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Query: UMLS:C0026918 (Mycobacterium)
 52,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reviewed 106 patients referred to our institution for treatment of peripheral tuberculous adenitis to establish the epidemiologic, clinical, and pathologic manifestations of this disease. Tuberculous lymphadenitis occurred predominantly in young, foreign-born women a mean of 5 years after arrival in the United States. Tuberculin skin tests were positive in 94% of cases. Lymphadenopathy occurred most frequently in the neck (57%) or supraclavicular area (26%) and involved 1-3 nodes. Forty (38%) patients had an abnormal chest radiograph consistent with granulomatous infection. Culture-positive pulmonary tuberculosis was diagnosed in 41% of those patients with abnormal chest radiographs. Fine needle aspiration was an essential step in the evaluation and diagnosis of tuberculous lymphadenitis. Granulomas were seen in 61% of fine needle aspirates and 88% of surgical biopsies. Positive cultures for Mycobacterium tuberculosis were obtained from 62% of fine needle aspirate samples and 71% of excisional biopsies. The presence of necrosis and/or neutrophilic inflammation in tissue samples correlated with culture positivity. Given the high yield of positive cultures from fine needle aspirates, surgery was rarely indicated as an initial step in immunocompetent adults. In this cohort, 101 patients received a final diagnosis of peripheral tuberculous lymphadenitis. Eighty-two percent received their entire therapy under direct observation, and response to antituberculous therapy was uniformly successful. Paradoxical expansion of adenopathy was seen in 20% of all patients and was more commonly noted in human immunodeficiency virus-seropositive patients. We present a diagnostic algorithm based on our experience.
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PMID:Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. 1626 10

Although bovine tuberculosis is widespread throughout Africa, very little is known about risk factors for Mycobacterium bovis infection in either human or cattle populations. A human case-control study was conducted in northern Tanzania, comparing risk factors and prevalence of cattle interdermal test positives of cases (cervical adenitis cases from which M. bovis was isolated) with age- and sex-matched controls (selected at random from potential hospital attendees within the community). A cattle cross-sectional study was also set-up involving 27 villages selected at random in four districts, with 10,549 cattle and 622 herds tested, and questionnaire surveys conducted in 239 households. M. bovis was confirmed in seven of 65 (10.8%) human cervical adenitis cases, of which only one came from a household owning infected cattle. M. bovis in human patients was associated with families in which a confirmed diagnosis of tuberculosis had previously been made (p<0.001) and with households far (>100m) from neighbours (p=0.003). In cattle, overall prevalence of intradermal test positives was low at 0.9% (0.70-1.06%), but widespread, with 11.8% (8.44-13.17%) herds containing at least one reactor. Prevalence of intradermal test positives increased significantly with cattle age (p<0.001). Herds with the following risk factors had a significantly greater prevalence of intradermal test positives: >50 cattle in the herd (p=0.024); herds housed inside at night (p=0.021) and herds in contact with wildlife (p=0.041). Furthermore, villages that experienced annual flooding had a higher prevalence of infection (p=0.043).
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PMID:Mycobacterium bovis in rural Tanzania: risk factors for infection in human and cattle populations. 1661 53

Nontuberculous mycobacterium (NTM) is one of the well-known causes of cervicofacial lymphadenopathy in children under 5 years of age. Children often present with a painless cervical mass that fails to respond to conventional antibiotics. They are often referred under the suspicion of a neoplasm or bacterial adenitis rather than NTM cervical lymphadenitis. The lack of systemic symptoms, modest or negative purified protein derivative test and absence of exposure to active tuberculosis are characteristics of NTM lymphadenitis. The diagnosis usually requires the isolation of pathogen or pathologic proof. Complete excision is the choice of treatment by the majority of authors in the literature. This not only enables rapid diagnosis but ensures the lowest recurrence rate. Medical management is sometimes successful when complete resection is impossible or refused. To our knowledge, the incidence of NTM cervical lymphadenitis in children is increasing throughout the world. However, such reports of children in Taiwan is lacking. Clinicians should suspect a possible nontuberculous mycobacterial infection when a cervical lump is found in a child.
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PMID:Mycobacterium abscessus cervical lymphadenitis: an immunocompetent child. 1691 25

Nontuberculous mycobacterial infections are rare in immunocompetent children, and usually present as adenitis. We report a case of a 6-year-old girl with a multifocal chronic osteomyelitis and pulmonary localisation due to Mycobacterium intracellulare associated with an autosomal dominant mutation of interferon gamma receptor 1 gene (INFGR1) leading to a syndrome of mendelian predisposition to mycobacteria infections by partial deficiency of intracellular signalisation of gamma interferon. This child has been cured with anti-mycobacteria drugs and gamma interferon. This report focus on the importance of looking for a susceptibility of the host to infectious diseases, which can lead to a specific treatment. As far as we know, this is the first case described in a tropical area.
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PMID:[Multifocal infection due to Mycobacterium intracellulare: first case of interferon gamma receptor partial dominant deficiency in tropical French territory]. 1722 23

Mycobacterium kansasii is one of the main mycobacterial species. Among the numerous subtypes, I and II subtypes are the only pathogens ones. A 56 years old woman has been under observation during her hospitalization for a cervical adenitis check-up; these one having been evolving for 2 months, without inflammatory syndrome. The failures of various antibiotics treatments lead one to withdraw some cervical ganglions whose histopathologic aspect reminds tuberculosis. These adenitis being isolated. An INH, rifampin, and ethambutol associated treatment is set up. After 2 weeks, the different cultures enable to isolated numerous photochromogenic colonies; a positive result is obtained with M. kansasii probe (Accuprobe). The identification is confirmed in 24 hours time with another molecular hybridation test (INNO-LiPA V2); the various specific probes of the different M. kansasii subtypes show it's not a I or II subtype (subtype IV by sequence analysis). This observation underlines the advantage and rapidity of the new diagnosis methods for nontuberculous mycobacterial diseases.
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PMID:[Cervical adenitis caused by Mycobacterium kansasii: advantage of the INNO-LiPA V2 test in diagnosis of nontuberculous mycobacterial diseases]. 1792 63

The present report reviews a decade of experience with nontuberculous mycobacterial adenitis at a pediatric referral centre, noting that patients are often subjected to multiple ineffective antibiotic courses, and that delays in diagnosis and referral for appropriate therapy are common. Notable clinical features include a mean age of presentation of 3.4 years, a male-to-female ratio of 1:1.5 and a gradual onset of painless, unilateral cervical adenopathy. Fever was absent in most patients (77%), and the disease failed to respond to antistaphylococcal antibiotics. The mean time to correct diagnosis was longer than three months (15 weeks). The clinical features of the disease are highlighted and presented with a practical diagnostic approach to the child with subacute/chronic adenitis. New molecular diagnostic tools and emerging mycobacteria are discussed, including the first reports of Mycobacterium malmoense adenitis in Canada.
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PMID:First Canadian Reports of Cervical Adenitis Due to Mycobacterium Malmoense and a 10-year Review of Nontuberculous Mycobacterial Adenitis. 1841 88

Tuberculous otitis media is a rare disease. Its diagnosis is often made late. We report the case of a 13-year-old girl presenting with a right chronic otitis media and a massive and painful cervical adenitis. High resolution CT-scan revealed cervical and mediastinal adenitis associated with extensive lesions involving the middle ear, mastoid air cells, and sphenoidal bone. The diagnosis of tuberculous otitis media was made on a positive tuberculin skin test and on the identification of Mycobacterium tuberculosis in gastric juices. The young girl progressed well after 9 months of antituberculous chemotherapy.
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PMID:[Tuberculous otitis media]. 1895 47

A prospective observational study was conducted to describe the clinical presentation, diagnostic yield of fine-needle aspiration (FNA) cytology and lymph node biopsy and the outcome of tuberculous (TB) adenitis in patients admitted to Hamad General Hospital, Qatar, between 1 January and 31 December 2006. TB adenitis that was predominantly cervical was confirmed in 35 patients (28M, 7F) with a mean age of 29.4+/-9 y. Of the 35 cases, caseating granulomata were confirmed by FNA in 20, by lymph node biopsy following negative FNA in 9, and by biopsy alone in 6. Mycobacterium tuberculosis was cultured from FNA alone in 24 cases, in 9 cases from biopsies after negative FNA and in 6 cases from biopsies alone. The tuberculin test (PPD) was positive in all patients with TB adenitis (100%), while an HIV test was negative in all. The sensitivity of FNA cytology alone was 69% but when combined with a skin test it was 85%. It can be concluded that FNA cytology has an important role in the evaluation of TB adenitis, as a non-invasive alternative to excisional biopsy. After 12 months from the start of a 6-month course of combined antituberculous treatment, 32 patients were cured whereas 3 patients had left the country before completing therapy.
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PMID:Clinical pattern of tuberculous adenitis in Qatar: experience with 35 patients. 1901 83

Tuberculosis is the prototype of infections that require a cellular immune response for their control. It has been shown that CD4+ T-lymphocytes are most important in the protective response against Mycobacterium tuberculosis. CD8+ T-lymphocytes are also important for effective T-cell immune response. This study compares CD4+ and CD8+ baseline values in patients with different manifestations of tuberculosis. CD4+ and CD8+ in three groups of patients with tuberculosis (pulmonary, lymphadenitis, meningitis/milliary involvement) and a group of healthy volunteers were enumerated using flowcytometry. Twenty-six patients with pulmonary tuberculosis, 10 with adenitis, 16 with meningitis or milliary tuberculosis and 16 healthy volunteers entered the study. Mean CD4 in meningitis/milliary group was significantly lower than all other groups (p<0.05). Mean CD4 counts of patients with pulmonary tuberculosis was also significantly lower than control group (p=0.01). Mean CD8 in meningitis/milliary group was significantly lower than control group (p=0.02). No relation was found between results of TSTs and CD4 values in three groups. CD4 depletion is an expectable phenomenon in patients with tuberculosis. This study shows that patients with more severe form of disease had the lowest number of both CD4 and CD8 cells which can be a sign of suppressed cellular immunity in these patients.
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PMID:CD4+ cell counts in patients with different clinical manifestations of tuberculosis. 1928 35

Tuberculous lymphadenitis is the most common cause of extra-pulmonary tuberculosis (TB) in developing countries. Lymphadenitis caused by non-tuberculous mycobacteria (NTM) requires consideration, particularly in immunocompromised patients and children in developed countries. Fine-Needle Aspiration Biopsy (FNAB) offers a valuable specimen collection technique, but culture confirmation, mycobacterial speciation and drug resistance testing (if indicated) is often unavailable in TB endemic areas and result in unacceptable diagnostic delay. We evaluated the diagnostic value of high-resolution DNA melting (HRM) analysis in the diagnosis of mycobacterial lymphadenopathy using FNAB and an inexpensive transport medium. Specimens were collected from patients referred to the FNAB Clinic at Tygerberg Hospital (June 2007-May 2008) with clinical mycobacterial lymphadenitis. Cytology, culture, and HRM were performed on all specimens. The reference standard for disease was defined as positive cytology (morphological evidence plus mycobacterial visualization) and/or a positive culture. Specimens were collected from 104 patients and mycobacterial disease was confirmed in 54 (51.9%); 52 Mycobacterium tuberculosis, 1 Mycobacterium Bovis BCG and 1 NTM. Cytology was positive in 83.3% (45/54) and culture in 72.2% (39/54) of patients. HRM identified 57.4% (31/54) of cases. By using the defined reference standard, we recorded 94.0% specificity and 51.9% sensitivity (positive predictive value 90.3%) with HRM analysis.HRM analysis allowed rapid and species specific diagnosis of mycobacterial lymph adenitis in the majority of patients, permitting early institution of appropriate therapy. Optimization of this technique requires further study.
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PMID:Combining fine-needle aspiration biopsy (FNAB) and high-resolution melt analysis to reduce diagnostic delay in Mycobacterial lymphadenitis. 1989 59


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