Background: Diagnosis of pediatric pulmonary tuberculosis (PTB) is a challenge. Symptoms are nonspecific. Young children are unable to expectorate sputum samples;the procedures for obtaining respiratory samples are in...Background: Diagnosis of pediatric pulmonary tuberculosis (PTB) is a challenge. Symptoms are nonspecific. Young children are unable to expectorate sputum samples;the procedures for obtaining respiratory samples are invasive. Thus Mycobacterium tuberculosis cultures and smears often are not performed. Stool samples were used as an alternative to respiratory samples for the diagnosis of pediatric PTB using stool Xpert MTB/RIF and its sensitivity for detecting the DNA of MTB in stool was determined. Methods: The study was a laboratory-based cross-sectional prospective design. Stool specimen was collected from PTB suspected children (<15 years) attended in Gertrude’s Children’s Hospital Nairobi and Kiambu District Hospital from September 2013 to March 2014. Stool for Xpert was processed in two ways, direct and prior extraction of DNA using QIAGEN stool DNA extraction kit. Result: A total sample of 91 stool specimen was collected from patients. Of these 53 (58.2%) had sputum ZN smear microscopy. Six (11.3%) of them were confirmed smear positive for PTB. Stool Gene Xpert was positive in all the six smear positive children. Four (7.5%) smear negative patients tested positive by stool Gene Xpert test. This association is significant (P = 0.000). Conclusion: This study reports that Mycobacterium tuberculosis DNA can be detected in stool using Xpert testing with a higher sensitivity. Therefore stool which can easily be obtained is an appropriate alternative sample for the diagnosis of PTB using Xpert assay for children unable to give respiratory samples. Furthermore Xpert turn round time is less than 2 hours.展开更多
Background: Tuberculosis remains a public health problem worldwide, and tuberculosis in pregnancy in particular can have effects on both mother and infant. Findings: We report a case of a 22- year-old female presentin...Background: Tuberculosis remains a public health problem worldwide, and tuberculosis in pregnancy in particular can have effects on both mother and infant. Findings: We report a case of a 22- year-old female presenting in preterm labor at 32 weeks gestation. Her pregnancy had been complicated by hearing loss and weight loss, and at the time of delivery, she was diagnosed with tuberculous otitis media and disseminated tuberculosis. Tuberculous otitis media is a rare form of tuberculosis disease, and in this case, had consequences for mother and infant. Conclusions: Importance of suspicion for tuberculosis disease in patients presenting with atypical symptoms but epidemiologic history is emphasized.展开更多
结核感染T细胞斑点试验(T-cell spot test for tuberculosis infection,T-SPOT.TB)作为一项新型免疫检测技术已广泛应用于儿童结核病的诊断.大量临床研究表明,相较于儿童结核病的其他诊断方法,斑点试验同时具备较高的灵敏度及较高的特异...结核感染T细胞斑点试验(T-cell spot test for tuberculosis infection,T-SPOT.TB)作为一项新型免疫检测技术已广泛应用于儿童结核病的诊断.大量临床研究表明,相较于儿童结核病的其他诊断方法,斑点试验同时具备较高的灵敏度及较高的特异度.该文章主要对其原理、影响因素、适用范围及其在非血体液中的研究进展进行综述.展开更多
Recurrent parotitis of childhood is a rare condition involving the largest salivary gland. The aetiology is multi-factorial and is usually non-obstructive or non-suppurative type of inflammation. It involves recurrent...Recurrent parotitis of childhood is a rare condition involving the largest salivary gland. The aetiology is multi-factorial and is usually non-obstructive or non-suppurative type of inflammation. It involves recurrent swelling of the parotid gland unilaterally or bilaterally over a period of months to years. Tuberculosis rarely involves the parotid gland, however in developing countries where tuberculosis prevalence is very high, any child with recurrent parotitis should be investigated for the same. We hereby, describe a 2 and half-year-old female child with recurrent parotid gland swelling below the right ear since 6 months. The swelling was acute in onset, gradually increasing in size with no discharge or pain. There was no history of fever, cough, cold, dryness of mouth or eyes, joint pain or rashes. There was history of koch’s contact in the maternal grandfather. A positive mantoux test and significant cervical lymphandenaopathy on Computed Tomography scan was noted. Common causes of recurrent parotitis, i.e. sjogrens syndrome, immunodeficiency and obstruction were ruled out. On the basis of the above history and investigations, the child was diagnosed as tuberculous parotitis.展开更多
文摘Background: Diagnosis of pediatric pulmonary tuberculosis (PTB) is a challenge. Symptoms are nonspecific. Young children are unable to expectorate sputum samples;the procedures for obtaining respiratory samples are invasive. Thus Mycobacterium tuberculosis cultures and smears often are not performed. Stool samples were used as an alternative to respiratory samples for the diagnosis of pediatric PTB using stool Xpert MTB/RIF and its sensitivity for detecting the DNA of MTB in stool was determined. Methods: The study was a laboratory-based cross-sectional prospective design. Stool specimen was collected from PTB suspected children (<15 years) attended in Gertrude’s Children’s Hospital Nairobi and Kiambu District Hospital from September 2013 to March 2014. Stool for Xpert was processed in two ways, direct and prior extraction of DNA using QIAGEN stool DNA extraction kit. Result: A total sample of 91 stool specimen was collected from patients. Of these 53 (58.2%) had sputum ZN smear microscopy. Six (11.3%) of them were confirmed smear positive for PTB. Stool Gene Xpert was positive in all the six smear positive children. Four (7.5%) smear negative patients tested positive by stool Gene Xpert test. This association is significant (P = 0.000). Conclusion: This study reports that Mycobacterium tuberculosis DNA can be detected in stool using Xpert testing with a higher sensitivity. Therefore stool which can easily be obtained is an appropriate alternative sample for the diagnosis of PTB using Xpert assay for children unable to give respiratory samples. Furthermore Xpert turn round time is less than 2 hours.
文摘Background: Tuberculosis remains a public health problem worldwide, and tuberculosis in pregnancy in particular can have effects on both mother and infant. Findings: We report a case of a 22- year-old female presenting in preterm labor at 32 weeks gestation. Her pregnancy had been complicated by hearing loss and weight loss, and at the time of delivery, she was diagnosed with tuberculous otitis media and disseminated tuberculosis. Tuberculous otitis media is a rare form of tuberculosis disease, and in this case, had consequences for mother and infant. Conclusions: Importance of suspicion for tuberculosis disease in patients presenting with atypical symptoms but epidemiologic history is emphasized.
文摘结核感染T细胞斑点试验(T-cell spot test for tuberculosis infection,T-SPOT.TB)作为一项新型免疫检测技术已广泛应用于儿童结核病的诊断.大量临床研究表明,相较于儿童结核病的其他诊断方法,斑点试验同时具备较高的灵敏度及较高的特异度.该文章主要对其原理、影响因素、适用范围及其在非血体液中的研究进展进行综述.
文摘Recurrent parotitis of childhood is a rare condition involving the largest salivary gland. The aetiology is multi-factorial and is usually non-obstructive or non-suppurative type of inflammation. It involves recurrent swelling of the parotid gland unilaterally or bilaterally over a period of months to years. Tuberculosis rarely involves the parotid gland, however in developing countries where tuberculosis prevalence is very high, any child with recurrent parotitis should be investigated for the same. We hereby, describe a 2 and half-year-old female child with recurrent parotid gland swelling below the right ear since 6 months. The swelling was acute in onset, gradually increasing in size with no discharge or pain. There was no history of fever, cough, cold, dryness of mouth or eyes, joint pain or rashes. There was history of koch’s contact in the maternal grandfather. A positive mantoux test and significant cervical lymphandenaopathy on Computed Tomography scan was noted. Common causes of recurrent parotitis, i.e. sjogrens syndrome, immunodeficiency and obstruction were ruled out. On the basis of the above history and investigations, the child was diagnosed as tuberculous parotitis.
