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Tytuł pozycji:

Program-wide review and follow-up of erythema Induratum of Bazin and tuberculosis-associated ocular inflammation management in a TB low-incidence setting: need for improved treatment candidate selection, therapy standardization, and care collaboration.

Tytuł :
Program-wide review and follow-up of erythema Induratum of Bazin and tuberculosis-associated ocular inflammation management in a TB low-incidence setting: need for improved treatment candidate selection, therapy standardization, and care collaboration.
Autorzy :
Connors WJ; Department of Medicine, University of Calgary, Alberta, Canada. .; Calgary Tuberculosis Services, Alberta, Canada. .; Foothills Medical Centre, Rm 303, 3rd Floor North Tower, 1403, 29th Street, NW, Calgary, Alberta, T2N 2T9, Canada. .
Fisher DA; Department of Medicine, University of Calgary, Alberta, Canada.; Calgary Tuberculosis Services, Alberta, Canada.
Kunimoto DY; Edmonton Tuberculosis Program, Alberta, Canada.; Faculty of Medicine and Dentistry, University of Alberta, Alberta, Edmonton, Canada.
Jarand JM; Department of Medicine, University of Calgary, Alberta, Canada.; Calgary Tuberculosis Services, Alberta, Canada.
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Źródło :
BMC Infectious Diseases [BMC Infect Dis] 2019 Jan 29; Vol. 19 (1), pp. 97. Date of Electronic Publication: 2019 Jan 29.
Typ publikacji :
Journal Article
Język :
English
Journal Info :
Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect. Dis. Subsets: MEDLINE
Imprint Name(s) :
Original Publication: London : BioMed Central, [2001-
MeSH Terms :
Cooperative Behavior*
Patient Care Team*/organization & administration
Patient Care Team*/standards
Patient Selection*
Erythema Induratum/*therapy
Standard of Care/*standards
Tuberculosis, Ocular/*therapy
Adult ; Antitubercular Agents/therapeutic use ; Canada/epidemiology ; Erythema Induratum/complications ; Erythema Induratum/epidemiology ; Female ; Follow-Up Studies ; Health Services Needs and Demand ; Humans ; Incidence ; Male ; Middle Aged ; Mycobacterium tuberculosis/physiology ; Quality Improvement/organization & administration ; Quality Improvement/standards ; Reference Standards ; Retrospective Studies ; Standard of Care/organization & administration ; Treatment Outcome ; Tuberculosis, Ocular/complications ; Tuberculosis, Ocular/epidemiology ; Young Adult
Contributed Indexing :
Keywords: Canada; Erythema induratum; Treatment outcome; Tuberculids; Tuberculosis; Tuberculosis-associated ocular inflammation; Uveitis
Substance Nomenclature :
0 (Antitubercular Agents)
Entry Date(s) :
Date Created: 20190131 Date Completed: 20190307 Latest Revision: 20190307
Update Code :
20190308
DOI :
10.1186/s12879-019-3737-5
PMID :
30696400
Czasopismo naukowe
Background: Erythema induratum of Bazin (EIB) - nodular vasculitis associated with Mycobacterium tuberculosis (TB) - and Tuberculosis-Associated Ocular Inflammation (TB-AOI) represent uncommon manifestations of TB. There is limited data and a lack of diagnostic and treatment standards for these conditions.
Methods: Eleven-year retrospective review of EIB and TB-AOI cases managed in a provincial TB program with prospective phone-based follow-up of anti-tubercular therapy (ATT) recipients. Presumptive TB-AOI and EIB diagnoses were determined by ophthalmologist or dermatologist assessments correlated with positive tuberculin skin test and/or QuantiFERON-TB Gold, along with pathologic criteria in EIB cases.
Results: Of 21 EIB and 20 TB-AOI cases that received ATT, 13 and 11, respectively, were reached for follow-up. The majority of EIB and TB-AOI cases were female and immigrated from TB high-burden countries. Median durations of pre-diagnosis symptoms were 2 and 0.8 years (IQR 2.5 & 1.1) for EIB and TB-AOI cases, respectively. Overall, 14 different ATT regimens were used for a median duration of 6 months (range 5-9). ATT related adverse events resulting in treatment discontinuation occurred in 14% of EIB and 10% of TB-AOI cases. On last follow-up, 76% of EIB and 42% of TB-AOI had improvement or resolution of disease.
Conclusion: EIB and TB-AOI were uncommon presentations receiving variable therapy. While treatment response was modest for EIB cases, TB-AOI cases had sub-optimal treatment outcomes. The unique diagnostic and management challenges presented by these conditions in TB low-incidence settings highlight a need for improved treatment candidate selection, therapy standardization, and cross-specialty medical collaboration.
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