2022, Number 2
<< Back Next >>
Rev Cubana Med Trop 2022; 74 (2)
Lymphodenitis by Mycobacterium in immunocompetent and living with HIV/AIDS patients
Mederos CLM, Sardiñas AM, García LG, Martínez RMR, Díaz RR
Language: Spanish
References: 29
Page:
PDF size: 393.27 Kb.
ABSTRACT
Introduction:
The coinfection of human immunodeficiency virus (HIV) and tuberculosis has altered its histological presentation; this is particularly frequent in lymphadenitis.
Objective:
To carry out the etiological characterization of lymphadenopathies produced by the genus Mycobacterium, highlighting the importance of early diagnosis of this disease to avoid dissemination of the infection, both in immunocompetent and immunodeficient patients, specifically HIV/AIDS.
Methods:
A descriptive-prospective study was carried out between January 2017 - January 2019. During this period, 5640 samples were received, of these 81 obtained from lymph node tissue, the sample collection was mostly surgical 74 (91.35%) and 7 (8.64%) by aspiration biopsy (BAAF). Of the total samples, 60 (74.07%) were from HIV / AIDS patients, the samples were decontaminated by the 4% sulfuric acid method and cultured in solid Löwenstein-Jensen medium and incubated at 370C, the readings were made weekly. For the identification of Mycobacterium tuberculosis, the commercial SD TB AgMPT64 immunochromatographic rapid test was performed.
Results:
Of 81 samples analyzed, 22 (27.16%) isolates were obtained, 16 (72.72%) of Mycobacterium tuberculosis (MTB), and 6 (27.27%) of non-tuberculous species, of these 18 (81.81%) were from HIV / AIDS patients.
Conclusion:
For all the above, diagnostic surveillance is important in this type of extrapulmonary infection, both for M tuberculosis and for other non-tuberculous species and to be able to start specific treatment early, avoiding the spread of the infection, since it can have fatal consequences on all in patients with some type of immunosuppression, such as HIV/AIDS. If a patient maintains a prolonged fever, with lymphadenopathy, without respiratory symptoms and does not respond to antibiotic treatment, it is necessary to consider this type of infection.
REFERENCES
World Health Organization. WHO consolidated guidelines on tuberculosis Rapid diagnostics for tuberculosis detection Module 3. 2020 [electronic version].
Ramírez-Lapausa M, Menéndez-Saldaña A, Noguerado-Asensio A. Tuberculosis extrapulmonar, una revisión. Rev Esp Sanid Penit. 2015;17:3-11.
Chaves W, Buitrago JF, Dueñas A, Bejarano JC. Acerca de la tuberculosis extrapulmonar. Repert Med Cir. 2017;26(2):90-7.
Cruz ID, Velázquez JR, Alejandre A. Linfadenopatía tuberculosa. Diagnóstico y tratamiento. Informe de un caso. Arch Argent Pediatr. 2011;109(2):26-9.
Bekedam HJ, Boeree M, Kamenya A, Liomba G, Ngwira B, Subramanyam VR, et al. Tuberculous lymphadenitis, a diagnostic problem in areas of high prevalence of HIV and tuberculosis. Trans R Soc Trop Med Hyg. 1997;91(3):294-7.
Erhabor O, Aeremiah J, Adias ZTC, Okere C. The prevalence of human immunodeficiency virus infection among TB patients in Port Harcourt Nigeria. HIV AIDS. 2010;12(2):1-5.
Mederos LM, Fleites G, Capó V, De Armas Y, Acosta MA, Martínez MR, et al. Linfadenitis por Mycobacterium incluyendo pacientes infectados por el virus de inmunodeficiencia humana. Arch Ven Farm y Terap. 2011;30:54-7.
Tejashree A, Ranganath R. MPT64 Antigen detection for Rapid confirmation of M. tuberculosis isolates. BMC Research Notes. 2011;4:79.
Barrera L. Manual para el diagnóstico bacteriológico de la tuberculosis. Normas y guía teórica. Parte II. Cultivo. INEI, ANLIS Dr. Carlos Malbrán. Argentina. Organización Panamericana de la Salud; Oficina Regional de la Organización Mundial de la Salud; 2008.
Mederos LM, Sardiñas M, García G, Martínez MR, Díaz R. Identificación de especies micobacterianas ambientales u oportunistas en pacientes sintomáticos y con VIH/sida. Salud(i) Ciencia. 2020 [09/07/2021];24:12-8. Disponible en: http://www.siicsalud.com/dato/experto.php/16303710.
Peralta I, Cabrera MC, Gutiérrez MJ. Coinfección TB/VIH: una amenaza para los programas de control de ambas enfermedades. Medicent Electrón. 2015;19(3):160-2.
García-Elorriaga G, Degollado-Estrada E, Villagómez-Ruíz A, Cortés-Torres N, Arreguín-Reséndiz L, Rey-Pineda G, et al. Identification of Mycobacterium avium intracellulare complex by PCR of AIDS and disseminated mycobacteriosis. Rev Med Inst Mex Seguro Soc. 2016;54(2):170-5.
Mederos Cuervo LM, Fleites G, Acosta MA, Romero JM, Valdés L, León R, et al. Micobacteriosis peritoneal por Mycobacterium avium-intracellulare en paciente con el síndrome de inmunodeficiencia adquirida. Salud(i) Ciencia. 2017;22(11):352-6.
Mederos LM, Reyes A, Rodríguez P, Valdés L, Sardiñas M, Martínez MR, et al. Coinfección por Mycobacterium malmoense y Mycobacterium tuberculosis en paciente con el síndrome de inmunodeficiencia humana. Rev Peru Med Exp Salud Publica. 2014;31(4):788-92.
Gupta AK, Nayar M, Chandra M. Critical appraisal cytology of fine needle aspiration cytology in tuberculosis lymphadenitis. Acta Cytol. 1992;36:391-4.
Tadesse M, Abebe G, Abdissa K, Bekele A, Bezabih M, Apers L, et al. Concentration of lymph node aspirate improves the sensitivity of acid fast smear microscopy for the diagnosis of tuberculous lymphadenitis in Jimma, southwest Ethiopia. PLoS One. 2014;9:106726.
Arcianaga W, Orjuela DL. Tuberculosis extrapulmonar: Revisión de 102 casos, Hospital de San Jorge de Pereira 2000-2004. Biomédica. 2006;26:71-80.
García Rodríguez JF, Álvarez Díaz H, Lorenzo García MV, Mariño Callejo A, Fernández Rial A, Sesma Sánchez P. Extrapulmonary tuberculosis: epidemiology and risk factors. Enferm Infecc Microbiol Clin. 2011;29(7):502-9.
González Martín J, García García JM, Anibarro L, Vidal R, Esteban J, Blanquer R, et al. Documento de consenso sobre diagnóstico, tratamiento y prevención de la tuberculosis. Enferm Infecc Microbiol Clin. 2010;28(5):297.e20.
Fisher D, Elwood K. Nonrespiratory tuberculosis. In: Canadian Thoracic Society, Canadian Lung Association, and the Public Health Agency of Canada, editors. Canadian Tuberculosis Standards. 7th edition. Ottawa: Canadian Thoracic Society; 2013.
García-Río I, Fernández-Peñas P, Jesús Fernández-Herrera J, García-Díez A. Infección cutánea por Mycobacterium chelonae. Revisión de seis casos. Actas Dermosifiliogr. 2002;93(10):584-7.
Baik SJ, Yoo K, Kim TH, Moon LH, Cho MS. A case of obstructive jaundice caused by tuberculous lymphadenitis: A literature review. Clin Mol Hepatol. 2014;20:208-13.
Mederos Cuervo LM, Acosta Suárez MA, Cálas Echevarría V, Cárdenas García A, Galarza Hernández M, León Canga R, et al. Caso inusual de tuberculosis cutánea por Mycobacterium tuberculosis en paciente con síndrome de inmunodeficiencia adquirida. Revista de la Sociedad Venezolana de Microbiología. 2017;37:30-3.
Ministerio de Salud Pública; Cuba; Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud. La Habana: MINSAP; 2019.
García Acosta JA, Delgado Rodríguez AE. Tuberculosis ganglionar como forma de presentación de la tuberculosis extrapulmonar. Rev Ciencias Médicas. 2015;19(6):1195-1200.
Arpa A, Ledón A, Travieso S, Nodarse R. Tuberculosis ganglionar. Rev Cub Med Militar. 2018;47(2):1-6.
Lemus D, Echemendía M, Díaz R, Rodríguez D, Martínez A, Suárez L, et al. Resistencia a fármacos antituberculosos en Cuba, 2015-2017. Rev Cubana Med Tropical. 2021;73(1):e590.
Ramírez-Lapausa M, Menéndez-Saldaña A, Noguerado-Asensio A. Tuberculosis extrapulmonar, una revisión. Rev Esp Sanid Penit. 2015;17:3-11.
Deveci HS, Kule M, Kule ZA, Habesoglu TE. Diagnostic challenge in cervical tuberculous lymphadenitis: A review. North Clin Istanb. 2016;3(2):150-55. DOI: https://doi.org/10.14744/nci.2016.20982 29.