Search

Objective: Study of Co-relation between Clinical and Diagnostic profile of Pediatric Tuberculosis in a tertiary care hospital. Methods: This hospital-based observational study was conducted at the Department of Pediatrics, Muzaffarnagar Medical College and Hospital, covering a population of children aged

Tuberculosis of the breast, also referred to as tuberculous mastitis, represents an extremely rare presentation of tuberculosis. It constitutes < 0.1 % of all breast pathology in developed countries and <2 % of all tuberculous cases globally. It's an infrequent manifestation of extra-pulmonary tuberculosis. It is characterized by diagnostic challenges with majority of preliminary clinical diagnosis being breast carcinoma or pyogenic breast abscess. The diagnosis is challenging due to the nonspecific clinical and radiological findings, in addition to insufficient specimen with often negative microscopy and culture results. We report the case of tuberculosis of the right breast in a young multiparous woman, a healthcare worker who presented with clinical features suspected to be breast tuberculosis in whom diagnosis was made based on clinical, haematological parameters and tuberculin skin test only. She was commenced on anti-tuberculous medications with excellent clinical response after 6 months of therapy. This report highlights the importance of considering tuberculosis as a differential diagnosis in women with breast lumps and sinuses. In addition, this report also highlights the diagnostic challenges in breast tuberculosis and how a high index of suspicion and non-bacteriological investigation could be relied upon for its diagnosis. [ABSTRACT FROM AUTHOR]

Background: Early diagnosis of pediatric tuberculosis (TB) still remains a challenge due to the paucibacillary nature of the disease. Objectives: To assess the role of CB-NAAT in diagnosing pulmonary and extrapulmonary tuberculosis as compared to AFB smear and Mycobacterium tuberculosis culture in clinically diagnosed pediatric tuberculosis cases. Study design: Hospital-based prospective study. Methods: A total of142 patients with strong clinical suspicion of pulmonary or extra-pulmonary tuberculosiswere enrolled over a period of two yearsand then results of CB-NAAT were compared to conventional methods (culture/ AFB smear) on follow-up. Results: In subjects who had clinically diagnosed tuberculosis, culture was positive in 18.9% of cases, AFB smear was positive in only 12.1% whereas CB-NAAT was positive in 55.4% of subjects. The sensitivity, specificity, PPV, and NPV of CB-NAAT in patients with culture proven tuberculosis were100%, 83.3%, 47.5%, and 100% respectively with a diagnostic accuracy of 93.3%. and 60%, 100%, 100%, and 65.8% respectively with a diagnostic accuracy of 80.2% in clinically diagnosed pulmonary cases. Conclusion:CB-NAAT has true diagnostic potential with good sensitivity in confirmed cases and significantly better sensitivity than conventional methods in clinically diagnosed cases. [ABSTRACT FROM AUTHOR]

Background: Early diagnosis of pediatric tuberculosis (TB) still remains a challenge due to the paucibacillary nature of the disease. Objectives: To assess the role of CB-NAAT in diagnosing pulmonary and extrapulmonary tuberculosis as compared to AFB smear and Mycobacterium tuberculosis culture in clinically diagnosed pediatric tuberculosis cases. Study design: Hospital-based prospective study. Methods: A total of142 patients with strong clinical suspicion of pulmonary or extra-pulmonary tuberculosis were enrolled over a period of two years and then results of CB-NAAT were compared to conventional methods (culture/ AFB smear) on follow-up. Results: In subjects who had clinically diagnosed tuberculosis, culture was positive in 18.9% of cases, AFB smear was positive in only 12.1% whereas CB-NAAT was positive in 55.4% of subjects. The sensitivity, specificity, PPV, and NPV of CB-NAAT in patients with culture proven tuberculosis were100%, 83.3%, 47.5%, and 100% respectively with a diagnostic accuracy of 93.3%. and 60%, 100%, 100%, and 65.8% respectively with a diagnostic accuracy of 80.2% in clinically diagnosed pulmonary cases. Conclusion: CB-NAAT has true diagnostic potential with good sensitivity in confirmed cases and significantly better sensitivity than conventional methods in clinically diagnosed cases.

We evaluated the Xpert MTB/Rif Ultra assay performance for Mycobacterium tuberculosis (MTB) detection in formalin-fixed paraffin-embedded tissue (FFPET) compared to mycobacterial culture or laboratory-developed MTB PCR test (LDT). FFPET samples with histological features suggestive of tuberculosis from 2018 to 2023 were selected. Five hundred microlitres of tissue lysis buffer was added to FFPET scrolls and incubated at 75 °C for 5 min. After adding 50 µl of proteinase K and overnight incubation at 56 °C, sample aliquots were processed as per the manufacturer's instructions. MTB culture or LDT assay results were used as a reference for sensitivity and specificity calculations. Of 51 eligible FFPET, 32 were positive for MTB either by culture or LDT PCR on FFPET. Xpert MTB/Rif Ultra detected MTB in 23/32 positive specimens [71.9%, 95% confidence interval (CI) 54.6-84.4%]. Of nine discordant specimens, seven were MTB positive by culture and two were identified by LDT MTB PCR only, as no specimen was submitted for MTB culture. Of 19 negative samples, 100% specificity (95% CI 83.2-100.0%) was attained via Xpert MTB/Rif Ultra. Implementation of Xpert MTB/Rif Ultra on FFPET within clinical laboratories is promising, given its improved turnaround time compared to MTB culture and ability to detect MTB in cases where no tissue is available for culture.

Purpose: Tuberculosis is one of the dreadful infections and India contributes to substantial burden of TB cases globally. Though majority of cases are pulmonary, extra-pulmonary tuberculosis (EPTB) share significant burden, more in HIV-positive persons. Despite the striking burden, very few studies have been conducted in India and present study was undertaken to determine trends of EPTB at our tertiary care centre., Methods: This was a retrospective study conducted over a period of 4 years 3 months. Diagnosis of EPTB was based on suspected clinical features, with positive micobiological evidence with cartridge based nucleic acid amplification test (CBNAAT) with/without microscopy., Results: A total of 10,560 samples (pulmonary and extra-pulmonary) were received during the study period, of which 3972 were extrapulmonary. Of these, a total of 18% were noted to be positive for EPTB. Trend of positivity revealed highest burden in 2018 and a decline was noted over the years, however, rise in cases was noted in 2022. Pleural, meningitis, musculoskeletal, peritoneal and pericardial TB was more common in males, while lymphadenitis was more common in females (p value: <0.0001). Pleural TB (31%) was the most common presentation, followed by lymphadenitis. A gradual decline in lymphadenitis was noted with significantly increasing trend only for musculoskeletal TB. Rifampicin resistance was detected in 7.45% of positive samples, of which the maximum rate of resistance was noted in lymph node aspirates (11.11%), followed by musculoskeletal and pleural samples., Conclusion: The present study showed a gradual decline in positivity of EPTB cases over the years. Younger productive age group with more propensity to transmit infection was the most commonly affected, with pleural TB as the most common presentation. Rare presentations of EPTB also contributed major share. Higher rates of resistance underline requisite to strengthen ongoing programs, to achieve the End TB strategy by 2025., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Introduction: The aim of this study is to review how did the first three COVID-19 waves affected the diagnostic of tuberculosis and to describe the extra-pulmonary Mycobacterium tuberculosis complex (TB) diagnosis., Materials and Methods: A retrospective observational study was done during the first three waves of pandemic to ascertain the impact on TB samples and to recover the extra-pulmonary TB cases we included the first two years of COVID-19. All relevant data was recovered from hospital and Clinical Microbiology records., Results: Prepandemic period showed an average of 44 samples per week for TB study; during the first three waves this number dropped to 23.1 per week. A reduction of 67.7% of pulmonary TB diagnosis was observed and an increase of 33.3% diagnosis of extra-pulmonary TB was noted when comparing pre-pandemic and pandemic period., Discussion: The number of declared cases and samples for TB diagnosis dropped during the first three COVID-19 waves due to the overstretched Public Health System which could lead to a delay in diagnosis, treatment and to the spread of TB disease in the general population. Surveillance programs should be reinforced to avoid this., (Copyright © 2022 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)