• Title/Summary/Keyword: Latent tuberculous infection

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Treatment of latent tuberculous infection in children and adolescent (소아청소년기 잠복결핵 감염의 치료)

  • Kim, Jong-Hyun
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.519-528
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    • 2009
  • Tuberculosis continues to cause an unacceptably high toll of disease and death among children worldwide. Whereas intense scientific and clinical research efforts into novel diagnostic, therapeutic, and preventive interventions have focused on tuberculosis in adults, childhood tuberculosis has been relatively neglected. However, children are particularly vulnerable to severe disease and death following infection, and those with latent infection become the reservoir for future transmission following disease reactivation in adulthood, fuelling future epidemics. Therefore, it is very important to understand the significance, diagnosis and treatment of latent tuberculous infection to decrease a future disease burden of tuberculosis. Unfortunately, these concept still have not fully implicated in Korean National Tuberculosis Control Program, it should be engaged and enforced as soon as possible.

A Case of Peritoneal Tuberculosis Developed after Infliximab Therapy for Refractory RA

  • Min, Ji-Yeon;Bang, So-Young;Min, Seung-Yeon;Lee, Dae-Sung;Kim, Bo-Sang;Kim, Jeong-Eun;Lee, Eun-Sung;Pyo, Ju-Yeon;Sohn, Jang-Won;Kim, Tae-Hyung;Lee, Hye-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.4
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    • pp.234-238
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    • 2012
  • Recently, interferon gamma releasing assay has been recommended to compensate the tuberculin skin test (TST) for screening for latent tuberculosis infection (LTBI). Although it improved the detection of LTBI before treatment with tumor necrosis factor blocker, its application to immune suppressed patients is limited. We report a case of peritoneal tuberculosis (TB) developed in a patient who tested positive for TST and QuantiFERON-TB Gold (QFT-G) before infliximab therapy, to emphasize the importance of monitoring during treatment. A 52-year-old woman presented with abdominal distension. She had been diagnosed with seropositive rheumatoid arthritis six years ago. She had started taking infliximab six months ago. All screening tests for TB were performed and the results of all were negative. At admission, the results of repeated TST and QFT-G tests were positive. Histopathological examination confirmed peritoneal TB. The patient started anti-TB therapy and the symptoms were relieved.

Sensitivity of Whole-Blood Interferon-Gamma Release Assay According to the Severity and the Location of Disease in Patients with Active Tuberculosis (활동성 결핵의 중증도 및 병변 부위에 따른 전혈 인터페론 감마 분비능 측정의 민감도)

  • Kim, Yi-Young;Lee, Jae-Hee;Lee, Yoon-Jee;Lee, So-Yeon;Lee, Yong-Hun;Choi, Keum-Ju;HwangBo, Yup;Cha, Seung-Ick;Park, Jae-Yong;Jung, Tae-Hoon;Park, Jun-Sik;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.2
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    • pp.125-131
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    • 2011
  • Background: The clinical manifestation of $M.$ $tuberculosis$ infection ranges from asymptomatic latent infection, to focal forms with minimal symptoms and low bacterial burdens, and finally to advanced tuberculosis (TB) with severe symptoms and high bacillary loads. We investigated the diagnostic sensitivity of the whole-blood interferon-${\gamma}$ release assay according to the wide spectrum of clinical phenotypes. Methods: In patients diagnosed with active TB that underwent $QuantiFERON^{(R)}$ (QFT) testing, the QFT results were compared with patients known to be infected with pulmonary tuberculosis (P-TB) and extra-pulmonary TB (EP-TB). In addition, the results of the QFT test were further analyzed according to the radiographic extent of disease in patients with P-TB and the location of disease in patients with EP-TB. Results: There were no statistical differences in the overall distribution of QFT results between 177 patients with P-TB and 84 patients with EP-TB; the positive results of QFT test in patients with P-TB and EP-TB were 70.1% and 64.3%, respectively. Among patients with P-TB, patients with mild extents of disease showed higher frequency of positive results of QFT test than that of patients with severe form (75.2% vs. 57.1%, respectively; p=0.043) mainly due to an increase of indeterminate results in severe P-TB. Patients with TB pleurisy showed lower sensitivity by the QFT test than those with tuberculous lymphadenitis (48.8% vs. 78.8%, respectively; p=0.019). Conclusion: Although QFT test showed similar results between overall patients with P-TB and EP-TB, individual sensitivity was different according to the radiographic extent of disease in P-TB and the location of disease in EP-TB.