AIM OF THE STUDY: The aim of this study was to estimate the prevalence of M. tuberculosis infection in adult SLE patients & its relation to disease duration, activity, damage and treatment. Also, to compare the performance of IGRA in detection of M. tuberculosis infection with TST in those patients. PATIENTS AND METHODS: I- Patients: A cross-sectional study included 100 SLE patients fulfilling the American college of Rheumatology (ACR) revised classification criteria for SLE(8). All patients were recruited randomly from the Rheumatology outpatient clinic and the inpatient ward of Internal Medicine and Rheumatology department at Ain Shams University hospital. The nature of the present study was explained to all participants. The laboratory …show more content…
The skin test reaction was read between 48 and 72 hours after administration. The reaction was measured in millimeters of the induration (palpable, raised, hardened area or swelling). The diameter of the indurated area was measured across the forearm (perpendicular to the long axis). An induration of 5 or more millimeters was considered positive (15). Interferon Gamma Release Assays (IGRA) using The QuantiFERON-TB GOLD In-Tube (QFT-GIT) test: QuantiFERON® TB Gold In-Tube (Cellestis Limited, Victoria, Australia) was used according to the manufacturer’s instructions. QFT-GIT was considered positive if the IFN-γ level of nil was ≤ 8.0 IU/ml and that of TB antigen minus nil was ≥0.35 IU/ml and ≥25 % of nil value. The test was considered negative if the IFN-γ level of nil was ≤ 8.0 IU/ml and that of TB antigen minus nil was ≤ 0.35 and < 25% of Nil value. The result was considered indeterminate if the IFN-γ level of nil was ≥ 8.0 IU/ml(16). Microscopic examination of appropriate specimen for the presence of acid-fast-bacilli (AFB) and culture over Lowenstein Jensen (LJ) medium for tubercle bacilli were done for all patients with positive results of QFT-GIT or TST tests. Also, Plain chest radiography (posteroanterior view) was done; cavitary lung lesions, nodules, reticulonodular infiltrates, effusion and hilar lymphadenopathy were considered as CXR abnormalities (17). Latent
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Tuberculosis, the white plague as used to be called once upon a time is still one of the deadliest bacterial killers affecting almost all parts, all corners of the globe. Though successful anti-tubercular antibiotic regimens and effective vaccine are available for decades and being used in the battle against Koch’s bacillus, Mycobacterium tuberculosis, the causative agent of this chronic multi organ granulomatous disease, our strand in the battle continuously seems to be in the losing side. Moreover the increasing prevalence of HIV-AIDS and diabetes mellitus is being proved to be providing predisposition to tuberculosis. As witnessed by the WHO, which has estimated that, in the year 2012, 8.6 million people have developed tuberculosis and 1.3 million have died of the disease including 320000 deaths of HIV-TB co-infected people (Global tuberculosis report 2013. World Health Organization; 2013). Long term antibiotic therapy and that too associated with several side effects and discomforts have diminished patient compliance with the anti-tubercular chemotherapy. This fact in turn has raised the new deadlier MDR-TB and XDR-TB strains. The whole scenario is a matter of panic and questioning the effectiveness of anti-tubercular antibiotics, immunologic efficacy of century old BCG vaccine and all other medical advents.
Tuberculosis is caused by the bacteria “Mycobacterium Tuberculosis” and is mainly causes infection of the lungs (WHO, 2016). Its mode of transmission is airborne, so it can be passed on by inhalation of airborne droplets which carrying the bacteria, when an infected patient coughs, sneezes, or spits the TB germs into the air (WHO, 1026). Among the symptoms of active TB are: cough with sputum and blood, chest pains, weakness, fever and night sweats (WHO, 2016). Most at risk to get the TB infection are people with weakened immune system such as people who are suffering from chronic diseases such as diabetes mellitus, severe kidney disease, silicosis and especially HIV infection (CDC, 2016). Children and Tobacco users are also at greater risk to fall ill with TB.
Canada has had many events where tuberculosis was having an outbreak in 1924 through 1948, but since then it has been decreasing. We have dealt with this problem back in 2012 where an outbreak of tuberculosis infected 8% of the individuals in the extremely small Northern Quebec community of Kangiqsualujjuaq. After the outbreak The Public Health Agency of Canada is running over to discover the origin of the outburst its spread. Officials are also bringing up more additional resources to the place, such as a mobile x-ray machine. Tuberculosis is a disease caused by bacteria that travel from person to person. A person who is infected with tuberculosis, but does not show any symptoms at all may have dormant tuberculosis and can still transmit
There are many tests are available to diagnose SLE. The tests available are antinuclear antibody (ANA), complete blood count (CBC), chest x-ray, serum creatinine, and urinalysis . CBC is used to check red blood cells, white blood cells and platelet level which are typically abnormal in patients with SLE . Urinalysis checks for kidney function, measuring the levels of protein and check for any urinal tract infection . A complete physical is also conducted and the heart is checked for abnormal sounds or friction rubbing . To classify a person with SLE, physicians abide to the American College of Rheumatology (ACR) criteria list, in which 4 out of the 12 criteria must be present in a patient and this shows a specificity of 95%
Communicable Disease Paper Tuberculosis Communicable diseases rely on fluid exchange, contaminated substance, or close contact to travel from an infected carrier to a healthy individual. Many people have never heard of a disease called tuberculosis (TB) or not fully aware how serious this disease really is. I will briefly summarize the research that was conducted on tuberculosis by describing the disease in details and discussing efforts to control it, indentify environmental factors related to tuberculosis, and explain the influence of lifestyles, socioeconomic status, as well as disease management. I will also briefly describe what public health departments are doing to reduce the threat, and include data, evidence, and plan to
The diagnosis of SLE is difficult. Autoimmune diseases are a group of related conditions that present similar symptoms. One autoimmune disease is not a unique disease with its own unique symptoms, instead autoimmune diseases are a group of related conditions (see fig 2 and table2). Currently there are no definite number of how many autoimmune diseases exist, however, there is a range of autoimmune diseases that varies from 80 to as many as 120 (EHP,
TB patients need to take two first line drugs for a period of 18 months – two years, with this chemotherapy patient is non infectious within a period of 2 weeks and can come back to his normal daily activities even going back to work also. As a result hospitalization for TB these days is minimal; patients who tested positive for TB were usually hospitalized until smear is negative continuing the chemotherapy on an outpatient basis. Hospitalization is also useful in assessing or analyzing the drug side effects during chemotherapy.
SLE may cause a wide range of neurological and psychiatric symptoms including those due to central, peripheral and autonomic nervous system and different psychiatric syndromes. In 1999, the ACR developed a standardized nomenclature system for the NP syndromes of SLE for the purposes of classification and reporting (The American College of Rheumatology, 1997; 1999). It distinguishes three subsets of syndromes: psychiatric disorders, cognitive deficits and acute confusional states; neurological syndromes of the CNS and neurological syndromes of the peripheral nervous system (The American College of Rheumatology, 1997; 1999). Anxiety,
TB infection is transmitted through air by droplet nuclei that contain M. tuberculosis complex. Droplets are expelled when infected patients exhale, cough or sneeze. When the tiny bacilli are inhaled, they reach alveoli at lungs and start to multiply. TB infection may develop TB disease as bacilli can pass through blood, lymph nodes and other parts of the body. Miliary or disseminated disease occurs when large numbers of M.tuberculosis attack other organs and tissues such as bones, kidney, female reproductive system and nervous system. World Health Organization1 reported that South-East Asia Region has the highest TB incidence rate (3.2 million cases) in the world, while The Americas region has the lowest rate (280000 cases). Approximately 1.3 million of people died from TB in 2008 and the highest mortality was in South-East Asia Region1. Table 1 shows that Australia is one of the countries that has the lowest TB cases; in 2007, 1300 cases were reported and the mortality rate was 100 per year5; in 2008, 1400 cases were reported1. Table 2 shows that Vietnam has much higher number of cases in
In order to determine if TB infection is present, a skin test can be performed on the arm. TB infection is positive if swelling/hardness of the performed part of the skin appears in the size of a dime or bigger.
“Tuberculosis (TB) is a contagious and an often severe airborne disease caused by bacterial infection. TB is transmitted from an infected person to a susceptible person in airborne particles, called droplet nuclei, through the air usually through sneezing, coughing, spitting and singing. This bacterium usually attacks the lungs, but it also may affect any part of the body such as the kidney, spine and brain. Not everyone infected with TB bacteria becomes sick. As a result there are two TB- related conditions that exist; latent TB infection and TB disease. The latent TB does not cause any symptoms because the bacterium situated in the lungs is inactive. People can have latent TB for weeks or even years before developing active TB. If this disease is not treated properly, it can be fatal. The symptoms of TB disease depend on where in the body the TB bacteria are growing. Pulmonary TB is the most common and the symptoms are a bad cough that lasts for 3 weeks or longer, chest pain, blood discharge while coughing, weakness or fatigue, weight loss, no appetite, chills, fever and sweating at night” (CDC, 2016).
This study was conducted on thirty adult patients with SLE Patients were selected from rheumatology outpatient's clinic of AL-Zahraa hospital, Cairo, Egypt, during the period from June 2015 till October 2016. SLE patients fulfilling the American College of Rheumatology (ACR) revised criteria for the diagnosis of SLE were included11. Patients with clinical manifestations of SLE such as malar rash, photosensitivity, alopecia, oral ulcers arthritis, nephritis, neuropathy and hypertension were included in the study. Current medications were recorded , Patients with diabetes mellitus, malignancies and those with a diagnosis of mixed connective tissue disease were excluded. The study also included thirty age and sex matched apparently healthy
To increase TB detection, Georgia introduced laboratory diagnosis of tuberculosis and MDR-TB detection technologies in 2011. This helped to detect approximately 63 percent of MDR-TB cases. However, one-third of patients with MDR-TB remains undetected and represents a source of TB infection. Despite universal access to MDR-TB treatment, almost third of patients do not undertake treatment. Also every tenth case of detected TB is qualified as MDR-TB (USAID Georgia Tuberculosis Prevention Project, 2013). For these reasons, Georgia remains a high burden country for MDR TB (Partnership for Social initiatives , 2013)