24 de março: Dia Mundial de Combate a Tuberculose
tuberculose
Diagnosis of opportunistic infections: HIV co-infections – tuberculosis.
diagnosis_of_opportunistic_infections___hiv-99413
Excelente revisão. Muito além do bK de escarro e PPD.
Aos Residentes: leitura obrigatória.
Latent Tuberculosis: New Testing Recommendations
CDC supports the new USPSTF recommendations for latent tuberculosis testing, and a larger role for primary care clinicians in identifying patients for testing.
Fonte: Latent Tuberculosis: New Testing Recommendations
Excelente revisão sobre novos e antigos métodos de diagnóstico de tuberculose latente, e o que fazer com essa informação, do ponto de vista do CDC.
WHO: TB Kills More Than HIV and Malaria, More Effort Needed
With at least three people dying of TB per minute, global actions and investments fall far short of those needed to end the global TB epidemic, the WHO says.
Fonte: WHO: TB Kills More Than HIV and Malaria, More Effort Needed
Antiretroviral therapy improves survival among TB-HIV co-infected patients who have CD4+ T-cell count above 350cells/mm(3) | Read by QxMD
BACKGROUND: Co-infection with Mycobacterium tuberculosis remains a leading cause of morbidity and mortality among HIV infected individuals especially in developing countries. Early initiation of cART in these patients when CD4+ T cell count is less than 200cells/mm(3) has reduced disease progression and mortality. However for patients with higher CD4+ T cell counts greater than 350cells/mm(3) evidence is conflicting. In this study we seek to evaluate the effectiveness of cART in reducing mortality among TB-HIV co-infected patients with CD4â+âT cells above 350cells/mm(3) at the time of TB diagnosis. METHOD: In a retrospective cohort study we analyzed 337 HIV-TB co-infected patients with CD4+ T cells above 350cells/mm(3) at baseline who were diagnosed between 2006 and 2012 in the southern province of Zambia. The primary outcome was all-cause mortality. We estimated the effect of cART by comparing survival according to cART and controlling for differential loss to follow-up. RESULTS: Of the 257 patients on cART, 22 died (9 %) and 20 (8 %) were lost to follow-up; of 80 patients not on cART, 20 died (25 %) and 19 (24 %) were lost to follow-up. Patients treated with cART had better survival compared to those not treated (Pâ<â0â·â0001, log-rank test). In a proportional hazard regression adjusting for Cotrimoxazole, the risk of death was reduced by 78 % with cART (95 % CI: 0â·â47, 0â·â91). In a propensity score analysis, the effect of cART was still beneficial. CONCLUSION: In patients with HIV-associated TB and CD4+ T cells above 350cells/mm(3), treatment with cART reduced mortality for up to 4 years as compared to no cART and was associated with better retention in care.
Imagem: caverna tuberculosa.
Paciente da nossa enfermaria, recidiva de tuberculose, com BAAR + no escarro.
WHO: TB Kills More Than HIV and Malaria, More Effort Needed
With at least three people dying of TB per minute, global actions and investments fall far short of those needed to end the global TB epidemic, the WHO says.
Fonte: WHO: TB Kills More Than HIV and Malaria, More Effort Needed
E ainda tem quem ache que a tuberculose está em declínio.
imagem: ciclo da tuberculose
Da pagina 
All Things Microbial
Pathogenic Life Cycle of M. tuberculosis
M. tuberculosis infection initiates when fine aerosol particles containing the bacteria coughed up by an individual with active disease are deposited in the lower lungs of a new host. The bacteria recruit macrophages to the surface of the lung, which become infected, and serve to transport the bacteria across the lung epithelium to deeper tissues. A new round of macrophage recruitment to the original infected macrophage is initiated, forming the granuloma, an organized aggregate of differentiated macrophages and other immune cells. The granuloma in its early stages expands infection by allowing bacteria to spread to the newly arriving macrophages. As adaptive immunity develops, the granuloma can restrict bacterial growth. However, under many circumstances, the infected granuloma macrophages can undergo necrosis, forming a necrotic core that supports bacterial growth and transmission to the next host.
Dica da página veio da minha grande mestra em microbiologia, a Dra Angela von Nowakonski.
Incidência de tuberculose nas prisões é 28 vezes maior que na população em geral
Incidência de tuberculose nas prisões é 28 vezes maior que na população em geral
Típica noticía nova-velha. Não é de hoje que no Brasil (tal como em muitos outros países) o sistema carcerário se transformou não só num santuário para o bacilo de Koch, como também para o desenvolvimento das cepas mais resistentes ao esquema de tratamento.
CDC | TB | Fact Sheets – Diagnosis of TB Disease
Centers for Disease Control and Prevention, Division of Tuberculosis Elimination
Fonte: CDC | TB | Fact Sheets – Diagnosis of TB Disease
Como gancho do post anterior, esta página do CDC explica os pormenores desta ferramenta diagnóstica.
blog infectologia em geral 