Dual infection with Mycobacterium tuberculosis and Mycobacterium leprae at same site in an immunocompetent patient: An unusual presentation

Ghosh, Romana; Barua, Jayanta Kumar; Garg, Abhimanyu; Barman, Bhakti Pada

doi:10.4103/ijd.ijd_715_16

Cited by 4 publications

(1 citation statement)

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“…However, HE staining lacks specificity and frequently reveals granulomatous inflammation with or without necrosis ( Rui-e, 2020 ). Although AFB staining is a straightforward method for screening mycobacteria, it exhibits low sensitivity and can struggle to distinguish non-TB mycobacteria (NTM) ( Jain et al, 2017 ) and certain leprosy cases ( Ghosh et al, 2017 ). The GeneXpert MTB/RIF (Xpert) assay, recommended by the World Health Organization, has been widely used in clinical practice ( World Health Organization, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Nanopore-based targeted next-generation sequencing of tissue samples for tuberculosis diagnosis

Gao,

Yang,

Wang

et al. 2024

Front. Microbiol.

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ObjectiveDiagnosing tuberculosis (TB) can be particularly challenging in the absence of sputum for pulmonary tuberculosis cases and extrapulmonary TB (EPTB). This study evaluated the utility of nanopore-based targeted next-generation sequencing (tNGS) for diagnosing TB in tissue samples, and compared its efficacy with other established diagnostic methods.MethodsA total of 110 tissue samples from clinical cases were examined. The sensitivity and specificity of tNGS were benchmarked against a range of existing diagnostic approaches including hematoxylin and eosin (HE) staining in conjunction with acid-fast bacilli (AFB) detection, HE staining combined with PCR, HE staining paired with immunohistochemistry (IHC) using anti-MPT64, and the Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF) assay.ResultsThe sensitivity and specificity of tNGS were 88.2 and 94.1%, respectively. The respective sensitivities for HE staining combined with AFB, HE staining combined with PCR, HE staining combined with IHC using anti-MPT64, and Xpert MTB/RIF were 30.1, 49.5, 47.3, and 59.1%. The specificities for these methods were 82.4, 88.2, 94.1, and 94.1%, respectively. Analysis of drug resistance based on tNGS results indicated that 10 of 93 TB patients (10.75%) had potential drug resistance.ConclusionTargeted next-generation sequencing achieved higher accuracy than other established diagnostic methods, and can play a crucial role in the rapid and accurate diagnosis of TB, including drug-resistant TB.

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Section: Introductionmentioning

confidence: 99%

Nanopore-based targeted next-generation sequencing of tissue samples for tuberculosis diagnosis

Gao,

Yang,

Wang

et al. 2024

Front. Microbiol.

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Bacterial, fungal and parasitic co-infections in leprosy: A scoping review

et al. 2023

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Background In leprosy patients, the most commonly reported non-viral co-infections are Tuberculosis, Leishmaniasis, Chromoblastomycosis and Helminths. The presence of a secondary infection is believed to increase the likelihood of leprosy reactions. The purpose of this review was to describe the clinical and epidemiological characteristics of the most reported bacterial, fungal, and parasitic co-infections in leprosy. Methodology/Principal findings Following the PRISMA Extension for Scoping Reviews guidelines, a systematic literature search was conducted by two independent reviewers, resulting in the inclusion of 89 studies. For tuberculosis, a total of 211 cases were identified, with a median age of 36 years and male predominance (82%). Leprosy was the initial infection in 89% of cases, 82% of individuals had multibacillary disease, and 17% developed leprosy reactions. For leishmaniasis, 464 cases were identified, with a median age of 44 years and male predominance (83%). Leprosy was the initial infection in 44% of cases, 76% of individuals presented with multibacillary disease, and 18% developed leprosy reactions. Regarding chromoblastomycosis, we identified 19 cases with a median age of 54 years and male predominance (88%). Leprosy was the primary infection in 66% of cases, 70% of individuals had multibacillary disease, and 35% developed leprosy reactions. Additionally, we found 151 cases of co-infection with leprosy and helminths, with a median age of 43 years and male predominance (68%). Leprosy was the primary infection in 66% of cases, and 76% of individuals presented with multibacillary disease, while the occurrence of leprosy reactions varied from 37% to 81% across studies. Conclusion We observed a male-dominated pattern of co-infections among working-age individuals with multibacillary leprosy. Unlike prior studies reporting increased leprosy reactions in chronic viral co-infections, our findings did not indicate any increase among bacterial, fungal, or parasitic co-infections. Rather, co-infections with tuberculosis and leishmaniasis appeared to reduce leprosy reactions.

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Disseminated tuberculosis in association with erythema nodosum leprosum

Shenoy¹,

Raj²,

Bhat³

et al. 2022

BLDE University Journal of Health Sciences

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Mycobacterial diseases are endemic in India but simultaneous occurrence of tuberculosis and leprosy is rarely reported. We report a case of disseminated tuberculosis in an immunocompromised host due long-standing unsupervised corticosteroid intake with erythema nodosum leprosum (type 2 lepra reaction). The patient presented with generalized erythematous papulonodular skin lesions with malaise and body ache for the past 2 years. Later, he developed fever and testicular pain for which he sought medical advice. The diagnosis was based on the various laboratory and imaging studies supported by demonstration of Mycobacterium tuberculosis and Mycobacterium leprae in sputum and skin smears, respectively. The patient developed hepatitis which led to management challenges, however, the institution of antitubercular and antileprosy therapy in titrating doses resulted in improvement of the patient's condition.

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Dual infection with Mycobacterium tuberculosis and Mycobacterium leprae at same site in an immunocompetent patient: An unusual presentation

Cited by 4 publications

References 5 publications

Nanopore-based targeted next-generation sequencing of tissue samples for tuberculosis diagnosis

Nanopore-based targeted next-generation sequencing of tissue samples for tuberculosis diagnosis

Bacterial, fungal and parasitic co-infections in leprosy: A scoping review

Disseminated tuberculosis in association with erythema nodosum leprosum

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