Cervical Tuberculosis: A Decision Tree for Protecting Healthcare Workers

Roberts, Daniel S.; Dowdall, Jayme R.; Winter, Leslie K.; Sulis, Carol; Grillone, Gregory A.; Grundfast, Kenneth M.

doi:10.1097/mlg.0b013e3181770940

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…Fine-needle aspiration (FNA) biopsy of affected lymph nodes is a useful initial procedure with a reported sensitivity of 77%, specificity of 93% and diagnostic accuracy of 62% (see Table 2). [22][23][24][25][26][27]98,99 If it is non-diagnostic, the highest-yield procedure is an excisional lymph node biopsy, which has a sensitivity of 80%. Incisional biopsies are discouraged because of the risk of sinus tract formation at the biopsy site.…”

Section: Table 2 Sensitivity and Specificity Of Diagnostic Tests Inmentioning

confidence: 99%

Tuberculosis of the foot mimicking Charcot arthropathy

Agabawi

Walkty

Pilkey

et al. 2018

Official Journal of the Association of Medical Microbiology and

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Mycobacterium tuberculosis bone and joint infection accounts for 2% to 3% of all tuberculosis cases but is uncommon in the foot. A 32-year-old woman had foot pain and swelling, and radiographs showed midfoot bony destruction and fragmentation. She was diagnosed with Charcot arthropathy, but had no neuropathy or improvement despite total contact casting. Bone biopsy 16 months after initial presentation did not show acid-fast bacilli on smear, but M. tuberculosis was recovered on culture; concurrent chest radiographs showed patchy and nodular opacities in both upper lung zones, consistent with previous pulmonary tuberculosis. Sputum smear showed acid-fast bacilli and culture yielded M. tuberculosis. In retrospect, the patient was at increased risk for M. tuberculosis infection because of previous residence in Myanmar and India. Clinicians should consider M. tuberculosis infection in the differential diagnosis of Charcot arthropathy for patients who have exposure history and absence of risk factors for Charcot arthropathy.

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Section: Table 2 Sensitivity and Specificity Of Diagnostic Tests Inmentioning

confidence: 99%

Tuberculosis of the foot mimicking Charcot arthropathy

Agabawi

Walkty

Pilkey

et al. 2018

Official Journal of the Association of Medical Microbiology and

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“…Bei einer 20-jährigen Patientin, welche unter einer persistierenden unilateralen Otorrhoe klagte, zeigte sich ein entdiff erenzier- [ 11 ] . Eine in der Literatur beschriebene tuberkulosetypische Lokalisation der involvierten zervikalen Lymphknoten in den dorsalen und kaudalen Halspartien [ 9 , 12 -14 ] konnten wir in unserem Studienkollektiv nicht bestätigen.…”

Section: Cavum Tympaniunclassified

“…Lebensdekade und klagen über eine Dysphonie (80-100 % ) und/oder eine Odynophagie (50-67 % ) [ 22 ] . Für den behandelnden HNO-Arzt ist es wichtig zu wissen, dass eine Larynxtuberkulose in 80-90 % mit einer off enen Lungentuberkulose assoziiert ist [ 11 ] .…”

Section: Larynxtuberkuloseunclassified

Erstdiagnose einer Tuberkulose im HNO-Bereich

et al. 2011

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“…Reports of tuberculosis transmission from extra-pulmonary sites have generally involved open wounds in known tuberculous patients. [26] We are not aware of any instances of disease transmission attributed to FNA biopsy. On the contrary, FNA has been specifically recommended for the diagnosis of tuberculous lymphadenitis, with reported sensitivity and specificity of 93 and 77 percent.…”

Section: Equipment and Suppliesmentioning

confidence: 99%

Progression from on-site to point-of-care fine needle aspiration service: Opportunities and challenges

Gupta

2010

CytoJournal

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BackgroundStandard-of-care requires the availability of an efficient, economical and accurate on-site fine needle aspiration (FNA) service. Presence of a trained individual during the procedure ensures an improved patient care. Appropriate selection of the equipment, interaction with the clinicians and compliance with the various regulations during the procedure is essential. This is often done by an on-site FNA service. Organization and implementation of such a system in a large academic center is challenging.Methodwe reviewed the ambulatory care needs in the new Perelman Center for Advanced Medicine (PeCAM). Multiple (9) FNA sites have been established keeping in view the patient's convenience, clinic demands, various regulatory requirements and laboratory staff. Each location has dedicated FNA station with microscopes and supplies. In addition, state- ofthe -art technologies including a mobile FNA cart (Penn-A- Cart), remote specimen evaluation (TeleCyP) have been incorporated.ResultsThe new set up is extremely efficient and much valued by the patients and the clinicians. It has improved patient care.ConclusionWith necessary investments and resources a point-of-care FNA service has been created which has improved patient care. This, albeit with certain modifications may serve as a model for FNA service.

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Cervical Tuberculosis: A Decision Tree for Protecting Healthcare Workers

Abstract: To facilitate interpretation and rapid diagnosis while minimizing risk to health care providers, we provide a decision tree based on new federal guidelines and the clinical experience of a team of infectious disease specialists and otolaryngologists.

Cited by 8 publications

References 21 publications

Tuberculosis of the foot mimicking Charcot arthropathy

Tuberculosis of the foot mimicking Charcot arthropathy

Erstdiagnose einer Tuberkulose im HNO-Bereich

Progression from on-site to point-of-care fine needle aspiration service: Opportunities and challenges

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