颈部淋巴结结核超声造影分析

颈部淋巴结结核以颈部肿块为主要表现,临床症状常不典型,易出现误诊、漏诊而延误治疗时机。常规超声检查能显示淋巴结部位、大小、包膜及内部回声,但显示微小血管的能力有限,因此对颈部淋巴结结核的诊断有一定的局限性。     

Six-month chemotherapy for urogenital tuberculosis

Rifampicin (RMP, 600 mg), isoniazid (INH, 300 mg) and pyrazinamide (PZA, 1,000 mg) administered daily in the hospital for a duration of 2 months was followed at home by daily administration of 600 mg RMP and 300 mg INH for a duration of 4 months. 113 patients with previously untreated and bacteriologically proven urogenital tuberculosis were admitted to the study. Therapy was completed and evaluated in 106 (94%) patients. No failure of chemotherapy was observed during the treatment; one bacteriologically proven relapse occurred after completion of treatment within the 45- to 63-month follow-up. This 6-month chemotherapy seems as efficient as the standard treatment which lasted for 18-24 months.     

Coexistence of isolated peripancreatic tuberculous lymphadenitis with pancreatic cancer

Isolated peripancreatic tuberculous lymphadenitis (IPTL) is rare and difficult to diagnose because it has an insidious course without any specific clinical, laboratorial or radiological findings. In some cases, it is similar to a pancreatic tumour; however, the coexistence of both pathologies is rare. In the present study, we report on a case with synchronism of IPTL and pancreatic cancer presenting with intractable watery diarrhoea and weight loss.     

Six-month intermittent chemotherapy for tuberculosis in the Mseleni Health Ward of KwaZulu

Three hundred and seventy-three tuberculosis patients in a rural African setting were treated with a 6-month twice-weekly chemotherapy course. The recurrence rate for those with caseating pulmonary tuberculosis was 7.3% overall. In the second stage of the study, a modified form of supervised ambulatory therapy was used and compliance rates and recurrence rates assessed; 84.8% achieved 90% or more compliance and the recurrence rate was 8.7%.     

Whither short-course chemotherapy for tuberculous meningitis?

Short-course chemotherapy is well established for the treatment of pulmonary tuberculosis but not for extrapulmonary disease. We present a series of 35 cases in which chemotherapy for tuberculous meningitis was given for a period of less than 2 years. Short-term therapy was associated with recrudescence of tuberculous meningitis and, in some cases, with the development of deep cerebral infarcts and permanent neurological deficits. We think short-term chemotherapy for tuberculosis of the central nervous system is inadequate.     

Peripancreatic tuberculous lymphadenitis mimicking carcinoma: report of a case

Peripancreatic tuberculous lymphadenitis is a rare clinical entity and it usually raises serious diagnostic problems. We report a case of a solitary abdominal tuberculoma. A 45-year old woman was admitted to hospital with obstructive jaundice. An exploratory laparotomy was performed. A conglomerated mass, penetrating into the pancreas was found. Since exact diagnosis could not be obtained by peroperative frozen sections, standard Whipple procedure, segmental portal vein resection and reconstruction with autogenous saphenous vein were performed. Histopathological examination of the resected specimen revealed tuberculous lymphadenitis. The patient was given an anti-tuberculous treatment and a good response was noted. Abdominal tuberculoma is often mistaken for a malignant neoplasm and a high grade of suspicion is neccessary in order to make the exact diagnosis and optimal medical treatment of this entity.