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Surgery and TB empyema

A Ghoor, T Mabaso, K Mopeli, A Izu, S A Madhi, S G Lala, C Verwey, Z Dangor
BACKGROUND: There is a paucity of information on empyema in children from low- and middle-income countries since the introduction of the pneumococcal conjugate vaccine. OBJECTIVES: To describe the aetiology and management of empyema in a setting of high HIV and tuberculosis (TB) prevalence. METHODS: A retrospective descriptive study was undertaken between January 2012 and December 2016 in children aged <14 years at a large secondary-tertiary referral hospital in Soweto, South Africa...
November 26, 2018: South African Medical Journal
Dmitry Borisovich Giller, Boris Dmitrievich Giller, Galina Vitalievna Giller, Galina Vladimirovna Shcherbakova, Anuar Bahtibaevich Bizhanov, Inga Igorevna Enilenis, Aleksey Aleksandrovich Glotov
OBJECTIVES: Surgical interventional has been key in the treatment of tuberculosis (TB) for a long time. Its importance diminished after the emergence of chemotherapy. However, the spread of rapid multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB has led us to return to surgery to treat TB. Today, every second patient in Russia with destructive TB has either MDR or XDR TB, which is the reason for the low efficacy of conservative treatment. In 2015, treatment with drugs resulted in clinical recovery in only 29...
May 1, 2018: European Journal of Cardio-thoracic Surgery
Mudasiru A Salami, Arinola A Sanusi, Victor O Adegboye
OBJECTIVES: To review the current indications and outcome of pulmonary resections for tuberculosis (TB) at the Cardiothoracic Surgery Unit of the University College Hospital, Ibadan, Nigeria. SUBJECTS AND METHODS: A retrospective case series review of patients who had lung resections from January 2014 to January 2017 was performed. Data obtained from medical records included demographics, presenting symptoms, indication for surgery, preoperative evaluation and preparation, operative procedure, postoperative complications, and follow-up...
2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Dragan Subotic, Piotr Yablonskiy, Giorgia Sulis, Ioan Cordos, Danail Petrov, Rosella Centis, Lia D'Ambrosio, Giovanni Sotgiu, Giovanni Battista Migliori
Tuberculosis (TB) is still a major public health concern, mostly affecting resource-constrained settings and marginalized populations. The fight against the disease is hindered by the growing emergence of drug-resistant forms whose management can be rather challenging. Surgery may play an important role to support diagnosis and treatment of the most complex cases and improve their therapeutic outcome. We conducted a non-systematic review of the literature based on relevant keywords through PubMed database. Papers in English and Russian were included...
July 2016: Journal of Thoracic Disease
Louise Dunphy, Prashanth Shetty, Ajitkumar Kavidasan, Alexandra Rice
A 33-year-old man, born in India but resident in the UK for 5 years, presented to the emergency department with a 4-week history of a dry cough and right-sided pleuritic chest pain. He reported systemic features, including fever and unintentional weight loss. His medical history included vitamin D deficiency. He had travelled to India 10 months previously and denied any exposure to tuberculosis (TB). He was an ex-smoker with a 20 pack history. Respiratory examination confirmed decreased air entry of the right lower lobe and stony dullness on percussion...
January 4, 2016: BMJ Case Reports
Richard Long, James Barrie, Charles A Peloquin
BACKGROUND: Chronic tuberculous empyema (CTE) is a rare and unusual, low grade and protracted, infection of the pleural space resulting in marked thickening, even calcification of the visceral and parietal pleura. Historically its management has been extraordinarily challenging. Differential penetration of anti-TB drugs into the pleural space has resulted in acquired drug resistance and surgery to remove the empyema or close a complicating bronchopleural fistula (BPF) has been technically difficult or unacceptably hazardous...
August 12, 2015: BMC Infectious Diseases
Gerard R Alexander, Bruce Biccard
OBJECTIVES: This review was undertaken to compare treatment outcomes in human immunodeficiency virus (HIV) negative versus HIV-positive patients following adjuvant lung resection for drug-resistant tuberculosis (DR-TB) in patients deemed feasible for surgery. Despite appropriate medical therapy, mortality remains extremely high and cure rates poor in patients with DR-TB and HIV co-infection. Therefore, adjuvant lung resection may warrant a more prominent role in the treatment of these patients...
March 2016: European Journal of Cardio-thoracic Surgery
Rajhmun Madansein, Shreemanta Parida, Nesri Padayatchi, Nalini Singh, Iqbal Master, Kantharuben Naidu, Alimuddin Zumla, Markus Maeurer
Surgery for drug-resistant tuberculosis has been shown to be safe and effective, with similar level of mortalities associated with surgical intervention observed with that for lung cancer. While surgery has been an option to treat TB in the pre-antibiotic era, it is now increasingly used to treat complications of pulmonary TB, particularly in patients with drug-resistant TB who do not respond to medical treatment. The two most frequent indications for lung resection in drug- resistant TB, are i) failed medical treatment with persistent sputum positivity or ii) patients who have had medical treatment and are sputum negative, but with persistent localized cavitary disease or bronchiectasis...
March 2015: International Journal of Infectious Diseases: IJID
M A Quddus, M J Uddin, M M Bhuiyan
This is a retrospective study of 200 cases of Extra Pulmonary Tuberculosis (EPTB) and this study was conducted from January 2010 to July 2011 at Sheheed Ziaur Rahman Medical College Hospital and TB clinic, Bogra, Bangladesh. Data were collected from the Hospital records on demographics, clinical, laboratory and treatment out come status. The incidence of EPTB was high in 16-45 years age group (55%), mean age was 35.67±14.6 years and predominated in Female patients (60%). Extra pulmonary Tuberculosis (EPTB) still constitutes an important clinical problem in Bangladesh...
October 2014: Mymensingh Medical Journal: MMJ
Ravindra Kumar Dewan, Loven Moodley
Most of thoracic surgery developed as a result of efforts to treat tuberculosis (TB). The role of surgical therapy has declined but the role of surgery in TB still remains in situations like diagnostic difficulties, persistent sputum positive state despite therapy and complications and sequel like haemoptysis, destroyed or bronchiectatic lungs or empyema with or without broncho-pleural fistula (BPF). Various procedures have a role according to the indication. Some of the procedures have become obsolete but lobectomy, pneumonectomy, thoracoplasty, decortication and open window thoracostomy continue to be relevant...
March 2014: Journal of Thoracic Disease
M Bouchikh, A Achir, M Caidi, S El Aziz, A Benosman
INTRODUCTION: Multidrug-resistant tuberculosis (MDR-TB) is a worldwide health problem. Surgery is often used as an adjuvent therapy with anti-tuberculosis agents. The aim of this study is to present our results of pulmonary resections in the treatment of MDR-TB. MATERIAL AND METHODS: [corrected] This is a retrospective monocentric study of 29 patients operated on between 1995 and 2010 for MDR-TB. RESULTS: Tuberculosis was evolving from 9 to 108 months with a median of 34...
December 2013: Revue de Pneumologie Clinique
Petre Vlah-Horea Botianu, Alexandru-Mihail Botianu
SESSION TYPE: Thoracic Surgery Posters IPRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PMPURPOSE: The purpose of this study is to evaluate the late imagistic and clinical features of the patients with a history of plombage thoracoplasty for tuberculosis (TB) admitted to our unit.METHODS: Between 01.01.1990-01.01.2012 we admitted in our clinic a total number of 5 patients with a history of plombage thoracoplasty. The plombage was performed with: balls (2 cases), autologous rib (2 cases) and oil-filled bag (1case)...
October 1, 2012: Chest
Michael Papiashvili, Ilan Barmd, Lior Sasson, Moshe Lidji, Klementy Litman, Atara Hendler, Vladimir Polanski, Leiv Treizer, Daniele Bendayan
BACKGROUND: Multidrug-resistant tuberculosis (MDR-1B) presents a difficult therapeutic problem due to the failure of medical treatment. Pulmonary resection is an important adjunctive therapy for selected patients with MDR-TB. OBJECTIVES: To assess the efficacy of pulmonary resection in the management of MDR-TB patients. METHODS: We retrospectively reviewed the charts of MDR-TB patients referred for major pulmonary resections as part of a treatment strategy...
December 2012: Israel Medical Association Journal: IMAJ
Mazda K Turel, Ranjith K Moorthy, Vedantam Rajshekhar
Despite tuberculosis (TB) being endemic in many parts of the world, its prevalence in infancy is low. Neurotuberculosis in this age is even rarer and presents either as meningitis or intracranial tuberculoma on the background of exposure to the disease. We report occurrence of multidrug-resistant tuberculous subdural empyema in a three-month-old girl as the initial presenting manifestation of TB in the absence of any exposure to the disease. She was successfully managed with surgery and drugs with good outcome at 18 months...
March 2012: Neurology India
Andrei Cristian Bobocea, Cristian Paleru, Ciprian Lovin, Olga Dănăilă, Ciprian Bolca, Radu Stoica, Ioan Cordoş
Bronchopleural fistulas and empyema are the most devastating complications after lung resection. The optimal management remains a major subject of controversy for thoracic surgeons over the wide variety of therapeutic approaches, none suitable for all patients. In 1996 Azorin et al. reported the first successful mediastinoscopic reclosure by stapling of an insufficient bronchial stump after left pneumonectomy using video-assisted mediastinoscopy. The authors report the first national case of left-sided bronchopleural fistula closure using video-assisted mediastinoscopy, describing their experience with this technique...
January 2012: Pneumologia: Revista Societății Române de Pneumologie
Reza Bagheri, Seyed Ziaollah Haghi, Mohammad Taghi Mashhadi Rajabi, Mohammad Motamedshariati, Shima Sheibani
BACKGROUND: Both incidence and complications of pleuropulmonary tuberculosis (TB) have increased due to recent increase of immunocompromising conditions. The aim of this study was to assess surgical outcomes in patients suffering from complicated pleuropulmonary TB. METHODS: This study included 108 patients with pleuropulmonary TB who underwent surgery. Age, sex, surgical indications, operative techniques, complications, mortality, and morbidity were evaluated. RESULTS: Male-female ratio was 1:11 with mean age of 40 years; 72...
March 2013: Thoracic and Cardiovascular Surgeon
Lianqi Bai, Zheng Hong, Changfan Gong, Dongjie Yan, Zikun Liang
OBJECTIVES: Compared to the use of anti-TB drugs for the treatment of tuberculosis (TB), surgery is destructive and is associated with higher risk. Whether surgery is needed for the treatment of TB-destroyed lungs (for short: destroyed lungs) is still controversial and unresolved in the clinic. METHODS: Retrospective analysis of treatment efficacy was performed on 172 cases of destroyed lungs (176 surgeries) in the Thoracic Surgery Department of our hospital from April 1992 to June 2010...
February 2012: European Journal of Cardio-thoracic Surgery
Sadik Yaldiz, Soner Gursoy, Ahmet Ucvet, Seyda Ors Kaya
PURPOSE: Drug resistance has become a major problem in the treatment of tuberculosis, and pulmonary resection in combination with chemotherapy appears to be an effective measure for the treatment. The purpose of this study was to investigate the results of resection for multidrug-resistant pulmonary tuberculosis (MDR-TB). PATIENTS AND METHODS: We retrospectively reviewed case files from January 2003 to December 2006 of 13 patients with MDR-TB underwent pulmonary resection...
2011: Annals of Thoracic and Cardiovascular Surgery
Min-Woong Kang, Hong Kwan Kim, Yong Soo Choi, Kwhanmien Kim, Young Mog Shim, Won-Jung Koh, Jhingook Kim
BACKGROUND: Multidrug-resistant (MDR) and extensive drug-resistant (XDR) tuberculosis (TB) are still significant health problems. Surgical resection is an adjunctive intervention for patients with MDR or XDR TB. This study presents the short-term and long-term results of surgical treatment for MDR or XDR TB at a single center. METHODS: Between May 1996 and March 2008, surgical resection was performed on 72 patients with MDR or XDR TB at a single institution. Among these patients, 26 patients (36%) had XDR TB...
May 2010: Annals of Thoracic Surgery
Petre Vlah-Horea Botianu, Adrian Cristian Dobrica, Alexandra Butiurca, Alexandru Mihail Botianu
OBJECTIVE: The objective of our article is to analyse the results of complex space-filling procedures for chronic intrathoracic suppurations. METHODS: We performed a retrospective analysis of 76 consecutive patients operated in our unit between 1 January 2003 and 31 December 2008, who presented pleural and/or pulmonary suppurations not amenable to decortication or resection; 36 patients (47%) had tuberculosis (TB) lesions (28 with positive cultures at the moment of surgery, seven with multi-drug-resistant (MDR) infections), 13 patients (17%) had postoperative empyema, 18 patients (24%) presented with frank intrapleural rupture of a pulmonary cavity and 26 patients (34%) presented with bronchial fistula...
February 2010: European Journal of Cardio-thoracic Surgery
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