• Title/Summary/Keyword: Diagnosis tuberculosis

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A Case of Miliary Tuberculosis Mimicking ARDS due to Bilateral Severe Pneumonia (양측성 중증 폐렴으로 인한 ARDS로 오진된 속립성 결핵)

  • Han, Koon Hee;Jung, Bock Hyun;Kim, Young Don;Hwang, Jung Won;Hong, Hyun Il;Yoon, Sung Kyu;Kim, Mi Hye;Ryu, Dae Sik;Kang, Gil Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.109-113
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    • 2005
  • Miliary tuberculosis is the most serious form of tuberculous disease, but is rarely complicated with acute respiratory distress syndrome (ARDS). When a patient with miliary tuberculosis initially presents with ARDS, the mortality is much higher. Therefore, the early detection of miliary tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. The diagnosis of miliary tuberculosis may be easy if the patient presents typical clinical manifestations associated with the characteristic pattern of miliary nodules on chest radiology. However, the diagnosis of miliary tuberculosis when complicated with ARDS can be difficult due to the nonspecific radiologic patterns, such as diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. However, these nonspecific patterns are known as less likely findings of miliary tuberculosis. We experienced a pregnant woman with miliary tuberculosis, mimicking ARDS due to bilateral severe pneumonia. She was admitted, via the emergency room, with sudden onset of fever, chill, cough and dyspnea. The initial chest PA and HRCT showed diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. All bacteriological studies, including blood and sputum cultures, tuberculosis-PCR and serologic study for infectious disease were negative. However, the definite diagnosis of unusual miliary tuberculosis as the underlying cause of ARDS was confirmed from the radiological finding and transbronchial fiberoptic lung biopsy. We report this case, with a review of the literature.

Radiological Findings of Lung Cancer: Focus on Atypical Pattern (폐암의 방사선 소견(비전형적 소견을 중심으로))

  • Sung, Dong-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.554-561
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    • 2005
  • The clinical and radiographic findings of lung cancer have been well established many journals. Even if the radiographic findings of lung cancer show a typical pattern, the specific cell type of lung cancer sometimes needs to be determined prior to a pathological diagnosis. For example, the usual finding of a squamous cell carcinoma is similar to other cancer types such as an adenocarcinoma or a small cell carcinoma but with a lower incidence. Therefore, it should not be used to make a diagnosis of the cell type prior to a pathological diagnosis. Many unusual findings of lung cancer, so called atypical pattern have been reported, but atypical findings are widely accepted. The more important thing is not to diagnose a specific cell type of cancer but to differentiate it from other benign conditions such as tuberculosis, fungal infections or organizing pneumonia. This paper presents typical information of the cell type of lung cancer along with the atypical radiographic findings.

Comparison of Different CNN Models in Tuberculosis Detecting

  • Liu, Jian;Huang, Yidi
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.14 no.8
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    • pp.3519-3533
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    • 2020
  • Tuberculosis is a chronic and delayed infection which is easily experienced by young people. According to the statistics of the World Health Organization (WHO), there are nearly ten million fell ill with tuberculosis and a total of 1.5 million people died from tuberculosis in 2018 (including 251000 people with HIV). Tuberculosis is the largest single infectious pathogen that leads to death. In order to help doctors with tuberculosis diagnosis, we compare the tuberculosis classification abilities of six popular convolutional neural network (CNN) models in the same data set to find the best model. Before training, we optimize three parts of CNN to achieve better results. We employ sigmoid function to replace the step function as the activation function. What's more, we use binary cross entropy function as the cost function to replace traditional quadratic cost function. Finally, we choose stochastic gradient descent (SGD) as gradient descent algorithm. From the results of our experiments, we find that Densenet121 is most suitable for tuberculosis diagnosis and achieve a highest accuracy of 0.835. The optimization and expansion depend on the increase of data set and the improvements of Densenet121.

2020 KSC/KATRD Guideline for the Diagnosis and Treatment of Pulmonary Hypertension: Executive Summary

  • Park, Jae-Hyeong;Na, Jin Oh;Lee, Jae Seung;Kim, Yee Hyung;Chang, Hyuk-Jae;Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the Korean Society of Cardiology (KSC) and the Korean Academy of Tuberculosis and Respiratory Diseases (KATRD),
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.1
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    • pp.1-10
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    • 2022
  • Pulmonary hypertension (PH) is a condition of increased blood pressure in the pulmonary arteries and is diagnosed with an increased a mean pulmonary artery pressure ≥25 mm Hg. This condition may be associated with multiple clinical situations. Based on pathophysiological mechanisms, clinical presentation, hemodynamic profiles, and treatment strategies, the patients were classified into five clinical groups. Although there have been major advances in the management of PH, it is still associated with significant morbidity and mortality. The diagnosis and treatment of PH have been performed mainly by following European guidelines, even in Korea because the country lacks localized PH guidelines. European treatment guidelines do not reflect the actual status of Korea. Therefore, the European diagnosis and treatment of PH have not been tailored well to suit the needs of Korean patients with PH. To address this issue, we developed this guideline to facilitate the diagnosis and treatment of PH appropriately in Korea, a country where the consensus for the diagnosis and treatment of PH remains insufficient. This is the first edition of the guidelines for the diagnosis and treatment of PH in Korea, and it is primarily based on the '2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.' with the acceptance and adaptation of recent publications of PH.

pncA Mutations in the Specimens from Extrapulmonary Tuberculosis

  • Lee, Jae-Chun;Yun, Yeo-Jun;Kqueen, Cheah-Yoke;Lee, Jong-Hoo;Kim, Hee-Youn;Kim, Young-Ree;Kook, Yoon-Hoh;Lee, Keun-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.6
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    • pp.475-480
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    • 2012
  • Background: Pyrazinamide (PZA) is an effective antitubercular drug that becomes toxic to Mycobacterium tuberculosis when converted to pyrazinoic acid by pyrazinamidase (PZase), encoded by mycobacterial pncA. A strong association was noted between the loss of PZase activity and PZA resistance. The causative organisms in extrapulmonary tuberculosis are rarely cultured and isolated. To detect pncA mutations in specimens from extrapulmonary tuberculosis as confirmative diagnosis of mycobacterial infection and alternative susceptibility test to PZA. Methods: Specimens were collected from clinically proven extrapulmonary tuberculosis. pncA was sequenced and compared with wild-type pncA. Results: pncA from 30 specimens from 23 donors were successfully amplified (56.6% in specimens, 59% in donors). Six mutations in pncA were detected (20.0% in amplified specimens, 26.1% in specimen donors) at nucleotide positions of 169, 248 and 419. The mutation at position 169 results in substitution of aspartic acid for histidine, a possible allelic variation of M. bovis that have intrinsic PZA resistance. The mutation at position 248 changes proline into arginine and that at position 419, arginine into histidine. Conclusion: DNA-based diagnosis using pncA may be simultaneously useful for the early diagnosis of mycobacterial infection and the rapid susceptibility to PZA in extrapulmonary tuberculosis. A potential implication of pncA allelic variation at 169 might be suggested as a rapid diagnostic test for M. bovis infection or Bacille Calmette-Gu$\acute{e}$rin (BCG) reactivation.

A study on Duration of Treatment and Its Outcome by Characteracterstics of Tuberculosis Patients Registered at the Health Center (보건소등록(保健所登錄) 결핵환자(結核患者)의 특성별(特性別) 치료기간(治療期間) 및 치료귀결(治療歸結)에 관(關)한 연구(硏究))

  • Kim, Kwang-Tae
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.285-292
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    • 1974
  • It is well known fact that many tuberculosis patients have often experienced interuption of treatment while their treatment. Because most of cases were inproved subjective symptome by adequate treatment for 3-6 months and patients misunderstood to be heal completely by their own dicision, It become the cause of emergency of drug resistance and chronic incurable diseases. The author intended to clarify the duration of treatment and its outcome by some characteristics of tuberculosis patients. The results obtained were as follows: 1. The rate of treatment for tuberculosis patients by each duration with 1-6, 7-12, 13-13, 19-24 and 25 or more months were 16, 23, 20, 14 and 25 percents respectively. The duration of treatment increased in patients with advancing age, better educated and registered at health center between 7-12 months after diagnosis for tuberculosis. 2. The rate of complete treatment, defaulters, death and migration were 43, 13, 8, and 10 percents respectively. The rate of complete treatment were high in older, better educated and registered at health center between 7-12 months after diagnosis. The rate of defaulters were high in younger, no educated and registered within 1 month after diagnosis. The rate of death was high in older and migration was high in younger.

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A Case of Intestinal Tuberculosis Concurring with Endobronchial and Laryngeal Tuberculosis (장결핵과 동반된 기관지 내 및 후두 결핵 1례)

  • Kim, Su Jin;Park, Su Eun;Lee, Min Gi;Kim, Gun Il;Lee, Chang Hun;Park, Jae Hong
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.714-717
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    • 2003
  • Although the incidence of tuberculosis has been reduced recently because of the advance of anti-tuberculosis chemotherapy, improvements of public health, and early diagnosis, it is still high in developing countries. Intestinal tuberculosis can occur at any age, but young adults and female are more affected. Early diagnosis of childhood intestinal tuberculosis is difficult, largely because of vague symptoms and nonspecific signs. Recently, tuberculosis of the larynx combined with pulmonary tuberculosis has become quite a rare disease since anti-tuberculous chemotherapy and preventive activities are prevalent. Laryngeal tuberculosis, while relatively well recognized in the adult population, is a rare disease in chidren and adolescents. There are few reports of intestinal tuberculosis combined with endobronchial and laryngeal tuberculosis in children. We have experienced a case of intestinal tuberculosis which concurred with endobronchial and laryngeal tuberculosis in an 18-year-old girl who presented with abdominal pain, diarrhea, weight loss, a brassy cough, and anemia, which was diagnosed by a colonoscopy and bronchoscopy with biopsy.

Calcaneal Osteomyelitis Presenting as a Paradoxical Reaction during Treatment of Multidrug-Resistant Tuberculosis (다제내성 결핵의 치료 중 역설적 반응으로 나타난 종골 골수염)

  • Han, Yong Hyun;Lee, Chang Hwa;Bae, Min Joon;Hwang, Kihun
    • Clinical Pain
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    • v.18 no.2
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    • pp.102-106
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    • 2019
  • Tuberculosis in the foot progresses gradually; thus, diagnosis is usually delayed, and early treatment is rarely provided. If osteomyelitis occurs due to delayed diagnosis and treatment, surgical treatment should be considered. We report the case of a 46-year-old man with osteomyelitis of the calcaneus who was diagnosed with multidrug-resistant pulmonary tuberculosis and he was treated with anti-tuberculosis drugs. Bilateral adrenal masses, abscess of both testes and a small wound in the left plantar heel were observed. Both adrenal masses and abscess were regarded as paradoxical reaction of anti-tuberculosis treatment. After 1 month, he developed a pain in the left plantar heel that was compatible with calcaneal osteomyelitis in radiological features. He underwent right orchiectomy for right scrotal abscess aggravation and surgical treatment for left calcaneal osteomyelitis. Mycobacterium tuberculosis was confirmed by polymerase chain reaction. The patient was immobilized by cast for 8 weeks and the heel pain gradually improved.

A Case of Retrophareangeal Tuberculosis Presenting as a Hypernasal Speech (과비음을 주소로 내원한 후인두의 결핵 1예)

  • Lee, Hyeong Joo;Kim, Dae Hwan;Kim, Jin Pyeong;Park, Jung Je
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.44-46
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    • 2018
  • Tuberculosis of the retropharynx is extremely rare. The diagnosis is frequently delayed because of its anatomical location and atypical symptom. It would be crucial to consider tuberculosis infection as a possible source of abscess and should be mindful about the tests to diagnose it. We experienced a 23-year-old man with retropharyngeal abscess caused by tuberculosis presenting hypernasality and hoarseness in the throat. In this article, we reviewed the etiology, diagnosis, and treatment of this case, with a review of literatures.

Observation on Sputum Cytology in Pulmonary Tuberculosis (폐결핵증 객담의 세포병리학적 관찰)

  • Park, In-Ae;Ham, Eui-Keun;Lee, Sang-Kook
    • The Korean Journal of Cytopathology
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    • v.4 no.2
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    • pp.100-104
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    • 1993
  • Sputum smears of 116 cases in 55 pulmonary tuberculosis patients with the demonstration of acid-fast bacilli in sputum were retrospectively reviewed to investigate the cytologic diagnosis of pulmonary tuberculosis in sputum. Epithelioid cells, multinucleated giant cells of Langhans or nonspecific type, or necrotic materials of caseation or nonspecific nature were found in 40% of the cases, but in 60% of the cases, only nonspecific findings including squamous metaplasia were found. Only in 6% of the cases, the cytologic diagnosis of tuberculosis was possible with the findings of epithelioid cells and muitlnucleated giant cells in a necrotic background.

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