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BCG instillations are considered to be the standard of care therapy for superficial urothelial bladder carcinoma. Although serious adverse events are uncommon, the presence of high fever for at least two days in conjunction with systemic and/or local organ manifestations (except for urogenital symptoms), with the exclusion of other causes, suffice for the diagnosis of a disseminated BCG infection. Microbiologic detection of the pathogen is not necessary for diagnosis, as the detection of granuloma is more often successful and sufficient. Therapy for this infection includes oral Isoniazid, Rifampicin and Ethambutol for six months. [ABSTRACT FROM AUTHOR]

Non-specific chronic constrictive pericarditis is a rare and debilitating chronic infection in developed countries and its rapid diagnosis and treatment has not affected its outcome and complication. A 15-year-old male, well nourished, negative HIV test, and without a history of previous pulmonary tuberculosis, was admitted to our hospital for exertional dyspnea (New York Heart Association, NYHA, functional class II). Our patient had had no pulmonary tuberculosis during childhood, had received anti-tuberculosis treatment, and was referred to our center for further surgical pericardiectomy. [ABSTRACT FROM AUTHOR]

Hintergrund: Die chronisch-obstruktive Lungenerkrankung (COPD) ist eine häufige Atemwegserkrankung, die durch eine anhaltende Einschränkung des Luftstroms gekennzeichnet ist. Berichte über eine Infektion mit Mycobacterium tuberculosis oder Nocardia bei COPD-Patienten liegen vor, eine Co-Infektion mit Mycobacterium tuberculosis und Nocardia ist jedoch selten. Hier beschreiben wir einen solchen Fall einer COPD-Patientin im Krankenhaus sowie das Diagnoseverfahren. Falldarstellung: Eine 79-jährige Landwirtin mit COPD wurde seit dem 10. Januar 2022 nacheinander in 2 Krankenhäuser eingeliefert. Ihre Hauptbeschwerden waren ein sich verschlimmernder Husten, Auswurf und Schnappatmung. Die mikrobiologische Untersuchung wurde im ersten Krankenhaus aus unbekannten Gründen nicht durchgeführt, die empirische Antibiotikabehandlung war nicht wirksam. Die Patientin wurde anschließend in unser Krankenhaus überwiesen. Nach der Untersuchung auf die Infektionsquelle und den Erreger wurde in ihrem Fall Tuberkulose diagnostiziert. Die Tuberkulosebehandlung brachte der Patientin keinen Nutzen, eine Remission der Atemwegssymptome blieb aus. Proben von Rückenmarksflüssigkeit und bronchoalveolärer Lavage-Flüssigkeit wurden im Anschluss für eine mikrobiologische Untersuchung eingeschickt. Die Ergebnisse wiesen auf Mycobacterium tuberculosis und Nocardia spp. hin. Nach 4-tägiger Bakterienkultur ergab sich das Wachstum von Nocardia spp. im Medium; Nocardia farcinica wurde durch MALDI-TOF-Massenspektrometrie und 16S-RNA identifiziert. Der Patientin wurden zur Behandlung der Co-Infektion Trimethoprim und Sulfamethoxazol (TMP/SMX) in Kombination mit Antituberkulotika verschrieben. Ihr Zustand verbesserte sich allmählich, sodass sie am 19. Februar 2022 aus dem Krankenhaus entlassen wurde. Die Ergebnisse der Nachbeobachtung waren allerdings unklar. Schlussfolgerungen: Eine Co-Infektion mit Nocardia und Mycobacterium tuberculosis sollte bei COPD-Patienten in Betracht gezogen werden. Wiederholte mikrobiologische und mikroskopische Untersuchungen sind in allgemeinen Krankenhäusern unerlässlich. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature 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.)

Der Artikel untersucht Paul Heyses Novelle Unheilbar hinsichtlich der Grenzerfahrungen der vermeintlich sterbenden Marie. Von einem Arzt hat sie die fehlerhafte Diagnose einer Lungentuberkulose bekommen und hält sich fortan in einem Sanatorium auf. Der Beitrag beleuchtet zum einen, inwiefern sich Marie zwischen Lebens- und Sterbekunst auf den vermeintlichen Tod vorbereitet. Zum anderen wird das Sanatorium ebenfalls als Grenzraum zwischen Leben und Tod verstanden und als Heterotopie im Sinne Foucaults untersucht. Dabei wird das Wechselspiel zwischen Räumlichkeit und der Ich-Erzählerin Marie näher fokussiert. In ihrer Einsamkeit sieht sie ihre neue Freiheit. Sie strebt danach, sich im heterotopen Ort des Sanatoriums von gesellschaftlichen Zwängen und überholten Moralvorstellungen zu befreien.

Copyright of Innere Medizin (2731-7080) is the property of Springer Nature 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: Children <15 years are at elevated risk of becoming infected with M. tuberculosis complex (Mtbc). Objective: To assess the magnitude of Mtbc transmission by healthcare workers (HCW) to children Methods: Medline, Google Scholar and Cochrane library were searched to select primary studies in which HCW was the presumed index case and exposed infants and children aged below 15 years were screened for latent TB infection (LTBI). Results: Of 4,702 abstracts, 19 original case reports covering one HCW each as presumed source case of Mtbc transmission to children, were identified. In sum, 11,511 children, of those 5,881 infants (51.1%), mostly in newborn nurseries, were considered contact persons and underwent tuberculin skin (TST) or Interferon gamma release assay (IGRA) testing. Test positivity was reported in 492/11,511 children (4.3%) coming from 14 studies. When test results considered falsely positive were excluded, the number of latently infected children decreased to 365/10,171 (3.6%). In all studies, the presumed duration of infectivity of the source case was, but the actual intensity and duration of exposure were not, decisive for the initiation of contact investigations. In only two of the studies, the contact time of the children towards the corresponding source case was estimated. Conclusions: The results of our review suggest that the risk of Mtbc transmission from HCW to children in healthcare setting is considerably lower than reported in household settings. However, as the preselection of pediatric contacts appeared in most cases to be vague, the data found in the literature probably underestimates the actual risk [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) are at increased risk of becoming infected with M. tuberculosis complex (Mtbc). Objective: To assess the magnitude of Mtbc transmission by children under the age of 15 years to HCW. Methods: Medline, Google Scholar and Cochrane library were searched to select primary studies in which a child was the presumed index case and exposed HCW were screened for latent TB infection (LTBI). Results: Of 4,702 abstracts, 15 original case reports covering 16 children with TB were identified. In sum, 1,395 HCW were contact persons and underwent testing. Ten of the studies reported TST conversion, amounting to 35 (2.9%) of the 1,228 HCW tested. In three of the TST-based and both of the studies that used IGRA testing, conversion was absent. 12 of the 15 studies (80%) reported exposure of HCW in neonatal intensive units (NICUs) to premature infants suffering from congenital pulmonary TB. One study including two infants addressed possible pulmonary Mtbc transmission in a general pediatric ward. Extrapulmonary transmission by aerosolized Mtbc was suggested in two patients, an infant with tuberculous peritonitis and a 12-year-old adolescent with pleurisy, and culture-confirmed only after the child had undergone video-assisted thoracoscopic surgery. Routine use of protective facemasks by HCW before exposure was not mentioned in any of the included studies. Conclusions: The results suggest that the risk of Mtbc transmission from children to HCW is low. Particular attention should be paid to infection risk during respiratory manipulations in NICUs. The consistent wearing of facemasks may further reduce the risk of Mtbc transmission. [ABSTRACT FROM AUTHOR]

Copyright of Wortfolge. Szyk Słów is the property of Wydawnictwo Uniwersytetu Slaskiego 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.)

A typifying characteristic of Homo sapiens is its ability to walk upright, which allowed humans to move about in grasslands, enabling them to leave the forests of central Africa and populate the rest of Africa and later the world, a success story like no other. Africa is the place of origin of Homo sapiens. The first major migration of anatomically modern humans, known as the Out-of-Africa migration, was the first of many migratory events of Homo sapiens that continue up to the current era that shaped the world and society. This article aims to describe the defining role of human migration in spreading infectious diseases from pre-history to the present. In future, infectious diseases will continue to spread through migration. However, by contrast, the spread of diseases will be exacerbated due to the opportunities provided in the Anthropocene epoch and will become progressively more challenging. Migration is a term that encompasses the simultaneous movement of large numbers or groups of people away from their original place of living and for a specific reason. The main reasons for migration are emigration/immigration, forced displacement, slavery, migrant labour, asylum seeking and refugees. In addition, war, conflict, and environmental disasters such as droughts, famine and overpopulation are other common causes of migration. Migration is usually unplanned; it happens without warning or advanced planning and is accompanied by a large-scale disruption in the socio-economic structure, health, and well-being of the migrants and/or other affected groups. Such major disruptions to individuals' normal living can weaken the immune system, leading to increased susceptibility to infectious diseases. In addition, temporary housing during migration can often also result in humanitarian disasters that increase opportunities for the transmission of infectious diseases. Migrants are also at risk of contracting new or previously-unencountered diseases prevalent in their chosen resettlement area. Conversely, migrants can carry with them microorganisms absent in the resettlement area. An example of this is the smallpox virus that was brought to South America by the Spanish colonisers. At that stage, poxvirus was absent in this continent, and the indigenous populations had no immunity to the pathogen. The transmission of the poxvirus by colonizers to indigenous populations almost destroyed the indigenous populations of the time. A form of migration that emerged more recently is travel. Travel migration is defined as the large number of unrelated individuals who travel simultaneously across the globe for work or pleasure. Travel migration has been enabled by advances in the speed by which air and train travel takes place. This results in large numbers of individuals being transported across the globe in a short period and over long distances. Travel by water, air and land resulted in the world's population being highly interconnected through the mingling of large numbers of people from geographically remote places but in a relatively short period. Travelling connects people and diseases across the globe. Examples of pathogens that spread through migration and that cause major infectious diseases include the smallpox virus, the human immuno-deficiency virus (HIV), and coronaviruses that cause Middle Eastern respiratory syndrome (MERS), coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS). Mycobacterium tuberculosis, the cause of tuberculosis, and Helicobacter pylori, which can cause gastric ulcers, are among the oldest known bacteria that infect humans and were already present in humans when the Out-of-Africa migration occurred. These two pathogens were carried with humans as they migrated and populated new areas of the world, and both have been present in large numbers of humans over millennia. These two organisms can only spread through very close contact between humans and have no host outside the body; therefore, they are great examples of how migration distributes infectious diseases across the world. Mycobacterium tuberculosis is exceptionally well-adapted to spread and cause disease among individuals with lower immunity, such as migrants. Poor housing conditions and crowding, which invariably result from migration due to humanitarian disasters, advance the transmission of pathogens such as tuberculosis. Major lifestyle changes of humans occurred from the Paleolithic to the Neolithic after the Out-of-Africa migration, which directly or indirectly benefited the transmission of diseases. During the Neolithic, animals were domesticated, and agriculture started, allowing people to settle down and establishing the first towns and cities. The domestication of animals created an opportunity for pathogens to cross from animals to humans and adapt to the new host to cause new infectious diseases in humans, called zoonosis. The Anthropocene dawned when deforestation, mining, farming, and other human activities left their mark. As a result, the Anthropocene offers unique opportunities for the emergence and spread of infectious diseases: firstly, by zoonosis or the transmission of diseases from animals to humans, and secondly, the spread of the diseases through migration. Furthermore, changes in the weather and climate can lead to environmental migration. This occurs when people need to abandon their normal place of living because of severe weather events such as droughts and ice ages. Labour migration was responsible for the spread of HIV from its place of origin in Africa. This virus initially landed in humans through inter-species cross-over from primates to humans in the 1950s from eating semi-cooked bush meat. As a result, it became established in the indigenous populations of Africa. HIV is a sexually transmitted disease amongst humans, and migratory labourers from Haiti were infected with the virus while working in the Congo, where they transmitted the virus to people in Haiti upon their return. The MERS and SARS coronaviruses became human pathogens due to bat-human species cross-over, probably due to eating bush meat. However, the rapid distribution of these two viruses to other areas of the world was enabled through travel migration and the highly connected world population. Similarly, the extremely rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) upon its discovery in December 2019 was partly due to travel migration. In future, the negative impact of infectious diseases can be prevented by having disaster preparedness plans to protect the health and well-being of migrants and resident populations. However, events that can potentially be disastrous are difficult to pre-empt: the world was largely unprepared on how to respond to the rapid spread of SARS-CoV-2 and how to control the ensuing pandemic. Other recent examples of similar unforeseen events are the Ukraine-Russian conflict that started in March 2022, which caused many people from Ukraine to flee to other countries for safety. The second example is the heavy rain of April 2022 in the KwaZulu-Natal Province of South Africa, which caused massive destruction of houses and infrastructure, resulting in affected people being displaced. In both cases, the reasons for migration can have a detrimental impact on the health of the affected people, which renders them susceptible to disease transmission. [ABSTRACT FROM AUTHOR]

Sammendrag Denne artikkelen er en nærstudie av tuberkulosedødelighet i Tromsø by i en periode med sterk befolkningsvekst og tettere bosetting. Fra og med 1878 har vi tilgang på en tilnærmet fullstendig registrering av individuelle dødsårsaker i begravelsesprotokollene for Tromsø, og sammenstilt med folketellingene av 1875, 1885, 1900, 1910 og 1920 har vi rekonstruert Tromsøs befolkning etter kjønn og alder for å kunne beregne dødelighetsrater basert på de som til enhver tid var under risiko for å dø i perioden 1878 til 1920. Våre funn viser at kvinner i aldersgruppen 15 til 49 år hadde en høyere dødelighet av tuberkulose, sammenliknet med menn, spesielt i tiårene før århundreskiftet. Hva som forårsaket disse tuberkulosedødsfallene er komplekst, men vi søker her å løfte frem tre forhold som kan bidra til en økt forståelse av både alder- og kjønnsforskjellene, nemlig mangelen på pasteurisering av melk, arvet motstandsdyktighet og migrasjon.

I den moderne velferdsstaten er det å bekjempe smittsomme sykdommer som covid-19 noe av det viktigste offentlige myndigheter kan være ansvarlig for overfor innbyggerne. Men samtidig reiser et offentlig ansvar for blant annet smittevern og kontrolltiltak mot smitte noen rettspolitiske spørsmål knyttet til forholdet mellom et samfunns sikkerhetsbehov og den enkeltes frihet. I denne artikkelen diskuterer jeg denne problemstillingen ved hjelp av en sammenligning av hvordan norske myndigheter har møtt koronapandemien i 2020–21 med hvordan kampen mot tuberkulosen ble organisert i Norge hundre år tidligere. Utfordringen den gangen som nå var at når en ny bakterie eller et virus oppstår og sprer seg, er det vanskelig å vite hvilke tiltak som kan og bør settes i verk når vi egentlig ikke vet hvordan vi best kan manøvrere oss gjennom krisen.

I Victoria (1898) av Knut Hamsun dør den kvinnelige hovedpersonen av tuberkulose bare 23 år gammel. Victoria er en av Hamsuns mest kjente romaner, men tuberkulosen som motiv har kun i liten grad påkalt kritikernes interesse. I denne artikkelen vil jeg drøfte hvordan fremstillingen av tuberkulose korresponderer med Hamsuns egen sykdomserfaring, samt med de rådende historiske og kulturelle forestillinger om sykdommen. Inspirert av Roland Barthes’ begrep «virkelighetseffekt» vil jeg vise hvordan medisinske og historiske fakta inngår eller transformeres som en del av romanens plot. Jeg vil vise hvordan Victoria ved hjelp av sykdomsmotivet står frem som en selvstendig og frigjort kvinneskikkelse samtidig som teksten påkaller stereotype forestillinger om unge tuberkuløse kvinner. Mens tuberkulosen i Victoria har tendert mot å bli sett på som et tegn på kjærlighet, vil jeg argumentere for at sykdommen i like stor grad fungerer som tegn på virkelighet.

Despite a decreasing incidence of tuberculosis (TB) over the last decades in Switzerland, the frequency of newly diagnosed tuberculous spondylitis has remained stable. It occurs most frequently in old, immunocompromised persons and/or persons who have moved to Switzerland from TB endemic areas. It is a chronic manifestation of TB, which is characterized by 'cold abscesses', neurological deficits and kyphotic spinal deformity. Tuberculous spondylitis is often diagnosed with a delay, which can lead to higher morbidity and treatment complexity. Antibiotic therapy is essential in tuberculous spondylitis. Surgical interventions aim to obtain samples, decompress nervous structures, obtain pain control and, if necessary, deformity correction/stabilization. This paper provides an overview of the modern diagnostic and therapeutic management of tuberculous spondylitis in Switzerland. [ABSTRACT FROM AUTHOR]

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Copyright of Nordlit is the property of Universitetet i Tromsoe 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.)

In Mycobacterium tuberculosis, mycolic acids and their glycerol, glucose, and trehalose esters ("cord factor") form the main part of the mycomembrane. Despite their first isolation almost a century ago, full stereochemical evaluation is lacking, as is a scalable synthesis required for accurate immunological, including vaccination, studies. Herein, we report an efficient, convergent, gram‐scale synthesis of four stereo‐isomers of a mycolic acid and its glucose ester. Binding to the antigen presenting protein CD1b and T cell activation studies are used to confirm the antigenicity of the synthetic material. The absolute stereochemistry of the syn‐methoxy methyl moiety in natural material is evaluated by comparing its optical rotation with that of synthetic material. [ABSTRACT FROM AUTHOR]

Pathogenesis hallmarks for tuberculosis (TB) are the Mycobacterium tuberculosis (Mtb) escape from phagolysosomal destruction and limited drug delivery into infected cells. Several nanomaterials can be entrapped in lysosomes, but the development of functional nanomaterials to promote phagolysosomal Mtb clearance remains a big challenge. Here, we report on the bactericidal effects of selenium nanoparticles (Se NPs) against Mtb and further introduce a novel nanomaterial‐assisted anti‐TB strategy manipulating Ison@Man‐Se NPs for synergistic drug‐induced and phagolysosomal destruction of Mtb. Ison@Man‐Se NPs preferentially entered macrophages and accumulated in lysosomes releasing Isoniazid. Surprisingly, Ison@Man‐Se/Man‐Se NPs further promoted the fusion of Mtb into lysosomes for synergistic lysosomal and Isoniazid destruction of Mtb. Concurrently, Ison@Man‐Se/Man‐Se NPs also induced autophagy sequestration of Mtb, evolving into lysosome‐associated autophagosomal Mtb degradation linked to ROS‐mitochondrial and PI3K/Akt/mTOR signaling pathways. This novel nanomaterial‐assisted anti‐TB strategy manipulating antimicrobial immunity and Mtb clearance may potentially serve in more effective therapeutics against TB and drug‐resistant TB. [ABSTRACT FROM AUTHOR]

The numbers of migrants, refugees and asylum seekers reached an unprecedented high in Europe in 2015 and 2016 but in 2019 they are back to the average numbers of the last 30 years. In contrast, frequencies of international and intercontinental travelers have continuously increased over the past decades and will continue to do so in the coming years. In 2018 more than 1.35 billion incoming travelers were reported worldwide by international organizations. Detailed knowledge of the epidemiology, transmission types, risk behavior and clinical presentation of acute and chronic central nervous system (CNS) infections enables timely diagnosis and initiation of potentially life-saving emergency treatment. Acute infections of the CNS, e.g. cerebral Plasmodium falciparum malaria or arboviral encephalitis, are seen most frequently and almost exclusively in travelers returning from tropical countries, whereas chronic CNS infections, e.g. tuberculous meningitis or neurocysticercosis, are typically seen in migrants and refugees. Beside CNS infections genetic diseases, environment-associated, nutrition-related, metabolic or cerebrovascular diseases also need to be considered when discussing differential diagnostic possibilities. [ABSTRACT FROM AUTHOR]

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After years of low incidence, a large increase of new tuberculosis (TB) cases has been reported in Germany since 2015. New immunotherapies for the treatment of multiple sclerosis (MS) are associated with a reduced immune competence and a potential increased risk for infections. Most neurologists lack specific experiences with TB infections. This article summarizes specific recommendations for the diagnostics and treatment of TB under MS immunotherapies with a focus on the situation in Germany. Due to low case numbers and little experience with the risk of TB under the new immunotherapies, the clinical competence network for MS (KKNMS) consensus recommendations have a low grade of evidence. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature 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 (TB) remains among the top 10 infectious diseases with highest mortality globally since the 1990s despite effective chemotherapy. Among 10 million patients that fell ill with tuberculosis in the year 2017, 36 % were undiagnosed or detected and not reported; the number goes as high as 55 % in Tanzania, showing that the diagnosis of TB is a big challenge in the developing countries. There have been great advancements in TB diagnostics with introduction of the molecular tests such as Xpert MTB/RIF, loop-mediated isothermal amplification, lipoarabinomannan urine strip test, and molecular line-probe assays. However, most of the hospitals in Tanzania still rely on the TB score chart in children, the WHO screening questions in adults, acid-fast bacilli and chest x-ray for the diagnosis of TB. Xpert MTB/RIF has been rolled-out but remains a challenge in settings where the samples for testing must be transported over many kilometers. Imaging by sonography – nowadays widely available even in rural settings of Tanzania – has been shown to be a useful tool in the diagnosis of extrapulmonary tuberculosis. Despite all the efforts and new diagnostics, 30–50 % of patients in high-burden TB countries are still empirically treated for tuberculosis. More efforts need to be placed if we are to reduce the death toll by 90 % until 2030. [ABSTRACT FROM AUTHOR]

Presentation of two practical cases from the ultrasound course in Ifakara, Tanzania. Case 1 shows the diagnostic value of abdominal and thorax ultrasound in a polytraumatized patient with splenic rupture. In case 2 the sonographic signs of pulmonary and extrapulmonary tuberculosis are presented. [ABSTRACT FROM AUTHOR]

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Copyright of Der Nephrologe is the property of Springer Nature 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 Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature 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.)

Weltweit leben vier von fünf Tabakkonsument*innen in wirtschaftlich sich entwickelnden Ländern, die einer enormen Belastung durch Tuberkulose und HIV-Erkrankungen ausgesetzt sind. Tuberkulose- oder HIV-Patient*innen, die rauchen, leiden trotz Behandlung unter schlechteren Prognosen. Verhaltensinterventionen zur Tabakentwöhnung sind in der routinemäßigen Gesundheitsversorgung eine Herausforderung. Qualität der Vermittlung und Patientenbindung müssen verbessert werden. Globally, four out of five tobacco users live in economically developing countries that are facing huge tuberculosis and HIV disease burdens. Tuberculosis or HIV patients, who smoke, suffer from poorer outcomes despite treatment. Behavioural tobacco treatments that are successful in supporting patients quit, are challenging to deliver in routine healthcare. Such treatments need to be simplified by enhancing quality of delivery and patient engagement. [ABSTRACT FROM AUTHOR]

This article reports the fulminant course of a pneumogenic sepsis with severe ARDS (acute respiratory failure) in a 36-year-old female Indian patient, who died within 14 h after admission to the intensive care unit due to a multiorgan failure. During treatment the diagnosis of a miliary tuberculosis was suspected but was only confirmed by the autopsy. Due to high hygiene standards, miliary tuberculosis as the cause of septic shock is rare in Europe. Only 1-2% of the patients with pulmonary miliary tuberculosis develop an ARDS with a mortality of 60-90%. Based on this case the diagnostics as well as treatment of the patient are described. Furthermore, the management of an open tuberculosis on an intensive care unit is explained. [ABSTRACT FROM AUTHOR]