40 research outputs found
In situ PCR for Mycobacterium tuberculosis in endoscopic mucosal biopsy specimens of intestinal tuberculosis and Crohn disease
Tuberculosis and Crohn disease are granulomatous disorders affecting the intestinal tract with similar clinical manifestations and pathologic features. We evaluated the use of in situ polymerase chain reaction (PCR) using Mycobacterium tuberculosis complex-specific primers for IS61 10 to differentiate these 2 disorders in archival mucosal biopsy specimens. In situ PCR was positive in 6 of 20 tuberculosis biopsy specimens and I of 20 Crohn disease biopsy specimens. Staining was localized to a site of granulomatous inflammation in 3 of the tuberculosis specimens and in the Crohn, disease specimen. In the other tuberculosis biopsy specimens, positive staining was localized to inflammatory granulation tissue and to a focus of intact mucosa without granulomatous inflammation. The presence of M tuberculosis DNA in Crohn disease could be due to coexisting latent tuberculosis or indicate a role for these bacteria in triggering an abnormal immune response. Therefore, in situ PCR is potentially useful to differentiate intestinal tuberculosis from Crohn disease, if the sensitivity is improved
Acute abdomen: An unusual presentation of disseminated Penicillium marneffei infection
Varied clinical presentations of Penicillium marneffei , an
opportunistic pathogen in HIV disease has been rarely described in
literature. We report a patient with advanced AIDS who presented to us
with prolonged fever and had features of an acute abdomen. On
radiologic imaging he had features of intestinal obstruction and
mesenteric lymphadenitis. A diagnosis was made possible by endoscopic
biopsies of the small bowel and bone marrow culture which grew P.
Marneffei . He was treated with intravenous amphotericin for 2 weeks
followed by oral itraconazole. This case is reported for its rarity and
unusual presentation and to sensitise clinicians and microbiologists to
consider this as an aetiology in patients with advanced HIV/AIDS who
present with acute abdomen, more so in patients from a distinct
geographic region - South-East Asi