• Title/Summary/Keyword: Tuberculosis, gastrointestinal

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Current Status of Fluoroquinolone Use for Treatment of Tuberculosis in a Tertiary Care Hospital in Korea

  • Kang, Bo Hyoung;Jo, Kyung-Wook;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.143-152
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    • 2017
  • Background: Fluoroquinolones are considered important substitutes for the treatment of tuberculosis. This study investigates the current status of fluoroquinolone for the treatment of tuberculosis. Methods: In 2009, a retrospective analysis was performed at one tertiary referral center for 953 patients diagnosed with tuberculosis. Results: A total of 226 patients (23.6%), who received fluoroquinolone at any time during treatment for tuberculosis, were enrolled in this study. The most common reasons for fluoroquinolone use were adverse events due to other anti-tuberculosis drugs (52.7%), drug resistance (23.5%), and underlying diseases (16.8%). Moxifloxacin (54.0%, 122/226) was the most commonly administered fluoroquinolone, followed by levofloxacin (36.3%, 82/226) and ofloxacin (9.7%, 22/226). The frequency of total adverse events from fluoroquinolone-containing anti-tuberculosis medication was 22.6%, whereas fluoroquinolone-related adverse events were estimated to be 2.2% (5/226). The most common fluoroquinolone-related adverse events were gastrointestinal problems (3.5%, 8/226). There were no significant differences in the treatment success rate between the fluoroquinolone and fluoroquinolone-$na{\ddot{i}}ve$ groups (78.3% vs. 78.4%, respectively). Conclusion: At our institution, fluoroquinolones are commonly used for the treatment of both multidrug-resistant tuberculosis and susceptible tuberculosis, especially as a substitute for adverse event-related drugs. Considering the low adverse event rates and the comparable treatment success rates, fluoroquinolones seem to be an invaluable drug for the treatment of tuberculosis.

A Case of Woman with Histrionic Personality who Suffered from Chronic Gastrointestinal Dysfunction (만성 위장장애를 호소하는 히스테리성 성격의 여자)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.101-108
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    • 1993
  • A case of a 38 year-old woman with histrionic personality who had chronic epigastric pain, dyspepsia and alternating bowel habit for more than 10 years was presented in detail on its course of two times of admission and follow-up. The diagnosis was thought as psychophy-siological disorder or gastrointestinal motility disorder of undefined etiology rather than hypo-chondriasis or Briquet's syndrome. She was characterized by sustained illness behavior and combined several physical illnesses. i.e. tuberculosis. anemia and hepatic stone. These physical diseases led to a blurring of psychological and physical boundaries regarding symptom formation. The points on consultation from medical part to psychiatric department were discussed and the supposed causal mechanisms in non-organic functional gastrointestinal disturbances were also reviewed. Physical and psychological modalities for the treatment and the abnormal illness behavior were mainly emphasized in this case.

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Imatinib-Mesylate Induced Interstitial Pneumonitis in Two CML Patients

  • Kim, Tae-Hoon;Kim, Byung-Gyu;Cho, Sung-Woo;Cho, Sung-Kyun;Kim, Hyun-Jung;Yuh, Young-Jin;Kim, Sung-Rok
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.3
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    • pp.210-215
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    • 2011
  • Imatinib mesylate, a selective inhibitor of BCR-ABL kinase activity, has demonstrated significant clinical efficacy in the treatment of chronic myeloid leukemia (CML) and gastrointestinal stromal tumors (GISTs). It has become the standard of treatment for these diseases. Although the toxicity profile of imatinib is superior to that of interferon or other cytotoxic agents, some adverse events including edema, gastrointestinal toxicities and hematologic toxicities are commonly observed in the patients treated by imatinib. We present two cases of imatinib induced interstitial pneumonitis during the treatment of a chronic phase of CML.

A Case of Adult Intussusception Induced by Intestinal Tuberculosis (장결핵으로 인한 성인 장중첩증 1예)

  • Kang, Hye-Sun;Kang, Ji-Young;Kang, Hyun-Hui;Kim, Hyeon-Jin;Lim, Keun-Joon;Kim, Seung-Kyoung;Lee, Sang-Haak;Moon, Hwa-Sik;Park, Jong-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.3
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    • pp.196-200
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    • 2010
  • Intussusception primarily occurs in children and is uncommon in adults. Moreover, intussusception caused by intestinal tuberculosis is very rare. We report a case of intussusception induced by intestinal tuberculosis. A 53-year-old man presented to our hospital with complaints of cough and sputum for 2 weeks. We started anti-tuberculosis medication as the patient's sputum acid-fast staining was positive. After 4 days of treatment, the patient developed abdominal cramping pain. Imaging studies showed ileo-ileal type intussusception. The patient underwent segmental resection of the small bowel and intestinal tuberculosis was confirmed on histological examination. He recovered after surgery and was discharged on anti-tuberculosis medication.

A Clinical Effect of Ofloxacin, Prothionamide, Cycloserine Streptomycin(Kanamycin or Tuberactinomycin) in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료에서 Ofloxacin, Prothionamide, Cycloserine, Streptomycin(Kanamycin or Tuberactinomycin) 4제요법의 임상 효과)

  • Song, Ju-Young;Yoo, Min-Kyu;Hong, Jae-Rack;Jeong, Jae-Man;Kim, Young-Jun;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.295-301
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    • 1995
  • Background: The serious problems in retreatment of pulmonary tuberculosis are a significant proportion of drug resistance. Preferably retreatment should contain the drugs which has never used before, so drug retreatment is limited in selection. A new antibacterial substance, ofloxacin(OFX) is the activity against mycobacterium tuberculosis and it has been used in the treatment of pulmonary tuberculosis. The present report concerns the result of retreatment of pulmonary tuberculosis patients containing OFX treated at National Kongju Tuberculosis Hospital. Method: A retrospective study was made through the regular follow up of 92 smear positive cases, who were treated by four drugs regimen between Mar 1991 and June 1994 at National Kongju Tuberculosis Hospital. Four drugs were, namely prothionamide, cycloserine, ofloxacin and streptomycin(kanamycin or tuberactinomycin). The duration of follow up was over one year. Results: 1) Out of 92 cases with positive sputum AFB smear, 67(73%) achieved the negative conversion. 2) Considering the negative sputum conversion in all the groups, the vast majority(85%) of sputum conversion occurred within the first 4 months. 3) The roentgenological improvement occurred in 49 percent on the whole and when the extent of disease was minimal, moderately, far advanced pulmonary tuberculosis, sputum AFB smear negative response to retreatment was 100%, 93%, 68%, respectively. 4) When the duration of patient's illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 87%, 76%, 65% and 55%, respectively. 5) Adverse reaction to prothionamide, with complaints of gastrointestinal troubles was common and hepatic dysfunction without jaundice was observed in 7 percent, convulsion in 1 percent, that to cycloserine occurred renal dysfunction & psycosis & convulsion, 2%, 1%, 1%, respectively. Tinnitus with KM occurred in 1% and dirrhea with OFX in 4%. Conclusion: The duration of patient's illness was shorter, sputum AFB smear negative response rate was better. Radiologic responses were not remarkable, but extent of disease by national tuberculosis association was smaller, the result of retreatment was better. Adverse reaction of the secondary antituberculosis agent was mainly observed gastrointestinal troubles, as regard to tolerance to the secondary drugs the role of the physician is of very important value and toxic effects can be overcome by the strong confidence.

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A case of intestinal tuberculosis complicated by miliary tuberculosis (파종성 폐결핵을 가진 남아에서 합병된 장결핵 1례)

  • Chung, Min Kook;Choi, Jeong Ho;Yoo, Jung Suk;Ahn, Seung In;Lee, Jin;Kim, Bong Lim;Kim, Jung A;Chang, Jin Keun
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1227-1231
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    • 2006
  • Intestinal tuberculosis presents with nonspecific and variable clinical manifestations. It is rarely seen in current clinical practice and the diagnosis may be missed or confused with many other disorders such as Crohns disease and intestinal neoplasms. The route of infection by tuberculous enteritis is variable and the treatment regimens used for treating pulmonary tuberculosis are generally effective for tuberculous enteritis as well. Uncomplicated tuberculous enteritis can be managed with a nine to 12- month course of antituberculous chemotherapy. If not treated early, the prognosis for intestinal tuberculosis is poor, with an overall mortality of between 19 percent and 38 percent. However, 90 percent of patients will respond to medical therapy alone if started early. Therefore, early detection and treatment is essential. Here we report a case of intestinal tuberculosis secondary to miliary tuberculosis.

A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl (12세 여아에게서 활동성 폐결핵에 동반된 장결핵 1례)

  • Park, Ga Young;Park, Jae Young;Kim, Chang Hwi;Kwak, Jeong Ja;Park, Jae Ock
    • Pediatric Infection and Vaccine
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    • v.20 no.3
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    • pp.190-196
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    • 2013
  • Intestinal tuberculosis (TB) is presented with nonspecific and variable clinical manifestations such as abdominal pain, diarrhea, fever and weight loss. Diagnosis of tuberculous enteritis may be missed or confused with many other chronic gastrointestinal disorders such as the Crohn disease and intestinal neoplasms. The diagnosis should be based on careful clinical evaluations, such as extra-intestinal signs and colonoscopic and histologic findings. Newer techniques such as PCR tests from the specimens through colonoscopic biopsy may be helpful to confirm diagnosis of tuberculous enteritis. The treatment regimens for pulmonary tuberculosis are generally effective for tuberculous enteritis as well. If not treated early, the prognosis of intestinal tuberculosis is poor. We report a case of tuberculous enteritis diagnosed by colonoscopic biopsy and TB PCR which was presented with diarrhea, abdominal pain, intermittent fever and weight loss in a 12-year-old girl with active pulmonary tuberculosis. The patient was treated successfully with antituberculosis agents for 11 months without any complications.

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Bronchoesophageal fistula in a patient with Crohn's disease receiving anti-tumor necrosis factor therapy

  • Kyunghwan Oh;Kee Don Choi;Hyeong Ryul Kim;Tae Sun Shim;Byong Duk Ye;Suk-Kyun Yang;Sang Hyoung Park
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.239-244
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    • 2023
  • Tuberculosis is an adverse event in patients with Crohn's disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn's disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient's condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

A Case of Behçet's Disease with Superior Vena Cava Syndrome (상대정맥증후군을 유발한 Behçet병 1예)

  • Kim, Young-Jee;Kim, Sang-Hun;Lee, Sang Moo;Ahn, Youngsoo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.657-663
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    • 2004
  • As a chronic multisystemic inflammatory disorder, Behçet's disease may manifest vascular, cardiac, neurological and gastrointestinal abnormalities. However, involvement of large veins, such as thrombosis of the superior or inferior vena cava, is a very rare complication. Herein, a case of superior vena cava syndrome, due to the thrombotic obstructions of the subclavian and brachiocephalic vein, is reported in a 27-year old woman with chronic Behçet's disease.

A Case of Rifampin-induced Thrombocytopenia in Pulmonary Tuberculosis (Rifampin으로 폐결핵 치료 중 발생한 혈소판 감소증 1례)

  • Park, Seok Won;Cho, Hee Suk;Kim, Hwang Min;Lim, Baek Keun;Kim, Jong Soo
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.240-244
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    • 2000
  • Rifampin is a bactericidal antibiotic used primarily in the treatment of tuberculosis. The adverse effects of rifampin, though few, include dermatologic, gastrointestinal, and hepatic manifestations. Occasionally it produces a flu-like syndrome, interstitial nephritis, hemolytic anemia, and thrombocytopenia. These manifestations usually appear in patients who take the drug intermittently. We experienced a 13 year-old girl who developed thrombocytopenia during rifampin administration of daily dosage, therefore we report a brief review with the related literatures.

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