3 research outputs found
TB co-infection with HIV/AIDS: a unique radiological presentation at Lacor hospital -a postconflict northern Uganda.
Background: Tuberculosis infection is thought as having the capacity to develop at any stage of HIV/AIDS infection. Pulmonary tuberculosis and extra-pulmonary tuberculosis are major complications in HIV/AIDS. Tuberculosis is still a diagnostic dilemma in low resource countries, with approximately 68.4% of all active pulmonary TB cases being negative for AAFBs on sputum. Additionally, it is reported that 46.7% of the active cases have disseminated TB with extra-pulmonary TB; further complicating the diagnosis in low resource communities. We therefore sought to clinically, histologically and radiologically characterize the various TB diagnosed in HIV/AIDS patients in Northern Uganda.Materials and Methods: A prospective cohort study was conducted on 320 sero-positive patients at Lacor Hospital. Clinical, histological, radiographic and ultra-sonographic features of confirmed HIV sero-positive patients with suspected TB co-infection were assessed. Patients were recruited consecutively and Chest, thoraco-lumbar and lumbar spine radiographs were taken and analyzed. Trans-thoracic ultrasonography for justified cases with pleural and pericardial effusion was conducted. FNAB and Tru-cut biopsies were performed for histological confirmation. Cases were followed-up for clinical outcomes within 2 months. Ethical review committee of Gulu University approved the study.Results: Atypical PTB chest x-ray findings: reticulo-nodular infiltrates 223(69.7%); hilar and mediastinal adenopathy 128(40%); pleural effusion 88(27.5%) and miliary 66(20.6%). Typical PTB chest x-ray findings: Apical reticulo-nodularities and fibro-cavitations 88(27.5%) and normal Chest x-ray 7(2.2%). Abdominal Ultrasound findings: porta-hepatis, para-aortic and splenic hilum lymphadenopathy 51(15.9%); Ascitis 26(8.1%); TB splenitis 17(5.3%) and TB nephritis with peri-renal abscess 1(0.3%). PTB was observed in 171(53.4%); disseminated TB in 135(42.2%) and EPTB in 14(4.4%). The majority 262(81.9%) of the patients improved and was discharged on DOTS while 58(18.1%) died.Conclusion: Imaging assessment is an important modality in TB/HIV/AIDS co-epidemic diagnosis. It is useful in making early diagnosis and prompt management of TB/HIV/AIDS co-infection.Key words: Tuberculosis, HIV/AIDS, co-infection, clinico-radiological methods, Lacor, Gulu (Uganda)
TB CO-INFECTION WITH HIV/AIDS: A UNIQUE RADIOLOGICAL PRESENTATION AT LACOR HOSPITAL; A POSTCONFLICT NORTHERN UGANDA.
Background: Tuberculosis (TB) infection is thought to develop at any stage of HIV infection. Pulmonary tuberculosis (PTB) and extra-pulmonary tuberculosis are major complications in HIV/AIDS patients. Tuberculosis is still a diagnostic dilemma in low resource countries, with approximately 68.4% of all active pulmonary cases being negative for AAFBs on sputum. Additionally, it is reported that 46.7% of the active cases have disseminated TB with extra-pulmonary TB; further complicating the diagnosis in post-conflict northern Uganda. We therefore sought to clinically and radiologically characterize the various TB diagnosed in HIV/AIDS patients in this low resource and post conflict environment.
Materials and Methods: A prospective cohort study was conducted on 320 sero-positive patients in Lacor Hospital. Clinical features, radiographic and ultrasonographic features of confirmed HIV sero-positive patients with suspected TB co-infection were assessed. Patients were recruited consecutively and the Chest radiographs, thoraco-lumbar and lumbar spine radiographs were taken and analyzed. Trans-thoracic ultrasonography (USS) for justified cases with pleural and pericardial effusion was conducted. FNAB and Tru-cut biopsies were performed for histological confirmation.
Cases were followed-up for clinical outcomes (improvement and demise) within 2 months. The ethics and review committee of Gulu University Medical School approved the study and patients who did not meet the inclusion criteria were excluded. Data was analyzed using SPSS 13.0.
Results: Atypical Chest x-ray finding included: reticulo-nodular infiltrates (69.7%); hilar and mediastinal adenopathy (40%); pleural effusion (27.5%) and miliary (20.6%).
Typical Chest x-ray finding included: Apical reticulo-nodularities and fibro-cavitations (27.5%), and normal Chest x-ray (2.2%).
Abdominal Ultrasonographic finding included: porta-hepatis, para-aortic and splenic hilum lymphadenopathy (15.9%); Ascitis (8.1%); TB splenitis (5.3%) and TB nephritis with peri-renal abscess (0.3%). PTB was observed in (53.4%); disseminated TB in (42.2%) and EPTB in (4.4%).
Majority (81.9%) of the patients improved and was discharged on DOTS while 18.1% died.
Conclusion: Imaging assessment is important adjuvant in HIV/AIDS/TB co-epidemic diagnosis. Early diagnosis and prompt management of TB co-infection ensures longer life and reduce morbidity and mortality
Antibiotic susceptibility of Staphylococcus aureus in suppurative lesions in Lacor Hospital, Uganda
Background: Staphylococcus aureus , a mainly acquired hospital
infection is responsible for many suppurative lesions and has
demonstrated the ability of developing resistance to many antimicrobial
agents leading to life threatening infections and long hospital stay.
Objective: To determined the prevalence and antibiotic susceptibility
of Staphylococcus aureus in suppurative lesions of the surgical ward
and outpatients of Lacor Hospital (Uganda). Methods: A
cross-sectional study was conducted at St. Mary’s Hospital Lacor
to determine the prevalence and antibiotic susceptibility profiles of
Staphylococcus aureus in suppurative lesions in both surgical
inpatients and outpatients. Using culture techniques on MacConkey and
blood agar, Staphylococcus aureus was isolated based on the colonial
characteristics and confirmed by Catalase and tube Coagulase tests. The
antibiotic susceptibility test was done using Kirby-Buer disk diffusion
method on 4% Salt Muellar Hinton II agar for the Methicillin and non
salted Muellar Hinton II agar for the other antibiotics (NCCLS M100S9).
Results: The prevalence of Staphylococcus aureus in 122 patients
sampled was 59.4% for the surgical inpatients and 48.3% for outpatients
giving an average prevalence of 53.9% for both groups of patients. The
average antibiotic susceptibility patterns for the 8 antibiotic tested
were: Ampicillin (75.0%), Chloramphenicol (34.4%), Ciprofloxacin
(1.6%), Erythromycin (7.8%), Gentamycin (0%), Methicillin (1.6%),
Tetracycline (45.3%) and Co-trimoxazole (50.0%). The resistance in
surgical inpatients was significantly higher than outpatients (t=1299,
p<0.05) and Methicillin resistance was confirmed by PCR.
Conclusion: Staphylococcus aureus is highly prevalent and more
resistant in inpatients. There is a higher risk of acquiring drug
resistant staphylococcus aureus infection in inpatients of Lacor
Hospital with a Methicillin resistance of 0% and 2.6% for out and
inpatients respectively