fluid *** most prevalent clinical symptoms of miliary tuberculosis were fever,lethargy,weariness,and *** 70%of chest radiographs,a miliary pattern was *** marrow biopsy was used to diagnose miliary tuberculosis in 80%of patients,while bronchoalveolar lavage was used in 20%of *** conventional 6-month treatment approach for tuberculous meningitis and miliary tuberculosis was used for all of the participants in the *** 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.

关键词： extrapulmonary tuberculosis Tuberculous meningitis Miliary tuberculosis Iran

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Soft tissue tuberculosis detected by next-generation sequencing:A case report and review of literature

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World Journal of Clinical Cases 2023年第3期11卷 709-718页

作者： Yan-Gai He Ya-Hui Huang Xiao-Lan Yi Kao-Liang Qian Ying Wang Hui Cheng Jun Hu Yuan Liu Department of Infectious Diseases The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina Department of Orthopedics The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina

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 *** 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 *** SUMMARY A 44-year-old man presented with recurrent swelling and ulcers on the left *** resonance imaging suggested a soft tissue *** lesion was surgically removed and tissue biopsy and culture were performed;however,no organism growth was ***,Mycobacterium tuberculosis was confirmed as the pathogen responsible for infection through next-generation sequencing analysis of the surgical *** patient received a standardized anti-tuberculosis treatment and showed clinical *** also performed a literature review on soft tissue tuberculosis using studies published in the past 10 *** 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.

关键词： Mycobacterium tuberculosis Soft tissue infection Next-generation sequencing extrapulmonary tuberculosis Diagnosis Case report

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Xpert MTB/RIF Ultra在肺外结核中的快速诊断（英文）

Xpert MTB/RIF Ultra在肺外结核中的快速诊断（英文）

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第一届中国临床分子诊断大会

作者：吴小翠谭光坤高荣樑姚岚郭银娟余方友范琳同济大学附属上海市肺科医院上海市东方医院

EPTB（extrapulmonary Tuberbulosis, EPTB） remains great challenge to be diagnosed. Xpert MTB/RIF Ultra（Xpert Ultra）, a next-generation diagnostic on the GeneXpert platform, has a substantially lower limit of detection（LOD） than that of Xpert MTB/RIF due to the use of multi-copy IS1081 and IS6110 insertion elements target sequences in Mycobacterium tuberculosis（MTB） strains, whereas the rapid diagnostic value on its utility for EPTB is limited. In this study, we aimed to evaluate its rapid diagnostic performance for patients with EPTB on extrapulmonary specimens. A total of 225 patients with suspected EPTB were prospectively enrolled. Among these, 200 cases were classified as having EPTB（43 confirmed, 157 probable cases）, and 25 cases were classified as non-EPTB. The sensitivity of Xpert Ultra, Xpert and culture for the diagnosis EPTB were 52.5%（95% confidence interval [CI], 45.4-59.6%）, 34%（95% CI, 27.6-41.1%） and 21.5%（95% CI, 16.2-28.0%）, respectively. The specificity of Xpert Ultra, Xpert and culture were 92.0%（95% CI, 72.5-98.6%）, 96.0%（95% CI, 77.7-99.8%） and 100%（95% CI, 83.4-100.0%）, respectively. The sensitivity of Xpert Ultra was significantly higher than that of Xpert and culture（p＜0.05）. By comparison of sensitivity of Xpert Ultra on different types of extrapulmonary specimens, Xpert Ultra can detect 78.9%（56/71） of EPTB on fine-needle aspiration（FNA） specimens and 43.7%（45/103） of EPTB on pleural fluid, which were comparatively higher than the sensitivity of Xpert and culture（p＜0.05）. In conclusion, our present study exhibited the more sensitive and rapid diagnostic performance of Xpert Ultra for EPTB compared with Xpert and culture.

关键词： Mycobacterium tuberculosis Xpert MTB/RIF Ultra Xpert MTB/RIF extrapulmonary tuberculosis Diagnosis

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