• Archives of Plastic Surgery
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• v.37 no.5
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• pp.705-707
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• 2010

Purpose: Tuberculous lymphadenitis constitutes about 30% of all types of extrapulmonary tuberculosis. Cervical lymphadenitis is the commonest form (70%), followed by axillary and inguinal. But inguinal tuberculous lymphadenitis is rare form. Especially isolated inguinal tuberculous lymphadenitis was seldom reported. In Korea, that case was not reported. This case emphasizes the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis. Methods: We experienced one case of isolated inguinal tuberculous lymphadenitis. We analyzed clinical features, preoperative assessments and method of treatments. Results: A 37-year-old female patient presented with a painless swelling in the left inguinal region of 12 month's duration. There was no history of urethral discharge, dysuria, genital sores, unprotected sexual contacts or trauma. Examination revealed enlarged left inguinal lymph nodes, $2{\times}1\;cm$, non-tender and firm mass. The external iliac, popliteal, right inguinal and other groups of lymph nodes were normal. Serologic tests, urinary tests and chest radiologic test were normal. The excision of mass was performed under the general anesthesia. A excisional biopsy showed chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. After excision, the primary repair was done and completely healed on postoperative 25 days. Conclusion: The isolated inguinal tuberculous lymphadenitis was rare form of inguinal suppurative mass. Although medical management is the principal mode of therapy of tuberculous adenitis and surgery is rarely necessary, we didn't consider the possibility of tuberculous lymphadenitis in our case. A high index of suspicion is essential for a diagnosis of isolated inguinal tuberculous lymphadenitis. Our case emphasizes this importance and illustrates the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.586-597
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• 1999

Background: Many diagnostic tests have developed to diagnose tuberculosis and other mycobacterial diseases but the diagnosis of tuberculosis relies largely on radiological findings and acid-fast staining of sputum and/or culture. Recently, new serologic diagnostic methods, which are safe and easy to use have been introduced into Korea. In this study, the usefulness of serologic diagnosis for tuberculosis and the disease pattern induced variation of the test were evaluated. Methods: Serological assay was performed upon 108 patients with two test kits, the ICT tuberculosis and the BioSign$^{TM}$TB, which are based upon a rapid immunochromatographic assay technique, capable of being interpreted within 15 minutes. The case groups consisted of 61 patients with active pulmonary tuberculosis(36 patients), extrapulmonary tuberculosis(3 patients), or both(22 patients). Control groups consisted of 47 patients with inactive old pulmonary tuberculosis(17 patients), nontuberculous pulmonary disease(16 patients) and nonpulmonary cardiac disease(14 patients). Results : The diagnostic sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of the ICT tuberculosis were 64.3%, 91.5%, 90.0% and 68.3% respectively. The diagnostic sensitivity, specificity, PPV and NPV of the BioSign$^{TM}$TB were 76.5%, 95.3%, 94.1 % and 78.8% respectively. Differences in sensitivity were not significant between patients with previous history of tuberculosis or patients without prior history of tuberculosis. The ICT tuberculosis test showed higher sensitivity in pulmonary tuberculosis patients(76.5%) than extrapulmonary tuberculosis patients(33.3%). There was no difference in sensitivity between patients with or without cavitary lesion by chest X-ray. Conclusion: Considering high specificity and PPV, serologic diagnosis using a rapid immunochromatographic assay device is another helpful diagnostic method in the diagnosis of tuberculosis, when combined with previous diagnostic methods such as chest X-ray, microbiologic study but it has limitation in terms of confirming the diagnosis for tuberculosis as the only diagnostic method because of relatively low sensitivity and NPV.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.174-179
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• 2006

Tuberculosis still ranks as one of the three most important infectious diseases in the world in terms of morbidity and mortality. In Korea, an increased incidence of tuberculosis has been observed in recent years. With the resurge of tuberculosis, extrapulmonary tuberculosis has increased, too. From this point of view, tuberculous arthritis affecting knee is rare in all forms of tuberculosis, but we can consider tuberculous arthritis in patients with osteomyelitis. We report the case of a 14-month-old male child who presented with fever and swelling on the left knee joint. Histologic examination of knee joint fluid showed consistent with tuberculosis. Ziehl-Neelsen stain of joint fluid was positive for acid-fast bacilli(AFB). The outcome was favorable after treatment with anti-tuberculosis medication. Because clinical signs and symptoms of musculoskeletal tuberculosis in children is more indolent, we can misdiagnose or delay diagnosis. The diagnosis of tuberculous arthritis can be elusive, necessitating a high index of suspicion.

• Advances in pediatric surgery
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• v.19 no.2
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• pp.150-155
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• 2013

Tuberculous Iliopsoas muscle abscess is a rare manifestation in patient with extrapulmonary tuberculosis and hardly observed in developed country. Paradoxical response to anti-tuberculous medication could make difficult therapeutic decision to clinicians. The authors report a case of tuberculous iliopsoas muscle abscess with multiple intraabdominal and thoracic abscesses in 9 year-old-boy who presented paradoxical response to anti-tuberculous treatment.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.207-211
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• 1991

A 31-year-old male has a $11.5{\times}10\;cm$ sized relatively well marginated round mass containing peripheral calcification in left upper lung field on chest roentgenograms and computed tomogram. There are no presenting symptoms including weight loss, and occupational exposures. Definitive diagnosis must differentiate from the variety of diseases whether malignancy or benign, extrapulmonary or intrapulmonary. This report described one case of malignant localized fibrous mesothelioma histologically.

• Tuberculosis and Respiratory Diseases
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• v.61 no.2
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• pp.162-166
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• 2006

The lung is the most common site for the metastasis of extrapulmonary malignant tumors. However, endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are the breast, renal and colorectal carcinomas. Lung metastasis from prostate cancer is often encountered but EBM is rare. We report a 74-year old man with endobronchial metastases from prostatic carcinoma presented with cough. The diagnosis of prostatic cancer and the endobronchial metastasis were confirmed by immunohistological staining with the prostate specific antigen. Hormonal therapy (lutenizing hormone releasing hormone agonist) was applied to this patient.

• Tuberculosis and Respiratory Diseases
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• v.76 no.5
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• pp.245-248
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• 2014

Miliary tuberculosis (TB) is a rare extrapulmonary form of TB, and there have been only two reports of miliary TB associated with infection with multidrug-resistant (MDR)-TB pathogen in an immunocompetent host. A 32-year-old woman was referred to our hospital because of abnormal findings on chest X-ray. The patient was diagnosed with MDR-TB by a line probe assay and was administered proper antituberculous drugs. After eight weeks, a solid-media drug sensitivity test revealed that the pathogen was resistant to ethambutol and streptomycin in addition to isoniazid and rifampicin. The patient was then treated with effective antituberculous drugs without delay after diagnosis of MDR-TB. To the best of our knowledge, this is the first case of miliary TB caused by MDR-TB pathogen in Korea.

• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.144-151
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• 1994

Background: Miliary tuberculosis almost always results from the discharge of infected caseous material into the blood stream, usually from a well hidden lymph node in the presentation of this disease in the past four decades, and although it is seen less frequent1y today than previously, its presentation and manifestation may require greater suspicion and diligence by the physician. We investigated the clinical characteristics, predisposing factors and accompanying diseases of miliary tuberculosis and tried to acquire the early diagnosis and treatment of this disease. Methods: A retrospective clinical study was done on 40 cases of miliary tuberculosis admitted to Hanyang University Hospital from Mar. 1989 to Dec.1992. The study investigated age and sex distribution, seasonal distribution, duration of symptoms before admission, pre-disposing factors, clinical symptoms, biochemical findings, chest X-ray findings, extrapulmonary tuberculosis associated with miliary tuberculosis, prognosis and mortality rate. Results: 1) The patients were most common in the age group between 20 and 29(23%) and the ratio of male to female was 1.4:1(male 23 : female 17). 2) Sputum smears for tubercle bacilli were positive in 5 cases(13%). 3) The most common clinical symptoms were fever with chilling(47.5%), coughing(47.5%), second most common symptom was dyspnea(32.5%), and the physical findings on admission were tachycardia(30%), weight loss(27.5%), meningeal signs(17.5%) in order. 4) The predisposing factors were heavy alcohol drinking(6 cases), steroid use(3 cases), pregnancy(2 cases) etc. 5) The chest X-ray findings on admission were miliary shadow only(40%), in addition pneumonic infiltration, pleurisy, and calcification in order. 6) The extrapulmonary tuberculosis associated with miliary tuberculosis were tuberculous meningitis(30%), bone and joint tuberculosis(17.5%), intestinal tuberculosis(15%) in order. 7) Biochemical findings were increased SGOT/SGPT(32.5%), increased alkaline phosphatase(32.5%), hypoalbuminemia(15%), hyponatremia(15%) etc. 8) About 4-6 weeks later after treatment(INH, RFP, PZA, EMB), 26 cases(65%) were improved on clinical symptoms or chest X-ray, 12 cases(30%) were stationary or aggravated, and 2 cases(5%) were died. Conclusion: For the early diagnosis and treatment of miliary tuberculosis, we must see its presentation and manifestation with greater interest and suspicion and investigate its predisposing factors and accompanying diseases.

• Tuberculosis and Respiratory Diseases
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• v.56 no.5
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• pp.550-554
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• 2004

A paragonimiasis infestation is caused by the paragonimus species. It is commonly found in the lung but has also been found to exist extrapulmonary infestations including cerebral, spinal, subcutaneous, hepatic, splenic, abdominal, urinary, and gynecologic infestation. On the other hand, a cutaneous infestation is extremely rare. Human infestation is caused by ingesting raw or undercooked intermediate hosts. Because paragonimus westermani larva mature to an adult worm in the lung, the possibility of identifying the adult worm of paragonimus westermani at extrapulmonary region is very rare. Case : After ingesting a fresh-water crab 1 month prior to the hospital visit, a 45-year old female patient was suffering from right pleuritic chest pain during that 1 month. The patient also complained of a palpable mass that was movable and migrating, and it was localized at the right upper quadrant of the abdomen. The eosinophil fraction of the white blood cell of peripheral blood and pleural fluid was elevated to 55.1% and 90%, respectively. Parasite eggs were not found in her sputum and stool examination. By using the enzyme-linked immunosorbent assay (ELISA), the paragonimus-specific IgG antibody titer was elevated to 0.28. During incisional biopsy, we were able to find the young adult worm of paragonimus westermani. We experienced the rare case of ectopic paragonimiasis with pleural effusion that was confirmed by identifying the adult worm of paragonimus westermani within the abdominal subcutaneous tissue. We report a case with brief literature reviews.

• The Journal of the Korea Contents Association
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• v.21 no.4
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• pp.487-497
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• 2021

The purpose of this study is to identify factors affecting length of stay(LOS) and death in tuberculosis(TB) patients by disease type, patient characteristic, admission and disease characteristic, and hospital characteristic from 2008 to 2017. Survey data was using Korean national hospital discharge in-depth survey data produced by Korea Disease Control and Prevention Agency. Study subjects were 10,634 inpatients with TB(A15, A16, A17, A18, A19, U88.0, U88.1, U84.30, U84.31) and analyzed frequency, chi-square test, Fisher's exact test, and logistic regression by using STATA 13.0. As a study result, the type of TB(extrapulmonary TB, multidrug-resistant TB, extensively drug-resistant TB), sex(woman), age(35-49, 50-64, 65-74, 75 years old or older), admission type(outpatient department), CCI(1-2 point, 3 point over), hospital location(metropolitan city) and bed size(300-499, 500-999, over 1000) were significantly influence LOS. Also, the type of TB(extrapulmonary TB, extensively drug-resistant TB), sex(woman), age(50-64, 65-74, 75 years old or older), residence(small town/rural), admission type(outpatient department), CCI(1-2 point, 3 point over), hospital location(provincial) were significantly influence death. In conclusion, the existing tuberculosis management has been patient management with rapid diagnosis and treatment following early detection. But other studies should be carried out for the system that identifies and supports high-risk groups of the long-term length of stay in hospital or high mortality rates as a result of treatment.