Mini-review: Silico-tuberculosis

Abstract

Silicosis continues to be a serious health issue in many countries and its elimination by 2030 (a target set by WHO and the International Labour Organization in 1995) is virtually impossible. The risk to develop pulmonary tuberculosis for silicosis patients is higher than for non-silicosis people, and there is also an increased risk of both pulmonary and extrapulmonary tuberculosis in individuals exposed to silica. HIV coinfection adds further to the risk, and in some countries, such as South Africa, miners living with HIV are a considerable number. The diagnosis of active tuberculosis superimposed on silicosis is often problematic, especially in initial phases, and chest X-ray and smear examination are particularly important for the diagnosis of pulmonary tuberculosis. Treatment is difficult; directly observed therapy is recommended, a duration of at least eight months is probably needed, drug reactions are frequent and the risk of relapse higher than in non-silicosis patients. TB prevention in silicosis patients is essential and include active surveillance of the workers, periodic chest X-rays, tuberculin skin test or interferon-gamma releasing assay testing, and, importantly, adoption of measures to reduce the exposure to silica dust. Chemoprophylaxis is possible with different regimens and needs to be expanded around the world, but efficacy is unfortunately limited. Silico-tuberculosis is still a challenging health problem in many countries and deserves attention worldwide.

Prevalence of concomitant pulmonary tuberculosis in patients with newly diagnosed silicosis in a tertiary care center in South India

“…17 It is noted that most of the cases are reported from lower-and lower-middle income countries, reason, no Most of the existing literature suggests that male sex and the age of 25-54 years are the greater risks of developing silicosis/silicotuberculosis. 10,13,14 The same is also observed in our study.…”

“…Of 54 patients, 38.9% (21) patients had an occupation of quarry working followed by 18.5% (10) patients that had occupation of bore well digging and tile working. About 11.1% (6) population had occupation of tooth powder factory working, 7.4% (4) patients had road laying, 3.7% (2) had glass factory working, and the least 1.85%…”

“…However, radiological findings of new opacities and pleural effusion in silicosis patients can be suspected for TB. 10 To be specific, progression in nodular profusions or size and changes in distinct patterns may be an indication of concomitant TB. 11 Even in the absence of TB bacilli in the sputum, radiological presentation can be considered for diagnosing TB.…”

Erasmus Syndrome: A Case Report and Literature Review

“…Because its respiratory manifestations and imaging findings can be easily confused with TB, an important differential to rule out among patients with silica exposure is active pulmonary TB. In fact, studies have suggested that silica exposure is a risk factor for the development of TB [ 16 , 17 , 18 ]. A meta-analysis conducted by Ehrlich et al (2021) illustrated an increased likelihood of developing TB among those with occupational exposure to silica dust (relative risk of 4.01, 95% confidence interval 2.88–5.58) [ 17 ].…”

Deadly dust: Silicotuberculosis as a downplayed and overlooked fatal disease in Indonesia

“…Pneumoconiosis is the most frequently found disease among all occupational diseases [ 1 ]. Silicosis is one of the most common pneumoconioses [ 2 ]. Silicosis is a pulmonary fibrosis disease caused by inhalation, retention, and pulmonary reaction to silica crystals that contain silicon dioxide (SiO2) [ 3 ].…”