Identification of risk factors and diagnostic methodology in serositis by M. tuberculosis

Autor: Hernández-Solis A; Secretaría de Salud, Hospital General de México “Dr. Eduardo Liceaga”, Unidad de Neumología y Cirugía de Tórax. Ciudad de México, México, González-Villa M, Ramírez-González E, Reding-Bernal A, Sánchez-Valadez T, de la Torriente-Mata R, González-González H, Cícero-Sabido R
Jazyk: Spanish; Castilian
Zdroj: Revista medica del Instituto Mexicano del Seguro Social [Rev Med Inst Mex Seguro Soc] 2018 Nov 30; Vol. 56 (4), pp. 364-370. Date of Electronic Publication: 2018 Nov 30.
Abstrakt: Background: Tuberculosis is a public health problem, extrapulmonary presentations have increased, it is difficult to diagnose because of the low bacillary load.
Objective: To identify risk factors and to evaluate the efficiency of diagnostic methods in pleural, meningeal, peritoneal and pericardial tuberculosis.
Methods: Prospective study of cases and controls. A multiple conditional logistic regression model was used to identify risk factors. Biopsy was performed and 7 mL of fluid was extracted from the affected site, Löwestein-Jensen and MGITI960 culture, Ziehl-Neelsen staining, adenosine deaminase and endpoint PCR directed to the insertion sequence 1S6110 for M. tuberculosis were performed.
Results: 116 patients were included, in 58 M. tuberculosis was confirmed by positive culture (meningeal Tb 34 cases, pleural 14, peritoneal 8, pericardial 2 cases) and 58 serositis of non-tuberculous etiology. Being a carrier of HIV and living with people infected with tuberculosis were the main risk factors OR = 3.6 and OR = 6.8. The staining had sensitivity of 25.9%, PCR of 65.5% and adenosine deaminase with 82.8%
Conclusions: Conventional diagnostic methods had low efficacy, adenosine deaminase and molecular biology techniques are the most useful, in our environment these tests should be performed immediately in patients with risk factors and suspected serositis of tuberculous origin.
Databáze: MEDLINE
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