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Tuberculosis in Childhood and Pregnancy
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Lindsay H. Cameron, Jeffrey R. Starke
Tuberculosis of the superficial lymph nodes, historically referred to as scrofula, is the most common form of extrapulmonary tuberculosis in children, accounting for approximately 67% of cases.63,67 Historically, scrofula was usually caused by drinking unpasteurized cow's milk laden with Mycobacterium bovis. However, through effective veterinary control, M. bovis has been nearly eliminated from North America. Most current cases of tuberculous lymphadenitis occur within 6–9 months of the initial infection, although some cases arise years later. The tonsillar, anterior cervical, submandibular, and supraclavicular nodes become involved secondary to extension of a primary lesion of the upper lung fields or abdomen. Infected lymph nodes in the inguinal, epitrochlear, or axillary regions result from regional adenitis associated with tuberculosis of the skin or skeletal system.
Diseases of the Hepatobiliary Tree and Pancreas Associated with Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
In many cases of hepatic tuberculosis, the principal clinical manifestations are of a general and nonspecific nature, and liver involvement is often inapparent. Occasionally, when the liver is severely affected, hepatic manifestations may predominate. It should be appreciated that the primary site of tuberculosis may be hidden. Tuberculous involvement of the liver may take one of several forms: Miliary (micronodular)Local (a) Tuberculoma (macronodular)(b) Abscess(c) Granulomatous hepatitis (see section “Inflammation Involving the Liver”, subsection “Granulomatous Hepatitis”.)(d) Tuberculous lymphadenitis
Infectious Diseases
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Vas Novelli, Delane Shingadia, Huda Al-Ansari
Complete surgical excision of involved lymph nodes is the definitive treatment for non-tuberculous lymphadenitis. If this is not possible, then a period of antituberculous chemotherapy may be necessary (up to 6 months usually). Pending results of sensitivity testing, a regimen of clarithromycin 15 mg/kg/day and rifampicin 10 mg/kg/day, with or without ethambutol 15 mg/kg/day, is often used.
Tuberculosis screening among newly arrived asylum seekers in Denmark
Published in Infectious Diseases, 2022
Kristina Langholz Kristensen, Marie Norredam, Sidse Graff Jensen, Niels Seersholm, Marie Louise Jørgensen, Banoo Bakir Exsteen, Franziska Grundtvig Huber, Ebbe Munk-Andersen, Troels Lillebaek, Pernille Ravn
Among the 2,244 asylum seekers who attended the health assessment, two TB cases were identified (Figure 1). The first case (case #1) was identified at the initial health assessment where the asylum seekers presented with symptoms suggestive of TB. Thus, the asylum seeker was not identified as part of the active TB screening study. This was an African-born asylum seeker with weight loss, night sweats and enlarged lymph nodes. The CXR was normal and sputum smear and -cultures were negative. A lymph node biopsy showed caseous necrosis, which was interpreted as tuberculous lymphadenitis. The second TB case (case #2) was identified with both CXR- and sputum culture screening. This was an African-born asylum seeker with a CXR suggestive of TB. The asylum seeker was asymptomatic, sputum smear-negative but culture-positive and diagnosed with pulmonary TB. In both cases, standard treatment was initiated. However, case #2 was lost to follow-up after 2 months of treatment.
A Novel CD40L Mutation Associated with X-Linked Hyper IgM Syndrome in a Chinese Family
Published in Immunological Investigations, 2020
Liangshan Li, Jing Ji, Mengmeng Han, Yinglei Xu, Xiao Zhang, Wenmiao Liu, Shiguo Liu
The proband was admitted to hospital for the first time with 38.9°C of high fever and a small size of lump under left axilla at the age of 2 months on December 20, 2017. He was considered to be inflammatory infection due to the increased WBC. Although his fever was relieved after anti-infection symptomatic treatment, the lump gradually enlarged and was purulent with redness and swelling. Physical examinations indicated on February 9, 2018: A lump about 4.0 × 4.0 × 3.0 cm in size could be touched under the left axilla and the epidermis was ulcerated. The healing of left upper limb scar was poor. Laboratory tests: 16 KDa antibody (−), 38KDa antibody (−), LAM antibody (−), Mycobacterium tuberculosis IgM (−), IgG (−). Puncture cytology of the left axillary lump suggested tuberculous inflammation with infection. Chest CT showed bronchitis. Immunologic evaluation was shown in Table 1. Given antituberculosis and anti-infection treatment, the patient underwent focal cleaning of tuberculous lymphadenitis in the left axilla on February 14, 2018. Postoperative pathology showed lymphadenitis tuberculosa. Acid-fast bacilli (2+).
Mycobacterium scrofulaceum disease: experience from a tertiary medical centre and review of the literature
Published in Infectious Diseases, 2019
John W. Wilson, Anil C. Jagtiani, Nancy L. Wengenack
In a study assessing the cause of cervical lymphadenitis due to mycobacteria in patients between 1 and 12 years of age compared to those older than 12 years in the US, M. scrofulaceum and MAC accounted for 92% of infections in the 1–12 years old group and M. tuberculosis accounted for 95% of infections in patients older than 12 years [11]. Indeed, cervical tuberculous lymphadenitis remains a common form of extrapulmonary tuberculosis in adults and children from countries where tuberculosis is endemic [12]. In our patient series, we identified only one paediatric patient with cervical lymphadenitis. However, our centre has a notably smaller paediatric patient population compared to adults and to that of paediatric hospitals. Aside from MAC and M. scrofulaceum, other NTM species less commonly reported in cases of paediatric head and neck lymphadenitis include M. fortuitum complex, M. malmoense, M. terrae complex, M. marinum and M. haemophilum [13].