Talk:Tuberculosis

Article Checklist for "Tuberculosis"

Workgroup category or categories	Health Sciences Workgroup [Categories OK]
Article status	Developing article: beyond a stub, but incomplete
Underlinked article?	Yes
Basic cleanup done?	Yes
Checklist last edited by	Petréa Mitchell 12:50, 28 April 2007 (CDT)

To learn how to fill out this checklist, please see CZ:The Article Checklist.

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This is for starters, needs lots of work --Peter A. Lipson 13:26, 27 April 2007 (CDT)

Great to see this start! Writing out a plan for the article here is always helpful, or making the headings in the article as an outline. For example- if you want laryngeal tb to be a part, and made the heading I would write it. But maybe you will approach the subject from a different viewpoint than affected systems, you decide how this is best done and we will help. (If we can) Nancy Sculerati 14:45, 27 April 2007 (CDT) P.S. Nice to meet you.

Thanks much!--Peter A. Lipson 17:08, 27 April 2007 (CDT)

Some references

Immunosuppression

Watters DA. Surgery for tuberculosis before and after human immunodeficiency virus infection: a tropical perspective. [Review] [94 refs] [Journal Article. Review] British Journal of Surgery. 84(1):8-14, 1997 Jan. UI: 9043439

Aguado JM. Herrero JA. Gavalda J. Torre-Cisneros J. Blanes M. Rufi G. Moreno A. Gurgui M. Hayek M. Lumbreras C. Cantarell C. Clinical presentation and outcome of tuberculosis in kidney, liver, and heart transplant recipients in Spain. Spanish Transplantation Infection Study Group, GESITRA.[erratum appears in Transplantation 1997 Sep 27;64(6):942]. [Review] [22 refs] [Journal Article. Multicenter Study. Review] Transplantation. 63(9):1278-86, 1997 May 15. UI: 9158022 ACKGROUND: Tuberculosis is unusual in transplant recipients. The incidence, clinical manifestations, and optimal treatment of this disease in this population has not been adequately defined. The present study was undertaken to assess the incidence, clinical features, and response to therapy of Mycobacterium tuberculosis infection in solid-organ transplant recipients. METHODS: We evaluated retrospectively the incidence, clinical characteristics, diagnostic procedures, antituberculous treatment, clinical course, and factors influencing mortality in 51 solid-organ transplant recipients who developed tuberculosis after transplantation. We also reviewed the world literature on tuberculosis in solid-organ transplantation. RESULTS: The overall incidence of tuberculosis was 0.8%. The localization was pulmonary in 63% of the cases, disseminated in 25%, and extrapulmonary in 12%. Tuberculosis developed from 15 days to 13 years after surgery (mean, 23 months). In one third of the cases, diagnosis was not suspected initially, and in three cases, diagnosis was made at necropsy. Fever was the most frequent symptom, followed by constitutional symptoms, cough, respiratory insufficiency, and pleuritic pain. Fifteen patients (33%) developed hepatotoxicity during treatment; hepatotoxicity was severe in seven cases. Hepatotoxicity was higher in patients receiving four or more antituberculous drugs (50%) than in patients receiving three drugs (21%; P=0.03). Serum levels of cyclosporine decreased in the 26 patients under the simultaneous use of rifampin. Nine of them (35%) developed acute rejection, and five (56%) died, in comparison with 3 of 17 patients (18%) who did not develop rejection after the use of cyclosporine and rifampin (P=0.03). Although microbiological response was favorable in 94% of the 35 patients who completed 6 or more months of treatment, 16 other patients (31%) died before diagnosis or in the course of treatment. None of the patients treated for more than 9 months died as a consequence of tuberculosis, whereas the mortality rate was 33% among those treated for 6 to 9 months (P=0.03). Use of antilymphocyte antibodies or high doses of steroids for acute rejection before tuberculosis was associated with a higher mortality rate. CONCLUSIONS: M tuberculosis causes serious and potentially life-threatening disease in solid-organ transplant recipients. Treatment with at least three drugs during 9 months or more, avoiding the use of rifampin, appears to be appropriate. [References: 22]

Extrapulmonary

Long R. Guzman R. Greenberg H. Safneck J. Hershfield E. Tuberculous mycotic aneurysm of the aorta: review of published medical and surgical experience.[see comment]. [Review] [74 refs] [Case Reports. Journal Article. Review] Chest. 115(2):522-31, 1999 Feb. UI: 10027455