Tuberculosis infection remains an important cause of mortality. The clinical and radiological manifestations can be non-specific and resemble many other conditions, including malignancies. This could lead to diagnostic delay. We report the case of a 48-year-old woman with tuberculosis presenting with a right upper lobe mass manifesting as metastatic lung cancer. She also had liver cirrhosis secondary to chronic hepatitis B infection. She developed hepatitis two weeks into her tuberculosis treatment. Our case highlights the importance of considering tuberculosis in patients suspected to have underlying malignancy and to be aware of the potential adverse effects of treatment.
Lung Neoplasm ; Neoplasms ; Antitubercular Agents

Paradoxical response refers to the enlargement of old lesions or unexpected appearance of new lesions after initial improvement following treatment with antitubercular agents. Various types of paradoxical responses have been reported in the world, but they are rarely reported in Korean children. We report the case of a 17-year-old boy who was diagnosed with tuberculous pleurisy and was treated appropriately. Although the tuberculous pleurisy initially responded to medication with resolution of the pleural fluid, a new pulmonary lesion subsequently developed 3 weeks after the initiation of treatment that eventually cleared with continuation of the original drug regimen.
Adolescent ; Antitubercular Agents ; Child ; Humans ; Tuberculosis, Pleural

BACKGROUND: A paradoxical response is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion after initial improvement during theprocess of antituberculous treatment. The related factors for the development of a paradoxical response in patients with tuberculous pleurisy are not certain. METHODS: We selected patients with tuberculous pleurisy who had been treated for more than 4 months. The changes onthe serial chest X-ray findings before and after treatment were reviewed. Paradoxical responses were regarded as any worsening or development of new lesion at least 2 weeks after the initiation of treatment. The baseline clinical characteristics and laboratory findings of the peripheral blood and pleural fluid were compared between the patients with a paradoxical response and the patients without a paradoxical response. RESULTS: Paradoxical responses appeared in sixteen patients (21%) among the 77 patients.It took a mean of 38.6 days after the treatment and the time to resolve the paradoxical response was a mean of 32.1 days. For the patients with a paradoxical response, the median age was younger (30.5 years vs 39.0 years, respectively) and the lymphocytic percentage of white blood cells in the pleural fluid was higher (82.1% vs 69.6%, respectively) than for the patients without a paradoxical response. CONCLUSION: The development of a paradoxical response during the treatment of patients with tuberculous pleurisy was not rare and this was related with the age of the patients and the percentage of lymphocytic white blood cells in the pleural fluid.
Antitubercular Agents ; Humans ; Leukocytes ; Thorax ; Tuberculosis, Pleural

Antitubercular Agents/therapeutic use* ; Axilla ; Humans

Antitubercular Agents ; standards ; Child ; Humans ; Tuberculosis ; drug therapy ; prevention & control

Anti-tuberculosis drugs can produce levels of hepatotoxicity ranging from mild elevation of aminotransferase to severe acute hepatitis. A few cases of drug-induced autoimmune hepatitis or the drug reaction with eosinophilia and systemic symptom (DRESS) syndrome by anti-tuberculosis medications have been reported. However, concomitant occurrence of these two disorders has not been reported. Here, we present a case of severe acute hepatitis with DRESS syndrome and autoimmune hepatitis resulting from primary standard anti-tuberculosis drugs. Both conditions were successfully treated with a systemic steroid regimen.
Antitubercular Agents ; Drug Hypersensitivity Syndrome ; Eosinophilia* ; Ethambutol* ; Hepatitis ; Hepatitis, Autoimmune* ; Isoniazid*

Tuberculosis of the breast is a rare disease. Its diagnosis is difficult because clinical and radiological appearances are not specific and because isolation of the tubercle bacillus from the lesion is seldom possible. This disease is more common in women between 20 to 40 years of age, but is rare in male, elderly patients and prepubertal women. Difinite diagnosis rests on bacterilogical proof and histopathological findings -formation of a granuloma and usually caseous necrosis with or without demonstrable acid-fast bacilli. Treatment of the disease requires a combination of surgery and antitubercular drugs. We experienced 10 cases of tuberculosis of the breast and report with on them along a literature review.
Aged ; Antitubercular Agents ; Bacillus ; Breast* ; Diagnosis ; Female ; Granuloma ; Humans ; Male ; Necrosis ; Rare Diseases ; Tuberculosis*

OBJECTIVETo describe the current situation and explore risk factors to irregularly antipulmonary tuberculosis(TB) drugs taking in smear positive TB patients.

METHODSFour out of the forty counties in Chongqing were randomly sampled according to the levels of social and economic development. Totally, 405 new patients with smear positive tuberculosis were systematically sampled and a household survey was carried out. A multiple logistic regression model was fitted to explore the risk factors to irregularly anti-TB drugs taking.

RESULTSOf valid 401 cases, 50 (12.47%) did not take their drugs regularly and the top 3 reasons for irregular drugs taking were: (1) Adverse effects; (2)Economic hardship; (3) Stopped taking drugs when symptom disappeared. Results from multiple logistic regression analysis showed that factors as: self-perceived economical burden, awareness on TB before being infected and awareness on the fact that if anti-TB drugs can be stopped if the symptoms disappeared, were statistically significant to irregularly drugs taking.

CONCLUSIONStrengthening health education program and alleviation of economical burden might serve as two effective measures for regularly drugs taking among TB patients.

In recent studies some urea derivatives have been identified as potent anti-tuberculosis agents by targeting mycobacterial membrane protein large 3 (MmpL3). However, this compound series as exemplified by AU1235 exhibited poor in vitro pharmacokinetic profile. With AU1235 as the lead, we have identified a novel benzimidazole series as potential anti-tuberculosis agents by using scaffold hopping approach. Among these synthesized compounds, 2-aminobenzimidazole derivative 8b showed the potent anti-tuberculosis activity with the MIC value of 0.03 microg x mL(-1). This compound also showed improved metabolic stability compared to AU1235. Our investigation indicated that benzimidazole derivatives are the promising lead for further optimization as anti-tuberculosis agents.
Antitubercular Agents ; pharmacology ; Benzimidazoles ; chemistry ; pharmacology ; Drug Design ; Humans ; Structure-Activity Relationship ; Tuberculosis ; drug therapy

Antitubercular Agents ; pharmacology ; Drug Resistance, Bacterial ; genetics ; Genotype ; Mycobacterium tuberculosis ; classification ; drug effects ; genetics