We assessed the role of diabetes mellitus (DM) on treatment effects in drug-susceptible initial pulmonary tuberculosis (PTB) patients. A prospective study was conducted in eight provinces of China from October 2008 to December 2010. We enrolled 1,313 confirmed drug-susceptible initial PTB patients, and all subjects received the treatment regimen (2H3R3E3Z3/4H3R3) as recommended by the national guidelines. Of the 1,313 PTB patients, 157 (11.9%) had DM; these patients had more sputum smear-positive rates at the end of the second month [adjusted odds ratios (aOR) 2.829, 95% confidence intervals (CI) 1.783-4.490], and higher treatment failure (aOR 2.120, 95% CI 1.565-3.477) and death rates (aOR 1.536, 95% CI 1.011-2.628). DM was a contributing factor for culture-positive rates at the end of the second month and treatment failure and death of PTB patients, thus playing an unfavorable role in treatment effects of PTB.
Antitubercular Agents ; therapeutic use ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; therapy ; Female ; Humans ; Male ; Mycobacterium tuberculosis ; drug effects ; Tuberculosis, Pulmonary ; complications ; drug therapy ; epidemiology ; microbiology

OBJECTIVE: To analyze the intervention efficacy of lamivudine on liver dysfunction in patients undergoing anti-tuberculosis treatment for pulmonary tuberculosis complicated with chronic hepatitis B.
 METHODS: Corresponding data were retrieved from PubMed, Web of Science, Embase, the Cochrane Library, Chinese Biomedical Literature (CBM), VIP, China National Knowledge Infrastructure (CNKI) and Wanfang Database with randomly controlled trials regarding the chronic hepatitis B and tuberculosis by lamivudine. Statistical analysis was performed by Meta-analysis using Stata11.0.
 RESULTS: Fifteen randomly controlled trials including 967 chronic hepatitis B and tuberculosis cases met the inclusion criteria (564 cases in observation group and 403 cases in control group). Meta-analysis showed that the values of ALT, AST, TBIL and HBV-DNA load in the observation group were lower than those in the control group. The values of standardized mean difference (95% CI) were -2.58 (-3.55, -1.60), -2.43 (-3.33, -1.54), -1.56 (-2.18, -0.94) and -6.91 (-8.90, -4.92), while the combined effect of OR values for liver damage was 0.11 (0.06, 0.19). There were significant differences in the combined effect of each value between the two groups (P<0.05).
 CONCLUSION The intervention efficacy of lamivudine on liver dysfunction in patients undergoing anti-tuberculosis treatment for pulmonary tuberculosis complicated with chronic hepatitis B patients was good, which can reduce hepatitis B viral load levels.
Antitubercular Agents ; therapeutic use ; Antiviral Agents ; therapeutic use ; China ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Tuberculosis, Pulmonary ; complications ; drug therapy ; Viral Load

Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk for developing tuberculosis (TB). However, no studies have been reported regarding the development of nontuberculous mycobacterium (NTM) lung disease (NTMLD). We reviewed 795 patients with IPF from five university hospitals who were diagnosed by histological or radio-clinical criteria. In the 795 patients with IPF, pulmonary infections with mycobacterium tuberculosis (MTB) and NTM were found in 35 (4.4%) and 16 patients (2.0%), respectively, which was a higher frequency than that found in the general population. TB was more common in patients treated with immunosuppressants than in those who did not receive immunosuppressants (2.6% vs 1.4%, P = 0.12). Among the IPF patients who had mycobacterial infections,immunosuppressant users developed TB or NTMLD within 1 yr after treatment with immunosuppressants,while those occurred later than 2 yr after diagnosis of IPF in the subjects that did not receive immunosuppressants. Among 51 IPF patients who had mycobacterial infections, 9 (18%) died during follow-up. Of these, three died due to progression of pulmonary tuberculosis. TB and NTMLD is relatively common in patients with IPF in Korea and may be fatal in some groups. Careful evaluation of TB and NTMLD is necessary not only for immunosuppressant users, but also for nonusers with IPF.
Aged ; Cohort Studies ; Female ; Follow-Up Studies ; Hospitals, University ; Humans ; Idiopathic Pulmonary Fibrosis/complications/*diagnosis/pathology ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; Mycobacterium Infections/complications/*diagnosis/drug therapy ; Mycobacterium Infections, Nontuberculous/*diagnosis/drug therapy/pathology ; Retrospective Studies ; Tuberculosis, Pulmonary/complications/*diagnosis/pathology

No abstract available.
Adult ; Antitubercular Agents/therapeutic use ; Digestive System Fistula/diagnosis/drug therapy/*etiology ; Endoscopy, Digestive System ; Female ; Humans ; Tuberculosis, Pulmonary/*complications/drug therapy/pathology

Mycobacterium celatum is a nontuberculous mycobacterium that rarely causes pulmonary disease in immunocompetent subjects. We describe the successful treatment of M. celatum lung disease with antimicobacterial chemotherapy and combined pulmonary resection. A 33-year-old woman was referred to our hospital with a 3-month history of a productive cough. Her medical history included pulmonary tuberculosis 14 years earlier. Her chest X-ray revealed a large cavitary lesion in the left upper lobe. The sputum smear was positive for acid-fast bacilli, and M. celatum was subsequently identified in more than three sputum cultures, using molecular methods. After 1 year of therapy with clarithromycin, ethambutol, and ciprofloxacin, the patient underwent a pulmonary resection for a persistent cavitary lesion. The patient was considered cured after receiving 12 months of postoperative antimycobacterial chemotherapy. There has been no recurrence of disease for 18 months after treatment completion. In summary, M. celatum is an infrequent cause of potentially treatable pulmonary disease in immunocompetent subjects. Patients with M. celatum pulmonary disease who can tolerate resectional surgery might be considered for surgery, especially in cases of persistent cavitary lesions despite antimycobacterial chemotherapy.
Adult ; Anti-Infective Agents/*therapeutic use ; Female ; Humans ; Lung/*surgery ; Lung Diseases/*drug therapy/*microbiology/*surgery ; Mycobacterium/*metabolism ; Mycobacterium Infections/*drug therapy ; Radiography, Thoracic/methods ; Treatment Outcome ; Tuberculosis, Pulmonary/complications

Aged, 80 and over ; Antitubercular Agents ; therapeutic use ; Biopsy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Mycobacterium tuberculosis ; isolation & purification ; Pneumonia, Lipid ; diagnosis ; drug therapy ; etiology ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; diagnosis ; drug therapy ; etiology ; Zenker Diverticulum ; complications ; diagnosis

Abscess ; diagnosis ; etiology ; therapy ; Antitubercular Agents ; therapeutic use ; DNA, Bacterial ; analysis ; Debridement ; methods ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Metacarpus ; Middle Aged ; Mycobacterium tuberculosis ; genetics ; isolation & purification ; Tuberculosis, Pulmonary ; complications ; drug therapy ; microbiology

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymph node enlargement, and internal organ involvement. So far, numerous drugs such as sulfonamides, phenobarbital, sulfasalazine, carbamazepine, and phenytoin have been reported to cause the DRESS syndrome. We report a case in a 29-yr-old female patient who had been on celecoxib and anti-tuberculosis drugs for one month to treat knee joint pain and pulmonary tuberculosis. Our patient's clinical manifestations included fever, lymphadenopathy, rash, hypereosinophilia, and visceral involvement (hepatitis and pneumonitis). During the corticosteroid administration for DRESS syndrome, swallowing difficulty with profound muscle weakness had developed. Our patient was diagnosed as DRESS syndrome with eosinophilic polymyositis by a histopathologic study. After complete resolution of all symptoms, patch tests were positive for both celecoxib and ethambutol. Although further investigations might be needed to confirm the causality, celecoxib and ethambutol can be added to the list of drugs as having the possibility of DRESS syndrome.
Adult ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Antitubercular Agents/adverse effects ; Arthritis/complications/*drug therapy ; Drug Eruptions/*etiology/pathology ; Eosinophilia/*chemically induced/pathology ; Ethambutol/*adverse effects ; Female ; Humans ; Myositis/chemically induced/pathology ; Pyrazoles/*adverse effects ; Sulfonamides/*adverse effects ; Syndrome ; Tuberculosis, Pulmonary/complications/*drug therapy

BACKGROUND: Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. MATERIAL AND METHOD: A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. RESULTS: The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. CONCLUSION: There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.
Drug Therapy ; Empyema ; Female ; Fistula ; Hemorrhage ; Hope ; Humans ; Incidence ; Male ; Mastectomy, Segmental ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary* ; Wound Infection

Aged ; Anti-Bacterial Agents ; therapeutic use ; Humans ; Levofloxacin ; Middle Aged ; Ofloxacin ; therapeutic use ; Pneumoconiosis ; complications ; Tuberculosis, Pulmonary ; complications ; drug therapy