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Objective: We aimed to evaluate retrospectively extrapulmonary tuberculosis patients followed and treated in the infectious diseases clinic and outpatient clinic. Methods: The study included patients aged 18 years and older who were followed and treated with a diagnosis of extrapulmonary tuberculosis between January 1, 2013, and December 31, 2019. Data on the patient's demographics, clinical and laboratory findings, microbiological tests, histopathological examination results, radiological findings, treatments, and treatment durations were collected from patient files and the electronic document management system. Results: Of the 81 patients in the study, 49 (60.4%) were female, and 32 (39.6%) were male. The mean age was 49.55±18.85 years. Hypertension and diabetes mellitus were the most common comorbidities. Gastrointestinal system tuberculosis, musculoskeletal system tuberculosis, lymph node tuberculosis, and central nervous system tuberculosis were the most frequently observed clinical forms. Conclusions: Contrary to literature data, gastrointestinal system tuberculosis was found to be the most common form of extrapulmonary tuberculosis. Histopathological examinations were found to be at least as important and valuable as microbiological tests in the diagnosis of extrapulmonary tuberculosis. The rate of extrapulmonary involvement in tuberculosis is increasing worldwide. Tuberculosis should always be considered in differential diagnosis. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of General Medical Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Tuberculosis (TB) is one of the ten leading causes of death globally. The present study aims to examine the treatment outcomes in TB patients and to determine the factors associated with unsuccessful treatment outcomes. Materials and Methods: This study was a retrospective registry-based cohort study conducted in Ordu province of Turkey between 2017-2021. Logistic regression analysis was used to explore the risk factors associated with unsuccessful outcomes. Results: A total of 400 TB patients were included in the analysis. The observed overall treatment success rate (TSR) (cured or treatment completed) was 87.7% (351). 49 patients (12.3%) had unsuccessful treatment results (death, failure or loss to follow-up). Age>65 years (odds ratio [OR] =12.2, 95% confidence intervals [CI] =4.03-36.85), male gender (OR = 2.2, 95% CI = 1.05-4.45) and being foreign-born (OR = 9.2, 95% CI = 1.16-73.72) were identified as risk factors associated with unsuccessful outcomes in patients (p<0.05). Conclusions: Age>65 years, male gender and foreign-born patients tend to have unsuccessful treatment outcomes. Careful monitoring of patients with any of these characteristics and taking special precautions for them may help to decrease unsuccessful treatment outcomes. [ABSTRACT FROM AUTHOR]

Background/Aim: Tuberculosis (TB) remains a major global health problem with a high morbidity and mortality rate, approximately a quarter of the population is infected with tuberculosis. Drug susceptibility testing is an essential tool to identify and manage drug-resistant tuberculosis. This study was conducted to evaluate the drug susceptibility pattern of Mycobacterium tuberculosis complex strains isolated from a university hospital. Methods: A total of 10900 samples sent to the microbiology laboratory with the suspicion of tuberculosis clinically between January 2018 and January 2022 were analyzed retrospectively. The automated BACTEC MGIT 960 (Becton Dickinson, USA) was used for sample culture and susceptibility testing. The obtained data were statistically analyzed with the Statistical Package for Social Sciences (SPSS version 20). Results: Out of the 154 isolated positive samples, males and females constituted equal parts of the study population (50%). The majority of tuberculosis cases were in the age group of 56-75 years (42.2%). Pulmonary tuberculosis was detected in 139 (90.3%) of the patients while extrapulmonary TB cases were observed in 15 (9.7%) patients. As a result of susceptibility studies on positive samples, isoniazid resistance was 5.2%; streptomycin resistance 1.3%; ethambutol resistance was detected at a rate of 0.6% while no rifampicin resistant sample was found. Both streptomycin and isoniazid resistance were seen together in 1.3% of the samples. Conclusion: A similar resistance pattern of the first-line antituberculosis drugs was observed in other studies conducted in different provinces of Turkiye. The absence of multi-drug resistant and extensively drug-resistant tuberculosis in our study indicates that the tuberculosis surveillance program implemented in our region was successful. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a relatively common inflammatory disease globally with systemic implications and the treatment of psoriasis has advanced rapidly in recent years. However, current treatments, especially anti tumor necrosis factor (TNF) treatments, can lead to tuberculosis. Objectives: This study's objective was to analyze tuberculosis and psoriasis-related literature that was published between 1970 and 2021 by using scientometric techniques. Methods: In this bibliometric analysis study, the Web of Science database was used to find the articles on psoriasis and tuberculosis that were published between 1970 and 2021. The VOSviewer software program was used to generate visualization knowledge maps including co-citation, co-authorship, co-occurrence, and keyword analysis. Results: A total of 127 documents in the field of psoriasis and tuberculosis were indexed in the Web of Science database. The first reports were in 1971, but until 2004 there was no other publications. Since 2010 the number of publications started to increase. The most of the publications were articles (49.606%) and 91.339% of them were published in Science Citation Index Expanded indexed journals. 576 authors contributed to psoriasis and tuberculosis literature from 36 countries. The United States (n=26), Italy (n=21), Spain (n=12) were the first 3 countries in the number of publications. The most of the articles were from Dermatology (n=93, 73%) and Rheumatology (n=11, 9%) research areas. Conclusion: As can be understood from this current study on psoriasis and tuberculosis, it has become more popular, especially with anti-TNF treatments. This study recommends focusing more on tuberculosis, especially in psoriasis and psoriatic arthritis patients receiving anti-TNF therapy.

Background: Psoriasis is a relatively common inflammatory disease globally with systemic implications and the treatment of psoriasis has advanced rapidly in recent years. However, current treatments, especially anti-tumor necrosis factor (TNF) treatments, can lead to tuberculosis. Objectives: This study's objective was to analyze tuberculosis and psoriasis-related literature that was published between 1970 and 2021 by using scientometric techniques. Methods: In this bibliometric analysis study, the Web of Science database was used to find the articles on psoriasis and tuberculosis that were published between 1970 and 2021. The VOSviewer software program was used to generate visualization knowledge maps including co-citation, coauthorship, co-occurrence and keyword analysis. Results: A total of 127 documents in the field of psoriasis and tuberculosis were indexed in the Web of Science database. The first reports were in 1971, but until 2004 there was no other publications. Since 2010 the number of publications has begun to increase. While most of the publications were articles (49.606%), 91.339% of them were published in Science Citation Index Expanded journals. 576 authors contributed to psoriasis and tuberculosis literature from 36 countries. The United States (n=26), Italy (n=21), Spain (n=12) were the first 3 countries in the number of publications. Most of the articles were from Dermatology (n=93, 73%) and Rheumatology (n=11, 9%) research areas. Conclusion: As can be understood from this current study on psoriasis and tuberculosis, it has become more popular, especially with anti-TNF treatments. This study recommends focusing more on tuberculosis, especially in psoriasis and psoriatic arthritis patients receiving anti-TNF therapy. [ABSTRACT FROM AUTHOR]

Tuberculosis, a contagious lung ailment, stands as a prominent global mortality factor. Its significant impact on public health in Nigeria necessitates comprehensive intervention strategies. Detecting, preventing, and treating this disease remains imperative. Chest X-ray (CXR) images hold a pivotal role among diagnostic tools. Recent strides in deep learning have notably improved medical image analysis. In this research, we harnessed publicly available and proprietary CXR image datasets to construct robust models. Leveraging pre-trained deep neural networks, we aimed to enhance tuberculosis detection. Impressively, our experimentation yielded remarkable outcomes. Notably, f1-scores of 98% and 86% were attained on the respective public and private datasets. These results underscore the potency of deep neural networks in effectively identifying tuberculosis from CXR images. The study emphasizes the promise of this technology in combating the disease's spread and impact. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of InformaticsTechnologies is the property of Institute of Informatics, Gazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hamidiye Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Agriculture & Nature / Kahramanmaraş Sütçü İmam Üniversitesi Tarım & Doğa Dergisi is the property of Kahramanmaras Sutcu Imam Universitesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anthracite pigment accumulation in the bronchial mucosa can lead to bronchial hypertrophy and narrowing in the future. A patient pre-diagnosed with community-acquired pneumonia underwent fiberoptic bronchoscopy (FOB) and was subsequently treated with antibiotics, however no clinical or radiological response could be obtained. Fiberoptic bronchoscopy (FOB) revealed the mucosa of the lower basal segments of the right lung to be covered with black pigment, while the bronchi segments were found to be narrowed with mucosal infiltration. Based on these findings, a biopsy was performed with pre-diagnosis of malignancy developing on the basis of anthracosis. The pathological examination revealed granulomatous inflammation with caseified necrosis and acidresistant bacilli in the bronchoalveolar lavage. The patient was diagnosed with tuberculosis on the basis of anthracosis and was thus started on quadruple anti-tuberculosis treatment, and clinical, microbiological and radiological improvement was observed in the 4th month of follow-up. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ANKEM Antibiyotik & Kemoterapi Dergisi is the property of ANKEM Antibiyotik & Kemoterapi Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mersin Üniversitesi sağlık Bilimleri Dergisi is the property of Mersin University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nocardia infections are common in immunocompromised and organ transplant patients, although Nocardia species only rarely cause infections in immunocompetent patients. Pulmonary nocardiosis is the most common clinical manifestation of Nocardia species, and may imitate several pulmonary diseases, such as pulmonary tuberculosis (TB) in such high-risk settings for TB as Türkiye. We present here a rare case of an immunocompetent patient with pulmonary nocardiosis mimicking tuberculosis in terms of the history, clinical symptoms and radiological findings. Acid-fast staining and real-time polymerase chain reaction testing of the bronchoscopic lavage were negative for TB, and no Mycobacterium species proliferated in the culture. Two similar diseases were differentiated by lavage cytology. The patient improved dramatically following a short course of treatment over two months. [ABSTRACT FROM AUTHOR]

Medical thoracoscopy (MT) procedures are witnessing increased use worldwide as a minimally-invasive modality offering simultaneous diagnostic and therapeutic benefits to patients with unexplained pleural effusions. Re-expansion pulmonary edema (REPE) is a rare but potentially life-threatening complication associated with pleural effusion drainage that can happen following MT. Little is known about the incidence, risk factors or management strategies of REPE post-MT. We report here on the largest case series to date involving three patients with tuberculous pleural effusion (TPE) who developed REPE after MT. All three patients responded well to supportive measures, including oxygen therapy, intravenous diuretics and hydrocortisone. We believe this case series and literature review serve to highlight an uncommon but dangerous complication of MT. Early recognition, followed by prompt treatment of REPE can ensure a better clinical outcome. [ABSTRACT FROM AUTHOR]

Tüberküloz, Mycobacterium tuberculosis kompleks tarafından oluşturulan granülomatöz enfeksiyondur. Tüberküloz basili, dünya genelinde çok fazla kişide görülür ancak enfeksiyon oluşturma potansiyeli düşüktür. Enfeksiyon en sık az gelişmiş ülkelerde görülmekle birlikte, gelişmiş ülkelerde kentleşmenin yükselmesi ile toplu yaşam alanlarının ve buralarda zaman geçiren birey sayısında artış nedeni ile vakalar artmıştır. Dünya Sağlık Örgütü’nün tüberkülozu bitirme politikası gereğince olgu sayıları yakından kontrol edilmektedir. Dünya genelinde erişkin erkeklerde daha fazla oranda görülmektedir. HIV pozitif bireylerin tüberküloza olan hassasiyetleri bilinirken 2019 yılı içinde ortaya çıkan yeni tip Coronavirus, tüberküloz kaynaklı ölüm vakalarında artışa neden olmuştur. Vaka sayılarındaki artış ilaç tedavisi alan birey sayısının artmasına ve hastaların medikal takiplerinde aksaklıklar olmasına neden olmaktadır. İlaç kullanımının bırakılması en sık ilaç direncine sebep olan etkindir. Tüberküloz geçmişte olduğu gibi günümüzde de küresel halk sağlığı problemlerinin ilk sıralarında yer almaktadır. Yapılan çalışmalar ve alınan önlemler ile birlikte vaka sayılarında azalma trendi devam etmektedir. Bu azalışın sürekliliği için çalışmalar titizlikle devam etmelidir.

Copyright of Türk Radyoloji Seminerleri is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Tuberculosis (TB) is an old disease and it has infected millions of people worldwide. Since it is a highly infectious disease, many people became TB contact due to prolonged exposure to a person with TB infection. This group of people is at a higher risk of getting latent and active TB infection, hence a vulnerable group for active TB screening. This study explored the factors that determined the attitude score, the level of knowledge, attitude, and stigma (KAS) regarding TB disease among TB contact. Methods: This cross-sectional study used a validated KAS questionnaire, performed among 338 TB contacts from 5 health clinics in Kedah, Malaysia. The respondents were selected via convenience sampling. Simple and multiple linear regressions were used to analyze the data. Results: The mean KAS scores of participants are 73.5% [standard deviation (SD)=17.06], 83.0% (SD=10.33), and 67.0% (SD=16.72), respectively. Higher income (p=0.001), better knowledge score (p<0.001), and higher stigma score (p=0.003) are the significant associated factors for the attitude score. Conclusions: This study revealed that most of the TB contacts have good knowledge and constructive attitude toward TB prevention and screening, but their level of stigma on TB is high. The implementation of TB education and intervention programs among TB contacts are required especially among low-income groups. [ABSTRACT FROM AUTHOR]

Introduction: Childhood tuberculosis is a perspective that adult tuberculosis is not well controlled in the community. In this study, it was aimed to evaluate the epidemiological and clinical data of the cases we followed up with the diagnosis of tuberculosis. Materials and Methods: The clinical data of the cases who admitted to the Pediatric Infection Clinic and Outpatient Clinic of our hospital between 2010 and 2020 and were diagnosed with tuberculosis were retrospectively analyzed. Approval for the study was obtained from the Ethics Committee of Uludag University Medical Faculty with the decision no. 2020-5/3. Results: The mean age of 175 cases was 125±66,038 (median 132, 3-216) months, and 51% were female. 88% of the cases (n=154) live in Bursa and the majority of the admissions are from Osmangazi (n=41, 23.4%), Yıldırım (n=40, 22.9%), İnegöl (n=20, 11.5%) and Nilüfer (n=19, 10.9%). Pulmonary tuberculosis was seen in 55% (n=96) of the cases, extrapulmonary tuberculosis in 42% (n=74), and pulmonary and extrapulmonary tuberculosis in 3% (n=5). 25.7% (n=45) of all cases had a history of contact with tuberculosis. 6.3% (n=11) of the cases had a history of taking prophylaxis before. Cough in 46% (n=81) of cases, fever in 29% (n=50), weight loss in 14% (n=24), night sweats in 13% (n=22), 5% (n=8) had complaints of hemoptysis. The mean sedimentation value of the cases was 36±28.85 (median 27. 5-140) mm/hour, and the mean CRP value was 16±41.94 (median 1. 1-258) mg/L. The tuberculin skin test was positive in 65% (n=114) of the cases. Mycobacter ARB (acid-resistant bacillus) was positive in 19% (n=27) and culture was positive in 18% (n=25) of the cases evaluated microbiologically (n=142). PCR was positive in 45% (n=47) of the 104 cases in which mycobacterial PCR was examined. Side effects were observed in 11% of the cases, and hepatotoxicity was observed most frequently (n=11, 6.3%). One patient died in the seventh month of treatment due to complications related to cystic fibrosis. Conclusion: Tuberculosis is a highly contagious disease caused by Mycobacterium tuberculosis and may result in mortality if left untreated. In this study, culture positivity was found to be 18%, and the most common side effect was hepatotoxicity. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tuberculosis continues to be a significant global public health issue. Tuberculosis most often affects the lungs. However, children are more likely to have extrapulmonary involvement compared to adults. Ocular involvement is a rare extrapulmonary manifestation of tuberculosis. Ocular tuberculosis may affect any part of the eye and can be remain unnoticed due to the lack of clinically evident symptoms or findings, if there is no history of tuberculosis contact or other systemic signs or if these are not questioned. Here, we present an adolescent case who was diagnosed with pulmonary and ocular tuberculosis when investigating the underlying cause of granulomatous uveitis and successfully controlled with four drug regimen anti-tuberculosis and methylprednisolone treatment. In conclusion, ocular tuberculosis is an important cause of ocular morbidity. Diagnosis and follow-up require a multidisciplinary approach.

Amaç: Çocuklarda tüberkülozun erken ve doğru tanısı tüberküloz kontrolünde ve tedavisinde oldukça önemlidir. Bu çalışma ev içi aktif tüberküloz tanılı birey ile temas sonrası tüberküloz gelişme riskinin ve tanıya yönelik tetkiklerin değerlendirmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada 1 Mayıs 2019-2 Ocak 2020 tarihleri arasında hastanemiz çocuk enfeksiyon polikliniğine başvuran ev içi aktif tüberkülozlu birey ile teması olan 0-18 yaş arası ve tüberküloz proflaksisi almayan hastalar, retrospektif olarak incelendi. Olgulardan istenmiş olan kan tahlilleri, akciğer görüntülemesi ve 3 gün sabahları alınan mide açlık suyunda aside dirençli bakteri boyanma, mikobakteri kültürü, tüberküloz PCR tetkiklerine hastane bilgi yönetim sisteminden bakılarak formlara not edildi. Bulgular: Çalışmaya katılan çocuklar yaş, cinsiyet, şikâyet, indeks vakanın kimliği, BCG aşı skarının varlığı, ev içi temas süresi, PPD boyutu, laboratuvar sonuçları, akciğer görüntülemesi açısından incelendi. Tüberküloz hastalığı ve latent tüberküloz enfeksiyonu tedavisi alan çocuklar arasında yaş, indeks vakanın kimliği, akciğer görüntülemesi, C reaktif protein, lökosit, nötrofil değerleri ve PPD boyutu açısından istatistiksel olarak anlamlı fark saptandı (p

Purpose: This study aims to evaluate the results of the training about tuberculosis given to secondary school students and to compare the knowledge levels of the students who received the aforementioned training before and after the training depending on various variables. Materials and Methods: The universe of this descriptive study consists of 700 students studying in a secondary education institution affiliated with the Ministry of National Education in Adana. The sample, on the other hand, consisted of 600 students who are volunteered to participate in the study. Personal information form and tuberculosis information form are used as data collection tools in the study, and the data are obtained in the 2017-2018 academic year. Results: While females constitute 57.5% of 600 students participating in the study, males constitute 42.5%. The average age of the students is 16.45±1.08 years. The percentages of the tuberculosis knowledge level of the students before the training vary between 10 and 100 and the average is 59.31±15.61. The percentages of the tuberculosis knowledge level of the students after the training vary between 70 and 100 and the average is 95.30±7.35. The average percentage of tuberculosis knowledge level after training was found statistically significantly higher than that of the pre-training level. Conclusion: The increases in the correct answer to all questions in the questionnaire after the training compared to the pre-training level were found to be statistically significant.

Objective: All resources of the health system have been allocated to the pandemic to combat the coronavirus disease (COVID-19) epidemic that has affected the world. In addition, measures implemented during the pandemic, such as isolation, lockdown and restricted mobility, adversely affected tuberculosis (TB) control programs in our country and around the world. In this study, it was aimed to investigate the effect of the COVID-19 pandemic on TB patients and TB control program in Mersin province. Methods: In this study, a total 6328 samples of 3731 patients with a preliminary diagnosis of TB, from Mersin University Hospital and Mersin tuberculosis dispensaries, between January 2019 and December 2020, were included. In the study, how much the number of samples decreased during the 2020 pandemic period, the number of patients diagnosed with TB, the change in the age distribution of the patients, and the number of control samples from the treatment follow-up of TB patients were examined. Results: In the study, a decrease of 42.2% in the number of patients and a decrease of 45.4% in the number of samples were observed during the pandemic period of 2020.The highest decrease in the number of patients by months were observed in March, April and May (respectively 44.2%, 67.2% and 69.8%) when the pandemic started in our country and the restrictions were applied intensively. During the pandemic period, a decrease of 28.2% was observed in the number of TB positive patients. While the mean age of TB positive patients was 53.5±16.2 in 2019, it decreased to 40.3±19.6 years in 2020, and the decrease in the mean age was statistically significant (p <0.001). When the age groups between years are compared; While the rate of patients over 65 years of age was higher in 2019, the rate of patients under the age of 18 was found to be higher in 2020 (p=0.003). In the study, control samples came during treatment follow-up from 73% of TB patients in 2019 and 52.9% in 2020. The rate of decrease in the number of patients with control samples from TB positive patients during the pandemic period was found to be statistically significant (p=0.021). Conclusion: The findings of our study revealed that the restrictions applied during the pandemic period adversely affected the diagnosis and follow-up of TB in our region. In addition, the decrease in the average age of TB patients and the tendency towards younger age and the increase in the number of positive patients under the age of 18 suggest that intra-familial transmission increased in this period. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to compare of the results of LED fluorescent microscopy (LED FM) and Ehrlich Ziehl Neelsen (EZN) staining in the examination of the respiratory specimens and to evaluate the performance of LED fluorescent microscopy with culture. Methods: In the study, the respiratory specimens obtained from patients prediagnosed with pulmonary tuberculosis were examined in the Tuberculosis Laboratory of Manisa Celal Bayar University Hafsa Sultan Hospital between February 2018 and November 2019. Two smears from each specimen processed with NALC-NaOH method were prepared and they were evaluated both EZN and LED FM by blind readers. The results of culture were used as reference for determination of the performance of LED FM. Results: In the study 1499 respiratory specimens were evaluated with LED FM. Mycobacteria were grown in the culture of 134 specimens (8.9%). The sensitivity, specificity, positive predictive value, and negative predictive value of LED FM were found as 64.2% (95% GI, 61.8%-64.4%), 96% (95%GI, 95.7%-96.3%), 61.4% and Makale Dili "Türkçe"/Article Language "Turkish" 96.5%, respectively. The sensitivity, specificity, positive and negative predictive values of EZN were also found as 51.5% (95% GI, 49%-54%), 99.9% (95% GI, 99.7%-99.9%), 97.2% and 95.4%, respectively. However, smear scarceculture negative results (54/1365) with LED FM were obtained significantly higher than the results with EZN (0/1365, p=0.000). The reason of this was thought to be due to the lack of the experience of the readers. The reading time of LED FM was 69% time saving. The consistency between the readers was found to be good (Kappa value=0.71) and it was determined that LED FM could be preferred in routine examination as a result of the survey conducted to the readers. Conclusion: The sensitivity of LED FM was found 12.7% higher than the sensitivity of EZN. However, because of the high rate of false positive results, the introduction of LED-FM should be accompanied by appropriate training of the readers. It is also thought that the use of LED FM will be cost-effective in largescale laboratories in our country. [ABSTRACT FROM AUTHOR]

Objective: Interferon-γ release tests (IGRAs) and tuberculin skin testing (TST) are important helpful tests for diagnosing tuberculosis (TB) disease in children. It was aimed to compare the sensitivity and compatibility of QuantiFERON-TB Gold In-tube test (QFT) and TST used in children with TB and Latent tuberculosis infection (LTBI). Material and Methods: A total of 118 patients between September 2018 and January 2020 were included in the study prospectively to determine the case characteristics related to the performance of the tests, and to measure the sensitivity of these tests. Results: A total of 118 patients were included in the study; and 13 (11%) patients presented with pneumonia symptoms and 7 (6%) patients were diagnosed with TB in active TB Contact Screening. TB diagnosis was made 20% microbiologically. Mycobacterium tuberculosis culture positivity was found to be 10%. None of the patients had acid resistant bacilli positivity. The male / female rate was 74/44 in our study (p = 0.006). The median age was found to be 14 (1.17-19.2 years) in males, and 12 (0.33 -17.9 years) in females. The mean age of the LTBI Group was higher than the TB Group at significant levels (p <0.05), and was similar to the non-infected group (p>0.05). A total of 53.5% of the patients had a history of meeting someone with tuberculosis, and 97 children were vaccinated with BCG (82.2%). TST and QFT positivities were 19.5% and 22%, respectively. The most common radiological finding that was detected was consolidation areas. While there was moderate compliance between TST and IGRA test in patients with TB diagnosis (kappa =0.50, p=0.025), no compliance was found between tests in LTBI patients. In patients who were diagnosed with TB and LTBI, the sensitivity of TST was found to be 51.1%, and the sensitivity of QFT was found to be 60.4%. Conclusion: TST seems to continue as the most preferred method of diagnosis in rural areas with limited resources and poor laboratory infrastructure due to the costs and technical considerations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Faculty of Pharmacy of Ankara University / Ankara Üniversitesi Eczacilik Fakültesi Dergisi is the property of Ankara University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Spleen tuberculosis has occasionally been described in literature, mostly in immunocompromised patients with various risk factors. The presence of spleen involvement and splenomegaly makes this type of Mycobacterium tuberculosis infectiondifficult to diagnose. A 56-year-old woman who had mediastinal and abdominal lymphadenopathies with splenomegaly and was investigated with a pre-diagnosis of lymphoma, and with no significant medical history, presented with complaints of fever and malaise. Here, we present a case of tuberculous lymphadenitis and pleuritis accompanied by splenic tuberculosis with the appearance of granulomatous inflammation on pleural and spleen biopsy. Tuberculosis should be kept in mind as a differential diagnosis in diseases accompanied by a fever of unknown origin and lymphadenopathy. [ABSTRACT FROM AUTHOR]

HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immune Deficiency Syndrome), while PCP (Pneumocystis jiroveci pneumonia), tuberculosis, CMV (Cytomegalovirus) and candidiasis are the OIs (opportunistic infections) occurring due to immune deficiency. OIs, and bacterial pneumonias in particular, are the most common causes of mortality, which makes the screening and prophylactic therapy for OIs necessary. The synergy between tuberculosis and HIV has long been known, and worsens the prognosis. PCP is an OI that is caused by a fungus named P. jiroveci. COVID-19 has emerged as a new cause of death among AIDS patients. Screening and prophylactic therapy for Ols is vital for patients with AIDS, however, mortality may be high due to delays in screening and prophylaxis in those whose HIV positivity is detected coincidentally. We report here on a patient who applied to our hospital with suspected COVID-19 pneumonia who was found during followup to be HIV positive with PCP and pulmonary tuberculosis. [ABSTRACT FROM AUTHOR]

Abstract Background: The neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio(MLR) are useful biomarkers of inflammation used in many diseases to evaluate bacteremia, disease activity, recurrence rate, surveillance and prognosis. Objective: Aim of this study was to evaluate NLR and MLR in the differential diagnosis of children with pulmonary tuberculosis disease from CAP. Materials and Methods: I reviewed hospital-records of 50 children with pulmonary tuberculosis disease in the Pediatric Infectious Disease Ward between June 2016 and December 2018, and compared; NLR and MLR with 50 CAP and 50 healthy children. Also; erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were compared between the tuberculosis and CAP group. Results: When 3 groups were compared there was significant difference among NLR and MLR values between 3 groups. In pairwise-comparisons, there was significant difference among NLR and MLR values between tuberculosis versus healthy controls, and CAP versus healthy controls. However, there was no significant difference among NLR, MLR values between tuberculosis versus CAP groups. Conclusion: This study is unique that evluates NLR and MLR in tuberculosis differentiation. Although NLR and MLR values are useful biomarkers of inflammation in both pulmonary tuberculosis and CAP seperately, they’re not as useful as expected in differentiating tuberculosis from CAP in children.

Aim: We aimed to evaluate epidemiologic, clinical, laboratory, microbiologic features, treatment and outcomes of pediatric tuberculosis (TB) patients also to draw attention to immigrant patients. Material- Methods: We retrospectively conducted the medical records of children below 18 years of age with TB between January 2015 and September 2016. Results: A total of 20 TB patients (35% were Syrian refugees, total 65% female) with a median age of 135.5±52.6 months were evaluated. Fourteen (70%) patients were adolescent. The history of contact with an active TB disease patient was found in seven (35%) patients. Four (20%) patients had no complaint at admission whereas the most common symptom was prolonged cough > 2 weeks. Fifteen (75%) patients had a Bacillus Calmette–Guérin scar on the left shoulder. A total of 16 (80%) patients had a positive tuberculin skin test (TST) result. Microbiological confirmation was provided in four (20%) patients totally. The most common chest X-ray findings on admission were hilar lymphadenopathy. Ten (50%) patients had normal chest X-ray and were diagosed with abnormal thorax tomography findings. All of the patients were treated succesfully except one Syrian patients with miliary TB who died. Conclusion: Microbiological confirmation of childhood TB may be absent and the diagnosis can be confirmed in the light of contact history, positive TST reaction, compatible symtomps and radiological evidence. Particular attention might be paid to Syrian refugees, taking into epidemiological characteristics of TB disease and the density of immigrants in the place we live in.

Objective: The aim of this study was to evaluate the GenoType®MTBDRplus test for detection of rifampicin (RIF) resistance in MDR Mycobacterium tuberculosis complex strains. Materials and Methods: Twenty-five multidrug-resistant (MDR) Mycobacterium tuberculosis clinical strains were used, gene mutations causing RIF resistance were investigated by GenoType®MTBDRplus and the results were compared with the results of the BACTEC 460 TB system. The strain was sequenced if there was no mutation and absence Wild Type (WT). Mycobacterium tuberculosis ATCC 35838 was used as a quality control (QC) strain. Results: There was 96% compliance between the GenoType®MTBDRplus and BACTEC 460 TB system for the finding of RIF resistance. The most frequent mutation zone in MDR strains was rpoB S531L promotor zone (13 strains, 52%). The other rpoB gene mutations were H526Y (three strains, 12%) and H526D (three strains, 12%), while five strains (20%) had Δ2-Δ5 mutations in the wild type probes. There was no mutation in only one strain (4%) by GenoType®MTBDRplus but it was found to be as resistant to rifampicin by the BACTEC 460 TB system. This strain was sequenced and detected to have triple mutations. Mutations were found on codons 489, 493, and 503. Conclusion: GenoType®MTBDRplus showed good compatibility with the BACTEC 460 TB system in detecting rifampicin resistance, and it was thought that GenoType®MTBDRplus could be an effective and reliable test for RIF susceptibility testing in MDRTB patients, providing a significant advantage in technical time. [ABSTRACT FROM AUTHOR]

maç: Bu araştırmada, İstanbul ili Zeytinburnu ilçesindeki verem savaş dispanserine başvuran tüberküloz hastalarının tedaviye uyum durumları ve bunu etkileyen faktörlerin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Araştırmaya 85 hasta dahil edilmiş, ve bu hastalara ilişkili faktörleri araştırmak için anket formu uygulanmıştır. İlaçlarını almayı yarıda bırakmayan, tedavisi sürerken dispanserden ilaçlarını düzenli almaya gelen ve ilaç içmeyi unutmayan hastaların tedaviye uyumları olumlu olarak değerlendirilmiştir. Bulgular: Katılımcıların sadece %29,4’ünün ilaç almayı yarıda bıraktığı, %17,6’sının tedavisi sürerken ilacını almaya gelmediği ve %21,2’sinin de ilaç almayı unuttuğunu belirttiği saptanmıştır. İlaç almaya gelmeme” konulu olumsuz davranışın diğer ekonomik statülere göre özellikle orta gelir düzeyli grupta (post hoc) daha az oranda (%7,9’a karşılık %92,1) yaşandığı görülmüştür. Hastalık süresi uzadıkça “ilaç almayı yarıda bırakma” ve “ilaç almaya gelmeme” oranının arttığı saptanmıştır. Sonuç: Tüberküloz hastalarının tedaviye uyumlarında düzenli olarak ilaçlarını kullanması son derece önemlidir. Birinci basamak sağlık ekibinin ilgili süreçlere hakim olması, hastaların ilaç alımlarını engelleyen faktörleri bilerek kişinin tedaviye uyumunu artırıcı müdahaleleri planlayabilmesi toplum sağlığı açısından gereklidir.

Background: Tuberculosis is the leading cause of death due to an infectious agent worldwide. Childhood tuberculosis epidemiological data are limited due to the difficulty of microbiological diagnosis in children. In this study, it was planned to examine the sociodemographic and epidemiological data of childhood tuberculosis patients who were followed and treated in a single center. Materials and Methods: : Forty-seven patients diagnosed with tuberculosis, treated and followed-up in the Pediatric Infectious Diseases department for 2 years were retrospectively analyzed and included in the study. The clinical, radiological, histopathological and bacteriological results of the patients were recorded in the forms prepared from the hospital medical system Results: Twenty-six (55.3%) of the patients were female. Considering the age distribution, the median value is 14 (min/max 4-18) in patients with pulmonary tuberculosis, 12 (min/max 0-17) in patients with extrapulmonary tuberculosis, and the median value is 11 (min/max 0-17) years found in miliary tuberculosis. 80.9% of the patients were between the ages of 5-18. When the distribution of tuberculosis diseases was examined, 31.9% of them were pulmonary tuberculosis, 55.3% of them were extrapulmonary tuberculosis, 12.7% of them were miliary tuberculosis. The majority of extrapulmonary tuberculosis was 38.2% tuberculous lymphadenitis. Biopsy was taken for histopathological diagnosis in 51% of patients. While fever, cough, night sweats, loss of appetite/weight loss were the most common symptoms in patients with pulmonary tuberculosis, swelling in the neck and armpits in patients with extrapulmonary tuberculosis, fever was the most common in miliary tuberculosis. Conclusions: Although this study covers a 2-year period and is in a single center, it supports that childhood tuberculosis disease is still seen at a high rate in our region. Especially childhood tuberculosis is an indirect indicator of the failures in diagnosis and treatment of adult tuberculosis disease in the community. Therefore, it is necessary to improve effective tuberculosis screening and prevention services. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Anesthesiology Reanimation is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Tuberculosis (TB), which continues to be a global health problem, is under the influence of environmental factors and host genetic factors. In this study, -1478CA/del (rs33989964) located in the cytokine signal suppressor (SOCS)-1 gene promoter region and 1335G/C (rs11549428) located in the exon-2 region of single nucleotide polymorphisms (single nucleotide polymorphism - SNP) in TB patients. It was aimed to investigate the relationship between susceptibility or resistance to TB. Materials and Methods: The study included 90 TB patients with Mycobacterium tuberculosis complex isolated in the culture of clinical specimens and 90 healthy blood donors as a control group. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods were used to determine the investigated SNPs. Results: -1478CA/del SNP was found in Hardy-Weinberg balance in the patient and healthy control group. There was no statistically significant relationship between the groups in terms of allele frequency (p=0.327) and genotype distribution (p=0.291). According to the PCR-RFLP results of 1335G/C SNP, the presence of the C allele was detected in all patient and control groups, statistical evaluation could not be performed. Conclusion: As a result of our study, no relationship was found between SNPs investigated in the SOCS-1 gene region and resistance or susceptibility to TB. For this study, it should be kept in mind that there may be different polymorphisms on the SOCS-1 gene, which is not the subject of our research but needs to be investigated. [ABSTRACT FROM AUTHOR]

Amaç: Ülkemizde tüberküloz hala önemli bir halk sağlığı sorunudur. Son yıllarda akciğer dışı tüberküloz olgularımızda artış görülmektedir. Tüberküloz lenfadenit olguları akciğer dışı tüberkülozun önemli bir bölümünü oluşturmaktadır. Biz bu çalışmada tüberküloz lenfadenit tanısıyla takip ettiğimiz hastaların demografik, klinik, laboratuar, radyolojik verilerini ortaya koyup hem farkındalık yaratmayı hem de hastalığın özelliklerini ortaya koymayı hedefledik. Materyal-metot: Bu çalışma, Aralık 2011-Aralık 2019 yılları arasında hastanemizde takip edilen toplam 41 tüberküloz lenfadenitli hastanın verisini içeren retrospektif bir çalışmadır. Hastaların yaş, cinsiyet gibi demografik bilgileri, altta yatan hastalıkları, risk faktörleri, klinik özellikleri, laboratuar ve radyolojik bulguları, tedavi süreleri kaydedilmiştir. Bulgular: Tüberküloz lenfadenit tanısıyla takip edilen toplam 41 hasta çalışmaya dahil edildi. Hastaların 25 (%61)’i kadın, 16 (%39)’sı erkekti. Yaş ortalaması 42,07±1,84 (Yaş aralığı 18-78) idi. Hastaların %17.1’inde hipertansiyon, %9.8’inde diyabetes mellitus, %7.3’ünde kronik böbrek yetmezliği mevcuttu. Sadece 1 hasta HIV pozitifti. Yine hastaların %51.2’inde ateş mevcutken, en sık semptom %70.7 ile gece terlemesi idi. Servikal bölge %39 oranında tutulmuşken, %19.5’inde aksiler bölge, %12.2’sinde abdomen, %4.9’unda torakal bölge tutulumu mevcuttu. Onaltı hastada tanıda radyolojik yöntem olarak ultrasonografi (USG), diğerlerinde bilgisayarlı tomografi (BT), pozitron emisyon tomografi ile BT (PET-BT) ya da birden fazla yöntem kullanılmıştı. Sonuç: Tüberküloz lenfadenit, lenfadenopatilerin özellikle lenfomanın ayırıcı tanısında düşünülmelidir. Klinik bulgular nonspesifik olduğundan tanıda radyolojik ve histopatolojik bulgular önemlidir. Bu olgularda mikrobiyolojik olarak tanı koymak oldukça güçtür.

İstanbul ve çevresinde verem savaşımı için 1903 yılında Ligue contre la Tuberculose (Phitisie pulmonaire) de Constantinople adıyla bir dernek kurulmuştur. Dr. Kleovulos H. Kokolatos (Cléobule C. Coccolatos, 1865-1944) tarafından kurulan bu dernek, 1912 yılında Société internationale contre la Tuberculose de Constantinople adını almıştır. Böylece, I. Dünya Savaşı’nın sonunda kurulan Veremle Mücadele Osmanlı Cemiyeti’nden önce, İstanbullu hekimlerin Vereme (Fitizi Pulmoner, Akciğer Tüberkülozu) Karşı Savaşım Birliği’ni oluşturarak Türkiye’nin öncü sağlık örgütleri arasına katıldıkları saptanmaktadır. Kleovulos Kokolatos, aynı yıllarda ayrıca Bulletin médical de Constantinople adlı aylık bir dergi yayımlamıştır. Derneğin 1903 ve 1912 tarihli tüzüklerinde, din, milliyet ve cinsiyet ayrımı yapılmadan İstanbul halkına veremden korunma çarelerini öğretme, yoksul hastalara parasız sağlık hizmeti sunma, dispanser ve sanatoryumlar kurma amaçları öne çıkmaktadır. Dernek üyeleri, özellikle tüberküloz hastalığının erken tanısı, sağaltımı ve genel hijyen uygulamaları eğitiminde başarı sağlamış görünmektedir. Dr. Kleovulos Kokolatos’un yirminci yüzyılın başında tüberküloza karşı başlattığı uluslararası savaşım Türkiye’nin verem savaş derneklerine örnek olmuştur.

Giriş: Tüberküloz (TB), dünya genelinde önemli bir halk sağlığı sorunudur. TB basili en fazla akciğeri enfekte ederek pulmoner TB'ye yol açmakla birlikte lenfo-hematojen yolla tüm vücuda yayılarak ekstrapulmoner TB'ye yol açabilir. Bu çalışmada erişkin ekstrapulmoner TB tanısıyla takip edilen hastaların sosyo-demografik ve klinik özelliklerinin, tanısal ve genel laboratuvar sonuçlarının ve terapötik yaklaşımların değerlendirilmesi amaçlandı. Gereç ve Yöntem: Bu retrospektif çok merkezli çalışmaya Ocak 2015-Aralık 2022 tarihleri arasında ekstrapulmoner TB nedeniyle takip edilen 18 yaşından büyük hastalar dahil edildi. Hastaların sosyodemografik bilgileri, klinik semptomları, tanısal radyolojik ve laboratuvar tetkik sonuçları, terapötik yaklaşımlar ve tedavi sonu değerlendirmeleri analiz edildi. Bulgular: Bu çalışmaya ekstrapulmoner TB tanılı 602 hasta (389'u kadın; %65) dahil edildi, yaş ortalamaları 44 yıldı (17-91 yıl aralığında). Hastalardan 21'i (%3,5) tanı konulduktan sonraki bir yıl içinde öldü. Hastaların ilk başvuruda en fazla tarifledikleri konstitüsyonel semptomlar sıklık sırasına göre; halsizlik (%57), iştahsızlık (%53,7) gece terlemesi (%51,4), kilo kaybı (%48,9) ve ateş (%33,2) idi. Tutulumun en fazla olduğu lokalizasyonlar lenf nodu (%49,1), plevra (%9,7) ve abdomen (%9,4) iken en az tutulan organ tiroid beziydi (%0,1). En fazla tutulum olan lenf nodları ise servikal (%51,3) bölgedekilerdi. Kemik-eklem TB'sinde spinal tutulumun (spondilodiskit) daha fazla olduğu özellikle lomber bölgenin etkilendiği belirlendi. Tanısal tetkikler bakımından çalışılan örneklerin %27,5'inde ARB pozitifliği, %41'inde TB PCR pozitifliği, %91,2'sinde adenozin deaminaz yüksekliği (özellikle plevra ve periton sıvılarında) ve %40,9'unda mikobakteri kültüründe üreme saptandı. Ayrıca hastaların %66,6'sında BCG skarı vardı, %60,2'sinin TDT ve %70,2'sinin interferon-gama salınım test sonucu pozitifti. Biyopsi yapılan hastaların %97,7'sinin histopatolojisi granülomatoz iltihap (kazeifiye nekrotizan %51,4, nekrotizan %32,6, non-nekrotizan %13,8) olarak raporlandı. Laboratuvar tetkiklerinde en fazla saptanan patolojik bulgular eritrosit sedimentasyon hızı artışı (%65,5) ve C-reaktif protein (CRP) artışıydı (%63,1). CRP düzeyindeki artış tutulan organ sayısındaki artışla paraleldi. Verilen ortalama anti-TB tedavi süresi 8,03±3,24 aydı. Anti-TB tedavisine bağlı hepatotoksisite görülme oranı %8,9'du. Sonuç: Çalışmada başta servikal istasyonlar olmak üzere lenf nodu tutulumunun ön planda olduğu görüldü. Spinal tutulumda lomber bölgenin daha çok etkilenmesi önemli bir veridir. Adenozin deaminaz düzeyinin plevra ve periton sıvısında yüksek olması TB tanısını destekleyici bir sonuçtur. Ayrıca CRP'nin tutulan organ sayısıyla paralel olarak artması çalışmanın önemli sonuçlarından biridir. [ABSTRACT FROM AUTHOR]

Giriş: Renal transplantasyon son dönem böbrek yetmezliği hastalarının yaşam kalitesinde olumlu değişiklikler sağlayan en seçkin tedavidir. İmmünosüpresyona bağlı enfeksiyöz komplikasyonlar nakil sonrası artmış mortalite ve morbiditenin en önemli nedenlerindendir. Bu olguda renal transplantasyondan sonra geç dönemde meydana gelen birden fazla patojenin etken olduğu kolit sunuldu. Olgu: Hipertansiyona bağlı kronik böbrek yetmezliği nedeni ile 2019 yılında babasından renal transplantasyon yapılan 39 yaşında erkek hasta bir aydır devam eden ishal, yüksek ateş ve kilo kaybı ile nefroloji polikliniğine başvurmuş. Clostridioides difficile toxin-b tetkiki pozitifliği ile oral metronidazol tedavisi başlanmış. İshalinde gerileme olmaması nedeni ile nefroloji servisine yatırılan ve tarafımıza konsülte edilen hastanın fizik muayenesinde sağ alt kadranda hassasiyet mevcuttu, diğer muayene bulguları doğaldı. Oral vankomisin tedavisi başlandı. İshalde gerileme olmaması nedeni ile gönderilen dışkı etken panelinde Norovirus PCR pozitif, kan CMV PCR <34,5 IU/ml olarak sonuçlandı. Yüksek ateş ve akut faz reaktan artışı olan hastanın tedavisine meropenem ve tigesiklin eklendi. Abdomen bilgisayarlı tomografisinde çekum duvarında ve distal ileal bölgede 14 cm segmentte diffüz asimetrik duvar kalınlaşması izlendi. Kolonoskopisinde çıkan kolondan çekuma kadar uzanan üzeri eksudalı düzensiz sınırlı ülsere frajil kitlesel lezyon izlendi (Şekil 1). Gastroenterolojinin ön planda malignite düşündüğü hastanın doku örneklerinden sadece patoloji gönderilmiş olup patolojisi çıkan kolonda nekrotizan granülomatöz, diğer alanlarda nekrotizan olmayan granülomların olması nedeni ile ayırıcı tanıda öncelikle tüberküloz, yersinia gibi enfeksiyöz nedenler düşünülmelidir şeklinde raporlandı. EZN negatif boyandı. Tedavisine yersinia kolitine yönelik siprofloksasin eklendi. Tüberküloz açısından doku mikobakteriyoloji örnekleri gönderilmesi önerildi. Gastroenteroloji tarafından perforasyon riski nedeni ile kolonoskopi ileri tarihe ertelenedi. Oral vankomisin, meropenem, tigesiklin, siprofloksasin altında ishali devam eden hastanın tedavisine gastrointestinal tüberküloz ön tanısıyla izoniazid, rifampisin, etambutol ve pirazinamid eklendi. Antitüberküloz tedavi altında kliniği düzelen hastanın diğer antibiyoterapileri 14 günde kesildi. Antitüberküloz tedavisinin 20. gününde yüksek ateş ve ishali tekrarlayan hastanın kontrol kolonoskopisinde hepatik fleksuradan çekuma kadar uzanan düzensiz sınırlı frajil polipoid lezyonlar önceki incelemeyle kıyaslandığında boyutlarında regresyon ve terminal ileumda ülsere eksudalı alanlar izlendi. Kan CMV PCR 7,53x102 IU/ml ve doku CMV PCR 9,58x103 IU/ml olan hastanın tedavisine gansiklovir eklendi. Antitüberküloz ve gansiklovir ile klinik ve laboratuvar yanıt alındı. Sonuç: İmmünsüpresif hastalarda fırsatçı enfeksiyonlar açısından dikkatli olunmalıdır. Gerekli durumlarda invaziv tetkikler mutlaka yapılmalıdır. [ABSTRACT FROM AUTHOR]

Giriş: Skrofuloderma kemik, eklem veya lenf bezi tüberkülozu gibi bir odaktan komşuluk yoluyla ya da primer odaktan hematojen yolla deriye ulaşan bir re-enfeksiyondur. Bu yazıda derideki kronik lezyonların ayırıcı tanısında tüberkülozun akılda tutulması gerektiğini hatırlatmak amacı ile boyunda pürülan akıntılı ülsere lezyon ile başvurup skrofuloderma tanısı alan bir olgu sunulmuştur. Olgu: Yetmiş yaşında kadın hasta 3 aydır devam eden boyun sağ tarafında şişlik şikayeti ile kliniğimize başvurdu. Özgeçmişinde hastanın nöroendokrin tümör tanısı ile aktif kemoterapi almaktayken 2 ay önce boyun sağ tarafında şişlik şikayetiyle dış merkeze başvurduğu öğrenildi. Hastanın çekilen pozitron emisyon tomografisi-bilgisayarlı tomografisinde boyunda sağ juguler lenfatik lojda 1 cm boyutunda birkaç adet ve sağ posterior servikal üçgende 35x18 mm boyutunda kistik komponenti yoğun lenf nodu, sağda belirgin bilateral aksiller fossada önceki görüntülemelerine göre morfolojik olarak progrese, kalsifikasyonlar içeren hafif artmış aktivite tutulumu gösteren lenfadenopatiler izlenmişti. Ön planda granülomatöz hastalıklar, enflamatuar prosesler lehine değerlendirilmekle birlikte, düşük olasılıkla malignite ekarte edilememektedir şeklinde raporlanmıştı. Sağ posterior servikal üçgendeki lenf nodundan ince iğne aspirasyon biyopsisi (İİAB) yapılmıştı. Pürülan görünümlü örneğin direkt mikroskobik incelemesinde orta yoğunlukta lökosit görülmüş, mikroorganizma görülmemiş ve kültüründe üreme olmamıştı. Patolojisi nekrotizan pürülan materyal, apse içeriği ile uyumlu olarak raporlanan hastaya ampirik olarak trimetoprim-sulfametoksazol ve klindamisin tedavisi başlanmış. Klinik yanıt alınamayan hasta kliniğimize yönlendirilmişti. Eşinde 30 yıl önce geçirilmiş açık akciğer tüberkülozu öyküsü mevcuttu. Fizik muayenesinde genel durumu iyi, şuuru açık, vital bulguları stabildi. Boyun sağ lateralinde 2 cm boyutunda cilde fistülüze minimal akıntılı süpüratif lenf nodu mevcuttu. Diğer fizik muayene bulguları doğaldı. Laboratuar değerlerinde belirgin özellik yoktu. Hastanın primer açık açılı glokomda (PAAG) de özellik yoktu. Tüberkülin Deri testi (PPD) 16 mm olarak sonuçlandı. Hastanın lenf nodundan tekrar İİAB yapıldı. Apse kültüründe bol lökosit görüldü, mikroorganizma görülmedi. Patolojisi granulomatoz dermatit, fibrinoid nekroz, süpürasyon bulguları şeklinde sonuçlandı. Biyopsi materyalinde tüberküloz basilinin (ARB) negatif, mikobakteri polimeraz zincir reaksiyonu pozitif olarak sonuçlandı. Mikobakteri kültüründe Mycobacterium tuberculosis complex üredi. Hastaya tüberküloz lenfadenit tanısıyla 2 ay dörtlü (INH, rifampisin, etambutol, pirazinamid) anti-tüberküloz tedavi başlandı. İkinci aydan sonra tedavi izoniazid+rifampisin olarak 6 aya tamamlandı. Hastanın lezyonları geriledi ve yeni bir lezyon gelişimi olmadı. Sonuç: Ülkemiz gibi tüberkülozun endemik olduğu bölgelerde cilde fistülüze lenf nodu varlığında ayırıcı tanıda skrofuloderma düşünülmelidir. [ABSTRACT FROM AUTHOR]

The prevalence of tuberculosis, especially immunodeficiency virus infection and AIDS, are serious problems for human health. An equally serious public health concern is that multidrug resistance increases the rate of tuberculosis. Examining the proportions among multidrug-resistant tuberculosis patients, only a few alternative chemotherapeutic regimens are currently available, resulting in low therapeutic outcomes and high mortality. First generation drugs used in the treatment of tuberculosis are isoniazid, ethambutol, pyrazinamide and rifampin. Tuberculosis bacillus is gaining drug resistance. On the other hand, thiourea derivatives such as ethionamide (ETA), prothionamide (PTA), thioacetazone (TAZ) and isoxyl (ISO), fluoroquinolones, amikacin, kanamycin, capreomycin and similar drugs are used as second generation drugs. However, resistance to these drugs is also observed. There is an urgent need to develop new, effective antituberculosis drugs with different bactericidal mechanisms than these. Thioureas are versatile chemicals with extraordinary biological applications. The most prominent biological applications of thioureas are the treatment of infections. They are used as antioxidants, ant allergens, antibacterial agents, anti-inflammatory, anti-thyroid drugs, anti-epileptic drugs, anti-hypertensive, rodenticide, anti-cancer drug, DNA binding and urease inhibitors. Studies have shown that these compounds can be used as drugs to treat human diseases such as microbial infections, tuberculosis, carcinomas, malaria, urease inhibitors and anti-inflammatory. Few studies have tried their metal complexes and compared their efficacy with that of ligands. In the literature review, no studies were found that investigated the anti-tuberculosis properties of benzoylthiourea derivatives, especially other noble metal complexes. More studies are needed, especially on tuberculosis-active new benzoylthiourea ligands and their transition metal complexes. This review has been prepared to draw attention to the subject. [ABSTRACT FROM AUTHOR]