Tomografía computarizada y reacción en cadena de la polimerasa en la infección tuberculosa de la infancia

Durán, D. Gómez-Pastrana; Mateo, P. Caro; Santiago, R. Torronteras; Quesada, María Luisa Anguita; Barrio, Antonio María López; Martín, Arturo Sousa; González, J.

doi:10.1016/s0300-2896(15)30684-0

Cited by 12 publications

(4 citation statements)

References 30 publications

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“…13,26,27 These findings created controversy over the need of performing TCT systematically and treating presence of adenopathies as active disease. Authors such as Gómez-Pastrana 28,29 and Moreno Pérez et al 7 defend its usefulness in symptomatic children with normal or doubtful CXR to determine the area affected by TB and to check whether patient's symptoms are related to TB. However, asymptomatic children they consider that moderate increase in pulmonary lymph nodes is naturally related to primary infection with TB and usually resolved spontaneously.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of thoracic CT to diagnose tuberculosis disease in patients younger than 4 years of age

Garrido

Hernández

Perales

et al. 2012

Pediatric Pulmonology

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Section: Discussionmentioning

confidence: 99%

Usefulness of thoracic CT to diagnose tuberculosis disease in patients younger than 4 years of age

Garrido

Hernández

Perales

et al. 2012

Pediatric Pulmonology

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“…In these clinical presentations, the Ziehl‐Neelsen stain for acid‐fast bacilli in smears tends to be negative, making it necessary to wait for culture of the bacteria, which typically takes at least 2 weeks, in order to confirm the diagnosis [1]. The use of DNA amplification methods for the detection of Mycobacterium tuberculosis in respiratory samples has yielded encouraging results, even in children [2–6], but there is little reported experience with clinical samples other than sputum.…”

Section: Results Of Two Culture Techniques Used and Time Taken For Thmentioning

confidence: 99%

The use of a genetic amplification technique (LCx MTB) to diagnose extrapulmonary tuberculosis

Torres-Lana

Lecuona

Hernández-Gracia

et al. 1999

Clinical Microbiology and Infection

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Concise Communications 6 5performed in a primary and secondary healthcare center and it possibly indicates the colonization rate of the community. This first VRE clinical isolate of the VanB phenotype is probably the tip of the vancomycin resistance 'iceberg' in our hospital. It indlcates a possible need for adjustments in the testing of vancomycin resistance and in VRE carriage surveillance in all tertiary-care institutions, since the transfer of seriously ill patients h m one hospital to another is common practice. Clinical laboratories must adopt a sensitivity testing method that is able to recognize the VanB phenotype, and should also apply a surveillance program for VRE based on the agar-screening test. They must also try to reinforce the infection control policies, to reduce the risk of nosocomial transmission of VRE. References 1. 2.3. 4. 5.6. MurrayBE. The life and times of the enterococcus. Clin Microbiol Rev 1990; 3: 46-65. Chenoweth C, Shaberg D. The epidemiology of enterococci. Eur J Clin Microbiol Infect Dis 1990; 9 80-9. Murray BE. What can we do about vancomycin-resistant enterococci? Clin Infect Dis 1995; 20: 1134-6. Jordens JZ, Bates J, Gri6ths DT. Faecal carriage and nosocomial spread of vancomycin-mistant Enterococasfaccium. J Antimicrob Chemother 1994; 3 4 515-28. Van der Auwera P, Pensart N, Korten V, M u p y B, Ledercq R. Influence of oral glycopeptide on the fecal flora of human volunteers: selection of highly glycopeptide-resistant enterococci. J Infect Dis 1996; 173: 1129-36. Dutka-Mallen S, Even S, C o d n P. Detection of glycopeptide mistance genotypes and idendcation to the species level of clinically relevant enterococci by P C R J Clin Microbiol 1995; 33(1): 24-7. 7. Murray BE. Diversity among multidrug-resistant enterococci. 8. 9 10. 11. 12. 13.14. 15. 16. Emerg Infect Dis1998; 4(1): 3 7 4 7 . Leqlerc R, Derlot E, D u d J, Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in EnterommcsfarEium. N Engl J Med 1988; 319 15761. Swenson JM, Clark NM, Ferraro MJ, et al. Development of a standardized screening method for detection of vancomycinresistant enterococci. J Clin Microbiol 1997; 3 2 0 : 17004. Giamarcllou H, Xirouchaki E, the Amfiaraeion Center for Chemotherapeutic Studies. Epidemiology of nosocomid Entero-COCNS spp. isolates from hospitals in Athens [abstract 1551. In: Program and absacts of the 23rd Panhellenic Medical Conference, Athens, Greece. Athens: Athens Medical Society, 1997 41. WHONET Greece. Susceptibility results of Gnm-positive cocci for the period Jan-Dec 1997. Arch Hellenic Med 1998; 15(2): 221-2. Douboyas J, Tsakris A. Prevalence of antibiotic resistance among enterococci isolated in Greece. J Antimicrob Chemother 1995; 35: 236-8. Tsakris A, Pournaras S, Douboyas J. Changes in antimicrobial resistance of enterococci isolated in Greece. J Antimicrob Chemother 1997; 4 0 735-7. Papaparaskevas J, Stefanou J, Tdvn M, Zoga P, Matsas M, Avlami A. Using the WHONET softwve to monitor antibiotic resistance in a large teaching hospital; results for the y...

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“…Later, another group performed CT with intravenous contrast on 22 children with a positive tuberculin test, asymptomatic, normal chest X-ray and negative culture. In 14 of them (63 %) lymph nodes, mainly in the paratracheal chains, were found that had been missed on the chest X-ray; PCR was positive in 4 children with an abnormal CT and in none with a normal CT 32 . Subsequent studies have reported similar results in 50 % and 58 % of children with tuberculosis infection in whom an increases in the size of hilar or mediastinal lymph glands were detected by CT, which had not been seen in the chest X-ray (Sanchez y Altet en Comunicaciones a la XXIX Reunión de la SENP, Bilbao 2007).…”

Section: Ct In Children With Tuberculosis Infection and With No Apparmentioning

confidence: 99%

“…The presence of lymph glands in other locations was considered abnormal. Another study took as a reference 14 children who were being screened for lung metastases and considered a size greater than 5 mm as abnormal 32 . Some authors consider that any gland observed using CT as pathological [33][34] .…”

Section: According To the Size Of The Lymph Glandsmentioning

confidence: 99%

Should pulmonary computed tomography be performed in children with tuberculosis infection without apparent disease?

Gómez‐Pastrana¹,

Carceller-Blanchard²

2007

An Pediatr (Barc)

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Background During early childhood, in particular, there is a continuum between tuberculosis infection and disease. When establishing the diagnosis in a child with suspected tuberculosis, the distinction between infection and disease frequently depends on the interpretation of the chest X-ray. Some studies have shown hilar and mediastinal lymphadenopathies on computed tomography (CT) in children with tuberculosis infection without apparent disease, i.e., asymptomatic children with a positive tuberculin skin test and normal chest X-ray. These observations raise the issue of whether pulmonary CT should be performed in children with tuberculosis infection without apparent disease and whether different types of therapy should be administered depending on the results. Methods We reviewed the physiopathology of tuberculosis infection and disease, diagnostic methods and treatment, and the literature on the use of pulmonary CT scan in pediatric tuberculosis. Results Modern CT scanners indicate hilar and mediastinal lymphadenopathies in many of the children with tuberculosis infection with no apparent disease on chest X-rays. However, neither the size nor the morphology of these adenopathies allows active tuberculosis to be diagnosed. The natural history of childhood tuberculosis indicates that most children show hilar lymphadenopathies after the primary infection, although progression to disease is rare and is characterized by the presence of clinical symptoms. The exceptions are children younger than 4 years old and those with immune alterations who more frequently show progression of infection to disease and who require close follow-up. In addition, the experience accumulated over many years in the treatment of tuberculosis infection with isoniazid has shown this drug to be effective in both short-and long-term prevention of active disease. Official guidelines and expert opinion do not recommend systematic pulmonary CT scan in these children or modification of treatment according to the results. Conclusions Hilar and mediastinal lymph nodes are frequently found in the CT scans of children with tuberculosis infection without apparent disease but there is no evidence that these adenopathies indicate active disease or that these children require different treatment. Consequently, until demonstrated otherwise, pulmonary CT scanning and changes in chemoprophylaxis are not justified in children with tuberculosis infection.

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Tomografía computarizada y reacción en cadena de la polimerasa en la infección tuberculosa de la infancia

Cited by 12 publications

References 30 publications

Usefulness of thoracic CT to diagnose tuberculosis disease in patients younger than 4 years of age

Usefulness of thoracic CT to diagnose tuberculosis disease in patients younger than 4 years of age

The use of a genetic amplification technique (LCx MTB) to diagnose extrapulmonary tuberculosis

Should pulmonary computed tomography be performed in children with tuberculosis infection without apparent disease?

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