Sputum smear and Gene-Xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis

We discuss a case of a 60-year-old man with no known comorbidities who presented with sudden onset severe haemoptysis and chest pain. Sputum and pleural fluid smears for acid fast bacillus and Gene-Xpert were repeatedly negative. Pleural fluid cytology demonstrated presence of fungal organisms with...
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Autor*in:	Yvonne Ayerki Nartey [verfasserIn] Rosemary Kuenyefu Awindaogo [verfasserIn] Ama Gyadua Boadu [verfasserIn] Kofi Ulzen-Appiah [verfasserIn] Bashiru Babatunde Jimah [verfasserIn] Elizabeth Agyare [verfasserIn] Yaw Asante Awuku [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch ; Französisch

Erschienen:	2020

Schlagwörter:	mycobacterium tuberculosis pulmonary tuberculosis extra-pulmonary tuberculosis mycobacterial culture

Übergeordnetes Werk:	In: PAMJ Clinical Medicine - PAMJ, 2020, 3(2020), 164
Übergeordnetes Werk:	volume:3 ; year:2020 ; number:164

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.11604/pamj-cm.2020.3.164.24997

Katalog-ID:	DOAJ069926735

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allfieldsSound	10.11604/pamj-cm.2020.3.164.24997 doi (DE-627)DOAJ069926735 (DE-599)DOAJ95843f2d50314613ae3903fb9d577ff9 DE-627 ger DE-627 rakwb eng fre Yvonne Ayerki Nartey verfasserin aut Sputum smear and Gene-Xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We discuss a case of a 60-year-old man with no known comorbidities who presented with sudden onset severe haemoptysis and chest pain. Sputum and pleural fluid smears for acid fast bacillus and Gene-Xpert were repeatedly negative. Pleural fluid cytology demonstrated presence of fungal organisms with hyphae and serum IgE was elevated. The patient developed a haemorrhagic pericardial effusion and cardiac tamponade. Sputum mycobacterial culture after 7 weeks was positive for Mycobacterium tuberculosi. This case highlights the difficulties that may be associated with diagnosis of PTB in the acute clinical setting and the importance of mycobacterial culture, particularly in the presence of negative initial investigations and superadded non-tuberculous infections. Furthermore, it demonstrates the potential clinical course of MTB infection, including development of severe extra-pulmonary complications. Finally, it highlights the importance of the multidisciplinary team in assessing the need to presumptively start anti-TB medication in selected cases. mycobacterium tuberculosis pulmonary tuberculosis extra-pulmonary tuberculosis mycobacterial culture Medicine R Rosemary Kuenyefu Awindaogo verfasserin aut Ama Gyadua Boadu verfasserin aut Kofi Ulzen-Appiah verfasserin aut Bashiru Babatunde Jimah verfasserin aut Elizabeth Agyare verfasserin aut Yaw Asante Awuku verfasserin aut In PAMJ Clinical Medicine PAMJ, 2020 3(2020), 164 (DE-627)1697194044 27072797 nnns volume:3 year:2020 number:164 https://doi.org/10.11604/pamj-cm.2020.3.164.24997 kostenfrei https://doaj.org/article/95843f2d50314613ae3903fb9d577ff9 kostenfrei https://www.clinical-medicine.panafrican-med-journal.com/content/article/3/164/pdf/164.pdf kostenfrei https://doaj.org/toc/2707-2797 Journal toc kostenfrei https://doaj.org/toc/2707-2797 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2020 164
language	English French
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authorswithroles_txt_mv	Yvonne Ayerki Nartey @@aut@@ Rosemary Kuenyefu Awindaogo @@aut@@ Ama Gyadua Boadu @@aut@@ Kofi Ulzen-Appiah @@aut@@ Bashiru Babatunde Jimah @@aut@@ Elizabeth Agyare @@aut@@ Yaw Asante Awuku @@aut@@
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author	Yvonne Ayerki Nartey
spellingShingle	Yvonne Ayerki Nartey misc mycobacterium tuberculosis misc pulmonary tuberculosis misc extra-pulmonary tuberculosis misc mycobacterial culture misc Medicine misc R Sputum smear and Gene-Xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis
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topic_title	Sputum smear and Gene-Xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis mycobacterium tuberculosis pulmonary tuberculosis extra-pulmonary tuberculosis mycobacterial culture
topic	misc mycobacterium tuberculosis misc pulmonary tuberculosis misc extra-pulmonary tuberculosis misc mycobacterial culture misc Medicine misc R
topic_unstemmed	misc mycobacterium tuberculosis misc pulmonary tuberculosis misc extra-pulmonary tuberculosis misc mycobacterial culture misc Medicine misc R
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title	Sputum smear and Gene-Xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis
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title_full	Sputum smear and Gene-Xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis
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author_browse	Yvonne Ayerki Nartey Rosemary Kuenyefu Awindaogo Ama Gyadua Boadu Kofi Ulzen-Appiah Bashiru Babatunde Jimah Elizabeth Agyare Yaw Asante Awuku
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title_sort	sputum smear and gene-xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis
title_auth	Sputum smear and Gene-Xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis
abstract	We discuss a case of a 60-year-old man with no known comorbidities who presented with sudden onset severe haemoptysis and chest pain. Sputum and pleural fluid smears for acid fast bacillus and Gene-Xpert were repeatedly negative. Pleural fluid cytology demonstrated presence of fungal organisms with hyphae and serum IgE was elevated. The patient developed a haemorrhagic pericardial effusion and cardiac tamponade. Sputum mycobacterial culture after 7 weeks was positive for Mycobacterium tuberculosi. This case highlights the difficulties that may be associated with diagnosis of PTB in the acute clinical setting and the importance of mycobacterial culture, particularly in the presence of negative initial investigations and superadded non-tuberculous infections. Furthermore, it demonstrates the potential clinical course of MTB infection, including development of severe extra-pulmonary complications. Finally, it highlights the importance of the multidisciplinary team in assessing the need to presumptively start anti-TB medication in selected cases.
abstractGer	We discuss a case of a 60-year-old man with no known comorbidities who presented with sudden onset severe haemoptysis and chest pain. Sputum and pleural fluid smears for acid fast bacillus and Gene-Xpert were repeatedly negative. Pleural fluid cytology demonstrated presence of fungal organisms with hyphae and serum IgE was elevated. The patient developed a haemorrhagic pericardial effusion and cardiac tamponade. Sputum mycobacterial culture after 7 weeks was positive for Mycobacterium tuberculosi. This case highlights the difficulties that may be associated with diagnosis of PTB in the acute clinical setting and the importance of mycobacterial culture, particularly in the presence of negative initial investigations and superadded non-tuberculous infections. Furthermore, it demonstrates the potential clinical course of MTB infection, including development of severe extra-pulmonary complications. Finally, it highlights the importance of the multidisciplinary team in assessing the need to presumptively start anti-TB medication in selected cases.
abstract_unstemmed	We discuss a case of a 60-year-old man with no known comorbidities who presented with sudden onset severe haemoptysis and chest pain. Sputum and pleural fluid smears for acid fast bacillus and Gene-Xpert were repeatedly negative. Pleural fluid cytology demonstrated presence of fungal organisms with hyphae and serum IgE was elevated. The patient developed a haemorrhagic pericardial effusion and cardiac tamponade. Sputum mycobacterial culture after 7 weeks was positive for Mycobacterium tuberculosi. This case highlights the difficulties that may be associated with diagnosis of PTB in the acute clinical setting and the importance of mycobacterial culture, particularly in the presence of negative initial investigations and superadded non-tuberculous infections. Furthermore, it demonstrates the potential clinical course of MTB infection, including development of severe extra-pulmonary complications. Finally, it highlights the importance of the multidisciplinary team in assessing the need to presumptively start anti-TB medication in selected cases.
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title_short	Sputum smear and Gene-Xpert negative pulmonary tuberculosis; a diagnostic dilemma in primary tuberculosis
url	https://doi.org/10.11604/pamj-cm.2020.3.164.24997 https://doaj.org/article/95843f2d50314613ae3903fb9d577ff9 https://www.clinical-medicine.panafrican-med-journal.com/content/article/3/164/pdf/164.pdf https://doaj.org/toc/2707-2797
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author2	Rosemary Kuenyefu Awindaogo Ama Gyadua Boadu Kofi Ulzen-Appiah Bashiru Babatunde Jimah Elizabeth Agyare Yaw Asante Awuku
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