The Experts below are selected from a list of 2307 Experts worldwide ranked by ideXlab platform
Jamilla Rajab - One of the best experts on this subject based on the ideXlab platform.
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Isolated splenic tuberculosis with subsequent Paradoxical deterioration: a case report
BMC Research Notes, 2017Co-Authors: Frederick Wangai, Loice Achieng, George Otieno, Jacqueline Njoroge, Tabitha Wambaire, Jamilla RajabAbstract:Background Isolated tuberculosis of the spleen has been described occasionally in literature, mostly in immunosuppressed individuals with various risk factors. Sequestration in the spleen makes such Mycobacterium tuberculosis infection difficult to diagnose. This report describes an extremely rare case of isolated splenic tuberculosis in an immunocompetent individual. Case presentation A 26 year old Kenyan male presented with pyrexia of unknown origin, with negative screening tests for bacterial, fungal and parasitic infections. Ziehl–Neelsen staining and GeneXpert tests were negative for M. tuberculosis . Diagnosis of isolated splenic tuberculosis was made on core biopsy of the spleen. The patient initially worsened upon treatment with antituberculous medication attributable to the ‘Paradoxical Reaction’ phenomenon, before making full recovery. Conclusions This case highlights the need to continuously be on the lookout for tuberculosis especially in unusual presentations, including subsequent Paradoxical Reaction which may be encountered.
Jin Soo Lee - One of the best experts on this subject based on the ideXlab platform.
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Paradoxical Reaction of tuberculous vertebral osteomyelitis a case series
Infectious diseases, 2015Co-Authors: Ji Hyeon Baek, Hea Yoon Kwon, Jin Soo LeeAbstract:AbstractParadoxical Reactions of tuberculosis (TB) in vertebral osteomyelitis are very rarely reported. We experienced four cases of severe Paradoxical Reactions in tuberculous vertebral osteomyelitis. Four cases of tuberculous vertebral osteomyelitis were confirmed by an acid-fast bacilli smear or culture. The patients were human immunodeficiency virus negative, and were all initially treated with isoniazid, ethambutol, rifampicin and pyrazinamide. Their symptoms improved with anti-TB drugs. However, after 2–12 weeks, their symptoms had recurred, and spinal magnetic resonance imaging at the time of readmission revealed an aggravation of vertebral osteomyelitis. Operations were carried out to relieve severe pain or spinal cord decompression. Through continued anti-TB drug therapy, all patients recovered without sequelae.
Michael Maley - One of the best experts on this subject based on the ideXlab platform.
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017 Paradoxical Reaction in tuberculous meningitis a tertiary referral hospital retrospective experience of concomitant immunosuppression therapy
Journal of Neurology Neurosurgery and Psychiatry, 2018Co-Authors: David Ledingham, Shadi Elwahsh, Cecilia Cappelensmith, Suzanne J Hodgkinson, Alan Mcdougall, Michael MaleyAbstract:Introduction Tuberculous meningitis (TBM) accounts for Methods Retrospective review of 12 HIV-negative patients admitted to Liverpool Hospital, Sydney (2005–2017) with laboratory and/or radiologically confirmed TBM. Results Median age 40 (range 22–81 years), 7 males. Eleven patients were of Asia-Pacific origin. All eleven presented with central nervous system manifestations and 1 had preceding miliary TB. Nine patients had extra-cranial TB involvement, including 8 with past or current pulmonary disease. Cerebrospinal fluid (CSF) TB PCR/culture was positive in 10 patients. One patient had multi-resistant TB. PR of TBM developed in 5 patients despite concomitant corticosteroids in 4. Two cases had refractory PR. Case 1. 22 year old Vietnamese male presented with 6 week history of progressive headache and neck stiffness. CSF demonstrated 61 WCC (75% neutrophils), protein 2.67 g/L (n Case 2. 47 year old Filipino male presented with 3 week history of headache and neck stiffness and 3 day history of fever, dysarthria and diplopia. MRI brain showed basal meningitis, hydrocephalus and left putaminal infarction. CSF demonstrated 245 WCC (35% neutrophils), protein 0.68 g/L, glucose 1.8 mmol/L. Despite concomitant anti-tuberculosis and corticosteroid treatment, the patient developed PR-induced worsening hydrocephalus necessitating ventriculo-peritoneal shunting. Cyclosporin was added with gradual PR resolution. Conclusion Our case series highlights the importance of concomitant corticosteroids in TBM and the potential role of cyclosporin in refractory PR.
Suzanne J Hodgkinson - One of the best experts on this subject based on the ideXlab platform.
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017 Paradoxical Reaction in tuberculous meningitis a tertiary referral hospital retrospective experience of concomitant immunosuppression therapy
Journal of Neurology Neurosurgery and Psychiatry, 2018Co-Authors: David Ledingham, Shadi Elwahsh, Cecilia Cappelensmith, Suzanne J Hodgkinson, Alan Mcdougall, Michael MaleyAbstract:Introduction Tuberculous meningitis (TBM) accounts for Methods Retrospective review of 12 HIV-negative patients admitted to Liverpool Hospital, Sydney (2005–2017) with laboratory and/or radiologically confirmed TBM. Results Median age 40 (range 22–81 years), 7 males. Eleven patients were of Asia-Pacific origin. All eleven presented with central nervous system manifestations and 1 had preceding miliary TB. Nine patients had extra-cranial TB involvement, including 8 with past or current pulmonary disease. Cerebrospinal fluid (CSF) TB PCR/culture was positive in 10 patients. One patient had multi-resistant TB. PR of TBM developed in 5 patients despite concomitant corticosteroids in 4. Two cases had refractory PR. Case 1. 22 year old Vietnamese male presented with 6 week history of progressive headache and neck stiffness. CSF demonstrated 61 WCC (75% neutrophils), protein 2.67 g/L (n Case 2. 47 year old Filipino male presented with 3 week history of headache and neck stiffness and 3 day history of fever, dysarthria and diplopia. MRI brain showed basal meningitis, hydrocephalus and left putaminal infarction. CSF demonstrated 245 WCC (35% neutrophils), protein 0.68 g/L, glucose 1.8 mmol/L. Despite concomitant anti-tuberculosis and corticosteroid treatment, the patient developed PR-induced worsening hydrocephalus necessitating ventriculo-peritoneal shunting. Cyclosporin was added with gradual PR resolution. Conclusion Our case series highlights the importance of concomitant corticosteroids in TBM and the potential role of cyclosporin in refractory PR.
Shadi Elwahsh - One of the best experts on this subject based on the ideXlab platform.
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017 Paradoxical Reaction in tuberculous meningitis a tertiary referral hospital retrospective experience of concomitant immunosuppression therapy
Journal of Neurology Neurosurgery and Psychiatry, 2018Co-Authors: David Ledingham, Shadi Elwahsh, Cecilia Cappelensmith, Suzanne J Hodgkinson, Alan Mcdougall, Michael MaleyAbstract:Introduction Tuberculous meningitis (TBM) accounts for Methods Retrospective review of 12 HIV-negative patients admitted to Liverpool Hospital, Sydney (2005–2017) with laboratory and/or radiologically confirmed TBM. Results Median age 40 (range 22–81 years), 7 males. Eleven patients were of Asia-Pacific origin. All eleven presented with central nervous system manifestations and 1 had preceding miliary TB. Nine patients had extra-cranial TB involvement, including 8 with past or current pulmonary disease. Cerebrospinal fluid (CSF) TB PCR/culture was positive in 10 patients. One patient had multi-resistant TB. PR of TBM developed in 5 patients despite concomitant corticosteroids in 4. Two cases had refractory PR. Case 1. 22 year old Vietnamese male presented with 6 week history of progressive headache and neck stiffness. CSF demonstrated 61 WCC (75% neutrophils), protein 2.67 g/L (n Case 2. 47 year old Filipino male presented with 3 week history of headache and neck stiffness and 3 day history of fever, dysarthria and diplopia. MRI brain showed basal meningitis, hydrocephalus and left putaminal infarction. CSF demonstrated 245 WCC (35% neutrophils), protein 0.68 g/L, glucose 1.8 mmol/L. Despite concomitant anti-tuberculosis and corticosteroid treatment, the patient developed PR-induced worsening hydrocephalus necessitating ventriculo-peritoneal shunting. Cyclosporin was added with gradual PR resolution. Conclusion Our case series highlights the importance of concomitant corticosteroids in TBM and the potential role of cyclosporin in refractory PR.
