A subject infected by tubercle bacilli may immediately develop the disease (primary tuberculosis), witch occurs in a few number of infected persons, or may overcome the primary infection (a latent carrier of the infection). Nowadays there are about two milliard people with a latent tubercular infection. About 10% of them will develop active tuberculosis during their lifetime. Detection of latent tuberculosis and its treatment decreases the risk of developing the active form of the disease. Until recently, the tuberculin test was a single screening method to identify the subjects with tubercular infection. In recent years, some novel in vitro tests to diagnose the tubercular infection have been designed. These tests measure the cell-mediated immune response quantifying the emission of interferon gamma by T cells in response to stimulation by Mycobacterium tuberculosis specific antigens. These tests are more sensitive and specific than the tuberculin skin test, but they are just an accessory tool, i.e., a link in the diagnostic chain of the tubercular infection.

Although, as in our case, the majority of DIP patients improve on treatment, some patients still develop progressive irreversible fibrosis despite therapy.

Abstract

The genesis of auto-immune antibodies directed against the own tissue antigens of a host may be due to the host's immune response to mycobacteria. The prospective study included 110 patients treated for active pulmonary tuberculosis and the control group of 60 healthy subjects, volontary blood donors. Applying the method of indirect immnunofluorescence and cryostat sections of rat organs and human larynx cancer epithelial cell line (HEp-2 cells), the prescence of the following autoantibodies in the serum of the examined patients was examined: anti,nclear (ANA), anticardiac (ACA), antimitochondrial (AMA), antiparietal (APA), anti smooth muscular (ASMA), antithyroidal (ATA), rheumnatoid factor (RF). These autoantibodies were determined in the course oftreatment and five years later. Low levels of some examined autoantibodies were detected in the serum of a number of the examined patients. No significant difference in the presence of the analysed antibodies was registered between the sexes. In the course of the treatment a reversible hyper-gammaglobulinemia developed, which was at least partially due to the presence of autoantibodies in the patients blood serum. Besides possibly involved mechanisms of molecular mimicry and polyclonal lymphocyte activation, the presence of antinuclear antibodies in the patient's serum is at least partially due to isoniazide treatment. The finding of other autoantibodies is nonspecific and not related to the mycobacterial infection or antituberculosis drug administration.

Introduction. Among infectious diseases, tuberculosis ranks first in terms of morbidity and mortality. It mainly affects the lungs, but it can affect any organ in the body. Case Report. A 29-year old female patient, bacillus Calmette-Guerin vaccinated, human immunodeficiency virus-negative, non-smoker, active athlete, presented with magnetic resonance imaging of the spine indicating vertebral body collapse of Th10 with signs of intraosseous infiltration, extraosseous prevertebral, and extracorporeal spread into the spinal canal. Corpectomy of Th10 and Th11 with an anterior fusion of Th9-12 was performed by neurosurgical intervention. Histopathological examination of the vertebral body confirmed a necrotic granulomatous inflammation. No acid-fast bacilli were seen by Ziehl-Neelsen staining, while Mycobacterium tuberculosis culture was positive. Chest X-ray and computed tomography were normal, induced sputum smear microscopy was negative for Mycobacterium tuberculosis. The antituberculosis therapy lasted for 12 months. Conclusion. Spinal tuberculosis is a differential diagnostic problem in relation to pyogenic infections and metastatic bone tumors.