We present the case of a 73-year old patient suffering from chronic flexor tendon synovitis of the wrist with carpal tunnel syndrome. He underwent synovectomy and median nerve release. Primary bacteriology was negative. Histology of the excised synovia revelead non-caseating granuloma as typical for sarcoidosis. Further screening for sarcoidosis was negative. Culture of a sample harvested from ...

The ability of Mycobacterium kansasii and groups II and III of the atypical mycobacteria to utilize oleic acid, as well as selected carbohydrates and other compounds, as sources of carbon for growth was compared with that of the H37Rv and H37Ra strains of M. tuberculosis. The highest rate of growth of all of the mycobacteria examined occurred in the medium containing oleic acid as the carbon so...

Most first-line anti-tuberculosis drugs have less in vitro activity against atypical mycobacteria. Loop-mediated isothermal amplification (LAMP) was used for the rapid diagnosis of mycobacterial species. The sensitivity of LAMP was 96.1% (49/51) in smear-positive and culture-positive sputum samples and 85.0% (17/20) in smear-negative and culture-positive samples. Of the 77 total LAMP-positive s...

Central nervous system tuberculosis (TB) was identified in 20 cases of unexplained encephalitis referred to the California Encephalitis Project. Atypical features (encephalitic symptoms, rapid onset, age) and diagnostic challenges (insensitive cerebrospinal fluid [CSF] TB PCR result, elevated CSF glucose levels in patients with diabetes, negative result for tuberculin skin test) complicated dia...

Sir, Anti-tumour necrosis factor alpha (TNF-α) agents, such as infliximab, adalimumab and etanercept, are remarkably effective in the treatment of rheumatoid arthritis (RA), Crohn's disease and psoriasis vulgaris (1–4). Recent case reports have described the treatment of hidradenitis suppurativa (5) and acne conglobata (6) with infliximab. Regardless of the dramatic improvement in symptoms, it ...

We report an 82 yr old man with isolated intrathoracic lymphadenopathy of tuberculous origin, which is an extremely uncommon presentation of tuberculosis especially in elderly Caucasian patients. The diagnosis was suggested by the computerized tomographic (CT)-scan showing central hypodense areas after contrast, and was subsequently proved by mediastinoscopic biopsy with histological and microb...

Extrapulmonary tuberculosis, constitutes almost one-fifth of all tuberculosis cases and less than 1% of all cases involving liver. Here we report a case of isolated hepatic tuberculoma mimicking solitary liver mass on MRI, recovered with antiTB treatment. The radiologic features of hepatic tuberculoma can mimic liver tumors, cholangiocarcinomas, liver abscess and hydatid cyst, or may present wi...

A modified amidase test for differentiation of mycobacteria is described. A total of 224 atypical mycobacteria, 154 Mycobacterium tuberculosis, and 26 M. bovis strains were classified by this procedure. Of the 404 strains of various species studied, 400 exhibited an amidase spectrum identical to the established pattern. The simplicity of this method may promote its application in routine examin...

Tuberculosis (TB) is often considered in the differential diagnosis of pyrexia of unknown origin (PUO) and miliary tuberculosis (MTB) a common cause of PUO. MTB is a potentially lethal disease if not rapidly diagnosed and treated, but remains a potential problem as the presentation may be nonspecific, and unusual associations may be overlooked. A high index of clinical suspicion, early diagnosi...

CASE REPORT We present the case of a 26 year-old Pakistani male, who after the presumptive diagnosis of anterior tuberculous scleritis (by an atypical clinical appearance and positive epidemiological link), was diagnosed with pulmonary tuberculosis. DISCUSSION Nodular anterior scleritis is an uncommon presentation of tuberculosis (TB). It is considered a diagnostic challenge because of the di...