• Title/Summary/Keyword: anti-tuberculosis

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Medical Management of Drug-Resistant Tuberculosis

  • Jeon, Doosoo
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.168-174
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    • 2015
  • Drug-resistant tuberculosis (TB) is still a major threat worldwide. However, recent scientific advances in diagnostic and therapeutic tools have improved the management of drug-resistant TB. The development of rapid molecular testing methods allows for the early detection of drug resistance and prompt initiation of an appropriate treatment. In addition, there has been growing supportive evidence for shorter treatment regimens in multidrug-resistant TB; and for the first time in over 50 years, new anti-TB drugs have been developed. The World Health Organization has recently revised their guidelines, primarily based on evidence from a meta-analysis of individual patient data (n=9,153) derived from 32 observational studies, and outlined the recommended combination and correct use of available anti-TB drugs. This review summarizes the updated guidelines with a focus on the medical management of drug-resistant TB.

Studies on the anti-pulmonary tuberculosis of Inonotus obliquus (차가버섯의 항결핵 활성에 대한 연구)

  • Song, Ho-Yeon;Lee, Dae-Jin;Lee, Byung-Eui
    • Journal of Mushroom
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    • v.9 no.4
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    • pp.190-193
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    • 2011
  • Inonotus obliquus is a traditional medicine mushroom that was developed from traditional medicine originating in ancient. It has been applied for cancer or immunotherapy, but its effect on pulmonary tuberculosis is not reported. Therefore, we measured the pulmonary tuberculosis therapeutic effect of methyl alcohol extract from MGIT 960 system with fluorescent indicator. Inonotus obliquus extract showed 14 day more inhibitory activity than the positive control. In addition, the anti-pulmonary tuberculosis activity of Inonotus obliquus was $50{\mu}m$. These results suggest that Inonotus obliquus methyl alcohol extracts could contribute to inhibition of pulmonary tuberculosis.

Diagnosis and Treatment of Extrapulmonary Tuberculosis

  • Lee, Ji Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.47-55
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    • 2015
  • Extrapulmonary tuberculosis (EPTB) constitutes about 20% of all cases of tuberculosis (TB) in Korea. Diagnosing EPTB remains challenging because clinical samples obtained from relatively inaccessible sites may be paucibacillary, thus decreasing the sensitivity of diagnostic tests. Whenever practical, every effort should be made to obtain appropriate specimens for both mycobacteriologic and histopathologic examinations. The measurement of biochemical markers in TB-affected serosal fluids (adenosine deaminase or gamma interferon) and molecular biology techniques such as polymerase chain reaction may be useful adjuncts in the diagnosis of EPTB. Although the disease usually responds to standard anti-TB drug therapy, the ideal regimen and duration of treatment have not yet been established. A paradoxical response frequently occurs during anti-TB therapy. It should be distinguished from other causes of clinical deterioration. Surgery is required mainly to obtain valid diagnostic specimens and to manage complications. Because smear microscopy or culture is not available to monitor patients with EPTB, clinical monitoring is the usual way to assess the response to treatment.

The Patterns of Acquiring Anti-Mycobacterial Drug Resistance by Susceptible Strains of Mycobacterium tuberculosis (항결핵제 감수성 결핵에서의 내성 변화 추이)

  • Lee, Kyutaeg;Chong, Moo-Sang
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.137-142
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    • 2021
  • This study investigated the patterns of acquiring anti-mycobacterial resistance in individuals who were susceptible to all anti-mycobacterial drugs in their initial treatment. From 2010 to 2019, anti-mycobacterial drug susceptibility tests were conducted on patients who were referred to the Green Cross Laboratories. The test results of 594 anti-mycobacterial drug sensitivity tests were collected at 111 medical institutions. The first test results had 594 cases in which all anti-mycobacterial drugs were susceptible. Isoniazid (INH), rifampin (RIF), streptomycin (SM), and quinolone (QUI) showed the highest single-resistant conversion rates. Out of 56 patients, 17 patients (30.4%) showed a high conversion rate of resistance to both INH and RIF. The tracking period was analyzed from a minimum of 98 days to 1,862 days, and an average of 435.6 days for INH, and a minimum of 108 days to 1,673 days, with an average of 457.7 days for RIF. In the case of tuberculosis patients who are susceptible to all anti-mycobacterial drugs, it is considered that the conversion to resistant and multi-drug resistant tuberculosis (MDR-TB) must be confirmed through an anti-mycobacterial susceptibility test after 3 months. It is hoped that this study will help the national tuberculosis management project to improve public health.

Anti-tuberculosis effects of frankincense through immune responses of Mycobacterium tuberculosis-infected macrophages (결핵균이 감염된 대식세포의 면역반응을 통한 유향(Frankincense)의 항결핵효과)

  • Son, Eun-Soon;Lee, Sun Kyoung;Cho, Sang-Nae;Park, Hae-Ryoung;Lee, Jong Seok
    • Korean Journal of Food Science and Technology
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    • v.53 no.6
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    • pp.756-760
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    • 2021
  • Frankincense has been used as a traditional medicine for treating rheumatoid arthritis, dermatitis, and muscle pain. In this study, the anti-tuberculosis effects of Frankincense were evaluated in immune responses of macrophages. Frankincense methanol extract was not cytotoxic to the host. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide reduction assay using human macrophage (THP-1) cells did not show cytotoxic effects or morphological changes with treatments of 31.3, 62.5, and 125 ㎍/mL Frankincense methanol extract (FRM). Inhibitory effects of Frankincense methanol extract on the growth of Mycobacterium tuberculosis in human macrophages were investigated. The immune response was measured by monitoring the levels of TNF-α and IL-1β in THP-1 cells with or without M. tuberculosis infection under Frankincense methanol extract treatment. Inflammatory cytokine levels and M. tuberculosis numbers were reduced in THP-1 cells treated with Frankincense methanol extract. Therefore, Frankincense methanol extract could be used as a potential anti-tuberculosis agent.

The Patterns of Conversion to Anti-Tuberculosis Drug Resistance in Mycobacterium tuberculosis (결핵균의 항결핵제 내성 전환 패턴)

  • Chong, Moo-Sang;Lee, Kyutaeg
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.125-132
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    • 2022
  • The prevalence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) are increasing. We analyzed the patterns of drug resistance and tracking period days of acquiring anti-mycobacterial resistance. From January 2010 to December 2019, drug susceptibility tests (DST) were performed by the absolute concentration method using the Löwenstein-Jensen solid medium and pyrazinamidase activity test (to assess pyrazinamide resistance) in samples from patients who were referred to the Green Cross Laboratories in Yongin. Among the cases that showed resistance to one or more anti-tuberculosis drugs, 55 patients (33.1%) were resistant to isoniazid (INH) at the time of initial referral, and the rates for the development of resistant anti-tuberculosis drugs were ethambutol (EMB) (26.6%), rifampicin (RFP) (21.9%), quinolones (QUI) (21.9%) and pyrazinamide (PZA) (10.9%), in that order. In the cases sensitive to all 10 anti-tuberculosis drugs initially, the development of resistance to INH was the most frequent, seen in 43 patients (7.2%). The average follow-up period was 435.6 days, and the resistance development was observed in the order of INH (7.2%), RFP (3.9%), SM (1.9%), QUI (0.7%), amikacin (AMK) (0.5%), and EMB (0.5%). The conversion of susceptible strains to resistant strains is an important warning sign for the patient, especially in cases of conversion to MDR or XDR. This information would be helpful for improving patient care during TB treatment.

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 Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy

  • Lee, Suhyeon;Yu, Yeonsil;An, Jinyoung;Lee, Jeongmin;Son, Jin-Sung;Lee, Young Kyung;Song, Sookhee;Kim, Hyeok;Kim, Suhyun
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.4
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    • pp.178-183
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    • 2014
  • Here, we report a case of pulmonary paragonimiasis that was improved with initial anti-tuberculosis (TB) therapy but confused with reactivated pulmonary TB. A 53-year-old Chinese female presented with a persistent productive cough with foul smelling phlegm and blood streaked sputum. Radiologic findings showed subpleural cavitary consolidation in the right upper lobe (RUL). Bronchoscopic and cytological examination showed no remarkable medical feature. She was diagnosed with smear-negative TB, and her radiologic findings improved after receiving a 6-month anti-TB therapy. The chest CT scans, however, obtained at 4 months after completion of anti-TB therapy showed a newly developed subpleural consolidation in the RUL. She refused pathologic confirmation and was re-treated with anti-TB medication. Nevertheless, her chest CT scans revealed newly developed cavitary nodules at 5 months after re-treatment. She underwent thoracoscopic wedge resection; the pathological examination reported that granuloma caused by Paragonimus westermani. Paragonimiasis should also be considered in patients assessed with smear-negative pulmonary TB.