Tuberculous colitis, an important extra-pulmonary tuberculosis, is still prevalent in the developing countries and has been resurging in the Western world. The duration and dose of anti-tuberculous therapy have not yet been clarified in the tuberculous colitis. We experienced a case of tuberculous colitis, which relapsed after 9 months of therapy. A 28-year-old man presented with hematochezia and was diagnosed as tuberculous colitis on the basis of colonoscopic findings. He was treated with anti-tuberculous agents for 9 months successfully. Three months later, however, he complained of hematochezia again, suggesting the relapse of tuberculous colitis. He had taken anti-tuberculous therapy for another 15 months and showed no evidence of relapse. Although anti-tuberculous therapy is efficient for tuberculous colitis, rare cases of reactivation should be reminded.
Adult ; Colitis/*drug therapy/microbiology ; English Abstract ; Humans ; Male ; Recurrence ; Tuberculosis, Gastrointestinal/*drug therapy

Aged ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Pneumoconiosis ; drug therapy ; microbiology ; Tuberculosis, Multidrug-Resistant ; drug therapy ; microbiology

Tuberculous encephalopathy (TBE) is an important diagnosis in countries with a high prevalence of tuberculosis. TBE is a life-threatening condition but rarely reported in the modern literature. We reported a case of a man with extensive parenchymal lesions involving the brainstem and right cerebellar hemisphere that resolved after treatment. The clinical, laboratory and pathological features of this case are highlighted and the pathogenesis is discussed.
Aged ; Antitubercular Agents ; therapeutic use ; Brain Diseases ; diagnosis ; drug therapy ; microbiology ; Humans ; Hydrocephalus ; diagnosis ; drug therapy ; microbiology ; Male ; Tuberculosis, Central Nervous System ; diagnosis ; drug therapy ; microbiology

A worsening scenario of drug-resistant tuberculosis has increased the need for new treatment strategies to tackle this worldwide emergency. There is a pressing need to simplify and shorten the current 6-month treatment regimen for drug-susceptible tuberculosis. Rifamycins and fluoroquinolones, as well as several new drugs, are potential candidates under evaluation. At the same time, treatment outcomes of patients with drug-resistant tuberculosis should be improved through optimizing the use of fluoroquinolones, repurposed agents and newly developed drugs. In this context, the safety and tolerance of new therapeutic approaches must be addressed.
Animals ; Antitubercular Agents/adverse effects/*therapeutic use ; *Drug Discovery ; *Drug Repositioning ; Drug Resistance, Bacterial ; Drug Therapy, Combination ; Extensively Drug-Resistant Tuberculosis/drug therapy/microbiology ; Humans ; Lung/*drug effects/microbiology ; Mycobacterium tuberculosis/*drug effects/pathogenicity ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant/diagnosis/*drug therapy/microbiology ; Tuberculosis, Pulmonary/diagnosis/*drug therapy/microbiology

Postoperative infections following spine surgery are usually attributable to bacterial organisms. Staphylococcus aureus is known to be the most common single pathogen leading to this infection, and the number of infections caused by methicillin-resistant Staphylococcus aureus is increasing. However, there is a paucity of literature addressing postoperative infection with Mycobacterium tuberculosis. We encountered a case of tuberculous spondylitis after spine surgery. A man had fever with low back pain three weeks after posterior interbody fusion with instrumentation for a herniated intervertebral disc at the L4-L5 level. He had been treated with antibiotics for an extended period of time under the impression that he had a bacterial infection, but his symptoms and laboratory data had not improved. Polymerase chain reaction for Mycobacterium tuberculosis turned out to be positive. The patient's symptoms finally improved when he was treated with antituberculosis medication.
Adult ; Humans ; Low Back Pain/etiology ; Lumbar Vertebrae/surgery ; Male ; Postoperative Complications/*microbiology ; Spondylitis/etiology/*microbiology ; Thoracic Vertebrae/*microbiology/pathology ; Tuberculosis/drug therapy/*microbiology ; Tuberculosis, Spinal/complications/drug therapy/*microbiology

We report a rare case of oculomotor nerve palsy and choroidal tuberculous granuloma associated with tuberculous meningoencephalitis. A 15-year-old male visited our hospital for an acute drop of the left eyelid and diplopia. He has been on anti-tuberculous drugs (isoniazid, rifampin) for 1 year for his tuberculous encephalitis. A neurological examination revealed a conscious clear patient with isolated left oculomotor nerve palsy, which manifested as ptosis, and a fundus examination revealed choroidal tuberculoma. Other anti-tuberculous drugs (pyrazinamide, ethambutol) and a steroid (dexamethasone) were added. After 3 months on this medication, ptosis of the left upper eyelid improved and the choroidal tuberculoma decreasedin size, but a right homonymous visual field defect remained. When a patient with tuberculous meningitis presents with abrupt onset oculomotor nerve palsy, rapid re-diagnosis should be undertaken and proper treatment initiated, because the prognosis is critically dependent on the timing of adequate treatment.
Adolescent ; Antitubercular Agents/therapeutic use ; Blepharoptosis/diagnosis/drug therapy/microbiology ; Choroid Diseases/diagnosis/drug therapy/*microbiology ; Dexamethasone/therapeutic use ; Drug Therapy, Combination ; Ethambutol/therapeutic use ; Glucocorticoids/therapeutic use ; Humans ; Magnetic Resonance Imaging ; Male ; Meningoencephalitis/diagnosis/drug therapy/*microbiology ; Mycobacterium tuberculosis/*isolation & purification ; Oculomotor Nerve Diseases/diagnosis/drug therapy/*microbiology ; Perimetry ; Pyrazinamide/therapeutic use ; Radiography, Thoracic ; Tuberculoma/diagnosis/drug therapy/*microbiology ; Tuberculosis, Meningeal/diagnosis/drug therapy/*microbiology ; Tuberculosis, Ocular/diagnosis/drug therapy/microbiology ; Visual Fields

Antitubercular Agents ; pharmacology ; therapeutic use ; Child ; Drug Resistance, Multiple, Bacterial ; Drug Therapy, Combination ; Humans ; Tuberculosis, Multidrug-Resistant ; drug therapy ; microbiology

OBJECTIVETo compare the clinical characteristics of rifampin-dependent (R-dependent Mycobacterium tuberculosis) and rifampin-resistant (R-resistant Mycobacterium tuberculosis) patients with pulmonary tuberculosis.

METHODSThe clinical data including the demographic data, age groups, course of disease, history of chemotherapy with anti-TB drugs, and results of drug susceptibility test were collected from 61 cases of R-dependent pulmonary tuberculosis and 148 cases of R-resistant pulmonary tuberculosis treated between October, 2008 and January, 2012.

RESULTSMost of the R-dependent and R-resistant patients were between 30 and 44 years of age. The R-dependent patients included 12 receiving the first treatment patients and 49 with previous treatments, and the R-resistant patients included 11 without and 137 with previous treatments. The multi-drug resistant rate was 80.3% in R-dependent group, as compared to 92.6% in R-resistant group.

CONCLUSIONMost of the patients infected with R-dependent Mycobacterium tuberculosis are young or middle-aged, often having serious disease conditions. Detecting rifampin dependence is important for patients with initial treatment failure. Multi-drug resistance therapy guideline should be applied to patients infected with R-dependent Mycobacterium tuberculosis to improve the cure rate.

Adolescent ; Adult ; Aged ; Antitubercular Agents ; pharmacology ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; drug effects ; Rifampin ; pharmacology ; therapeutic use ; Tuberculosis, Multidrug-Resistant ; drug therapy ; microbiology ; Tuberculosis, Pulmonary ; drug therapy ; microbiology ; Young Adult

BACKGROUNDMalnutrition and tuberculosis (TB) tend to interact with each other. TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions. Nutrition support can promote recovery in the subject being treated for TB. The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy.

METHODSEnglish database of the Cochrane Controlled Trials Register, PubMed, EMBASE, and Chinese database of CBM, CNKI, VIP, and WANFANG were searched. Randomized controlled trials comparing nutrition support (given for more than 2 weeks) with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included. Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer. Data were entered and analyzed by RevMan 5.2 software, and meta-analysis was done using risk ratios (RR s) for dichotomous variables and mean differences (MDs) for continuous variables with 95% confidence intervals (CI s).

RESULTSA total of 19 studies (3681 participants) were included. In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears- or culture-negative conversion rate and chest X-ray (CXR) absorption rate were 1.10 (1.04, 1.17) and 1.22 (1.08, 1.39), respectively, the pooled MD and its 95% CI of body mass index (BMI) and time of sputum smears or culture negativity were 0.59 (0.16, 1.2) and - 5.42 (-7.93, -2.92), respectively, compared with the control group. The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant (P = 0.76, 0.24, 0.28, and 0.20, respectively) between the intervention group and the control group. No systemic adverse events were recorded.

CONCLUSIONSDuring anti-TB course, nutrition support may be helpful in treatment of TB patients by improving both sputum smears- or culture-negative conversion rate and BMI, shortening the time of sputum conversion negative. Whether it can improve the final clinical effect, there still needs high-level quality studies to confirm in the future.

Animals ; Antitubercular Agents ; therapeutic use ; Humans ; Malnutrition ; therapy ; Nutritional Support ; Sputum ; microbiology ; Tuberculosis, Pulmonary ; drug therapy ; therapy

Anti-Bacterial Agents ; chemistry ; pharmacology ; Drug Resistance, Bacterial ; drug effects ; Humans ; Mycobacterium tuberculosis ; chemistry ; drug effects ; Tuberculosis, Multidrug-Resistant ; drug therapy ; microbiology