Contemporary Concise Review 2018: Respiratory infections and tuberculosis

Hui, David S.; Leung, Chi Chiu

doi:10.1111/resp.13542

Cited by 5 publications

(5 citation statements)

References 51 publications

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“…In another study, 45% of patients with TB were similarly diagnosed with hyponatremia and 4% with SIADH [ 13 ]. A recent review summarised that hyponatremia was registered in more than half of TB cases, with older age being a risk factor [ 7 , 8 , 22 , 23 ], corroborating the results of our study. We circumvented the age bias by performing an age-adjusted analysis as hyponatremia is known to be generally more frequent in older patients [ 1 ].…”

Section: Discussionsupporting

confidence: 91%

Associations of hyponatremia and SIADH with increased mortality, young age and infection parameters in patients with tuberculosis

Bal

Gompelmann²,

Krebs³

et al. 2022

PLoS ONE

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Background and objective Hyponatremia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) are associated with and can be caused by tuberculosis (TB) through meningitis by locally invading the hypothalamus, adrenal, or pituitary glands or possibly through ectopic ADH production. This study assessed the association of TB mortality with hyponatremia and SIADH in a large cohort of a university hospital in Austria. Methods This retrospective study enrolled patients with hyponatremia and patients diagnosed with TB from 01/2001-11/2019 to assess the prevalence of TB in hyponatremia and TB morbidity and mortality in patients with and without hyponatremia. Sex, age, microbiological results, laboratory tests and comorbidities were analysed and used to calculate survival rates. Results Of 107.532 patients with hyponatremia (0.07%) and 186 patients with TB (43%), 80 patients were diagnosed with both—hyponatremia and TB. Only three TB patients had SIADH, precluding further SIADH analysis. In hyponatremia, young age and high CRP levels showed significant associations with TB diagnosis (p<0.0001). Survival rates of patients diagnosed with TB with moderate to profound hyponatremia were significantly lower than those without hyponatremia (p = 0.002). Conclusion In this study of a large cohort from a tertiary care hospital in a non-endemic area of TB, 0.07% of patients presenting with hyponatremia, but especially younger patients and patients with high CRP values, were diagnosed with TB. Crucially, patients with moderate to profound hyponatremia had a significantly higher mortality rate and thus required increased medical care.

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Section: Discussionsupporting

confidence: 91%

Associations of hyponatremia and SIADH with increased mortality, young age and infection parameters in patients with tuberculosis

Bal

Gompelmann²,

Krebs³

et al. 2022

PLoS ONE

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“…Better understanding of genetics of antitubercular phenotypic drug resistance will facilitate the development of accurate molecular diagnostics for resistant MTB strains [ 65 ]. Though WGS has a revolutionizing power in drug susceptibility tests, the associated costs, facility requirements, and other issues need to be addressed prior to its use [ 66 ].…”

Section: Genetic Aspects Of Tbmentioning

confidence: 99%

“…In that grouping, the first group included levofloxacin/moxifloxacin, bedaquiline and linezolid; the second group included clofazimine and terizidone/cycloserine. Finally, the group third included PZA, imipenem-cilastatin, meropenem, ethambutol, delamanid, amkiacin/SM, theionamide/prothionamide, and p-aminosalicylic acid, which are used in cases where the first two groups are not usable [ 66 ].…”

Section: Resistance Issues With Antitubercular Drugsmentioning

confidence: 99%

“…Finally, the third group includes PZA, impipenem-cilastatin, meropenem, ethambutol, delamanid, amkiacin/SM, theionamide/prothionamide, and p-aminosalicylic acid, which are used in cases where the first two groups are not usable. Ageing population vulnerability poses a public health challenge, especially those coming from many Asian countries [ 66 ].…”

Section: Impact Of Treatment Optionsmentioning

confidence: 99%

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A Saudi Arabian Public Health Perspective of Tuberculosis

Saati

Khurram

Faidah

et al. 2021

IJERPH

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Tuberculosis is a global health challenge due to its spreading potential. The Kingdom of Saudi Arabia (KSA) faces a challenge in the spread of tuberculosis from migrant workers, but the foremost threat is the huge number of pilgrims who travel to visit sacred sites of the Islamic world located in the holy cities of Makkah and Al Madina. Pilgrims visit throughout the year but especially in the months of Ramadan and Zul-Hijah. The rise of resistance in Mycobacterium tuberculosis is an established global phenomenon that makes such large congregations likely hotspots in the dissemination and spread of disease at a global level. Although very stringent and effective measures exist, the threat remains due to the ever-changing dynamics of this highly pathogenic disease. This overview primarily highlights the current public health challenges posed by this disease to the Saudi health system, which needs to be highlighted not only to the concerned authorities of KSA, but also to the concerned global quarters since the pilgrims and migrants come from all parts of the world with a majority coming from high tuberculosis-burdened countries.

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“…While TB diagnostics are moving towards whole-genome sequencing for drug susceptibility testing, and highly individualized treatment regimens, at present the World Health Organization (WHO) recommends either the conventional 18-24-month regimen or a shorter 9-12-month regimen for selected patients, although the latter has a marginally less favourable outcome. 89 Drugs for the conventional regimen have recently been reclassified into three categories: Group A drugs (levofloxacin/moxifloxacin, bedaquiline and linezolid) that should preferably all be included in the regimen; Group B drugs (clofazimine and cycloserine/terizidone) that are added after Group A; and Group C drugs (ethambutol, delamanid, pyrazinamide, imipenem/cilastatin, meropenem, amikacin/streptomycin, ethionamide/prothionamide and p-aminosalicylic acid) are used to complete the regimen. 90 Cases where the diagnosis of pleural TB is made on the basis of a biopsy demonstrating granulomas, but efforts to identify the Mycobacterium and its sensitivity profile have failed, present a unique clinical dilemma.…”

Section: Anti-tb Treatmentmentioning

confidence: 99%

Tuberculous pleural effusion

2019

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Tuberculous effusion is a common disease entity with a spectrum of presentations from a largely benign effusion, which resolves completely, to a complicated effusion with loculations, pleural thickening and even frank empyema, all of which may have a lasting effect on lung function. The pathogenesis is a combination of true pleural infection and an effusive hypersensitivity reaction, compartmentalized within the pleural space. Diagnostic thoracentesis with thorough pleural fluid analysis including biomarkers such as adenosine deaminase and gamma interferon achieves high accuracy in the correct clinical context. Definitive diagnosis may require invasive procedures to demonstrate histological evidence of caseating granulomas or microbiological evidence of the organism on smear or culture. Drug resistance is an emerging problem that requires vigilance and extra effort to acquire a complete drug sensitivity profile for each tuberculous effusion treated. Nucleic acid amplification tests such as Xpert MTB/RIF can be invaluable in this instance; however, the yield is low in pleural fluid. Treatment consists of standard anti‐tuberculous therapy or a guideline‐based individualized regimen in the case of drug resistance. There is low‐quality evidence that suggests possible benefit from corticosteroids; however, they are not currently recommended due to concomitant increased risk of adverse effects. Small studies report some short‐ and long‐term benefit from interventions such as therapeutic thoracentesis, intrapleural fibrinolytics and surgery but many questions remain to be answered.

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Contemporary Concise Review 2018: Respiratory infections and tuberculosis

Cited by 5 publications

References 51 publications

Associations of hyponatremia and SIADH with increased mortality, young age and infection parameters in patients with tuberculosis

Associations of hyponatremia and SIADH with increased mortality, young age and infection parameters in patients with tuberculosis

A Saudi Arabian Public Health Perspective of Tuberculosis

Tuberculous pleural effusion

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