TB or not TB? Difficulties in the diagnosis op tuberculosis in HIV-negative immigrants to Germany
<p>Abstract</p> <p>Background</p> <p>Immigrants to Germany and their children are at particular risk for tuberculosis (TB).</p> <p>Methods</p> <p>35 Patients (10 male/25 female aged 2 - 59 years (median 33 years) originating mostly from high inci...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2011-09-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | http://www.eurjmedres.com/content/16/9/381 |
| _version_ | 1818205867450826752 |
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| author | Singh DD Vogel M Müller-Stöver I el Scheich T Winzer M Göbels S Hüttig F Heinrich S MacKenzie G Jensen B Reuter S Häussinger D Richter J |
| author_facet | Singh DD Vogel M Müller-Stöver I el Scheich T Winzer M Göbels S Hüttig F Heinrich S MacKenzie G Jensen B Reuter S Häussinger D Richter J |
| author_sort | Singh DD |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Immigrants to Germany and their children are at particular risk for tuberculosis (TB).</p> <p>Methods</p> <p>35 Patients (10 male/25 female aged 2 - 59 years (median 33 years) originating mostly from high incidence countries in Asia (19 [54.3%]) in Africa (14 [40.0%] and East Europe (2 [5.7%]), attended at the Tropical Medicine unit were analysed.</p> <p>Results</p> <p>Primary clinical presentation was most frequently lymphadenitis (13 [37.1%]). other organs involved included bones (7 [20.0%]), central nervous system (5 [14.3%]), urogenital organs (3 [8.6%]), lung (3 [8.6%]), mediastinum, (2 [5.7%]) and abdomen (2 [5.7%]). ESR was abnormal in 21/28 (75.0%), CRP in 20/35 (57.1%), and protein electrophoresis in 22/26 (84.6%) cases. The tuberculin skin test was strongly positive in all 15 cases where the test had been performed. Tuberculosis interferon gamma release assay (TB-IGRA) was positive in all 35 cases (100%). PCR for nucleic acids of <it>Mycobacterium (M.) tuberculosis </it>complex was positive in only 7/20 (35.0%) cases. <it>M. tuberculosis </it>was identified in 32/35 (91.4%), <it>M. bovis </it>in 2 (5.7%) cases. 1 case was diagnosed clinically. All patients were negative for HIV. Typical histopathology was seen in the 29 cases, where biopsies had been taken. Chest-X-ray did not reveal specific pulmonary lesions in the majority of cases (22/35 [62.9%]). Diagnosis of TB was mostly delayed (4 to 299 weeks, [median 8]). The most frequent primary suspicion was a malignancy (17/35 [48.6%]) while TB was initially suspected in 5 cases only. Diagnosis of TB is impeded by its multifaceted presentation especially in immigrants.</p> |
| first_indexed | 2024-12-12T04:03:57Z |
| format | Article |
| id | doaj.art-626d8f3c5d764fbdb3fea2e2e6890657 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-12-12T04:03:57Z |
| publishDate | 2011-09-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-626d8f3c5d764fbdb3fea2e2e68906572022-12-22T00:38:50ZengBMCEuropean Journal of Medical Research2047-783X2011-09-0116938110.1186/2047-783X-16-9-381TB or not TB? Difficulties in the diagnosis op tuberculosis in HIV-negative immigrants to GermanySingh DDVogel MMüller-Stöver Iel Scheich TWinzer MGöbels SHüttig FHeinrich SMacKenzie GJensen BReuter SHäussinger DRichter J<p>Abstract</p> <p>Background</p> <p>Immigrants to Germany and their children are at particular risk for tuberculosis (TB).</p> <p>Methods</p> <p>35 Patients (10 male/25 female aged 2 - 59 years (median 33 years) originating mostly from high incidence countries in Asia (19 [54.3%]) in Africa (14 [40.0%] and East Europe (2 [5.7%]), attended at the Tropical Medicine unit were analysed.</p> <p>Results</p> <p>Primary clinical presentation was most frequently lymphadenitis (13 [37.1%]). other organs involved included bones (7 [20.0%]), central nervous system (5 [14.3%]), urogenital organs (3 [8.6%]), lung (3 [8.6%]), mediastinum, (2 [5.7%]) and abdomen (2 [5.7%]). ESR was abnormal in 21/28 (75.0%), CRP in 20/35 (57.1%), and protein electrophoresis in 22/26 (84.6%) cases. The tuberculin skin test was strongly positive in all 15 cases where the test had been performed. Tuberculosis interferon gamma release assay (TB-IGRA) was positive in all 35 cases (100%). PCR for nucleic acids of <it>Mycobacterium (M.) tuberculosis </it>complex was positive in only 7/20 (35.0%) cases. <it>M. tuberculosis </it>was identified in 32/35 (91.4%), <it>M. bovis </it>in 2 (5.7%) cases. 1 case was diagnosed clinically. All patients were negative for HIV. Typical histopathology was seen in the 29 cases, where biopsies had been taken. Chest-X-ray did not reveal specific pulmonary lesions in the majority of cases (22/35 [62.9%]). Diagnosis of TB was mostly delayed (4 to 299 weeks, [median 8]). The most frequent primary suspicion was a malignancy (17/35 [48.6%]) while TB was initially suspected in 5 cases only. Diagnosis of TB is impeded by its multifaceted presentation especially in immigrants.</p>http://www.eurjmedres.com/content/16/9/381TuberculosisMycobacterium<it>M. tuberculosis</it><it>M. bovis</it>migrantschildrenlymphomaneoplasiadiagnosticstuberculin skin testTBC-IGRA |
| spellingShingle | Singh DD Vogel M Müller-Stöver I el Scheich T Winzer M Göbels S Hüttig F Heinrich S MacKenzie G Jensen B Reuter S Häussinger D Richter J TB or not TB? Difficulties in the diagnosis op tuberculosis in HIV-negative immigrants to Germany European Journal of Medical Research Tuberculosis Mycobacterium <it>M. tuberculosis</it> <it>M. bovis</it> migrants children lymphoma neoplasia diagnostics tuberculin skin test TBC-IGRA |
| title | TB or not TB? Difficulties in the diagnosis op tuberculosis in HIV-negative immigrants to Germany |
| title_full | TB or not TB? Difficulties in the diagnosis op tuberculosis in HIV-negative immigrants to Germany |
| title_fullStr | TB or not TB? Difficulties in the diagnosis op tuberculosis in HIV-negative immigrants to Germany |
| title_full_unstemmed | TB or not TB? Difficulties in the diagnosis op tuberculosis in HIV-negative immigrants to Germany |
| title_short | TB or not TB? Difficulties in the diagnosis op tuberculosis in HIV-negative immigrants to Germany |
| title_sort | tb or not tb difficulties in the diagnosis op tuberculosis in hiv negative immigrants to germany |
| topic | Tuberculosis Mycobacterium <it>M. tuberculosis</it> <it>M. bovis</it> migrants children lymphoma neoplasia diagnostics tuberculin skin test TBC-IGRA |
| url | http://www.eurjmedres.com/content/16/9/381 |
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