An Outbreak of Tuberculosis with Accelerated Progression among Persons Infected with the Human Immunodeficiency Virus

Daley, Charles L.; Small, Peter M.; Schecter, Gisela; Schoolnik, Gary K.; McAdam, Ruth A.; Jacobs, William R.; Hopewell, Philip C.

doi:10.1056/nejm199201233260404

Cited by 903 publications

(386 citation statements)

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“…Therefore, in cases of pneumonia, tuberculosis must be considered, especially in regions where the disease is more prevalent and in individuals infected with HIV. (26,27) In southern Brazil, Whites outnumber non-Whites. (28) However, in the present study, 28 (47.5%) of the cases of tuberculous pneumonia occurred in Black individuals.…”

Section: Discussionmentioning

confidence: 99%

Pneumonia tuberculosa: um estudo de 59 casos confirmados microbiologicamente

Moreira¹,

Fochesatto

Moreira

et al. 2011

J. bras. pneumol.

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Objective: To study the clinical, epidemiological, radiographic and endoscopic features of individuals with tuberculous pneumonia. Methods: We evaluated 2,828 consecutive tuberculosis patients treated at a public health center between December of 2005 and February of 2007. Of those, 59 (2.1%) had pulmonary involvement consistent with fistula between a lymph node and a bronchus. Results: Of the 59 patients studied, 43 (73%) were between 20 and 50 years of age, 31 (53%) were male, and 28 (47%) were Black. The most common symptoms were cough (in 100%), fever (in 88%), expectoration (in 81%), and weight loss (in 40%). Comorbidities were reported in 35 cases (59%), the most common being HIV infection (in 20%) and diabetes (in 15%). On chest X-rays, consolidation was observed, predominantly in the upper lobes (in 68%). The diagnostic confirmation (identification of AFB) was made through the sputum smear microscopy in the majority of the cases and by bronchoscopy (BAL examination or bronchial biopsy) in the remainder. Bronchial lesions were clearly indicative or suggestive of fistula in three cases and five cases, respectively. Conclusions: Tuberculous pneumonia presents as acute respiratory infection, initiating with a dry cough that is followed by fever. Chest X-rays show alveolar consolidation. In most cases, tuberculous pneumonia was accompanied by at least one comorbid condition, the most common being HIV infection, and the etiological diagnosis was made through sputum smear microscopy for AFB. Bronchoscopy findings were indicative of bronchial fistula in eight cases (13%).Keywords: Mycobacterium tuberculosis; Pneumonia; Bronchial fistula; Lymph nodes. ResumoObjetivo: Estudar os aspectos clínicos, epidemiológicos, radiológicos e endoscópicos encontrados em indivíduos com pneumonia tuberculosa. Métodos: Entre dezembro de 2005 e fevereiro de 2007, foram estudados 2.828 pacientes com tuberculose que foram consecutivamente atendidos em uma unidade de saúde pública. Desses, 59 (2,1%) tiveram envolvimento pulmonar compatível com fístula entre um linfonodo e um brônquio. Resultados: Dos 59 pacientes estudados, 43 (73%) tinham entre 20 e 50 anos de idade, 31 (53%) eram do sexo masculino, e 28 (47%) eram negros. Os sintomas mais frequentes foram tosse (100%), febre (88%), expectoração (81%) e perda de peso (40%). Comorbidades foram registradas em 35 pacientes (59%), especialmente a infecção por HIV (20%) e diabetes (15%). Na radiografia de tórax, a consolidação predominou nos lobos superiores (em 68%). A confirmação diagnóstica (presença de BAAR) foi feita principalmente por baciloscopia direta do escarro, seguida por broncoscopia (LBA e biópsia brônquica). Lesões brônquicas claramente indicativas ou sugestivas de fístula foram identificadas em três casos e cinco casos, respectivamente. Conclusões: A pneumonia tuberculosa apresenta-se como uma infecção respiratória aguda, com tosse seca seguida por febre. A radiografia de tórax mostra consolidação alveolar. Na maioria dos casos, a pneumonia tuberculosa foi acompanh...

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Section: Discussionmentioning

confidence: 99%

Pneumonia tuberculosa: um estudo de 59 casos confirmados microbiologicamente

Moreira¹,

Fochesatto

Moreira

et al. 2011

J. bras. pneumol.

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“…DNA fingerprinting can determine that in many of these outbreaks, the susceptibility of HIV-positive patients to tuberculosis infections and the accelerated breakdown to disease often result in more rapid transmission of the infection [42,50,55,149,153,165]. Furthermore, the study of MTB isolates obtained from AIDS patients by fingerprinting showed that reinfection and relapse both occur in HIV-infected patients, as the susceptibility to superinfections will most likely be related to the immune status of the patient.…”

Section: Use Of Genotyping To Study the Impact Of Hiv/aids And Drug Rmentioning

confidence: 99%

Pulmonary Tuberculosis and Mycobacterium Tuberculosis: Modern Molecular Epidemiology and Perspectives

Godreuil

Tazi

Bañuls³

2006

Encyclopedia of Infectious Diseases

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“…In addition to the above studies, molecular epidemiology studies have demonstrated the explosive potential for tuberculosis to progress to disease and spread amongst HIV-infected persons (50). In one study, epidemiological surveillance in a tuberculosis control program detected twelve cases of tuberculosis in a residential facility for persons with HIV disease.…”

Section: The Impact Of Hiv On Tuberculosismentioning

confidence: 99%

Epidemiología molecular de la tuberculosis: métodos y aplicaciones

2004

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The resurgence of tuberculosis around the world has renewed interest in understanding the epidemiology and pathogenesis of this disease. A revolutionary advance in the field of tuberculosis research has been the development of molecular techniques that permit identification and tracking of individual strains of Mycobacterium tuberculosis. With these techniques, molecular epidemiology has been established as a new discipline that adds another dimension to the classical epidemiology of tuberculosis and has increased our understanding of the transmission dynamics of M. tuberculosis. The increased epidemiological knowledge has led to discovery of inadequacies in tuberculosis control programs; this information has helped garner resources for program improvement and has highlighted the need for the continuous surveillance of tuberculosis. Additional genetic methods are being developed based on the knowledge of the genome sequence of M. tuberculosis. These simpler and less costly genotyping techniques promise to expand the application of molecular epidemiology to developing nations (where 90% of the disease burden occurs) in support of national tuberculosis programs. Furthermore, these tools permit ever more effective probes into the dynamics of transmission, the population structure, evolution and pathogenesis of M. tuberculosis.Key words: tuberculosis, Mycobacterium tuberculosis/pathogenicity/drug effects, molecular epidemiology, genotype, DNA fingerprinting/methods, restriction fragment length polymorphins. Epidemiología molecular de la tuberculosis: métodos y aplicacionesLa reemergencia de la tuberculosis en el mundo ha despertado el interés en el entendimiento de la epidemiología y patogénesis de esta enfermedad. Un revolucionario avance en este campo de investigación ha sido el desarrollo de técnicas moleculares que permiten identificar y establecer la huella particular de cada cepa de M. tuberculosis. Con el uso de estas técnicas, y el establecimiento de la epidemilogia molecular como nueva disciplina se adicionó otra dimensión a la epidemiologia clásica de la tuberculosis y ha incrementado el conocimiento de la dinámica de la transmisión de M. tuberculosis dentro de una población. En el proceso han sido identificados problemas en los programas de control, lo cual ha ayudado a obtener recursos para su mejoramineto e implementación. Aún más, se ha resaltado la necesidad de continuar vigilando esta enfermedad. Otras metodologías genotípicas han sido desarrolladas a partir del conocimiento de la secuencia del genoma de M. tuberculosis. Estas metodologías genotípicas de fácil implementación y bajo costo se deben aplicar en países en vía de desarrollo, donde existe el 90% de la enfermedad, como apoyo a los programas de control de la tuberculosis. Estas herramientas permitirán conocer la dinámica de transmisión de la tuberculosis, la estructura de la población, la evolución y patogénesis de M. tuberculosis.Palabras clave: tuberculosis, Mycobacterium tuberculosis/patogenicidad/efecto de drogas, epidemiología molecular,...

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An Outbreak of Tuberculosis with Accelerated Progression among Persons Infected with the Human Immunodeficiency Virus

Cited by 903 publications

References 8 publications

Pneumonia tuberculosa: um estudo de 59 casos confirmados microbiologicamente

Pneumonia tuberculosa: um estudo de 59 casos confirmados microbiologicamente

Pulmonary Tuberculosis and Mycobacterium Tuberculosis: Modern Molecular Epidemiology and Perspectives

Epidemiología molecular de la tuberculosis: métodos y aplicaciones

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