Context. This study was conducted at the National Tuberculosis Center in Burkina Faso from October 2007 through May 2008. Objective. Our objective was to compare the diagnostic performance of three staining methods: Kinyoun, auramine O, and Ziehl-Neelsen. Methods. Ziehl-Neelsen staining served as the reference method to assess the diagnostic performance of Kinyoun and auramine O staining. In all, 616 sputum smears from 233 patients were read with each method to detect acid-fast bacilli. SPSS was used for data analysis. Results. The results of auramine O staining showed positive diagnoses in 15.9% of the samples; sensitivity was 100%, specificity 95.6%, and the positive and negative predictive values 75.7% and 100% respectively. Kinyoun staining produced a positive diagnosis rate of 12%, sensitivity of 96.4%, specificity of 99.5%, and positive and negative predictive values of 96.4% and 99.5%. Conclusion. Our study indicates that auramine O staining had a better sensitivity for detecting acid-fast bacilli than Kinyoun staining. Accordingly, the use of auramine O staining should increase the detection rate for pulmonary tuberculosis in Burkina Faso.
A 49-year-old man who had recently emigrated from Myanmar presented with a 6-month history of rusty brown sputum with hemoptysis. A tuberculin skin test was positive, but sputum smears were negative for acid-fast bacilli, ova, and parasites.
A 17-year-old boy was assessed because of a 2-month history of pain and swelling on his left hand. He had visited Pakistan 6 months earlier. On examination, a hard nodule was noted around the left third metacarpal. Staining of exudate from the third metacarpal showed acid-fast bacilli.
The purpose of this study was to develop a method for identifying newly diagnosed tuberculosis (TB) patients at risk for TB adverse events in Tamaulipas, Mexico. Surveillance data between 2006 and 2013 (8431 subjects) was used to develop risk scores based on predictive modelling. The final models revealed that TB patients failing their treatment regimen were more likely to have at most a primary school education, multi-drug resistance (MDR)-TB, and few to moderate bacilli on acid-fast bacilli smear. TB patients who died were more likely to be older males with MDR-TB, HIV, malnutrition, and reporting excessive alcohol use. Modified risk scores were developed with strong predictability for treatment failure and death (c-statistic 0·65 and 0·70, respectively), and moderate predictability for drug resistance (c-statistic 0·57). Among TB patients with diabetes, risk scores showed moderate predictability for death (c-statistic 0·68). Our findings suggest that in the clinical setting, the use of our risk scores for TB treatment failure or death will help identify these individuals for tailored management to prevent these adverse events. In contrast, the available variables in the TB surveillance dataset are not robust predictors of drug resistance, indicating the need for prompt testing at time of diagnosis.
Only four cases of primary pituitary tubercular abscess have been reported. A 20-year-old ladypresented to us with headache and pituitary dysfunction. Radiology showedsellar tubercular abscess with suprasellar extension. Microscopic examination of pus collected during surgery showed granulomatous tissues and Acid Fast Bacilli. The response to antitubercular therapy was remarkable.
The objective of this study was to develop a predictive model for final smear-positive (SP) active pulmonary tuberculosis (aPTB) in patients with initial negative acid fast bacilli (AFB) sputum smears (iSN-SP-aPTB) based on high-resolution computed tomography (HRCT).
BCG sepsis is rarely seen with modern intravesical therapy and therefore its presentation may not be apparent to recently trained urologists. We describe BCG sepsis occurring in a patient treated with combined intravesical and intraurethral BCG which resulted in lung consolidation with acid-fast bacilli requiring cessation of BCG and initiation of systemic antibiotic therapy.
The modified acid fast staining technique is a commonly used procedure for the detection of coccidian parasites in developing countries. The morphological variations observed in these parasites play a significant role to some extent in both identification and diagnosis of these parasitic infections. A prospective cross sectional study was performed over three years. The fecal smears were stained by modified Kinyoun acid-fast staining technique and were extensively studied for morphological variations in the coccidian parasites. Out of a total of two thousand one hundred fifty one (n = 2,151) fecal samples received during the study period, 259 samples (12%) were positive for any one of the coccidian parasites. Morphological variations, especially in the staining character was noted in all the three coccidian parasites. This study was an attempt to characterize different variations in size, shape and staining characteristics of the three coccidian parasites.
Tuberculosis is an infection that requires at least 6 months of chemotherapy in order to clear the bacteria from the patient’s lungs. Usually, therapeutic monitoring is dependent on smear microscopy where a decline in acid-fast bacilli is observed. However, this might not be indicative of the actual decline of bacterial load and thus other tools such as culture and molecular assays are required for patient management.
We present a case of ocular tuberculosis (TB) presenting as scleral abscess with choroidal detachment. A 60-year-old woman presented with intense pain, redness, watering and decreased vision in the right eye (RE) for 1 week duration. Slit lamp examination of RE revealed diffuse scleritis with two pus-pointing areas in the supero-temporal quadrant suggesting scleral abscess. Fundus examination of the RE showed choroidal detachment in the temporal and inferior quadrant. Left eye examination was unremarkable. Ziehl-Neelsen staining of scleral biopsy showed acid-fast bacilli. PCR of the scleral tissue was also positive for Mycobacterium tuberculosis genome. The final diagnosis of tuberculous scleral abscess with choroidal detachment was made and patient showed good response to antitubercular treatment. In countries endemic for TB, it should be considered as a differential diagnosis for scleral abscess, since prompt diagnosis and treatment will ensure good visual outcome as depicted in our case.