rifampin and Calcinosis

Tuberculosis is an endemic disease responsible for death and morbidity in developing countries.. A 50-year-old man with no medical history was admitted to the emergency department for meningism associated with fever and confusion. The ophthalmic exam showed a decline in left visual acuity, reduced to light perception, VIth nerve left oculomotor paralysis, ocular fundus demonstrating a yellow tumor located on the posterior segment, measuring 1.5-2mm, papillomatous and prominent in the vitreous cavity. Fluorescein angiography showed a peritumoral choroiditis area, miliary tubercles of the choroid, and sectorial papillomatous edema. Color retinography unmasked inflamed posterior vitreous areas. Echography demonstrated a 4- to 5-mm oval hyperechogeneous and calcified tumor along with hyperechogeneous vitreous areas. Lumbar puncture showed lymphocytic meningitis associated with hyponatremia. The CT scan and MRI demonstrated optic neuritis. The antibiotic therapy was initiated and the outcome was favorable.. This case report shows the importance of systematic ocular fundus in the presence of systemic tuberculosis and outlines the assessment of color retinography to unmask vitreous lesions. It shows the importance of radiological imaging in the semiological study of orbital and cerebral lesions.

Topics: Adrenal Cortex Hormones; Anti-Inflammatory Agents; Antitubercular Agents; Calcinosis; Confusion; Diplopia; Drug Therapy, Combination; Fever; Humans; Isoniazid; Magnetic Resonance Imaging; Male; Meningoencephalitis; Middle Aged; Optic Neuritis; Papilledema; Pyrazinamide; Rifampin; Spinal Puncture; Streptomycin; Tuberculoma; Tuberculosis, Meningeal; Ultrasonography

Topics: Abdominal Pain; Adult; Animals; Brucella; Brucellosis; Calcinosis; Combined Modality Therapy; Doxycycline; Drug Therapy, Combination; Fever; Food Contamination; Food Microbiology; Hepatectomy; Humans; Liver Abscess; Male; Milk; Recurrence; Rifampin

A study conducted in 74 TT/TB patients, with gross thickening of nerves together with nerve abscess, showed calcification in 8 patients. Calcification was most common in the ulnar nerve followed by the lateral popliteal nerve. All eight patients were males with significantly longer duration of illness before start of treatment. Patients with late onset of nerve abscess were found to be more prone to calcium deposition in the nerves. Caseous pus of the abscess had high lipid content with raised cholesterol and cholesterol ester ratio to total lipids suggesting a dystrophic nature of calcification.

Topics: Abscess; Adolescent; Adult; Aged; Calcinosis; Child; Cholesterol; Cholesterol Esters; Dapsone; Female; Follow-Up Studies; Humans; Leprostatic Agents; Leprosy, Tuberculoid; Lipids; Male; Middle Aged; Peripheral Nervous System Diseases; Rifampin; Suppuration; Ulnar Nerve

From our data urinary tuberculosis, clearly reduced as regards past decennia, now results constant in annual number of cases. The reduced frequency sometimes requires some problems of differential diagnosis. After a few considerations about anatomo-pathologic aspects, we examine the diagnostic procedures starting from that urinary tuberculosis has not pathognomic clinical signs, except identification of M. tuberculosis in urine. The medical treatment consists in administering three drugs (rifampin, isoniazid, ethambutol) for 3 months and then two drugs for 6-9 months, on the ground of clinical course. Surgical treatment can be divided in destroying and preserving surgery. At last, endoscopic treatment takes aim at dilating ureteral stenoses.

Topics: Calcinosis; Diagnosis, Differential; Endoscopy; Ethambutol; Female; Humans; Isoniazid; Italy; Male; Pyelonephritis; Rifampin; Tuberculosis, Urogenital; Ureteral Calculi; Ureteral Obstruction; Urinary Tract Infections; Urine

The problem in the treatment of genitourinary tuberculosis was to find a new regimen of chemotherapy that was shorter in time but equally effective as the traditional 2-year method, using streptomycin, isoniazid and para-aminoslicylate. A short course of treatment using rifampin, isoniazid and ethambutol was then devised, the method depending on the severity of the disease using the Semb classification. This short course of chemotherapy was combined with an early operation in advanced or extensive disease in the urinary tract. The regimen is as satisfactory as the traditional method and a followup of 2 years is all that is necessary.

Topics: Adult; Aged; Antitubercular Agents; Calcinosis; Drug Administration Schedule; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Kidney Diseases; Male; Middle Aged; Rifampin; Tuberculosis, Urogenital

In the past year 20 new cases of genitourinary tuberculosis were referred for treatment at Wrightington Hospital. Many of these patients had waited a long time between diagnosis and referral and the start of effective treatment. We suggest that a new short course of chemotherapy should be used, and surgery undertaken during the first three months of treatment, but after the patient has had at least four weeks' drug treatment. After chemotherapy follow-up may be reduced to two years. Genitourinary tuberculosis remains a serious disease and should be managed by a urologist.

Topics: Adult; Aged; Calcinosis; Ethambutol; Female; Humans; Isoniazid; Kidney Diseases; Male; Middle Aged; Nephrectomy; Rifampin; Tuberculosis, Urogenital

Topics: Aminosalicylic Acids; Calcinosis; Drug Synergism; Epididymitis; Ethambutol; Female; Humans; Hypertension, Renal; Isoniazid; Kidney Calculi; Male; Mycobacterium tuberculosis; Nephrectomy; Prednisolone; Rifampin; Streptomycin; Tuberculosis, Urogenital; Ureteral Obstruction; Urinary Bladder; Urinary Diversion; Urine