• Journal of Korean Neurosurgical Society
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• v.39 no.6
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• pp.451-454
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• 2006

We present a case of a 68-year-old female with an atypical form of spinal tuberculosis, which involved posterior elements with multiple foci in two noncontiguous vertebral levels. The lesions caused spastic paraparesis and urinary hesitation. There was no evidence of pulmonary or other extrapulmonary tuberculous disease. Based on clinical and radiographic findings, this atypical spinal tuberculosis was preoperatively misdiagnosed as metastatic spine tumor. The histopathologic finding confirmed tuberculosis and the patient was treated successfully with surgery and antituberculous therapy. In case of a spinal lesion of unknown origin, it is important to be aware that atypical spinal tuberculosis can mimic metastatic spine tumor and tuberculosis should always be considered.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.600-605
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• 2005

Background : Primary multidrug-resistant tuberculosis is defined as Mycobacterium tuberculosis isolates that are resistant to at least isoniazid and rifampin in never-been-treated tuberculosis patients, and this malady is caused by the transmission of a resistant strain from one patient, who is infected with a resistant Mycobacterium tuberculosis strain, to another patient. The prevalence of primary multidrug-resistant tuberculosis could be a good indicator of the performance of tuberculosis control programs in recent years. We conducted a case-control study to identify the risk factors for primary multidrug-resistant tuberculosis. Methods : From January 1, 2001 to, June 30, 2003, by conducting prospective laboratory-based surveillance, we identified 29 hospitalized patients with P-MDRTB and these patients constituted a case group in this study. The controls were represented by all the patients with culture-confirmed drug susceptible tuberculosis who were admitted to National Masan Hospital during the same study period. The odds ratios for the patients with primary multidrug-resistant tuberculosis, as compared with those of the patients with drug susceptible tuberculosis, were calculated for each categorical variable with 95% confidence intervals. Results : Multivariate logistic regression showed that the presence of diabetes mellitus (odds ratio 2.68; 95% confidence interval, 1.05-6.86) was independently associated with having primary multidrug-resistant tuberculosis. Conclusion : This study has shown that diabetes mellitus might be one of the risk factors for primary multidrug-resistant tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.77 no.2
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• pp.94-97
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• 2014

Empyema necessitatis is a rare complication of an empyema. Although the incidence is thought to be decreased in the post-antibiotic era, immunocompromised patients such as patients with chronic kidney disease on dialysis are still at a higher risk. A 56-year-old woman on peritoneal dialysis presented with an enlarging mass on the right anterior chest wall. The chest computed tomography scan revealed an empyema necessitatis and the histopathologic findings revealed a granulomatous inflammation with caseation necrosis. The patient was treated with anti-tuberculous medication.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.408-411
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• 2021

Tuberculosis (TB)-infected giant bullae are rare. A 55-year-old man was referred when an infected bulla did not respond to empirical treatment. Computed tomography showed a giant bulla in the right upper lobe with an air-fluid level and surrounding infiltrate. Sputum culture, acid-fast bacilli (AFB) stain, and polymerase chain reaction (PCR) for TB were negative. Percutaneous drainage of the bullous fluid was performed. AFB stain and PCR were positive in the drained fluid. The patient was given anti-TB drugs and later underwent obliteration of the pulmonary cavity using talc. To summarize, we report a patient with a TB-infected giant bulla that was treated successfully with anti-TB drugs and obliteration of the pulmonary cavity using talc.

• Tuberculosis and Respiratory Diseases
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• v.71 no.6
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• pp.408-416
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• 2011

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a technique developed to allow mediastinal staging of lung cancer and also to evaluate intrathoracic lymphadenopathy. In a tuberculosis-endemic area, tuberculosis should be considered as an etiology of mediastinal lymphadenopathy. The aim of this study was to investigate the utility of the routine culture for tuberculosis from specimens of EBUS-TBNA. Methods: We prospectively performed routine culture for tuberculosis from aspiration or core biopsy specimens got from 86 patients who had undergone EBUS-TBNA due to mediastinal lymphadenopathy between March 2010 and March 2011. Results: A total of 135 lymph node aspiration and 118 core biopsy specimens were included in this analysis. We confirmed the malignancy in 62 (72.9%), tuberculosis in 7 (8.1%), sarcoidosis in 7 (8.1%), asperogillosis in 2 (2.3%) and pneumoconiosis in 2 (2.3%) patients. One lung cancer patient had pulmonary tuberculosis coincidentally and 5 patients had unknown lymphadenopathy. The number of positive culture for Mycobacterium tuberculsosis by EBUS-TBNA is 2 (1.5%) from 135 lymph node aspiration specimens and 2 (1.7%) from 118 core biopsy specimens. Out of eight patients confirmed with tuberculosis, only one patient had positive mycobacterial culture of aspiration specimen from EBUS-TBNA without histopathologic diagnosis. Conclusion: These results propose that routine culture for tuberculosis from EBUS-TBNA may not provide additional information for the diagnosis of coincident tuberculous lymphadenitis. However, if there is any possibility of tuberculous lymphadenopathy or pulmonary tuberculosis, it should be considered to perform EBUS-TBNA in patients who have negative sputum AFB smears or no sputum production.

• 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.62 no.6
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• pp.531-535
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• 2007

The esophagus is a rate site for rarely involved site of tuberculosis. The most common cause of esophageal tuberculosis is secondary involvement from adjacent tuberculous lymphadenitis. Esophago-nodal or esophagobronchial fistulas may be formed when tuberculous lymph nodes erode the adjacent esophageal or bronchial wall. We report a patient diagnosed with esophageal tuberculosis, which was complicated by an esophago-mediastinal fistula, by endoscopy, sputum acid fast bacilli (AFB) stain, chest computed tomography (CT), and an esophagogram. The patient was treated with antituberculous agents and chest CT and endoscopy showed that the fistula had closed completely.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.39-42
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• 2017

Tuberculosis is primarily a pulmonary disease and extrapulmonary involvement of the oral cavity is an infrequent occurrence accounting for 0.2 - 1.5% of all extrapulmonary sites. The authors report a case of primary tuberculosis of the oral tongue in a 60-years-old male patient who visited the clinic for ongoing tongue pain that he experienced for several months. The lesion was initially indistinguishable from the malignancy, but differential diagnosis was performed on the biopsy with Ziehl-Neelseen stain. After treatment with anti-tuberculosis, the oral lesion healed completely without surgery.

• Journal of Korean Neurosurgical Society
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• v.42 no.5
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• pp.406-409
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• 2007

Craniovertebral junction (CVJ) tuberculosis is a rare disease, potentially causing severe instability and neurological deficits. The authors present a case of CVJ tuberculosis with atlantoaxial dislocation and retropharyngeal abscess in a 28-year-old man with neck pain and quadriparesis. Radiological evaluations showed a widespread extradural lesion around the clivus, C1, and C2. Two stage operations with transoral decompression and posterior occipitocervical fusion were performed. The pathological findings confirmed the diagnosis of tuberculosis. Treatment options in CVJ tuberculosis are controversial without well-defined guidelines. But radical operation (anterior decompression and posterior fusion and fixation) is necessary in patient with neurological deficit due to cord compression, extensive bone destruction, and instability or dislocation. The diagnosis and treatment options are discussed.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.291-294
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• 2005