The Diagnosis and Treatment of Tuberculosis

Abstract

Refugees and asylum seekers are defined in many ways but can be considered as those who did not make a voluntary choice to leave their country of origin and cannot return home in safety. Outcome data are limited and mostly focused on perinatal and mental health but do suggest significant levels of unmet need. This scoping review considered 72 studies where refugees and asylum seekers formed part or all of the population studied. Access to appropriate health care across the WHO European Region is very varied and is overwhelmingly shaped by legal frameworks and the regulation of the migration process. The need for improved communication with asylum seekers and coordinated action between agencies within and beyond the medical system is widely noted. Improved data to support intersectoral working to address the health care needs of asylum seekers and refugees are imperative.

Disseminated Tuberculosis With Cardiac Tamponade in an Immunocompetent Individual

“…The gold standard method for diagnosis is culture from samples collected from the affected organ, most frequently the lung, via sputum, bronchial secretion or bronchoalveolar lavage sampling [7]. If extrapulmonary tuberculosis is suspected, other samples should be investigated such as aspirates, biopsies or body fluids (e.g., urine, stool, pericardial fluid) [7]. The culture method has a high sensitivity but it can take weeks to yield results, so other diagnostic tools should be used for a more rapid diagnosis [7].…”

“…If extrapulmonary tuberculosis is suspected, other samples should be investigated such as aspirates, biopsies or body fluids (e.g., urine, stool, pericardial fluid) [7]. The culture method has a high sensitivity but it can take weeks to yield results, so other diagnostic tools should be used for a more rapid diagnosis [7]. Two methods are frequently employed: direct microscopic demonstration of the pathogen using Ziehl-Neelsen stain and nucleic acid amplification tests (NAAT) [8].…”

Immune status changing helps diagnose osteoarticular tuberculosis

“…World health organization (WHO) estimates that 1.8 billion people, about one-fourth of the global population, are Mycobacterium tuberculosis (M.tb) infected, out of which roughly 10 million contracted tuberculosis (TB) and 1.6 million died of the disease [1][2][3]. Therefore, TB remains a leading global public health problem [4,5].…”

Atypische bakterielle Infektionen an der Hand

“…Dies setzt eine Kenntnis der Erkrankungen trotz seltener Inzidenz voraus. Mycobakterium-tuberculosis-Komplex (M. tuberculosis, M. africanum, M. bovis, M. microti) [1,2,6,8,9] 2019 starben weltweit 1,4 Millionen Menschen an Tuberkulose (TB), so dass diese Erkrankung eine der 10 häufigsten Todesursachen in der Welt ausmacht [10]. Laut "Bericht zur Epidemiologie der Tuberkulose in Deutschland" im Jahr 2019 [11] Eine tuberkulöse Monarthritis des Handgelenks ist zwar laut den Häufigkeitsangaben selten, aber mehrfach in Fallberichten und Fallsammlungen beschrieben [12][13][14][15].…”

“…Die Antibiose richtet sich je nach befallenem Organ und klinischem Befund, sie beträgt bei Lungenund Lymphknotenbefall mindestens 6 Monate, bei Knochen-oder Gelenkbefall mindestens 9 Monate. Ausweichpräparate bei Resistenzen sind Fluoroqinolone, welche nach Absprache mit einem spezialisierten Zentrum bis zu 20 Monate verabreicht werden müssen [9]. In den nachfolgenden Wochen blieb die Situation unverändert, so dass die Indikation zur Revisionsoperation gestellt wurde.…”