Mycobacterial infections diagnosis

Atypical (nontuberculous) mycobacteria Nontuberculous cervical lymphadenopathy (scrofula) occurs in children infected with M. scrofidaceum or M. kansasii. Patients may demonstrate a weakly positive PPD, but diagnosis often requires biopsy. Mycobacterial infections of the skin are usually due to M. marinum. M. avium-intracellulare infects patients with chronic pulmonary disease and may become fulminant in AIDS patients. Atypical mycobacteria are treated with combination chemotherapy or in some cases, surgery. Because drug resistance is more common in nontuberculous mycobacterial infections than in TB, the susceptibility of the infectious agent must be determined early in the course of treatment. 

Mycobacterial Infections Several recent studies assessed the risk of mycobacterial infections in patients receiving ICS. A nested case-control study from the Korean national claims database identified 4139 patients who developed tuberculosis after initiation of an inhaled respiratory medication and 20,583 controls when matched for age, sex, diagnosis and the date of inhaler use initiation [12 ]. ICS was foxmd to be dose dependently (P < 0.001) associated with an increased rate of diagnosis with tuberculosis (adjusted OR = 1.20,95% Cl = 1.08,1.34). While use of oral corticosteroids increased the risk of tuberculosis (adjusted OR = 1.83,95% Cl = 1.58,2.12), it was foxmd to be a significant effect modifier of the association between ICS use and tuberculosis (TB) development (interaction P = 0.02). In those that used oral corticosteroids, ICS did not increase the risk of developing TB (adjusted OR = 1.35 95% C3 = 0.86,2.12). However, in those that did not use oral corticosteroids, ICS use slightly increased the risk of developing TB (adjusted OR = 1.17 95% Cl = 1.03,1.33). 

According to the CDC, the diagnosis of AIDS constitutes certain opportunistic infections, neoplasms, encephalopathy or wasting syndrome in the presence of HIV infection. In 1993, the CDC expanded the criteria to also include CD4+ T-cell count below 200 cells/p,l in the presence of HIV infection. The most common opportunistic infections includepneumocystis carinii pneumonia, pneumonitis, toxoplasmosis, mycobacterial disease, recurrent herpes simplex virus infection and/or cytomegalovirus infection. Kaposi s sarcoma is the most common form of cancer. HIV-related nervous system diseases include acute septic meningitis, AIDS dementia complex, subacute encephalitis, HIV encephalopathy and CNS opportunistic infections and neoplasm. 

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