rifampin and Tuberculosis--Splenic

Tuberculosis caused by Mycobacterium tuberculosis presents a major health challenge in endemic countries and spares no organ in the human body. This infection is a mimicker of various disease processes such as metastasis, lymphoproliferative diseases, and other granulomatous conditions such as sarcoidosis and fungal infections. The most challenging and important differential is metastasis, especially in the disseminated form of tuberculosis. We present a histopathologically proven case of isolated hepatosplenic tuberculosis that was provisionally diagnosed as lymphoma due to its unusual, restricted involvement of the liver and spleen.

Topics: Abdominal Pain; Antitubercular Agents; Diagnosis, Differential; Ethambutol; Female; Humans; Isoniazid; Middle Aged; Pyrazinamide; Rifampin; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Hepatic; Tuberculosis, Splenic; Weight Loss

The diarylquinoline R207910 (TMC207) has potent bactericidal activity in a murine model of tuberculosis (TB), but its sterilizing activity has not been determined.. To evaluate the sterilizing activity of R207910-containing combinations in the murine model of TB.. Swiss mice were intravenously inoculated with 6 log(10) of Mycobacterium tuberculosis strain H37Rv, treated with R207910-containing regimens, and followed for 3 months to determine relapse rates (modified Cornell model).. Quantitative lung and spleen colony-forming unit counts and bacteriological relapse rates 3 months after the end of therapy were compared for the following regimens: 2, 3, or 4 months of R207910 (J) and pyrazinamide (Z) combined with rifampin (R) or isoniazid (H) or both and 3 or 4 months of a moxifloxacin (M)-containing regimen and 6 months of the standard WHO regimen RHZ. All J-treated mice were culture negative after 4 months of therapy. The relapse rate in the group treated with 4 months of JHRZ was similar to that of mice treated for 6 months with the RHZ regimen (6 vs. 17%; P = 0.54) and lower than that of RMZ (6 vs. 42%; P = 0,03), a moxifloxacin-containing regimen that was the most active in mice on once-daily basis.. Four months of treatment with some J-containing regimens was as effective as the 6-month standard regimen and more effective than 4 months of treatment with M-containing regimens. Supplementation of standard regimen (RHZ) with J or substitution of J for H may shorten the treatment duration needed to cure TB in patients.

Topics: Animals; Antitubercular Agents; Diarylquinolines; Disease Models, Animal; Drug Therapy, Combination; Female; Hydrolases; Isoniazid; Mice; Mycobacterium tuberculosis; Pyrazinamide; Quinolines; Rifampin; Tuberculosis; Tuberculosis, Pulmonary; Tuberculosis, Splenic

Tuberculosis is an important health problem in developing countries, with varying clinical presentations depending on the organs/systems involved. Tuberculosis is mostly seen in immuno-compromised individuals, such as those with acquired immune deficiency syndrome or malignancies. Here we report a case of a spleen tuberculoma in a 29-year-old male patient with no known immune deficiency. He first presented with abdominal pain, and subsequent ultrasonographic examination revealed a splenic lesion of 10 cm in diameter. A computerized tomography scan of the abdomen confirmed the presence of a solitary, hypodense, septated cystic lesion. Lack of evidence supporting the presence of a splenic infection or a primary/metastatic malignancy prompted explorative surgery where a septated abscess formation was discovered and splenectomy was performed. Histopathological examination revealed granulomatous inflammatory changes with Langerhans-type giant cells, which are consistent with tuberculosis. For a period of two months, antituberculosis therapy with four drugs, isoniazid, rifampicin, pyrazinamide, and ethambutol, was carried out. Pyrazinamide and ethambutol were quitted at the end of two months. Therapy with isoniazid and rifampicin was planned for an additional 10 months. We would like to call attention to yet another atypical presentation of extrapulmonary tuberculosis.

Topics: Adult; Antibiotics, Antitubercular; Drug Therapy, Combination; Humans; Isoniazid; Liver; Lymph Nodes; Male; Rifampin; Spleen; Splenectomy; Tomography, X-Ray Computed; Tuberculin Test; Tuberculosis, Splenic

Splenic tuberculosis is a rare entity. The case of an 18-year old patient admitted for fever and general malice is described. Echography and abdominal CT showed a hypodense image localized in the spleen. Splenic tuberculosis was diagnosed upon observation of alcohol acid resistant bacilli (AARB) in the biopsy obtained by punction of the abscess. Correct tuberculostatic treatment led to disappearance of the splenic abscess with no further therapeutic measures being required.

Topics: Abscess; Adolescent; Ethambutol; Female; Humans; Isoniazid; Rifampin; Time Factors; Tomography, X-Ray Computed; Tuberculosis, Splenic

Mice were infected intravenously with a streptomycin (SM)-dependent strain of tubercle bacilli which had been starved of the antibiotic. The inoculum persisted in the spleen for a fairly long period, especially keeping almost the initial level of viable counts in the first few weeks. Isoniazid (INH) administration exerted little effect on such fate of the infection at a bactericidal dose to the same strain multiplying under the supply of SM. Rifampicin (RFP) was, however, highly effective in either case. Similar results were obtained in the corresponding in vitro experiments. The data suggest that this animal model is a convenient system for screening drugs effective on the dormant tuberculous infection.

Topics: Animals; Antitubercular Agents; Drug Resistance, Microbial; Male; Mice; Mice, Inbred Strains; Mycobacterium tuberculosis; Rifampin; Tuberculosis, Pulmonary; Tuberculosis, Splenic

Topics: Animals; Drug Resistance, Microbial; Guinea Pigs; In Vitro Techniques; Mycobacterium tuberculosis; Rabbits; Rifampin; Tuberculosis; Tuberculosis, Hepatic; Tuberculosis, Lymph Node; Tuberculosis, Ocular; Tuberculosis, Splenic

Topics: Adolescent; Child, Preschool; Drug Tolerance; Ethambutol; Female; Humans; Isoniazid; Male; Prognosis; Rifampin; Time Factors; Tuberculosis; Tuberculosis, Hepatic; Tuberculosis, Lymph Node; Tuberculosis, Pulmonary; Tuberculosis, Splenic

Topics: Bone Marrow; Bone Marrow Examination; Cholestasis; Erythema; Ethambutol; Humans; Isoniazid; Leukopenia; Male; Middle Aged; Neutropenia; Peritonitis, Tuberculous; Rifampin; Streptomycin; Thrombocytopenia; Tuberculosis; Tuberculosis, Hepatic; Tuberculosis, Osteoarticular; Tuberculosis, Splenic; Vitamin B Complex

Topics: Adult; Aged; Chemical and Drug Induced Liver Injury; Drug Synergism; Female; Humans; Isoniazid; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary; Tuberculosis, Splenic

Topics: Animals; Cortisone; Drug Synergism; Isoniazid; Mice; Mycobacterium tuberculosis; Rifampin; Streptomycin; Time Factors; Tuberculosis; Tuberculosis, Pulmonary; Tuberculosis, Splenic