Document Detail


Case report: extra pulmonary tuberculosis in sickle cell disease.
MedLine Citation:
PMID:  17312749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In apparently healthy individuals, tuberculosis (TB) affects mainly the lungs however, worsening immune status tend to predispose to an increased tendency for extra-pulmonary tuberculosis (EPTB). We report the case of a 22 year old known sickle cell anaemia (HBS) female student with three-month history of bilateral hip pain, weight loss and swelling of the left hip with multiple discharging sinuses, paraplegia and recurrent fever. There was no preceding history of trauma. Full Blood Count (FBC) revealed leukocytosis with neutrophilia, monocytosis, thrombocytosis and Packed Cell Volume (PCV) of 23%. Erythrocyte sedimentation rate (ESR) was 120mm/Hr (Western Green) and retroviral screening was negative. Bacteriologic culture of the discharging sinuses grew Escherichia coli and Staphylococcus aureus, both sensitive to sparfloxacin. Smear microscopy for acid-fast-bacilli (AFB) was negative. Chest X-Ray was reported normal but X-Ray of the pelvis showed loss of L4/L5 disc space and appearances suggestive of avascular necrosis of the femoral heads. Clinical and haematological profile of the patient started to improve by the second month on therapeutic trial of anti-TB regimen. She had nine-month course of therapy and later discharged to physiotherapy clinic. Management of EPTB requires a high index of clinical suspicion and well-equipped laboratory to support the diagnosis. Therefore, this case report highlights the need to upgrade TB-diagnostic facilities in this environment.
Authors:
A O Kehinde; J A Olaniyi; E E Fakunle
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  African journal of medicine and medical sciences     Volume:  35     ISSN:  0309-3913     ISO Abbreviation:  Afr J Med Med Sci     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2007-02-22     Completed Date:  2007-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7801013     Medline TA:  Afr J Med Med Sci     Country:  Nigeria    
Other Details:
Languages:  eng     Pagination:  381-4     Citation Subset:  IM    
Affiliation:
Tuberculosis Research Laboratory, Department of Medical Microbiology and Parasitology, College of Medicine, University College Hospital, Ibadan, Nigeria. aokehinde@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anemia, Sickle Cell / complications*
Antitubercular Agents / therapeutic use
Blood Sedimentation
Drug Therapy, Combination
Female
Humans
Leukocyte Count
Platelet Count
Tuberculosis, Spinal / complications*,  diagnosis,  drug therapy
Chemical
Reg. No./Substance:
0/Antitubercular Agents

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