Chapter 7: Extra-pulmonary tuberculosis

Barss, Leila; Connors, William; Fisher, Dina

doi:10.1080/24745332.2022.2036073

Cited by 7 publications

(12 citation statements)

References 300 publications

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“…In Canada, this form of TB accounts for about 2.5% of all TB cases per year, and around half of these cases have vertebral disease. 3 In low-income regions, bone and joint TB is more commonly seen among children, usually developing shortly after primary infection. In high-income countries, however, it is most commonly seen among adults, resulting from TB reactivation, as we suspected with our patient.…”

Section: Discussionmentioning

confidence: 99%

“…In high-income countries, however, it is most commonly seen among adults, resulting from TB reactivation, as we suspected with our patient. 3 Extra-axial disease usually presents as a monoarthritis that affects the knee or hip.…”

Section: Discussionmentioning

confidence: 99%

“…Mycobacterial cultures also require specialized laboratories that are certified for biosafety containment level 3 and have clinical mycobacteriology accreditation to ensure quality assurance. 3 Joint fluid analysis often finds a leukocyte count in the inflammatory range, typically 10–20 × 10 9 /L, but may be higher. 7 …”

Section: Discussionmentioning

confidence: 99%

“…Treatment duration should be extended for patients with increased risk of relapse, such as those with extensive disease at presentation. 3 Unlike other causes of septic arthritis, TB arthritis does not require acute surgical management; surgery is reserved for treatment of complications related to joint destruction after completion of TB treatment. 3 …”

Section: Discussionmentioning

confidence: 99%

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Tuberculous monoarthritis of the knee joint

Gunton

Losie

Connors

2023

CMAJ

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Tuberculous monoarthritis of the knee joint

Gunton

Losie

Connors

2023

CMAJ

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“…to exclude the presence of other microorganisms; in some cases immunohistochemical tests for mycobacteria; and/or polymerase chain reaction (PCR) for Mycobacterium tuberculosis are performed. Moreover, clinical, blood tests (QuantiFERON-TB), and imaging data are corroborated in order to establish a diagnosis of TB [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

A New Artificial Intelligence-Based Method for Identifying Mycobacterium Tuberculosis in Ziehl–Neelsen Stain on Tissue

Zurac

Mogodici²,

Poncu

et al. 2022

Diagnostics

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Mycobacteria identification is crucial to diagnose tuberculosis. Since the bacillus is very small, finding it in Ziehl–Neelsen (ZN)-stained slides is a long task requiring significant pathologist’s effort. We developed an automated (AI-based) method of identification of mycobacteria. We prepared a training dataset of over 260,000 positive and over 700,000,000 negative patches annotated on scans of 510 whole slide images (WSI) of ZN-stained slides (110 positive and 400 negative). Several image augmentation techniques coupled with different custom computer vision architectures were used. WSIs automatic analysis was followed by a report indicating areas more likely to present mycobacteria. Our model performs AI-based diagnosis (the final decision of the diagnosis of WSI belongs to the pathologist). The results were validated internally on a dataset of 286,000 patches and tested in pathology laboratory settings on 60 ZN slides (23 positive and 37 negative). We compared the pathologists’ results obtained by separately evaluating slides and WSIs with the results given by a pathologist aided by automatic analysis of WSIs. Our architecture showed 0.977 area under the receiver operating characteristic curve. The clinical test presented 98.33% accuracy, 95.65% sensitivity, and 100% specificity for the AI-assisted method, outperforming any other AI-based proposed methods for AFB detection.

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Evaluation of GeneXpert MTB/Rif Ultra assay performance on formalin-fixed paraffin-embedded tissues for Mycobacterium tuberculosis detection

Lo,

Purych,

Sekirov

et al. 2024

Journal of Medical Microbiology

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We evaluated the Xpert MTB/Rif Ultra assay performance for Mycobacterium tuberculosis (MTB) detection in formalin-fixed paraffin-embedded tissue (FFPET) compared to mycobacterial culture or laboratory-developed MTB PCR test (LDT). FFPET samples with histological features suggestive of tuberculosis from 2018 to 2023 were selected. Five hundred microlitres of tissue lysis buffer was added to FFPET scrolls and incubated at 75 °C for 5 min. After adding 50 µl of proteinase K and overnight incubation at 56 °C, sample aliquots were processed as per the manufacturer’s instructions. MTB culture or LDT assay results were used as a reference for sensitivity and specificity calculations. Of 51 eligible FFPET, 32 were positive for MTB either by culture or LDT PCR on FFPET. Xpert MTB/Rif Ultra detected MTB in 23/32 positive specimens [71.9%, 95% confidence interval (CI) 54.6–84.4%]. Of nine discordant specimens, seven were MTB positive by culture and two were identified by LDT MTB PCR only, as no specimen was submitted for MTB culture. Of 19 negative samples, 100% specificity (95% CI 83.2–100.0%) was attained via Xpert MTB/Rif Ultra. Implementation of Xpert MTB/Rif Ultra on FFPET within clinical laboratories is promising, given its improved turnaround time compared to MTB culture and ability to detect MTB in cases where no tissue is available for culture.

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Chapter 7: Extra-pulmonary tuberculosis

Cited by 7 publications

References 300 publications

Tuberculous monoarthritis of the knee joint

Tuberculous monoarthritis of the knee joint

A New Artificial Intelligence-Based Method for Identifying Mycobacterium Tuberculosis in Ziehl–Neelsen Stain on Tissue

Evaluation of GeneXpert MTB/Rif Ultra assay performance on formalin-fixed paraffin-embedded tissues for Mycobacterium tuberculosis detection

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