Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory featu...Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory features of PCR-confirmed periocular TB. We retrospectively reviewed medical records of presumptive periocular TB and performed nested PCR test to confirm diagnosis. Nine cases were recruited. Clinical symptoms were chronic and insidious. Eight cases achieved favorable visual acuity, while one underwent enucleation due to fungalTB panophthalmitis. Sensitivity of caseous necrosis, acidfast bacilli（AFB） staining and interferon γ release assay（T-SPOT） test are 33.3%, 44.4% and 85.7% respectively. Low lymphocyte percentage（P=0.019） and high monocytelymphocyte ratio（P=0.042） positively correlate with AFB staining. Male gender（P=0.048） and Langhans giant cell（P=0.048） positively correlate with caseous necrosis. To conclude, traditional TB ancillary tests are not as sensitive as nested PCR technique. Several factors facilitate diagnosis including male gender, decreased lymphocytes, and typical Langhans giant cells.展开更多
Objective: In Ethiopia where there are limited diagnostic facilities, the actual burden of tuberculosis (TB) lymphadenitis is not well known. Therefore, we conducted this study to determine the proportion of TB lympha...Objective: In Ethiopia where there are limited diagnostic facilities, the actual burden of tuberculosis (TB) lymphadenitis is not well known. Therefore, we conducted this study to determine the proportion of TB lymphadenitis (TBL) in childhood and adults in Northwest Ethiopia. Materials and Methods: A prospective cross sectional study was conducted from April to May 2012. Fine needle aspiration cytology (FNAC) for cytological diagnosis of TBL was used. The diagnosis of TBL was established when cytological features from lymph node aspirates are strongly suggestive of TB. Descriptive and multivariate analysis was done using SPSS version 16. Results: Out of 1070 patients attending the cytological diagnosis in the study sites 437 (41%) were positive for TBL. Of the 437 registered TBL, 59 (13.5%) were pediatric patients and 378 (86.5%) were adults. There were more females than males with a male to female ratio of 0.8:1. The cervical region had the most common group of TBL with 321 (73.2%) patients. Most of all these patients 314 (75.3%), were matted with a majority of (250/314) being in the cervical region. Individuals who had contact history with TB patients (P = 0.046) were more likely to have TBL. Conclusions: In the studied region high prevalence of TBL was documented. Screening of TBL particularly for those who had contact with TB patients is recommended. Most patients in our study presented with matted lymph nodes, indicating that late arrival of patients to health institutions. Thus continuous and intensified public health strategies on health education and early referral system have to be done in order to link them to health institutions earlier than at present.展开更多
The caseous calcification of the mitral annulus (CCMA) is a rare variant of the mitral annulus calcification (MAC), with prevalence of 0.067% in general population. It is usually an asymptomatic condition but rarely i...The caseous calcification of the mitral annulus (CCMA) is a rare variant of the mitral annulus calcification (MAC), with prevalence of 0.067% in general population. It is usually an asymptomatic condition but rarely it can cause severe mitral valve dysfunction, embolization, and conduction abnormalities. Transthoracic echocardiography (TTE) is a useful diagnostic tool. However, it can be necessary a multi-modality imaging approach for a differential diagnosis among other intra-cardiac masses. We are presenting a case of CCMA in an 88-year-old woman admitted to our department for acute decompensation of chronic heart failure. TTE has shown pathognomonic findings of CCMA. Tridimensional trans-esophageal echocardiography (3D TEE) gave a better characterization of the CCMA, avoiding further diagnostic procedures.展开更多
Mitral Annular Calcification (MAC) is a degenerative process involving the fibrous ring of the mitral valve. Caseous Calcification of Mitral Annulus (CCMA) is a rare variant of MAC. This condition is benign and usuall...Mitral Annular Calcification (MAC) is a degenerative process involving the fibrous ring of the mitral valve. Caseous Calcification of Mitral Annulus (CCMA) is a rare variant of MAC. This condition is benign and usually needs no treatment. This is a case report of a 67-year-old woman with non-specific symptoms in whom a cardiac tumor was suspected by transthoracic Echocardiography. The use of multi-modality imaging strategy with transesophageal Echocardiography and cardiac MR scanning revealed however the diagnosis of CCMA and spared the patient an unnecessary operation.展开更多
基金Supported by National Natural Science Foundation of China (No.81800867)
文摘Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory features of PCR-confirmed periocular TB. We retrospectively reviewed medical records of presumptive periocular TB and performed nested PCR test to confirm diagnosis. Nine cases were recruited. Clinical symptoms were chronic and insidious. Eight cases achieved favorable visual acuity, while one underwent enucleation due to fungalTB panophthalmitis. Sensitivity of caseous necrosis, acidfast bacilli（AFB） staining and interferon γ release assay（T-SPOT） test are 33.3%, 44.4% and 85.7% respectively. Low lymphocyte percentage（P=0.019） and high monocytelymphocyte ratio（P=0.042） positively correlate with AFB staining. Male gender（P=0.048） and Langhans giant cell（P=0.048） positively correlate with caseous necrosis. To conclude, traditional TB ancillary tests are not as sensitive as nested PCR technique. Several factors facilitate diagnosis including male gender, decreased lymphocytes, and typical Langhans giant cells.
文摘Objective: In Ethiopia where there are limited diagnostic facilities, the actual burden of tuberculosis (TB) lymphadenitis is not well known. Therefore, we conducted this study to determine the proportion of TB lymphadenitis (TBL) in childhood and adults in Northwest Ethiopia. Materials and Methods: A prospective cross sectional study was conducted from April to May 2012. Fine needle aspiration cytology (FNAC) for cytological diagnosis of TBL was used. The diagnosis of TBL was established when cytological features from lymph node aspirates are strongly suggestive of TB. Descriptive and multivariate analysis was done using SPSS version 16. Results: Out of 1070 patients attending the cytological diagnosis in the study sites 437 (41%) were positive for TBL. Of the 437 registered TBL, 59 (13.5%) were pediatric patients and 378 (86.5%) were adults. There were more females than males with a male to female ratio of 0.8:1. The cervical region had the most common group of TBL with 321 (73.2%) patients. Most of all these patients 314 (75.3%), were matted with a majority of (250/314) being in the cervical region. Individuals who had contact history with TB patients (P = 0.046) were more likely to have TBL. Conclusions: In the studied region high prevalence of TBL was documented. Screening of TBL particularly for those who had contact with TB patients is recommended. Most patients in our study presented with matted lymph nodes, indicating that late arrival of patients to health institutions. Thus continuous and intensified public health strategies on health education and early referral system have to be done in order to link them to health institutions earlier than at present.
文摘The caseous calcification of the mitral annulus (CCMA) is a rare variant of the mitral annulus calcification (MAC), with prevalence of 0.067% in general population. It is usually an asymptomatic condition but rarely it can cause severe mitral valve dysfunction, embolization, and conduction abnormalities. Transthoracic echocardiography (TTE) is a useful diagnostic tool. However, it can be necessary a multi-modality imaging approach for a differential diagnosis among other intra-cardiac masses. We are presenting a case of CCMA in an 88-year-old woman admitted to our department for acute decompensation of chronic heart failure. TTE has shown pathognomonic findings of CCMA. Tridimensional trans-esophageal echocardiography (3D TEE) gave a better characterization of the CCMA, avoiding further diagnostic procedures.
文摘Mitral Annular Calcification (MAC) is a degenerative process involving the fibrous ring of the mitral valve. Caseous Calcification of Mitral Annulus (CCMA) is a rare variant of MAC. This condition is benign and usually needs no treatment. This is a case report of a 67-year-old woman with non-specific symptoms in whom a cardiac tumor was suspected by transthoracic Echocardiography. The use of multi-modality imaging strategy with transesophageal Echocardiography and cardiac MR scanning revealed however the diagnosis of CCMA and spared the patient an unnecessary operation.
