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1.  Diabetes mellitus: an important risk factor for reactivation of tuberculosis 
Summary
Diabetes mellitus was identified as a risk factor for developing tuberculosis (TB) infection, and relapse after therapy. The risk of acquiring TB is described as comparable to that of HIV population. The fact that diabetics are 3× times more prone to develop pulmonary TB than nondiabetics cannot be overlooked. With DM recognized as global epidemic, and TB affecting one-third of the world population, physicians must remain vigilant. We present a 45-year-old woman born in Dominican Republic (DR), with 10-year history of T2DM treated with metformin, arrived to our Urgency Room complaining of dry cough for the past 3months. Interview unveiled unintentional 15lbs weight loss, night sweats, occasional unquantified fever, and general malaise but denied bloody sputum. She traveled to DR 2years before, with no known ill exposure. Physical examination showed a thin body habitus, otherwise well appearing woman with stable vital signs, presenting solely right middle lung field ronchi. LDH, ESR, hsCRP and Hg A1C were elevated. Imaging revealed a right middle lobe cavitation. Sputum for AFB disclosed active pulmonary TB. Our case portrays that the consideration of TB as differential diagnosis in diabetics should be exercised with the same strength, as it is undertaken during the evaluation of HIV patients with lung cavitation. Inability to recognize TB will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace.
Learning points
Diabetes mellitus should be considered an important risk factor for the reactivation of pulmonary tuberculosis.High clinical suspicious should be taken into consideration as radiological findings for pulmonary tuberculosis in patients with diabetes mellitus may be atypical, involving middle and lower lobes.Inability to recognize pulmonary tuberculosis will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace.
doi:10.1530/EDM-16-0035
PMCID: PMC4967108  PMID: 27482384
2.  Cannon ball appearance on radiology in a middle-aged diabetic female 
Pulmonary tuberculosis is commonly presented as cavitary lesion and infiltrations. It commonly involves upper lobe. Lower lobe involvement is less common. Various atypical presentations of tuberculosis on radiology are reported like mass, solitary nodule, multi lober involvement including lower lobes. Atypical presentations are more commo in patients with immunocompromised conditions like Diabetes Mellitus, anemia, renal failure, liver diseases, HIV infection, malignancy, patients on immunosuppressive therapy. Cannon ball presentation of pulmonary tuberculosis is extremely rare and not so common. Common causes of cannon ball presentation in lung are metastasis, fungal infections, Wegener's grannulomatosis, sarcoidosis, etc. We report here a case of middle year female with diabetes mellitus presented with atypical symptoms with cannon ball appearance on radiology and found to be of tuberculosis in origin. Thus any patients with immunocompromised condition can present with atypical manifestation of tuberculosis either clinically or radiologicaly in high endemic countries for tuberculosis.
doi:10.4103/0970-2113.188988
PMCID: PMC5006345  PMID: 27625459
Cannon ball appearance; diabetes; pulmonary tuberculosis
3.  Report of the Committee on the Classification and Diagnostic Criteria of Diabetes Mellitus 
Abstract
Concept of Diabetes Mellitus:
Diabetes mellitus is a group of diseases associated with various metabolic disorders, the main feature of which is chronic hyperglycemia due to insufficient insulin action. Its pathogenesis involves both genetic and environmental factors. The long‐term persistence of metabolic disorders can cause susceptibility to specific complications and also foster arteriosclerosis. Diabetes mellitus is associated with a broad range of clinical presentations, from being asymptomatic to ketoacidosis or coma, depending on the degree of metabolic disorder.
Classification (Tables 1 and 2, and Figure 1):
 Etiological classification of diabetes mellitus and glucose metabolism disorders
Note: Those that cannot at present be classified as any of the above are called unclassifiable.
The occurrence of diabetes‐specific complications has not been confirmed in some of these conditions.
 Diabetes mellitus and glucose metabolism disorders due to other specific mechanisms and diseases
The occurrence of diabetes‐specific complications has not been confirmed in some of these conditions.
 A scheme of the relationship between etiology (mechanism) and patho‐physiological stages (states) of diabetes mellitus. Arrows pointing right represent worsening of glucose metabolism disorders (including onset of diabetes mellitus). Among the arrow lines, indicates the condition classified as ‘diabetes mellitus’. Arrows pointing left represent improvement in the glucose metabolism disorder. The broken lines indicate events of low frequency. For example, in type 2 diabetes mellitus, infection can lead to ketoacidosis and require temporary insulin treatment for survival. Also, once diabetes mellitus has developed, it is treated as diabetes mellitus regardless of improvement in glucose metabolism, therefore, the arrow lines pointing left are filled in black. In such cases, a broken line is used, because complete normalization of glucose metabolism is rare.
The classification of glucose metabolism disorders is principally derived from etiology, and includes staging of pathophysiology based on the degree of deficiency of insulin action. These disorders are classified into four groups: (i) type 1 diabetes mellitus; (ii) type 2 diabetes mellitus; (iii) diabetes mellitus due to other specific mechanisms or diseases; and (iv) gestational diabetes mellitus. Type 1 diabetes is characterized by destruction of pancreatic β‐cells. Type 2 diabetes is characterized by combinations of decreased insulin secretion and decreased insulin sensitivity (insulin resistance). Glucose metabolism disorders in category (iii) are divided into two subgroups; subgroup A is diabetes in which a genetic abnormality has been identified, and subgroup B is diabetes associated with other pathologic disorders or clinical conditions. The staging of glucose metabolism includes normal, borderline and diabetic stages depending on the degree of hyperglycemia occurring as a result of the lack of insulin action or clinical condition. The diabetic stage is then subdivided into three substages: non‐insulin‐ requiring, insulin‐requiring for glycemic control, and insulin‐dependent for survival. The two former conditions are called non‐insulin‐dependent diabetes and the latter is known as insulin‐dependent diabetes. In each individual, these stages may vary according to the deterioration or the improvement of the metabolic state, either spontaneously or by treatment.
Diagnosis (Tables 3–7 and Figure 2):
 Criteria of fasting plasma glucose levels and 75 g oral glucose tolerance test 2‐h value
*Casual plasma glucose ≥200 mg/dL (≥11.1 mmol/L) and HbA1c≥6.5% are also regarded as to indicate diabetic type.
Even for normal type, if 1‐h value is 180 mg/dL (10.0 mmol/L), the risk of progression to diabetes mellitus is greater than for <180 mg/dL (10.0 mmol/L) and should be treated as with borderline type (follow‐up observation, etc.). Fasting plasma glucose level of 100–109 mg/dL (5.5–6.0 mmol/L) is called ‘high‐normal’: within the range of normal fasting plasma glucose.
Plasma glucose level after glucose load in oral glucose tolerance test (OGTT) is not included in casual plasma glucose levels. The value for HbA1c (%) is indicated with 0.4% added to HbA1c (JDS) (%).
 Procedures for diagnosing diabetes mellitus
*The value for HbA1c (%) is indicated with 0.4% added to HbA1c (JDS) (%). **Hyperglycemia must be confirmed in a non‐stressful condition. OGTT, oral glucose tolerance test.
 Disorders and conditions associated with low HbA1c values
 Situations where a 75‐g oral glucose tolerance test is recommended
*The value for HbA1c (%) is indicated with 0.4% added to HbA1c (JDS) (%).
 Definition and diagnostic criteria of gestational diabetes mellitus
(IADPSG Consensus Panel, Reference 42, partly modified with permission of Diabetes Care).
 Flow chart outlining steps in the clinical diagnosis of diabetes mellitus. *The value for HbA1c (%) is indicated with 0.4% added to HbA1c (JDS) (%).
Categories of the State of Glycemia:  Confirmation of chronic hyperglycemia is essential for the diagnosis of diabetes mellitus. When plasma glucose levels are used to determine the categories of glycemia, patients are classified as having a diabetic type if they meet one of the following criteria: (i) fasting plasma glucose level of ≥126 mg/dL (≥7.0 mmol/L); (ii) 2‐h value of ≥200 mg/dL (≥11.1 mmol/L) in 75 g oral glucose tolerance test (OGTT); or (iii) casual plasma glucose level of ≥200 mg/dL (≥11.1 mmol/L). Normal type is defined as fasting plasma glucose level of <110 mg/dL (<6.1 mmol/L) and 2‐h value of <140 mg/dL (<7.8 mmol/L) in OGTT. Borderline type (neither diabetic nor normal type) is defined as falling between the diabetic and normal values. According to the current revision, in addition to the earlier listed plasma glucose values, hemoglobin A1c (HbA1c) has been given a more prominent position as one of the diagnostic criteria. That is, (iv) HbA1c≥6.5% is now also considered to indicate diabetic type. The value of HbA1c, which is equivalent to the internationally used HbA1c (%) (HbA1c [NGSP]) defined by the NGSP (National Glycohemoglobin Standardization Program), is expressed by adding 0.4% to the HbA1c (JDS) (%) defined by the Japan Diabetes Society (JDS).
Subjects with borderline type have a high rate of developing diabetes mellitus, and correspond to the combination of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) noted by the American Diabetes Association (ADA) and WHO. Although borderline cases show few of the specific complications of diabetes mellitus, the risk of arteriosclerosis is higher than those of normal type. When HbA1c is 6.0–6.4%, suspected diabetes mellitus cannot be excluded, and when HbA1c of 5.6–5.9% is included, it forms a group with a high risk for developing diabetes mellitus in the future, even if they do not have it currently.
Clinical Diagnosis:  1 If any of the criteria for diabetic type (i) through to (iv) is observed at the initial examination, the patient is judged to be ‘diabetic type’. Re‐examination is conducted on another day, and if ‘diabetic type’ is reconfirmed, diabetes mellitus is diagnosed. However, a diagnosis cannot be made only by the re‐examination of HbA1c alone. Moreover, if the plasma glucose values (any of criteria [i], [ii], or [iii]) and the HbA1c (criterion [iv]) in the same blood sample both indicate diabetic type, diabetes mellitus is diagnosed based on the initial examination alone. If HbA1c is used, it is essential that the plasma glucose level (criteria [i], [ii] or [iii]) also indicates diabetic type for a diagnosis of diabetes mellitus. When diabetes mellitus is suspected, HbA1c should be measured at the same time as examination for plasma glucose.2 If the plasma glucose level indicates diabetic type (any of [i], [ii], or [iii]) and either of the following conditions exists, diabetes mellitus can be diagnosed immediately at the initial examination.• The presence of typical symptoms of diabetes mellitus (thirst, polydipsia, polyuria, weight loss)• The presence of definite diabetic retinopathy3 If it can be confirmed that the above conditions 1 or 2 existed in the past, diabetes mellitus can be diagnosed or suspected regardless of the current test results.4 If the diagnosis of diabetes cannot be established by these procedures, the patient is followed up and re‐examined after an appropriate interval.5 The physician should assess not only the presence or absence of diabetes, but also its etiology and glycemic stage, and the presence and absence of diabetic complications or associated conditions.
Epidemiological Study:  For the purpose of estimating the frequency of diabetes mellitus, ‘diabetes mellitus’ can be substituted for the determination of ‘diabetic type’ from a single examination. In this case, HbA1c≥6.5% alone can be defined as ‘diabetes mellitus’.
Health Screening:  It is important not to misdiagnose diabetes mellitus, and thus clinical information such as family history and obesity should be referred to at the time of screening in addition to an index for plasma glucose level.
Gestational Diabetes Mellitus:  There are two hyperglycemic disorders in pregnancy: (i) gestational diabetes mellitus (GDM); and (ii) diabetes mellitus. GDM is diagnosed if one or more of the following criteria is met in a 75 g OGTT during pregnancy:
1 Fasting plasma glucose level of ≥92 mg/dL (5.1 mmol/L)2 1‐h value of ≥180 mg/dL (10.0 mmol/L)3 2‐h value of ≥153 mg/dL (8.5 mmol/L)
However, diabetes mellitus that is diagnosed by the clinical diagnosis of diabetes mellitus defined earlier is excluded from GDM. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00074.x, 2010)
doi:10.1111/j.2040-1124.2010.00074.x
PMCID: PMC4020724  PMID: 24843435
Diabetes mellitus; Clinical diagnosis; HbA1c
4.  Effect of age on presentation with diabetes: Comparison of nondiabetic patients with new smear-positive pulmonary tuberculosis patients 
Background:
Diabetes mellitus (DM) has been reported to modify the presenting features of pulmonary tuberculosis (PTB), but data regarding the effect of diabetes on the presentation of PTB are highly variable.
Objective:
To determine whether DM alters the demographic, clinical, and radiological manifestations of tuberculosis and whether the effect of diabetes varies with the age group of PTB patients.
Materials and Methods :
This prospective observational study was conducted on new smear-positive PTB patients with DM (PTB-DM group) and non-diabetic PTB patients (PTB group). Patients of both groups were again divided into six age groups (15–29, 30–39, 40–49, 50–59, 60–69, and >70 rears) to analyze and compare the impact of age on clinicoradiological presentations of PTB.
Results:
Patients in the PTB-DM group were significantly older (53.34 ± 14.06 year) in comparison to their nondiabetic counterparts (PTB group) (44.35 ± 18.14 year) (P < 0.001). The former group also had a lower male:female ratio, although the difference was not statistically significant (1.16:1 vs. 2.05:1, P = 0.101). Tuberculin positivity was significantly higher in the PTB group, compared with patients in the PTB-DM group (P < 0.004). The proportion of patients with lower lung field involvement (P = 0.003) and cavitations (P = 0.005) was also higher in the former group compared with the latter.
Conclusion:
Diabetic patients with tuberculosis were relatively older, had lower tuberculin positivity, and higher proportion of lower lung field involvement and cavitation in comparison to nondiabetic patients.
doi:10.4103/0970-2113.83975
PMCID: PMC3162756  PMID: 21886953
Comparative study; diabetes mellitus; pulmonary tuberculosis; radiology
5.  Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study 
PLoS ONE  2016;11(1):e0146876.
Background
The rising prevalence of diabetes mellitus (DM) worldwide, especially in developing countries, and the persistence of tuberculosis (TB) as a major public health issue in these same regions, emphasize the importance of investigating this association. Here, we compared the clinical profile and disease outcomes of TB patients with or without coincident DM in a TB reference center in Brazil.
Methods
We performed a retrospective analysis of a TB patient cohort (treatment naïve) of 408 individuals recruited at a TB primary care center in Brazil between 2004 and 2010. Data on diagnosis of TB and DM were used to define the groups. The study groups were compared with regard to TB disease presentation at diagnosis as well as to clinical outcomes such as cure and mortality rates upon anti-tuberculosis therapy (ATT) initiation. A composite score utilizing clinical, radiological and microbiological parameters was used to compare TB severity between the groups.
Results
DM patients were older than non-diabetic TB patients. In addition, diabetic individuals more frequently presented with cough, night sweats, hemoptysis and malaise than those without DM. The overall pattern of lung lesions assessed by chest radiographic examination was similar between the groups. Compared to non-diabetic patients, those with TB-diabetes exhibited positive acid-fast bacilli in sputum samples more frequently at diagnosis and at 30 days after ATT initiation. Notably, higher values of the TB severity score were significantly associated with TB-diabetes comorbidity after adjustment for confounding factors. Moreover, during ATT, diabetic patients required more frequent transfers to TB reference hospitals for complex clinical management. Nevertheless, overall mortality and cure rates were indistinguishable between the study groups.
Conclusions
These findings reinforce the idea that diabetes negatively impacts pulmonary TB severity. Our study argues for the systematic screening for DM in TB reference centers in endemic areas.
doi:10.1371/journal.pone.0146876
PMCID: PMC4709051  PMID: 26752596
6.  Predictors for Benign Solitary Pulmonary Nodule in Tuberculosis-Endemic Area 
Background
Solitary pulmonary nodule (SPN) may show different presentation in tuberculosis (TB)-endemic countries. The aim of this study was to identify clinical and radiological predictors favoring benign or malignant SPN in TB-endemic region.
Methods
Two hundred one SPNs in 201 consecutive Korean patients were included (<3 cm in diameter, all confirmed by pathology or bacteriology, 93 benign and 108 malignant diseases). For clinical parameters, age, sex, smoking status and amount, and past history of pulmonary tuberculosis and diabetes mellitus were investigated retrospectively. For radiological parameters, size, location, margin characteristics, presence of calcification, pleural tag, surrounding satellite nodule, cavitation, internal low attenuation, open bronchus sign, surrounding ground-glass opacity, enhancement pattern of the SPNs and mediastinal lymph node (LN) enlargement were analyzed on chest CT scans.
Results
Patients with a older age (60.7±9.6 vs 56.2±13.1, p = 0.008) and more than 40-pack years smoking (27.8% vs 14.0%, p = 0.017) were more frequently related with malignant than benign SPN. On chest CT scans, spiculated margin, contrast enhancement more than 20 Hounsfield unit and presence of pleural tag and mediastinal LN enlargement were more frequently observed in malignant than benign SPNs. In contrast to previous studies, satellite lesions (21.5% vs 1.9%, p < 0.001) and cavitation (20.4% vs 5.6%, p = 0.001) were more frequently seen in benign than malignant SPN. Positive predictive values of benignity were 90.9% and 76.0%, respectively, when satellite lesions and cavitation were found in cases of SPN.
Conclusion
Satellite lesions and cavitation on chest CT scan could be useful predictors for benign SPN in TB-endemic areas.
doi:10.3904/kjim.2001.16.4.236
PMCID: PMC4578052  PMID: 11855152
Pulmonary Coin Lesion; Risk Factors; Malignancy
7.  Are pulmonary opacities a marker of pulmonary tuberculosis? 
Background
On most occasions treatment of pulmonary tuberculosis is started by physicians based predominantly on radiological opacities. Since these opacities may not be suggestive of active pulmonary tuberculosis and most of these opacities may even remain unchanged after complete treatment, starting treatment solely on the basis of these opacities may lead to ambiguous end points of cure. In view of this, study of misdiagnosis of radiological opacities as active pulmonary tuberculosis by physicians was undertaken in one of the respiratory centers of Armed Forces hospitals.
Methods
This was a prospective study of patients referred to our center for confirmation of active disease and institutional therapy. All patients who were diagnosed as pulmonary tuberculosis predominantly on radiological basis by physicians were evaluated for active pulmonary tuberculosis clinically, radiologically and microbiologically. Patients found to have inactive disease were followed for one year. At three monthly review, history, clinical examination, sputum AFB and chest radiographs were done.
Results
There were 36 patients [all males, mean age: 36.9 years (range: 22–46 years)]. The most common initial presentation was of asymptomatic persons (33.3%) reporting for routine medical examination. The commonest radiological pattern was localized reticular opacities (52.8%)On follow up, only one patient was diagnosed to have pulmonary tuberculosis. The final diagnosis was consolidation in 6, bronchiectasis in 8, pulmonary tuberculosis in 1 and localized pulmonary fibrosis in 21 patients.
Conclusion
Diagnosing and treating tuberculosis predominantly on radiological basis is not appropriate and sputum microscopy and culture remains the cornerstone of diagnosing pulmonary tuberculosis.
doi:10.1016/j.mjafi.2013.02.002
PMCID: PMC3946516  PMID: 24623942
Pulmonary opacities; Radiological misdiagnosis; Pulmonary tuberculosis
8.  Glenohumeral tuberculous arthritis complicated with beta haemolytic streptococcus: An extraordinary rare association: A case report 
INTRODUCTION
Septic arthritis of the glenohumeral joint is a rare entity and its diagnosis is difficult with a superadded infection in the presence of underlying tuberculosis. We report the first case of group B beta haemolytic streptococcal glenohumeral arthritis with underlying tuberculosis.
CASE PRESENTATION
A 40 year old lady previously diagnosed to have poliomyelitis, rheumatoid arthritis, hepatitis C, and diabetes mellitus for the last 10 years, presented to the emergency room with diabetic ketoacidosis. Two weeks prior to presentation she developed fever along with pain and swelling in left shoulder with uncontrolled blood sugars. Local examination of the shoulder revealed global swelling with significant restricted range of motion. MRI showed a large multiloculated collection around the left shoulder joint extending into the axilla, and proximal arm. Urgent arthrotomy performed and about 120 ml thick pus was drained. The patient was started on clindamicin and antituberculous chemotherapy and her symptoms dramatically improved.
DISCUSSION
Bone and joint involvement accounts for approximately 2% of all reported cases of tuberculosis (TB), and it accounts for approximately 10% of the extra pulmonary cases of TB. Tuberculosis of the shoulder joint constitutes 1–10.5% of skeletal tuberculosis. Classical symptoms of fever, night sweats, and weight loss may be absent, and a concurrent pulmonary focus may not be evident in most cases.
CONCLUSION
Despite acute presentation of septic arthritis, in areas endemic for tuberculosis and particularly in an immunocompromised patient, workup for tuberculosis should be part of the routine evaluation.
doi:10.1016/j.ijscr.2011.09.008
PMCID: PMC3312055  PMID: 22382034
Glenohumeral tuberculous arthritis; Beta haemolytic streptococcus; Septic arthritis
9.  Overt diabetes mellitus among newly diagnosed Ugandan tuberculosis patients: a cross sectional study 
BMC Infectious Diseases  2013;13:122.
Background
There is a documented increase of diabetes mellitus in Sub Saharan Africa, a region where tuberculosis is highly endemic. Currently, diabetes mellitus is one of the recognised risk factors of tuberculosis. No study has reported the magnitude of diabetes mellitus among tuberculosis patients in Uganda, one of the countries with a high burden of tuberculosis.
Methods
This was a cross-sectional study conducted among 260 consenting adult patients with a confirmed diagnosis of tuberculosis admitted on the pulmonology wards of Mulago national referral and teaching hospital in Kampala, Uganda to determine the prevalence of diabetes mellitus and associated clinical factors. Laboratory findings as well as the socio-demographic and clinical data collected using a validated questionnaire was obtained. Point of care random blood sugar (RBS) testing was performed on all the patients prior to initiation of anti tuberculosis treatment. Diabetes mellitus was diagnosed if the RBS level was ≥ 200mg/dl in the presence of the classical symptoms of diabetes mellitus.
Results
The prevalence of diabetes mellitus among the admitted patients with tuberculosis was 8.5%. Only 5 (1.9%) patients with TB had a known diagnosis of diabetes mellitus at enrolment. Majority of the study participants with TB-DM co-infection had type 2 diabetes mellitus (n=20, 90.9%).
At bivariate analysis, raised mean ALT concentrations of ≥80 U/L were associated with DM (OR-6.1, 95% CI 1.4-26.36, p=0.032) and paradoxically, HIV co-infection was protective of DM (OR-0.32, 95% CI 0.13-0.79, P=0.016). The relationship between DM and HIV as well as that with ALT remained statistically significant at multivariate analysis (HIV: OR- 0.17 95%CI 0.06-0.51, p=0.002 and ALT: OR-11.42 95%CI 2.15-60.59, p=0.004).
Conclusion
This study demonstrates that diabetes mellitus is common among hospitalized tuberculosis patients in Uganda. The significant clinical predictors associated with diabetes mellitus among tuberculosis patients were HIV co-infection and raised mean serum alanine transaminase concentrations.
doi:10.1186/1471-2334-13-122
PMCID: PMC3599954  PMID: 23497232
10.  Prevalence of pulmonary tuberculosis in young adult patients with Type 1 diabetes mellitus in India 
Background
There is limited information on prevalence of pulmonary tuberculosis (PTB) in patients with type-1-diabetes. We assessed the prevalence of PTB in patients with type-1-diabetes attending the outpatient-clinic in a tertiary-care hospital.
Methods
151 patients with type-1-diabetes were screened for PTB by clinical examination and chest-radiography. Sputum Acid-Fast Bacilli Test (AFB) and Mycobacterium tuberculosis (M.tb) culture were performed in patients with clinical and radiological features suggestive of a possibility of PTB and also in those with history of PTB in the past. Their average glycated haemoglobin (HbA1c) during preceding 2 years was assessed. Sputum culture positive patients were managed by a pulmonologist.
Results
5/151 patients had respiratory symptoms and radiographic findings suggestive of PTB. 20/151 patients were asymptomatic but had history of PTB. Four of the five symptomatic patients and 12 with past PTB were positive for sputum M.tb by culture, giving a prevalence of 10.6 % sputum culture positive in type-1-diabetes. Average HbA1c was comparable in patients with and without positive sputum culture. ESR and Mantoux test were not discriminatory in these groups. Four clinically symptomatic M.tb culture positive and four asymptomatic patients with sputum culture positive for M.tb on two occasions (6 weeks apart) were put on antitubercular treatment (ATT). Patients who were culture positive for M.tb only on one occasion were kept on a close follow up.
Conclusions
Patients with type-1-diabetes mellitus in India have high prevalence of PTB. They need to be actively screened for PTB by sputum M.tb culture in order to initiate early treatment and to prevent transmission in the community.
doi:10.1186/s40248-016-0058-z
PMCID: PMC4862037  PMID: 27168934
Type1 Diabetes; Tuberculosis; HbA1c
11.  Evaluation of the status of tuberculosis as part of the clinical case definition of AIDS in India 
Postgraduate Medical Journal  2005;81(956):404-408.
Aim: To assess HIV associated tuberculosis in a high tuberculosis prevalence setting and its status in the clinical case definition of AIDS.
Methods: All HIV patients attending the infectious disease clinic, Varanasi, India between January 2001 and December 2003 were included in the study. They were stratified into three distinct immunological categories depending on their CD4 levels in accordance to Centers for Disease Control (CDC) classification. Tuberculosis of different organs was defined as detailed below.
Results: Tuberculosis was the commonest opportunistic disease, seen in 163 patients. Of these, 68 had exclusively pulmonary tuberculosis, 55 extrapulmonary disease, and 40 the disseminated form. Pulmonary and extrapulmonary tuberculosis had low positive predictive value (PPV) (51% and 42%) for CD4 levels of <200 when compared with the disseminated form (specificity 87% and PPV 75%). Among 86 patients with radiological evidence of tuberculosis, typical radiological features of post-primary tuberculosis were present in 60 cases (70%). Other features such as effusion (14 patients, 16%) and miliary shadows (12 patients, 14%) were comparatively rare.
Conclusion: Keeping pulmonary and extrapulmonary forms of tuberculosis in AIDS defining illness should be reconsidered. In a similar way tuberculosis in HIV patients from areas endemic with tuberculosis occurs in patients with a wide range of immune status and has a better prognosis than other AIDS defining illnesses. Therefore the inclusion of tuberculosis in clinical case definition of AIDS is not justified.
doi:10.1136/pgmj.2004.025726
PMCID: PMC1743281  PMID: 15937209
12.  Non-Caseating Granulomatous Infective Spondylitis: Melioidotic Spondylitis 
Asian Spine Journal  2016;10(6):1065-1071.
Study Design
Retrospective clinical analysis.
Purpose
To delineate the clinical presentation of melioidosis in the spine and to create awareness among healthcare professionals, particularly spine surgeons, regarding the diagnosis and treatment of melioidotic spondylitis.
Overview of Literature
Melioidosis is an emerging disease, particularly in developing countries, associated with a high mortality rate. Its causative pathogen, Burkholderia pseudomallei, has been labeled as a bio-terrorism agent.
Methods
We performed a retrospective analysis of patients who were culture positive for B. pseudomallei. Assessment of patients was performed using clinical, radiological, and blood parameters. Clinical measures included pain, neurological deficit, and return to work. Radiological measures included plain radiography of the spine and magnetic resonance imaging. Blood tests included erythrocyte sedimentation rate and C-reactive protein levels.
Results
Four patients having melioidosis with spondylitis were evaluated. All of them had diabetes mellitus; three had multiple abscesses which required incision and drainage. Their clinical spectrum was similar to that of tuberculous spondylitis; all had back pain and radiology revealed infective spondylodiscitis with prevertebral and paravertebral collections with psoas abscess. Three patients underwent ultrasound-guided drainage of the psoas abscess and one had aspiration of the subcutaneous abscess. Bacteriological cultures showed presence of B. pseudomallei, and histopathology showed non-caseating granulomatous inflammation. All patients were treated with intravenous Ceftazidime for 2 weeks, followed by oral bactrim double strength and Doxycycline for 20 weeks. All patients improved with treatment and were healed at follow up.
Conclusions
Melioidosis presents with a clinical spectrum similar to that of tuberculosis. A diagnosis of melioidotic spondylitis should be considered, particularly in patients with diabetes with neutrophilic leukocytosis and clinical-radiological features suggestive of infective spondylodiscitis. Bacteriological culture and histopathology helps in differentiating the two conditions. Health education for healthcare professionals is important for correctly diagnosing this disease.
doi:10.4184/asj.2016.10.6.1065
PMCID: PMC5164996  PMID: 27994782
Burkholderia pseudomallei; Melioidosis; Tuberculosis; Spondylitis; Non-caseating granuloma; Antibiotics
13.  The association of hyperglycaemia with prevalent tuberculosis: a population-based cross-sectional study 
BMC Infectious Diseases  2016;16:733.
Background
Systematic reviews suggest that the incidence of diagnosed tuberculosis is two- to- three times higher in those with diabetes mellitus than in those without. Few studies have previously reported the association between diabetes or hyperglycaemia and the prevalence of active tuberculosis and none in a population-based study with microbiologically-defined tuberculosis. Most have instead concentrated on cases of diagnosed tuberculosis that present to health facilities. We had the opportunity to measure glycaemia alongside prevalent tuberculosis. A focus on prevalent tuberculosis enables estimation of the contribution of hyperglycaemia to the population prevalence of tuberculosis.
Methods
A population-based cross-sectional study was conducted among adults in 24 communities from Zambia and the Western Cape (WC) province of South Africa. Prevalent tuberculosis was defined by the presence of a respiratory sample that was culture positive for M. tuberculosis. Glycaemia was measured by random blood glucose (RBG) concentration. Association with prevalent tuberculosis was explored across the whole spectrum of glycaemia.
Results
Among 27,800 Zambian and 11,367 Western Cape participants, 4,431 (15.9%) and 1,835 (16.1%) respectively had a RBG concentration ≥7.0 mmol/L, and 405 (1.5%) and 322 (2.8%) respectively had a RBG concentration ≥11.1 mmol/L. In Zambia, the prevalence of tuberculosis was 0 · 5% (142/27,395) among individuals with RBG concentration <11.1 mmol/L and also ≥11.1 mmol/L (2/405); corresponding figures for WC were 2 · 5% (272/11,045) and 4 · 0% (13/322). There was evidence for a positive linear association between hyperglycaemia and pulmonary prevalent tuberculosis. Taking a RBG cut-off 11.1 mmol/L, a combined analysis of data from Zambian and WC communities found evidence of association between hyperglycaemia and TB (adjusted odds ratio = 2 · 15, 95% CI [1 · 17–3 · 94]). The population attributable fraction of prevalent tuberculosis to hyperglycaemia for Zambia and WC combined was 0.99% (95% CI 0 · 12%–1.85%) for hyperglycaemia with a RBG cut-off of 11.1 mmol/L.
Conclusions
This study demonstrates an association between hyperglycaemia and prevalent tuberculosis in a large population-based survey in Zambia and Western Cape. However, assuming causation, this association contributes little to the prevalence of TB in these populations.
doi:10.1186/s12879-016-2066-1
PMCID: PMC5139015  PMID: 27919230
Zambia; South Africa; Logistic regression
14.  NK-CD11c+ Cell Crosstalk in Diabetes Enhances IL-6-Mediated Inflammation during Mycobacterium tuberculosis Infection 
PLoS Pathogens  2016;12(10):e1005972.
In this study, we developed a mouse model of type 2 diabetes mellitus (T2DM) using streptozotocin and nicotinamide and identified factors that increase susceptibility of T2DM mice to infection by Mycobacterium tuberculosis (Mtb). All Mtb-infected T2DM mice and 40% of uninfected T2DM mice died within 10 months, whereas all control mice survived. In Mtb-infected mice, T2DM increased the bacterial burden and pro- and anti-inflammatory cytokine and chemokine production in the lungs relative to those in uninfected T2DM mice and infected control mice. Levels of IL-6 also increased. Anti-IL-6 monoclonal antibody treatment of Mtb-infected acute- and chronic-T2DM mice increased survival (to 100%) and reduced pro- and anti-inflammatory cytokine expression. CD11c+ cells were the major source of IL-6 in Mtb-infected T2DM mice. Pulmonary natural killer (NK) cells in Mtb-infected T2DM mice further increased IL-6 production by autologous CD11c+ cells through their activating receptors. Anti-NK1.1 antibody treatment of Mtb-infected acute-T2DM mice increased survival and reduced pro- and anti-inflammatory cytokine expression. Furthermore, IL-6 increased inflammatory cytokine production by T lymphocytes in pulmonary tuberculosis patients with T2DM. Overall, the results suggest that NK-CD11c+ cell interactions increase IL-6 production, which in turn drives the pathological immune response and mortality associated with Mtb infection in diabetic mice.
Author Summary
In the current study, we employed an experimentally induced type 2 diabetes mellitus (T2DM) model in wild type C57BL/6 mice and investigated the immune response to Mycobacterium tuberculosis (Mtb) infection. We found that natural killer (NK) and CD11c+ cell interactions in Mtb-infected T2DM mice led to increased IL-6 production, which drives the pathological immune response and reduces survival of Mtb-infected T2DM mice. We also found that IL-6 increases inflammatory cytokine production in pulmonary tuberculosis patients with T2DM. The NK-CD11c+ axis and the IL-6 pathway may be promising new targets for host-directed therapies aimed at reducing the severity of immune pathology, which drives morbidity and mortality in those infected by tuberculosis (TB).The study demonstrates for the first time that NK-CD11c+ cell interactions increase IL-6-mediated inflammation and reduce survival in T2DM mice infected with Mtb. The NK-CD11c+ cell axis appears to be a promising new target for reducing inflammation and mortality in tuberculosis patients with type 2 diabetes.
doi:10.1371/journal.ppat.1005972
PMCID: PMC5082658  PMID: 27783671
15.  Non-healing gastro-duodenal ulcer: A rare presentation of primary abdominal tuberculosis 
Highlights
•This case has illustrated the difficulty of promptly diagnosing an unusual case of primary duodenal tuberculosis from chronic peptic ulcer disease, in the absence of pulmonary involvement in an immunocompetent patient.•A high index of clinical suspicion with a multidisciplinary team approach is required.•The first line of treatment for gastrointestinal tuberculosis is medical treatment, indicating that 6 months of an anti-tuberculosis regime is satisfactory. Surgical treatment should be sought for patients who develop complications such as obstruction, perforation, and stricture formation.•In the absence of positive pathological (polymerase chain reaction or acid-fast bacilli staining) and radiologic tests, the diagnosis is often established by obtaining a surgical histopathology specimen.
INTRODUCTION
We present a case of primary gastrointestinal tuberculosis that has culminated in ulcer formation, in the absence of pulmonary involvement in an immunocompetent patient.
PRESENTATION OF CASE
A 28-year-old Asian male presented to casualty with a 1-week history of epigastric cramping abdominal pain and several episodes of non-bilious vomiting. The patient deteriorated clinically, becoming more cachectic and given his unexplained weight loss, an oesophageal-gastro-duodenal endoscopic imaging confirmed a duodenal ulcer. The biopsy of the non-healing ulcer was the hallmark of the disease, revealing evidence of granulomatous inflammation consistent with tuberculosis bacilli.
DISCUSSION
Gastrointestinal tuberculosis with ulceration is rare with respect to the oesophagus, stomach and duodenum. This case proves to be unique, as our patient had experienced primary isolated gastric tuberculosis in the absence of pulmonary tuberculosis in a healthy individual. Immunohistochemical staining, histopathology and radiological investigations have demonstrated their importance in confirming abdominal tuberculosis and the extent of bowel involvement.
CONCLUSION
This case has illustrated the difficulties associated with a prompt diagnosis of an unusual case of primary duodenal tuberculosis from chronic peptic ulcer disease in an immunocompetent patient.
doi:10.1016/j.ijscr.2014.09.028
PMCID: PMC4347962  PMID: 25506841
Tuberculosis; Duodenum; Abdominal; Ulcer; Pathogenesis; Investigation
16.  Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report 
Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.
doi:10.4046/trd.2015.78.4.463
PMCID: PMC4620353  PMID: 26508947
Histiocytosis, Langerhans-Cell; Cystic Disease of Lung; Diabetes Insipidus; Diabetes Mellitus; Smoking Cessation
17.  Diabetes Mellitus Increases the Risk of Active Tuberculosis: A Systematic Review of 13 Observational Studies 
PLoS Medicine  2008;5(7):e152.
Background
Several studies have suggested that diabetes mellitus (DM) increases the risk of active tuberculosis (TB). The rising prevalence of DM in TB-endemic areas may adversely affect TB control. We conducted a systematic review and a meta-analysis of observational studies assessing the association of DM and TB in order to summarize the existing evidence and to assess methodological quality of the studies.
Methods and Findings
We searched the PubMed and EMBASE databases to identify observational studies that had reported an age-adjusted quantitative estimate of the association between DM and active TB disease. The search yielded 13 observational studies (n = 1,786,212 participants) with 17,698 TB cases. Random effects meta-analysis of cohort studies showed that DM was associated with an increased risk of TB (relative risk = 3.11, 95% CI 2.27–4.26). Case-control studies were heterogeneous and odds ratios ranged from 1.16 to 7.83. Subgroup analyses showed that effect estimates were higher in non-North American studies.
Conclusion
DM was associated with an increased risk of TB regardless of study design and population. People with DM may be important targets for interventions such as active case finding and treatment of latent TB and efforts to diagnose, detect, and treat DM may have a beneficial impact on TB control.
In a systematic review and meta-analysis including more than 17,000 tuberculosis cases, Christie Jeon and Megan Murray find that diabetes mellitus is associated with an approximately 3-fold increased risk of tuberculosis.
Editors' Summary
Background.
Every year, 8.8 million people develop active tuberculosis and 1.6 million people die from this highly contagious infection that usually affects the lungs. Tuberculosis is caused by Mycobacterium tuberculosis, bacteria that are spread through the air when people with active tuberculosis cough or sneeze. Most infected people never become ill—a third of the world's population is actually infected with M. tuberculosis—because the human immune system usually contains the infection. However, the bacteria remain dormant within the body and can cause disease many years later if host immunity declines because of increasing age or because of other medical conditions such as HIV infection. Active tuberculosis can be cured by taking a combination of several antibiotics every day for at least six months, and current control efforts concentrate on prompt detection and carefully monitored treatment of people with active tuberculosis to prevent further transmission of the bacteria.
Why Was This Study Done?
Despite this control strategy, tuberculosis remains a major health problem in many countries. To reduce the annual number of new tuberculosis cases (incidence) and the number of people with tuberculosis (prevalence) in such countries, it may be necessary to identify and target factors that increase an individual's risk of developing active tuberculosis. One possible risk factor for tuberculosis is diabetes, a condition characterized by high blood sugar levels and long-term complications involving the circulation, eyes and kidneys, and the body's ability to fight infection. 180 million people currently have diabetes, but this number is expected to double by 2030. Low- to middle-income countries (for example, India and China) have the highest burden of tuberculosis and are experiencing the fastest increase in diabetes prevalence. If diabetes does increase the risk of developing active tuberculosis, this overlap between the diabetes and tuberculosis epidemics could adversely affect global tuberculosis control efforts. In this study, the researchers undertake a systematic review (a search using specific criteria to identify relevant research studies, which are then appraised) and a random effects meta-analysis (a type of statistical analysis that pools the results of several studies) to learn more about the association between diabetes and tuberculosis.
What Did the Researchers Do and Find?
From their search of electronic databases, the researchers found 13 observational studies (nonexperimental investigations that record individual characteristics and health outcomes without trying to influence them in any way) that had examined whether diabetes mellitus increases the risk of active tuberculosis. Diabetes was positively associated with tuberculosis in all but one study, but the estimates of how much diabetes increases the risk of developing active tuberculosis were highly variable, ranging from no effect to an increased risk of nearly 8-fold in one study. The variability may represent true differences between the study populations, as higher increases in risk due to diabetes was found in studies conducted outside of North America, including Central America, Europe, and Asia; or it may reflect differences in how well each study was done. This variability meant that the researchers could not include all of the studies in their meta-analysis. However, the three prospective cohort studies (studies that follow a group of individuals with potential risk factors for a disease over time to see if they develop that disease) that they had identified in their systematic review had more consistent effects estimates, and were included in the meta-analysis. This meta-analysis showed that, compared to people without diabetes, people with diabetes had a 3-fold increased risk of developing active tuberculosis.
What Do These Findings Mean?
These findings support the idea that diabetes increases the risk of tuberculosis, a biologically plausible idea because, in experimental and clinical studies, diabetes was found to impair the immune responses needed to control bacterial infections. The 3-fold increased risk of tuberculosis associated with diabetes that the meta-analysis reveals suggests that diabetes may already be responsible for more than 10% of tuberculosis cases in countries such as India and China, a figure that will likely increase as diabetes becomes more common.
However, the estimate of this impact is based on three cohort studies from Asia; other studies suggest that the extent of the impact due to diabetes may vary by region and ethnicity. In populations where diabetes affects the risk of tuberculosis to a similar or greater extent, global tuberculosis control might benefit from active case finding and treatment of dormant tuberculosis in people with diabetes and from increased efforts to diagnose and treat diabetes.
Additional Information.
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0050152.
The US National Institute of Allergy and Infectious Diseases provides information on all aspects of tuberculosis
The US Centers for Disease Control and Prevention provide several fact sheets and other information resources about tuberculosis
The World Health Organization provides information (in several languages) on efforts to reduce the global burden of tuberculosis, including information on the Stop TB Strategy and the 2008 report Global Tuberculosis Control—Surveillance, Planning, Financing
The US Centers for Disease Control and Prevention provides information for the public and professionals on all aspects of diabetes
The US National Institute of Diabetes and Digestive and Kidney Diseases also provides information about diabetes (in English and Spanish)
doi:10.1371/journal.pmed.0050152
PMCID: PMC2459204  PMID: 18630984
18.  Comparative analysis of pulmonary and extrapulmonary tuberculosis of 411 cases 
Background
Tuberculosis is a disease that can involve every organ system. While pulmonary tuberculosis is the most common presentation, extrapulmonary tuberculosis (EPT) is also an important clinical problem. The current study aimed to outline and compare the demographic and clinical features of pulmonary and extrapulmonary tuberculosis cases in adults.
Methods
Medical records of 411 patients (190 women, 221 men) treated between January 2010 and July 2014 in provincial tuberculosis control dispensary was retrospectively reviewed. Demographic and clinical characteristics were compared for pulmonary and extrapulmonary tuberculosis cases.
Results
Of these 411 cases, 208 (50.6 %) had pulmonary tuberculosis (PTB) and 203 were diagnosed with extrapulmonary tuberculosis (EPTB) (49.4 %). The average ages for PTB and EPTB groups were 33.00-27.00 and 31.00-29.75, respectively (p = 0.513). Men were more frequently affected by PTB (59.6 %), while EPTB was more commonly detected in women (52.2 %) (p = 0.016). Main diagnostic modalities for PTB were sputum/smear analyses (72.7 %), clinical-radiological data (21.7 %) and biopsy (6.1 %); while biopsy (71.5 %), sputum/fluid analysis (18.8 %) and clinical-radiological data (4.9 %) were used for confirming EPTB (p < 0.0019). The most common sites of EPTB involvement were lymph nodes (39.4 %), followed by pleura (23.6 %), peritoneum (9.9 %) and bone (7.4 %).
Conclusıons
Extrapulmonary involvement of tuberculosis is common and females are more likely to be affected. Increased clinical awareness is important since atypical presentations of the disease may constitute diagnostic and therapeutic challenges.
doi:10.1186/s12941-015-0092-2
PMCID: PMC4504222  PMID: 26104066
Tuberculosis; Pulmonary; Extrapulmonary; Epidemiology
19.  Imaging Features of Pulmonary CT in Type 2 Diabetic Patients with Multidrug-Resistant Tuberculosis 
PLoS ONE  2016;11(3):e0152507.
Background
Until now, radiographic manifestations of multidrug-resistant pulmonary tuberculosis (MDR- TB) in patients with diabetes mellitus (DM) have not been reported. We conducted a study to investigate the imaging features of pulmonary computed tomography (CT) for type 2 diabetic (T2DM) patients with MDR-TB.
Methods
The clinical data and pulmonary CT findings of 39 type 2 diabetic patients with MDR-TB, 46 type 2 diabetic patients with drug-susceptible tuberculosis (DS-TB), and 72 pure drug-susceptible TB cases (without T2DM and MDR) treated at Dalian Tuberculosis Hospital from 2012 to 2015 were collected, and the clinical features and imaging differences of the three groups were compared.
Results
The clinical characteristics of the three groups of patients were not significantly different except with respect to age and previous treatment history. However, on imaging, the patients with MDR-TB showed consolidation in and above the pulmonary segments was significantly more extensive than that seen in the DS-TB group with or without T2DM.
Conclusion
Consolidation in or above multiple pulmonary segments with multiple mouth-eaten cavities and bronchial damage on pulmonary CT images in type 2 diabetic patients with tuberculosis suggests the possibility of multi-drug resistance.
doi:10.1371/journal.pone.0152507
PMCID: PMC4811435  PMID: 27022735
20.  Comparison of Epidemiological, Clinical, Laboratory and Radiological Features of Hospitalized Diabetic and Non-Diabetic Patients With Pulmonary Tuberculosis at Razi Hospital in Ahvaz 
Background:
Diabetes mellitus (DM) due to suppressive effect on cellular immunity can impact on progression of tuberculosis (TB).
Objectives:
The aim of this study was to investigate the impact of DM on the epidemiological, clinical and para clinical aspects of pulmonary TB.
Patients and Methods:
The information of 148 admitted pulmonary TB patients in infectious ward of Razi hospital in Ahvaz from 2009 to 2010 was extracted from their medical files. The patients were divided into two groups as TB with DM (n = 36) and TB without DM (n = 112). The related data on epidemiology, signs, symptoms, radiology and sputum smear examination in both groups were compared in SPSS 16 by using chi squared test.
Results:
The mean age of TB with DM patients was higher TB without DM patients (56.6 ± 12.7 vs. 44.8 ± 18.3; respectively, P = 0.006). Whereas cough, night sweating, fever and weigh loss was not statistically different, sputum, hemoptysis and dyspnea was more prominent in TB with DM (69.4%, 33.4%, 44.5% vs. 36.6%, 9.8%, 20.5%; P = 0.005, P = 0.001, P = 0.005, respectively). In chest x-ray, cavitation and reticulonodular pattern was more frequent in TB with DM (55.5%, 22.2% vs. 31.2%, 8% - P = 0.008, P = 0.02, respectively). The rate of sputum smear positivity in TB with DM and TB without DM was 66.6% and 47.3%, respectively (P = 0.03).
Conclusions:
According to the results of this study, in approach to every DM cases suffering of respiratory symptoms such as productive cough, hemoptysis and dyspnea in association with cavitation or miliary mottling in chest x-ray, pulmonary TB should be considered at the top of the differential diagnosis list.
doi:10.5812/jjm.12447
PMCID: PMC4255379  PMID: 25485064
Pulmonary tuberculosis; Diabetes Mellitus; Epidemiology; Clinical Features; Radiology
21.  Vitamin D status of patients with type 2 diabetes and sputum positive pulmonary tuberculosis 
Introduction:
Vitamin D deficiency is expected to be higher in patients with diabetes and pulmonary tuberculosis (TB). Studies estimating prevalence in the subset of patients with both diabetes and pulmonary TB are scarce.
Materials and Methods:
A total of 155 subjects were recruited; 46 patients with type 2 diabetes, 39 non-diabetic healthy controls, 30 patients of pulmonary TB and 40 patients with both pulmonary TB and type 2 diabetes. Vitamin D level (25 OH vitamin D) levels were done for all the 4 groups.
Results:
Mean vitamin D levels were not different between groups with TB, diabetes mellitus or combination of both, but the prevalence of severe vitamin D deficiency was higher in the group with both diabetes and TB (45%) as compared with the group with only TB (26.66%) and diabetes (17.39%) and healthy controls (7.69%).
Conclusion:
The prevalence of patients with severe vitamin D deficiency is higher in patients with dual affection of TB and diabetes mellitus as compared with either disorder alone implying that patients with type 2 diabetes with the most severe vitamin D deficiency are the one of the most predisposed to pulmonary TB.
doi:10.4103/2230-8210.123564
PMCID: PMC4046604  PMID: 24910835
Diabetes; pulmonary tuberculosis; vitamin D deficiency
22.  Tuberculosis and diabetes mellitus: convergence of two epidemics 
The Lancet infectious diseases  2009;9(12):737-746.
The link between diabetes mellitus and tuberculosis has been recognised for centuries. In recent decades, tuberculosis incidence has declined in high-income countries, but incidence remains high in countries that have high rates of infection with HIV, high prevalence of malnutrition and crowded living conditions, or poor tuberculosis control infrastructure. At the same time, diabetes mellitus prevalence is soaring globally, fuelled by obesity. There is growing evidence that diabetes mellitus is an important risk factor for tuberculosis and might affect disease presentation and treatment response. Furthermore, tuberculosis might induce glucose intolerance and worsen glycaemic control in people with diabetes. We review the epidemiology of the tuberculosis and diabetes epidemics, and provide a synopsis of the evidence for the role of diabetes mellitus in susceptibility to, clinical presentation of, and response to treatment for tuberculosis. In addition, we review potential mechanisms by which diabetes mellitus can cause tuberculosis, the effects of tuberculosis on diabetic control, and pharmacokinetic issues related to the co-management of diabetes and tuberculosis.
doi:10.1016/S1473-3099(09)70282-8
PMCID: PMC2945809  PMID: 19926034
23.  The 12th Edition of the Scientific Days of the National Institute for Infectious Diseases “Prof. Dr. Matei Bals” and the 12th National Infectious Diseases Conference 
Niculae, Cristian-Mihail | Manea, Eliza | Jipa, Raluca | Merisor, Simona | Moroti, Ruxandra | Benea, Serban | Hristea, Adriana | Neguț, Alina Cristina | Săndulescu, Oana | Streinu-Cercel, Anca | Mărculescu, Dana | Andrei, Magdalena Lorena | Ilie, Veronica | Popa, Marcela | Bleotu, Coralia | Chifiriuc, Carmen | Popa, Mircea Ioan | Streinu-Cercel, Adrian | Orfanu, Alina | Popescu, Cristina | Leuștean, Anca | Catană, Remulus | Negru, Anca | Badea, Alexandra | Orfanu, Radu | Tilișcan, Cătălin | Aramă, Victoria | Aramă, Ştefan Sorin | Vișan, Constanța-Angelica | Drăgănescu, Anca-Cristina | Bilașco, Anuța | Kouris, Camelia | Merișescu, Mădălina | Vasile, Magdalena | Slavu, Diana-Maria | Vintilă, Sabina | Osman, Endis | Oprea, Alina | Sandu, Sabina | Luminos, Monica | Orfanu, Alina | Aramă, Victoria | Aramă, Ştefan Sorin | Leuştean, Anca | Catană, Remulus | Negru, Anca | Popescu, Gabriel Adrian | Popescu, Cristina | Stanculete, Ramona Georgiana | Enoiu, Ana Vaduva | Marinescu, Adelina Raluca | Lazureanu, Voichita | Marinescu, Adelina-Raluca | Crișan, Alexandru | Lăzureanu, Voichița | Musta, Virgil | Nicolescu, Narcisa | Laza, Ruxandra | Negru, Anca-Ruxandra | Munteanu, Daniela-Ioana | Mihăilescu, Raluca | Catană, Remulus | Dorobăț, Olga | Rafila, Alexandru | Căpraru, Emilia | Niculescu, Marius | Marinescu, Rodica | Lupescu, Olivera | Predescu, Vlad | Streinu-Cercel, Adrian | Aramă, Victoria | Tălăpan, Daniela | Popescu, Ramona Ștefania | Bradu, Luminița | Florea, Dragoș | Streinu-Cercel, Adrian | Leca, Daniela Anicuta | Bunea, Elena | Teodor, Andra | Miftode, Egidia | Merișescu, Mădălina | Jugulete, Gheorghiță | Streinu-Cercel, Adrian | Florea, Dragoș | Luminos, Monica | Popescu, Ramona Ștefania | Dobrotă, Anamaria | Ilie, Adina | Preoțescu, Liliana Lucia | Hristea, Adriana | Jipa, Raluca | Irimescu, Nicoleta | Panait, Irina | Manea, Eliza | Merisor, Simona | Niculae, Cristian | Tălăpan, Daniela | Gavriliu, Liana Cătălina | Benea, Otilia Elisabeta | Benea, Șerban | Rafila, Alexandru | Dorobăț, Olga | Popoiu, Mona | Dragonu, Livia | Cupşa, Augustin | Diaconescu, Iulian | Niculescu, Irina | Giubelan, Lucian | Dumitrescu, Florentina | Stoian, Andreea Cristina | Guţă, Camelia | Puiu, Simona | Irina, Bunescu | Vallée, Marilyse | Huletsky, Ann | Boudreau, Dominique K. | Bérubé, Ève | Giroux, Richard | Longtin, Jean | Longtin, Yves | Bergeron, Michel G. | Roșculeț, Cleo Nicoleta | Toma, Dalila-Ana | Ciuca, Catrinel | Tălăpan, Daniela | Apostolescu, Cătălin | Rogoz, Andrei | Stangaciu, Andrei | Mitescu, Viorica | Vladoiu, Tudor | Iovănescu, Doina | Oana, Michaela | Costin, Simona | Neguț, Alina Cristina | Săndulescu, Oana | Streinu-Cercel, Anca | Moțoi, Maria Magdalena | Popa, Mircea Ioan | Streinu-Cercel, Adrian | Tălăpan, Daniela | Dorobăț, Olga Mihaela | Popoiu, Mona | Mihai, Alexandru | Iovănescu, Doina | Roşculeț, Cleo | Apostolescu, Cătălin | Popescu, Gabriel-Adrian | Abagiu, Adrian | Moroti-Constantinescu, Ruxandra | Hristea, Adriana | Aramă, Victoria | Benea, Otilia | Simoiu, Mădălina | Bacruban, Rodica | Streinu-Cercel, Adrian | Rafila, Alexandru | Dorobăț, Olga Mihaela | Tălăpan, Daniela | Mihai, Alexandru | Bădicuț, Ioana | Popoiu, Mona | Borcan, Alina | Rafila, Alexandru | Popescu, Gabriel Adrian | Hurmuzache, Mihnea | Enache, Georgiana | Ciocan, Alexandra | Bararu, Mircea | Popazu, Madalina | Iovănescu, Doina Viorica | Roșculeț, Cleo Nicoleta | Rogoz, Andrei | Apostolescu, Cătălin Gabriel | Mitescu, Viorica | Vladoiu, Tudor | Toma, Dalila | Ciuca, Catrinel | Iliescu, Laura | Minzala, Georgiana | Toma, Letitia | Baciu, Mihaela | Tanase, Alina | Orban, Carmen | Pantea, Victor | Placinta, Gheorghe | Cebotarescu, Valentin | Cojuhari, Lilia | Jimbei, Paulina | Popescu, Cristina | Leuștean, Anca | Dragomirescu, Cristina | Orfanu, Alina | Murariu, Cristina | Stratan, Laurențiu | Badea, Alexandra | Tilișcan, Cătălin | Munteanu, Daniela | Năstase, Raluca | Molagic, Violeta | Rădulescu, Mihaela | Catană, Remulus | Aramă, Victoria | Popescu, Cristina | Stratan, Laurențiu | Catană, Remulus | Leuștean, Anca | Dragomirescu, Cristina | Badea, Alexandra | Murariu, Cristina | Năstase, Raluca | Molagic, Violeta | Munteanu, Daniela | Tilișcan, Cătălin | Rădulescu, Mihaela | Orfanu, Alina | Diaconu, Ioan | Negru, Anca | Bodosca, Iulia | Niță, Violeta | Aramă, Victoria | Leuștean, Anca | Aramă, Victoria | Orfanu, Alina | Catană, Remulus | Stratan, Laurențiu | Dragomirescu, Cristina | Murariu, Cristina | Badea, Alexandra | Tilișcan, Cătălin | Munteanu, Daniela | Molagic, Violeta | Năstase, Raluca | Rădulescu, Mihaela | Popescu, Cristina | Popescu, Cristina | Dragomirescu, Cristina | Leuștean, Anca | Murariu, Cristina | Stratan, Laurențiu | Badea, Alexandra | Catană, Remulus | Orfanu, Alina | Năstase, Raluca Mihaela | Molagic, Violeta | Munteanu, Daniela | Tilișcan, Cătălin | Aramă, Victoria | Aramă, Victoria | Catană, Remulus | Dragomirescu, Cristina | Murariu, Cristina | Leuștean, Anca | Stratan, Laurențiu | Badea, Alexandra | Orfanu, Alina | Negru, Anca | Năstase, Raluca | Molagic, Violeta | Munteanu, Daniela | Tilișcan, Cătălin | Rădulescu, Mihaela | Diaconu, Ioan | Niță, Violeta | Bodoșca, Iulia | Popescu, Cristina | Popescu, Cristina | Badea, Alexandra | Leuștean, Anca | Orfanu, Alina | Negru, Anca | Stratan, Laurențiu | Dragomirescu, Cristina | Catană, Remulus | Murariu, Cristina | Molagic, Violeta | Năstase, Raluca | Tilișcan, Cătălin | Munteanu, Daniela | Rădulescu, Mihaela | Diaconu, Ioan | Niță, Violeta | Bodoșca, Iulia | Aramă, Victoria | Popescu, Cristina | Orfanu, Alina | Leuștean, Anca | Badea, Alexandra | Stratan, Laurențiu | Catană, Remulus | Tilișcan, Cătălin | Aramă, Victoria | Popescu, Cristina | Murariu, Cristina | Dragomirescu, Cristina | Leuștean, Anca | Stratan, Laurențiu | Orfanu, Alina | Badea, Alexandra | Catană, Remulus | Negru, Anca | Tilișcan, Cătălin | Munteanu, Daniela | Rădulescu, Mihaela | Molagic, Violeta | Năstase, Raluca Mihaela | Diaconu, Ioan Alexandru | Bodoșca, Iulia | Niță, Violeta | Aramă, Victoria | Erturk, Yagmur | Săndulescu, Oana | Neguț, Alina Cristina | Șchiopu, Claudiu Mihai | Streinu-Cercel, Adrian | Streinu-Cercel, Anca | Molagic, Violeta | Tilișcan, Cătălin | Popescu, Cristina | Mihăilescu, Raluca | Munteanu, Daniela | Năstase, Raluca | Negru, Anca | Tenita, Angelica | Aramă, Victoria | Aramă, Ștefan Sorin | Iacob, Simona Alexandra | Iacob, Diana Gabriela | Luminos, Monica | Streinu-Cercel, Anca | Săndulescu, Oana | Predescu, Mioara | Mărdărescu, Alexandra | Tilișcan, Cătălin | Săndulescu, Mihai | Șchiopu, Claudiu Mihai | Streinu-Cercel, Adrian | Roșculeț, Cleo Nicoleta | Ciuca, Catrinel Olimpia | Toma, Dalila Ana | Apostolescu, Cătălin Gabriel | Rogoz, Andrei | Mitu, Cristina Elena | Stangaciu, Andrei | Mitescu, Viorica Daniela | Vladoiu, Tudor Gheorghe | Iovănescu, Doina Viorica | Săndulescu, Oana | Streinu-Cercel, Anca | Stoica, Monica Andreea | Preoțescu, Liliana Lucia | Manolache, Daniela | Ceapraga, Gabriela Jana | Moțoi, Maria Magdalena | Bradu, Luminița | Ilie, Adina | Mircea, Gabriela | Durbală, Ionel | Streinu-Cercel, Adrian | Russu, Irina | Holban, Tiberiu | Pantilimonov, Tatiana | Chiriacov, Galina | Macvovei, Arcadie | Scorohodico, Elena | Dmitriev, Oleg | Costache, Diana Alexandra | Benea, Anca | Manea, Eliza | Niculae, Cristian | Jipa, Raluca | Hristea, Adriana | Benea, Elisabeta | Moroti, Ruxandra | Benea, Șerban | Mitran, Mihai | Georgescu, Carmen | Mitran, Loredana | Vladareanu, Simona | Magirescu, Andreea Ioana | Andreev, Viorica | Nicolau, Cristina | Largu, Alexandra | Dorobat, Carmen | Manciuc, Carmen | Andreev, Viorica | Magirescu, Andreea Ioana | Isac, Ina | Nicolau, Cristina | Largu, Alexandra | Dorobat, Carmen | Manciuc, Carmen | Șerban, Iulia Gabriela | Resul, Ghiulendan | Marcaș, Consuela | Marincu, Iosif | Poptelecan, Patricia | Trincă, Bogdan | Mitrescu, Sorina | Tudor, Anca | Vlad, Daliborca | Tirnea, Livius | Baydaroglu, Nurcan | Neguț, Alina Cristina | Săndulescu, Oana | Manolache, Daniela | Ceapraga, Gabriela | Stoica, Monica Andreea | Streinu-Cercel, Anca | Streinu-Cercel, Adrian | Manciuc, Carmen | Pagute, Mariana | Nicolau, Cristina | Dorobăț, Carmen | Largu, Alexandra | Diaconu, Ioan-Alexandru | Stratan, Laurențiu | Ion, Daniela | Nichita, Luciana | Popescu, Cristina | Năstase, Raluca | Munteanu, Daniela | Molagic, Violeta | Tilișcan, Cătălin | Rădulescu, Mihaela | Diaconu, Alexandra | Negru, Anca | Orfanu, Alina | Dragomirescu, Cristina | Catană, Remulus | Leuștean, Anca | Duport-Dodot, Irina | Murariu, Cristina | Bodoșca, Iulia | Niță, Violeta | Badea, Alexandra | Aramă, Victoria | Mărdărescu, Mariana | Petre, Cristina | Iancu, Marieta | Ungurianu, Rodica | Cibea, Alina | Drăghicenoiu, Ruxandra | Tudor, Ana Maria | Vlad, Delia | Petrea, Sorin | Matei, Carina | Oțelea, Dan | Crăciun, Carmen | Anghelina, Cristian | Mărdărescu, Alexandra | Dumea, Elena | Streinu-Cercel, Adrian | Rugină, Sorin | Petcu, Lucian Cristian | Halichidis, Stela | Cambrea, Simona Claudia | Chiriac, Carmen | Bodnar, Nina-Ioana | Zaharia-Kezdi, Iringo-Erzsebet | Gîrbovan, Cristina | Incze, Andrea | Georgescu, Anca Meda | Iacob, Simona Alexandra | Iacob, Diana Gabriela | Panaitescu, Eugenia | Luminos, Monica | Cojocaru, Manole | Iacob, Simona Alexandra | Iacob, Diana Gabriela | Luminos, Monica | Laurențiu, Vochita | Andreia, Vochita | Radu, Opreanu | Bogdan, Trinca | Ovidiu, Rosca | Iosif, Marincu | Zamfir, Ramona | Angelescu, Alina | Popa, Alena Andreea | Jipa, Raluca | Moroti, Ruxandra | Hristea, Adriana | Gavriliu, Liana | Benea, Șerban | Benea, Elisabeta | Popa, Alena-Andreea | Ducu, Georgeta | Camburu, Daniela | Cozma, Alina | Podani, Manuela | Dumitriu, Roxana | Gavriliu, Liana | Benea, Șerban | Benea, Elisabeta | Stoian, Andreea Cristina | Dumitrescu, Florentina | Cupșa, Augustin | Giubelan, Lucian | Niculescu, Irina | Ionescu, Loredana | Dragonu, Livia | Abagiu, Adrian Octavian | Stoica, Loredana Nicoleta | Blaga, Catrinel | Koulosousas, Archontis | Ștefănescu, Roxana | Atomoaie, Alice | Paraschiv, Florentina | Duna, Florin Matache | Olteanu, Rodica | Ion, Roxana | Zota, Alexandra | Jaballah, Isra Ennour | Mahfoud, Lara | Preda, Georgeta | Constantin, Magda | Nicolae, Ilinca | Ene, Corina Daniela | Mitran, Mădălina Irina | Benea, Vasile | Tampa, Mircea | Georgescu, Simona Roxana | Bodoșca, Iulia Cristina | Murariu, Cristina | Tilișcan, Cătălin | Aramă, Victoria | Popescu, Cristina | Munteanu, Daniela | Rădulescu, Mihaela | Molagic, Violeta | Năstase, Raluca | Orfanu, Alina | Leuștean, Anca | Catană, Remulus | Negru, Anca | Streinu-Cercel, Adrian | Aramă, Sorin | Caramăngiu, Iuliana | Rosca, Ovidiu | Cialma, Monica | Opreanu, Radu | Vochita, Laurențiu | Marincu, Iosif | Murărescu, Vlad | Palaghiță, Marilena | Neguț, Alina Cristina | Camburu, Cornel | Streinu-Cercel, Adrian | Duşan, Irina | Poptelecan, Patricia | Trincă, Bogdan | Mitrescu, Sorina | Tirnea, Livius | Marincu, Iosif | Nicolescu, Narcisa | Crișan, Alexandru | Lăzureanu, Voichița | Laza, Ruxandra | Musta, Virgil | Marinescu, Adelina-Raluca | Bîrlad, Andreea | Miron, Victor Daniel | Drăgănescu, Anca Cristina | Vișan, Constanța-Angelica | Bilașco, Anuța | Pițigoi, Daniela | Săndulescu, Oana | Luminos, Monica Luminița | Luminos, Monica | Osman, Endis | Vasile, Magdalena | Drăgănescu, Anca Cristina | Vișan, Constanța-Angelica | Bilașco, Anuța | Kouris, Camelia | Șchiopu, Sabina | Merișescu, Mădălina | Luminos, Monica | Drăgănescu, Anca Cristina | Vișan, Constanța-Angelica | Bilașco, Anuța | Kouris, Camelia | Osman, Endis | Vintilă, Sabina | Vasile, Magda | Merișescu, Mădălina | Gavriliu, Liana Cătălina | Benea, Otilia Elisabeta | Angelescu, Alina | Zamfir, Ramona | Camburu, Daniela | Ducu, Georgeta | Cozma, Alina | Dumitriu, Roxana | Podani, Manuela | Benea, Șerban | Ionică, Mihaela | Jugulete, Gheorghiță | Stăncescu, Adina | Popescu, Cristina Elena | Marin, Luminița | Zaharia, Diana | Dumitrescu, Cristina | Tudor, Lucia | Vintilă, Sabina | Vișan, Constanța-Angelica | Drăgănescu, Anca Cristina | Bilașco, Anuța | Vasile, Magda | Merișescu, Mădălina | Kouris, Camelia | Negulescu, Cristina | Osman, Endis | Slavu, Diana-Maria | Vintilă, Sabina | Pițigoi, Daniela | Luminos, Monica | Caliman-Sturdza, Olga Adriana | Roșculeț, Cleo | Ciuca, Catrinel Olimpia | Toma, Dalila | Apostolescu, Cătălin | Rogoz, Andrei | Stangaciu, Andrei | Mitescu, Viorica | Iovănescu, Doina | Camburu, Cornel | Manu, Bogdana | Vaduva-Enoiu, Ana | Stanculete, Ramona Georgiana | Marinescu, Adelina Raluca | Lazureanu, Voichita Elena | Niță, Elena-Violeta | Dumitru, Sînziana | Munteanu, Daniela-Ioana | Negru, Anca Ruxandra | Catană, Remulus | Diaconu, Ioan | Manu, Bogdana | Ionescu, Ligia | Ion, Liliana | Tilișcan, Cătălin | Aramă, Victoria | Iovănescu, Doina Viorica | Roșculeț, Cleo Nicoleta | Rogoz, Andrei | Apostolescu, Cătălin | Mitescu, Viorica | Vladoiu, Tudor | Toma, Dalila | Ciuca, Catrinel | Șerban, Iulia Gabriela | Neacșu, Marioara | Georgescu, Simona Roxana | Benea, Vasile | Ene, Corina Daniela | Tampa, Mircea | Mitran, Cristina Iulia | Nicolae, Ilinca | Pribac, George Ciprian | Prisca, Mirandolina | Ursoiu, Fulvia | Neamtu, Carmen | Totolici, Bogdan | Cotoraci, Coralia | Ardelean, Aurel | Albu, Simona Elena | Carsote, Mara | Miclăuș, Beatrice | Mihai, Diana | Săndulescu, Oana | Vasiliu, Cristina | Vasiliu, Cristina | Carsote, Mara | Gorgoi, Corina | Miclăuș, Beatrice | Mihai, Diana | Săndulescu, Oana | Albu, Simona Elena | Blescun, Amelia | Breaza, Gelu | Vintila, Sabina | Mihai, Felicia | Omer, Meilin | Dragan, Cornel | Pitigoi, Daniela | Ciucu, Mirela | Ionescu, Marius-Dan | Roskanovic, Cristina | Barbu, Valentina | Diaconescu, Iulian | Dumitrescu, Florentina | Niculescu, Irina | Ionică, Mihaela | Zamfir, Ramona-Alexandra | Cozma, Alina | Benea, Otilia Elisabeta | Dumitru, Alexandra-Sînziana | Munteanu, Daniela-Ioana | Niță, Violeta | Popescu, Cristina | Bodosca, Iulia | Tenita, Angelica | Ispas, Viorica | Aramă, Victoria | Benea, Vasile | Georgescu, Simona Roxana | Tampa, Mircea | Leahu, Diana Oana | Safta, Cristina Maria | Benea, Mihaela Anca | Săndulescu, Oana | Munteanu, Octavian | Bohâlțea, Roxana | Trașcă, Livia | Cîrstoiu, Monica | Iovănescu, Doina Viorica | Roșculeț, Cleo Nicoleta | Rogoz, Andrei | Apostolescu, Cătălin Gabriel | Mitescu, Viorica Daniela | Vladoiu, Tudor Gheorghe | Toma, Dalila | Ciuca, Catrinel | Georgescu, Mădălina | Pițigoi, Daniela | Ivanciuc, Alina Elena | Lazar, Mihaela | Ionescu, Teodora | Cherciu, Carmen Maria | Țecu, Cristina | Mihai, Maria Elena | Nițescu, Maria | Bacruban, Rodica | Azamfire, Delia | Dumitrescu, Aura | Ianosik, Elena | Leca, Daniela | Duca, Elena | Teodor, Andra | Bejan, Codrina | Ceaușu, Emanoil | Florescu, Simin-Aysel | Popescu, Corneliu | Târdei, Grațiela | Juganariu, Codrina | Lupulescu, Emilia | Rodina, Ligia | Cocuz, Maria Elena | Jugulete, Gheorghiță | Stăncescu, Adina | Popescu, Cristina Elena | Marin, Luminița | Zaharia, Diana | Dumitrescu, Cristina | Osman, Endis | Niculescu, Irina | Cupșa, Augustin | Diaconescu, Iulian | Dumitrescu, Florentina | Dragonu, Livia | Stoian, Andreea | Giubelan, Lucian | Roskanovic, Cristina | Zamfir, Ramona-Alexandra | Ionica, Mihaela | Benea, Otilia-Elisabeta | Sîrbu, Maria-Cristina | Dobrotă, AnaMaria | Neguț, Alina Cristina | Duda, Roxana | Bacruban, Rodica | Pițigoi, Daniela | Dragomirescu, Cristiana Cerasella | Tălăpan, Daniela | Dorobăț, Olga | Streinu-Cercel, Adrian | Streinu-Cercel, Anca | Ionica, Mihaela | Zamfir, Ramona-Alexandra | Cozma, Alina | Benea, Otilia Elisabeta | Fendrihan, Sergiu | Scortan, Ecaterina | Popa, Mircea Ioan | Popescu, Corneliu P. | Benea, Șerban N. | Petcu, Andra E. | Hristea, Adriana | Abagiu, Adrian | Podea, Iuliana A. | Jipa, Raluca E. | Ducu, Georgeta | Hrișcă, Raluca M. | Florea, Dragoș | Nica, Manuela | Manea, Eliza | Merișor, Simona | Nicolae, Cristian M. | Florescu, Simin A. | Dumitru, Irina M. | Ceaușu, Emanoil | Rugină, Sorin | Moroti, Ruxandra V. | Pițigoi, Daniela | Ionescu, Teodora | Săndulescu, Oana | Nițescu, Maria | Nițescu, Bogdan | Mustaţă, Iulia Monica | Boldeanu, Sorina Claudia | Furtunescu, Florentina | Streinu-Cercel, Adrian | Iacob, Diana Gabriela | Iacob, Simona Alexandra | Gheorghe, Mihaela | Slavcovici, Adriana | Tripon, Raluca | Iubu, Roxana | Marcu, Cristian | Sabou, Mihaela | Muntean, Monica | Chiriac, Ion | Holban, Tiberiu | Tazlavanu, Liviu | Jipa, Raluca | Manea, Eliza | Cernat, Roxana | Iringo, Kezdi | Vâță, Andrei | Arbune, Manuela | Moisil, Teodora | Hristea, Adriana | Ene, Corina-Daniela | Nicolae, Ilinca | Georgescu, Roxana Simona | Ene, Corina-Daniela | Ene, Cosmin-Victor | Georgescu, Roxana Simona | Ciortea, Marilena | Dulgheru, Lucreția | Nicolae, Ilinca | Luca, Mihaela Cătălina | Harja-Alexa, Ioana-Alina | Nemescu, Roxana | Popazu, Mădălina | Luca, Andrei Ștefan | Bancescu, Gabriela | Dabu, Bogdan | Bancescu, Adrian | Manea, Eliza | Jipa, Raluca | Hristea, Adriana | Ilie, Adina Elena | Pohrib, Săftica-Mariana | Neguț, Alina Cristina | Tache, Maria-Sabina | Moțoi, Maria Magdalena | Săndulescu, Oana | Iliescu, Ion Aurel | Streinu-Cercel, Adrian | Tecu, Cristina | Mihai, Maria-Elena | Lazăr, Mihaela | Cherciu, Carmen | Ivanciuc, Alina | Pițigoi, Daniela | Lupulescu, Emilia | Paliu, Mirela | Curescu, Manuela | Cerbu, Bianca | Marincu, Iosif | Mihai, Maria Elena | Cherciu, Carmen Maria | Ivanciuc, Alina Elena | Tecu, Cristina | Lupulescu, Emilia | Bunescu, Irina | Holban, Tiberiu | Pasnin, Ana | Semeniuc, Stela | Popovici, Raisa | Chiriacov, Galina
BMC Infectious Diseases  2016;16(Suppl 4):31-76.
Table of contents
A1 The outcome of patients with recurrent versus non-recurrent pneumococcal meningitis in a tertiary health-care hospital in Bucharest
Cristian-Mihail Niculae, Eliza Manea, Raluca Jipa, Simona Merisor, Ruxandra Moroti, Serban Benea, Adriana Hristea
A2 Influence of bacteriophages on sessile Gram-positive and Gram-negative bacteria
Alina Cristina Neguț, Oana Săndulescu, Anca Streinu-Cercel, Dana Mărculescu, Magdalena Lorena Andrei, Veronica Ilie, Marcela Popa, Coralia Bleotu, Carmen Chifiriuc, Mircea Ioan Popa, Adrian Streinu-Cercel
A3 The utility of inflammatory biomarkers in the prognostic evaluation of septic patients – past, present and future
Alina Orfanu, Cristina Popescu, Anca Leuștean, Remulus Catană, Anca Negru, Alexandra Badea, Radu Orfanu, Cătălin Tilișcan, Victoria Aramă, Ştefan Sorin Aramă
A4 Etiologic and clinical features of bacterial meningitis in infants
Constanța-Angelica Vișan, Anca-Cristina Drăgănescu, Anuța Bilașco, Camelia Kouris, Mădălina Merișescu, Magdalena Vasile, Diana-Maria Slavu, Sabina Vintilă, Endis Osman, Alina Oprea, Sabina Sandu, Monica Luminos
A5 The diagnostic and prognostic role of neutrophil to lymphocyte count ratio in sepsis
Alina Orfanu, Victoria Aramă, Ştefan Sorin Aramă, Anca Leuştean, Remulus Catană, Anca Negru, Gabriel Adrian Popescu, Cristina Popescu
A6 Whooping cough in a HIV positive patient
Ramona Georgiana Stanculete, Ana Vaduva Enoiu, Adelina Raluca Marinescu, Voichita Lazureanu
A7 Cronobacter sakazakii sepsis in varicella patient
Adelina-Raluca Marinescu, Alexandru Crișan, Voichița Lăzureanu, Virgil Musta, Narcisa Nicolescu, Ruxandra Laza
A8 Anaerobes an underdiagnosed cause of prosthesis joint infection
Anca-Ruxandra Negru, Daniela-Ioana Munteanu, Raluca Mihăilescu, Remulus Catană, Olga Dorobăț, Alexandru Rafila, Emilia Căpraru, Marius Niculescu, Rodica Marinescu, Olivera Lupescu, Vlad Predescu, Adrian Streinu-Cercel, Victoria Aramă, Daniela Tălăpan
A9 Streptococcus pneumoniae meningitis presenting with normal CSF – case presentation
Ramona Ștefania Popescu, Luminița Bradu, Dragoș Florea, Adrian Streinu-Cercel
A10 Extrapulmonary manifestations of infection with Mycoplasma pneumoniae – study on 24 cases
Daniela Anicuta Leca, Elena Bunea, Andra Teodor, Egidia Miftode
A11 The molecular diagnosis of severe bacterial sepsis in pediatric population
Mădălina Merișescu, Gheorghiță Jugulete, Adrian Streinu-Cercel, Dragoș Florea, Monica Luminos
A12 Acute Staphylococcus aureus endocarditis with multiple septic complications in a patient with diabetes mellitus – case presentation
Ramona Ștefania Popescu, Anamaria Dobrotă, Adina Ilie, Liliana Lucia Preoțescu
A13 Is Streptococcus suis meningitis an under-diagnosed zoonosis?
Adriana Hristea, Raluca Jipa, Nicoleta Irimescu, Irina Panait, Eliza Manea, Simona Merisor, Cristian Niculae, Daniela Tălăpan
A14 Klebsiella pneumoniae isolated from blood. Antimicrobial resistance – past and present
Liana Cătălina Gavriliu, Otilia Elisabeta Benea, Șerban Benea, Alexandru Rafila, Olga Dorobăț, Mona Popoiu
A15 Antibiotics resistance in Staphylococcus aureus isolated from blood cultures
Livia Dragonu, Augustin Cupşa, Iulian Diaconescu, Irina Niculescu, Lucian Giubelan, Florentina Dumitrescu, Andreea Cristina Stoian, Camelia Guţă, Simona Puiu
A16 Predominance of CTX-M enzymes in extended-spectrum β-lactamase-producing Enterobacteriaceae in two hospitals of Quebec City
Bunescu Irina, Marilyse Vallée, Ann Huletsky, Dominique K. Boudreau, Ève Bérubé, Richard Giroux, Jean Longtin, Yves Longtin, Michel G. Bergeron
A17 Postoperative meningoencephalitis with Acinetobacter baumannii XDR – a therapeutic challenge - Case report
Cleo Nicoleta Roșculeț, Dalila-Ana Toma, Catrinel Ciuca, Daniela Tălăpan, Cătălin Apostolescu, Andrei Rogoz, Andrei Stangaciu, Viorica Mitescu, Tudor Vladoiu, Doina Iovănescu
A18 Septic arthritis with Burkholderia cepacia
Michaela Oana, Simona Costin
A19 A novel approach for managing hard-to-treat infections
Alina Cristina Neguț, Oana Săndulescu, Anca Streinu-Cercel, Maria Magdalena Moțoi, Mircea Ioan Popa, Adrian Streinu-Cercel
A20 Nineteen months surveillance for multidrug resistant organisms (MDRO) by detecting asymptomatic colonization
Daniela Tălăpan, Olga Mihaela Dorobăț, Mona Popoiu, Alexandru Mihai, Doina Iovănescu, Cleo Roşculeț, Cătălin Apostolescu, Gabriel-Adrian Popescu, Adrian Abagiu, Ruxandra Moroti-Constantinescu, Adriana Hristea, Victoria Aramă, Otilia Benea, Mădălina Simoiu, Rodica Bacruban, Adrian Streinu-Cercel, Alexandru Rafila
A21 Antimicrobial resistance of Gram-positive cocci isolated from clinical specimens in the National Institute of Infectious Diseases “Prof Dr. Matei Balș” between 2009–2015
Olga Mihaela Dorobăț, Daniela Tălăpan, Alexandru Mihai, Ioana Bădicuț, Mona Popoiu, Alina Borcan, Alexandru Rafila
A22 The high percentage of carbapenem-resistant Gram-negative bacilli in Romania: an analysis and some proposals
Gabriel Adrian Popescu
A23 Etiological, clinical and therapeutic considerations on 78 cases of healthcare associated meningitis or ventriculitis admitted in the “Sf. Parascheva” infectious diseases clinical hospital, Iași, from 2011 to 2015
Mihnea Hurmuzache, Georgiana Enache, Alexandra Ciocan, Mircea Bararu, Madalina Popazu
A24 Nosocomial infection dynamics in an Intensive Care Department – an overview (epidemiological and clinical monitoring, advanced therapeutic intervention).
Doina Viorica Iovănescu, Cleo Nicoleta Roșculeț, Andrei Rogoz Cătălin Gabriel Apostolescu, Viorica Mitescu, Tudor Vladoiu, Dalila Toma, Catrinel Ciuca
A25 Safety and efficacy of interferon free treatment in patients with HCV chronic hepatitis- experience of a single Internal Medicine center
Laura Iliescu, Georgiana Minzala, Letitia Toma, Mihaela Baciu, Alina Tanase, Carmen Orban
A26 Viusid in treatment of chronic viral hepatitis B and C
Victor Pantea, Gheorghe Placinta, Valentin Cebotarescu, Lilia Cojuhari, Paulina Jimbei
A27 The management of hyperbilirubinemia in HCV cirrhotic patients who underwent therapy with direct acting antivirals
Cristina Popescu, Anca Leuștean, Cristina Dragomirescu, Alina Orfanu, Cristina Murariu, Laurențiu Stratan, Alexandra Badea, Cătălin Tilișcan, Daniela Munteanu, Raluca Năstase, Violeta Molagic, Mihaela Rădulescu, Remulus Catana, Victoria Aramă
A28 The efficacy of ombitasvir-paritaprevir/ritonavir, dasabuvir and ribavirin in patients with genotype 1 HCV compensated cirrhosis
Cristina Popescu, Laurențiu Stratan, Remulus Catana, Anca Leuștean, Cristina Dragomirescu, Alexandra Badea, Cristina Murariu, Raluca Năstase, Violeta Molagic, Daniela Munteanu, Cătălin Tilișcan, Mihaela Rădulescu, Alina Orfanu, Ioan Diaconu, Anca Negru, Iulia Bodosca, Violeta Niță, Victoria Aramă
A29 The efficacy of direct acting antivirals regimen without ribavirin in HCV genotype 1b infected patients with compensated cirrhosis
Anca Leuștean, Victoria Aramă, Alina Orfanu, Remulus Catana, Laurențiu Stratan, Cristina Dragomirescu, Cristina Murariu, Alexandra Badea, Cătălin Tilișcan, Daniela Munteanu, Violeta Molagic, Raluca Năstase, Mihaela Rădulescu, Cristina Popescu
A30 Liver decompensation during ombitasvir-paritaprevir/ritonavir-dasabuvir and ribavirin regimen in HCV infected patients with Child-Pugh A cirrhosis
Cristina Popescu, Cristina Dragomirescu, Anca Leuștean, Cristina Murariu, Laurențiu Stratan, Alexandra Badea, Remulus Catană, Alina Orfanu, Raluca Mihaela Năstase, Violeta Molagic, Daniela Munteanu, Cătălin Tilișcan, Victoria Aramă
A31 The safety of direct acting antivirals in HCV compensated cirrhotic patients - an interim analysis
Victoria Aramă, Remulus Catană, Cristina Dragomirescu, Cristina Murariu, Anca Leuștean, Laurențiu Stratan, Alexandra Badea, Alina Orfanu, Anca Negru, Raluca Năstase, Violeta Molagic, Daniela Munteanu, Cătălin Tilișcan, Mihaela Rădulescu, Ioan Diaconu, Violeta Niță, Iulia Bodoșca, Cristina Popescu
A32 The access of patients with HCV compensated cirrhosis to the National Program of therapy with direct acting antivirals
Cristina Popescu, Alexandra Badea, Anca Leuștean, Alina Orfanu, Anca Negru, Laurențiu Stratan, Cristina Dragomirescu, Remulus Catană, Cristina Murariu, Violeta Molagic, Raluca Năstase, Cătălin Tilișcan, Daniela Munteanu, Mihaela Rădulescu, Ioan Diaconu, Violeta Niță, Iulia Bodoșca, Victoria Aramă
A33 Severe reactivation of chronic hepatitis B after discontinuation of nucleos(t)ide analogues – a case series
Cristina Popescu, Alina Orfanu, Anca Leuștean, Alexandra Badea, Laurențiu Stratan, Remulus Catană, Cătălin Tilișcan, Victoria Aramă
A34 The dynamic of hematological disorders during direct acting antivirals therapy for HCV compensated cirrhosis
Cristina Popescu, Cristina Murariu, Cristina Dragomirescu, Anca Leuștean, Laurențiu Stratan, Alina Orfanu, Alexandra Badea, Remulus Catană, Anca Negru, Cătălin Tilișcan, Daniela Munteanu, Mihaela Rădulescu, Violeta Molagic, Raluca Mihaela Năstase, Ioan Alexandru Diaconu, Iulia Bodoșca, Violeta Niță, Victoria Aramă
A35 Behaviors, attitudes and risk factors for viral hepatitis in international medical students vs. the general population in Romania
Yagmur Erturk, Oana Săndulescu, Alina Cristina Neguț, Claudiu Mihai Șchiopu, Adrian Streinu-Cercel, Anca Streinu-Cercel
A36 Characteristics of hepatitis C virus reactivation due to immunosuppressive therapy in Romanian HCV infected patients with hematological malignancies
Violeta Molagic, Cătălin Tilișcan, Cristina Popescu, Raluca Mihăilescu, Daniela Munteanu, Raluca Năstase, Anca Negru, Angelica Tenita, Victoria Aramă, Ștefan Sorin Aramă
A37 The dynamic IFN-gamma serum levels during successful peginterferon-a 2a/ribavirin therapy in HCV chronic infection
Simona Alexandra Iacob, Diana Gabriela Iacob, Monica Luminos
A38 Overlapping risk factors for transmission of HBV, HCV and HIV in the general population in Romania
Anca Streinu-Cercel, Oana Săndulescu, Mioara Predescu, Alexandra Mărdărescu, Cătălin Tilișcan, Mihai Săndulescu, Claudiu Mihai Șchiopu, Adrian Streinu-Cercel
A39 Acute hepatitis - an uncommon neurological complication
Cleo Nicoleta Roșculeț, Catrinel Olimpia Ciuca, Dalila Ana Toma, Cătălin Gabriel Apostolescu, Andrei Rogoz, Cristina Elena Mitu, Andrei Stangaciu, Viorica Daniela Mitescu, Tudor Gheorghe Vladoiu, Doina Viorica Iovănescu
A40 Regression of liver fibrosis following sustained virological response in patients with chronic HCV infection and cirrhosis
Oana Săndulescu, Anca Streinu-Cercel, Monica Andreea Stoica, Liliana Lucia Preoțescu, Daniela Manolache, Gabriela Jana Ceapraga, Maria Magdalena Moțoi, Luminița Bradu, Adina Ilie, Gabriela Mircea, Ionel Durbală, Adrian Streinu-Cercel
A41 Preliminary results of treatment with sofosbuvir and daclatasvir of patients with chronic hepatitis C
Irina Russu, Tiberiu Holban, Tatiana Pantilimonov, Galina Chiriacov, Arcadie Macvovei, Elena Scorohodico, Oleg Dmitriev
A42 HIV-syphilis coinfection
Diana Alexandra Costache, Anca Benea, Eliza Manea, Cristian Niculae, Raluca Jipa, Adriana Hristea, Elisabeta Benea, Ruxandra Moroti, Șerban Benea
A43 Thrombophilia – additional risk factor for the evolution of pregnancy in HIV-positive patients
Mihai Mitran, Carmen Georgescu, Loredana Mitran, Simona Vladareanu
A44 The incidence of oropharyngeal candidiasis in hospitalized HIV infected pediatric Romanian cohort between 1 January - 31 December 2015
Andreea Ioana Magirescu, Viorica Andreev, Cristina Nicolau, Alexandra Largu, Carmen Dorobat, Carmen Manciuc
A45 TB incidence in HIV infected patients during the year of 2015
Viorica Andreev, Andreea Ioana Magirescu, Ina Isac, Cristina Nicolau, Alexandra Largu, Carmen Dorobat, Carmen Manciuc
A46 Retrospective analysis of HIV/AIDS deaths recorded in the Clinical Infectious Diseases Hospital, Constanța in the period 01 January 2014–30 June 2016. Epidemiological considerations.
Iulia Gabriela Șerban, Ghiulendan Resul, Consuela Marcaș
A47 Acute liver failure with favorable evolution in an HIV-HBV coinfected patient
Iosif Marincu, Patricia Poptelecan, Bogdan Trincă, Sorina Mitrescu, Anca Tudor, Daliborca Vlad, Livius Tirnea
A48 Lifestyle impact on HIV management
Nurcan Baydaroglu, Alina Cristina Neguț, Oana Săndulescu, Daniela Manolache, Gabriela Ceapraga, Monica Andreea Stoica, Anca Streinu-Cercel, Adrian Streinu-Cercel
49. HIV positive mothers newborns - clinical experience from January 2012 to June 2016
Carmen Manciuc, Mariana Pagute, Cristina Nicolau, Carmen Dorobăț, Alexandra Largu
A50 Rediscovering HIV-associated progressive multifocal leukoencephalopathy and HIV encephalopathy: clinical suspicion and subsequent brain autopsies
Ioan-Alexandru Diaconu, Laurențiu Stratan, Daniela Ion, Luciana Nichita, Cristina Popescu, Raluca Năstase, Daniela Munteanu, Violeta Molagic, Cătălin Tilișcan, Mihaela Rădulescu, Alexandra Diaconu, Anca Negru, Alina Orfanu, Cristina Dragomirescu, Remulus Catană, Anca Leuștean, Irina Duport-Dodot, Cristina Murariu, Iulia Bodoșca, Violeta Niță, Alexandra Badea, Victoria Aramă
A51 Antenatal surveillance of pregnant women with risk behavior and its impact on mother-to-child HIV transmission in Romania
Mariana Mărdărescu, Cristina Petre, Marieta Iancu, Rodica Ungurianu, Alina Cibea, Ruxandra Drăghicenoiu, Ana Maria Tudor, Delia Vlad, Sorin Petrea, Carina Matei, Dan Oțelea, Carmen Crăciun, Cristian Anghelina, Alexandra Mărdărescu
A52 Noninvasive assessments (APRI, Fib-4, transient elastography) of fibrosis in patients with HIV and HIV/HBV infection
Elena Dumea, Adrian Streinu-Cercel, Sorin Rugină, Lucian Cristian Petcu, Stela Halichidis, Simona Claudia Cambrea
A53 Undetectable HIV viral load – the main goal in the management of HIV-infected patients
Carmen Chiriac, Nina-Ioana Bodnar, Iringo-Erzsebet Zaharia-Kezdi, Cristina Gîrbovan, Andrea Incze, Anca Meda Georgescu
A54 LPS serum levels and correlation with immunological, virological and clinical outcome in HIV infected patients
Simona Alexandra Iacob, Diana Gabriela Iacob, Eugenia Panaitescu, Monica Luminos, Manole Cojocaru
A55 LL37 human cathelicidin serum levels are positively correlated with IFN gamma and alanine aminotransferase level in HCV infection
Simona Alexandra Iacob, Diana Gabriela Iacob, Monica Luminos
A56 Early diagnosis of pulmonary tuberculosis in a non-compliant HIV/AIDS late presenter patient
Vochita Laurențiu, Vochita Andreia, Opreanu Radu, Trinca Bogdan, Rosca Ovidiu, Marincu Iosif
A57 Evolution of antiretroviral regimens in naϊve patients in 2016
Ramona Zamfir, Alina Angelescu, Alena Andreea Popa, Raluca Jipa, Ruxandra Moroti, Adriana Hristea, Liana Gavriliu, Șerban Benea, Elisabeta Benea
A58 The unfavorable risk factors for HIV infected persons with positive blood cultures hospitalized at the National Institute for Infectious Diseases “Prof. Dr. Matei Balș” in 2015
Alena-Andreea Popa, Georgeta Ducu, Daniela Camburu, Alina Cozma, Manuela Podani, Roxana Dumitriu, Liana Gavriliu, Șerban Benea, Elisabeta Benea
A59 Epidemiological aspects of HIV infection in Oltenia region
Andreea Cristina Stoian, Florentina Dumitrescu, Augustin Cupșa, Lucian Giubelan, Irina Niculescu, Loredana Ionescu, Livia Dragonu
A60 HIV risk behaviors and prevalence among patients in methadone maintenance therapy (MMT) from Arena center, Bucharest
Adrian Octavian Abagiu, Loredana Nicoleta Stoica, Catrinel Blaga, Archontis Koulosousas, Roxana Ștefănescu, Alice Atomoaie, Florentina Paraschiv, Florin Matache Duna
A61 Therapeutic options in a case of severe psoriasis associated with both HIV infection and hepatitis C virus previously treated with fumaric acid esters
Rodica Olteanu, Roxana Ion, Alexandra Zota, Isra Ennour Jaballah, Lara Mahfoud, Georgeta Preda, Magda Constantin
A62 Prevalence of autoantibodies against gangliosides in asymptomatic HIV-infected patients
Ilinca Nicolae, Corina Daniela Ene, Mădălina Irina Mitran, Vasile Benea, Mircea Tampa, Simona Roxana Georgescu
A63 Subclinical inflammation in HIV-infected patients undergoing antiretroviral therapy – a cross sectional study
Iulia Cristina Bodoșca, Cristina Murariu, Cătălin Tilișcan, Victoria Aramă, Cristina Popescu, Daniela Munteanu, Mihaela Rădulescu, Violeta Molagic, Raluca Năstase, Alina Orfanu, Anca Leuștean, Remulus Catană, Anca Negru, Adrian Streinu-Cercel, Sorin Aramă
A64 Severe Guillain-Barré syndrome occurring after chickenpox with favorable evolution
Iuliana CAramăngiu, Ovidiu Rosca, Monica Cialma, Radu Opreanu, Laurențiu Vochita, Iosif Marincu
A65 Echovirus 30 infection with pulmonary and cardiac complications – case report
Vlad Murărescu, Marilena Palaghiță, Alina Cristina Neguț, Cornel Camburu, Adrian Streinu-Cercel
A66 Herpetic encephalitis with favorable evolution in an adult immunocompetent patient
Irina Duşan, Patricia Poptelecan, Bogdan Trincă, Sorina Mitrescu, Livius Tirnea, Iosif Marincu
A67 Clinical-evolutional aspects in present-day measles
Narcisa Nicolescu, Alexandru Crișan, Voichița Lăzureanu, Ruxandra Laza, Virgil Musta, Adelina-Raluca Marinescu, Andreea Bîrlad
A68 Pneumococcal superinfection in children with influenza
Victor Daniel Miron, Anca Cristina Drăgănescu, Constanța-Angelica Vișan, Anuța Bilașco, Daniela Pițigoi, Oana Săndulescu, Monica Luminița Luminos
A69 Varicella complicated with transverse myelitis - case presentation
Monica Luminos, Endis Osman, Magdalena Vasile, Anca Cristina Drăgănescu, Constanța-Angelica Vișan, Anuța Bilașco, Camelia Kouris, Sabina Șchiopu, Mădălina Merișescu
A70 Clinical forms of enterovirus infections during the summer season of 2016
Monica Luminos, Anca Cristina Drăgănescu, Constanța-Angelica Vișan, Anuța Bilașco, Camelia Kouris, Endis Osman, Sabina Vintilă, Magda Vasile, Mădălina Merișescu
A71 Face off – HIV and lymphoma – case series presentation
Liana Cătălina Gavriliu, Otilia Elisabeta Benea, Alina Angelescu, Ramona Zamfir, Daniela Camburu, Georgeta Ducu, Alina Cozma, Roxana Dumitriu, Manuela Podani, Șerban Benea, Mihaela Ionică
A72 Coxsackie infection complicated by pancytopenia – pediatric case report
Gheorghiță Jugulete, Adina Stăncescu, Cristina Elena Popescu, Luminița Marin, Diana Zaharia, Cristina Dumitrescu, Lucia Tudor, Sabina Vintilă
A73 Viral respiratory infections in children in the season 2015–2016
Constanța-Angelica Vișan, Anca Cristina Drăgănescu, Anuța Bilașco, Magda Vasile, Mădălina Merișescu, Camelia Kouris, Cristina Negulescu, Endis Osman, Diana-Maria Slavu, Sabina Vintilă, Daniela Pițigoi, Monica Luminos
A75 The severity of A H1N1 Influenza infection in the 2015–2016 season
Cleo Roșculeț, Catrinel Olimpia Ciuca, Dalila Toma, Cătălin Apostolescu, Andrei Rogoz, Andrei Stangaciu, Viorica Mitescu, Doina Iovănescu, Cornel Camburu, Bogdana Manu
A76 Acute respiratory distress syndrome in a child with measles
Ana Vaduva-Enoiu, Ramona Georgiana Stanculete, Adelina Raluca Marinescu, Voichita Elena Lazureanu
A77 Management challenges of right-sided infectious endocarditis in an HIV positive patient – case presentation
Elena-Violeta Niță, Sînziana Dumitru, Daniela-Ioana Munteanu, Anca Ruxandra Negru, Remulus Catană, Ioan Diaconu, Bogdana Manu, Ligia Ionescu, Liliana Ion, Cătălin Tilișcan, Victoria Aramă
A78 Bacterial infection in critical patients with severe A H1N1 influenza virus infection (epidemiology, development, therapeutic decisions)
Doina Viorica Iovănescu, Cleo Nicoleta Roșculeț, Andrei Rogoz, Cătălin Apostolescu, Viorica Mitescu, Tudor Vladoiu, Dalila Toma, Catrinel Ciuca
A79 Epidemiological aspects of severe acute respiratory infection cases (SARI) in the season 2015–2016, in the Clinical Hospital of Infectious Diseases – Constanța, Romania
Iulia Gabriela Șerban, Marioara Neacșu
A80Overexpression of IL-6 trans signaling pathway in viral infections
Simona Roxana Georgescu, Vasile Benea, Corina Daniela Ene, Mircea Tampa, Cristina Iulia Mitran, Ilinca Nicolae
A81 Acute viral hepatitis B with persistent HBsAg – description and evolution
George Ciprian Pribac, Mirandolina Prisca, Fulvia Ursoiu, Carmen Neamtu, Bogdan Totolici, Coralia Cotoraci, Aurel Ardelean
A82 Prevalence of cervical pathogens in a population of pregnant female patients monitored in a tertiary care hospital in Bucharest, Romania
Simona Elena Albu, Mara Carsote, Beatrice Miclăuș, Diana Mihai, Oana Săndulescu, Cristina Vasiliu
A83 Prevalence of group B Streptococcus during pregnancy in a cohort of patients monitored in a tertiary care hospital in Bucharest, Romania
Cristina Vasiliu, Mara Carsote, Corina Gorgoi, Beatrice Miclăuș, Diana Mihai, Oana Săndulescu, Simona Elena Albu
A84 Infectious hematoma in the gastrocnemius muscle – case presentation
Amelia Blescun, Gelu Breaza
A85 Reflections towards the underexplored HTLV Romanian viral circulation - adult T‐cell leukemia/lymphomas, a case series
Sabina Vintila, Felicia Mihai, Meilin Omer, Cornel Dragan, Daniela Pitigoi
A86 A febrile confusion syndrome with acute onset – case presentation
Mirela Ciucu, Marius-Dan Ionescu, Cristina Roskanovic, Valentina Barbu, Iulian Diaconescu, Florentina Dumitrescu, Irina Niculescu
A87 Retrobulbar optic neuritis in a HIV-positive patient - case report
Mihaela Ionică, Ramona-Alexandra Zamfir, Alina Cozma, Otilia Elisabeta Benea
A88 A rare presentation of Q fever – case presentation
Alexandra-Sînziana Dumitru, Daniela-Ioana Munteanu, Violeta Niță, Cristina Popescu, Iulia Bodosca, Angelica Tenita, Viorica Ispas, Victoria Aramă
A89 Tinea incognita – case presentation
Vasile Benea, Simona Roxana Georgescu, Mircea Tampa, Diana Oana Leahu, Cristina Maria Safta, Mihaela Anca Benea
A90 Incidence and risk factors associated with TORCH infections during pregnancy
Oana Săndulescu, Octavian Munteanu, Roxana Bohâlțea, Livia Trașcă, Monica Cîrstoiu
A91 Acute respiratory failure in critical patients with sepsis
Doina Viorica Iovănescu, Cleo Nicoleta Roșculeț, Andrei Rogoz, Cătălin Gabriel Apostolescu, Viorica Daniela Mitescu, Tudor Gheorghe Vladoiu, Dalila Toma, Catrinel Ciuca
A92 Cochleo-vestibular deficit secondary to Granulicatella elegans meningitis
Mădălina Georgescu
A93 Influenza 2015/2016 – clinical, epidemiological and virological characteristics of cases admitted in three infectious diseases hospitals
Daniela Pițigoi, Alina Elena Ivanciuc, Mihaela Lazar, Teodora Ionescu, Carmen Maria Cherciu, Cristina Țecu, Maria Elena Mihai, Maria Nițescu, Rodica Bacruban, Delia Azamfire, Aura Dumitrescu, Elena Ianosik, Daniela Leca, Elena Duca, Andra Teodor, Codrina Bejan, Emanoil Ceaușu, Simin-Aysel Florescu, Corneliu Popescu, Grațiela Târdei, Codrina Juganariu, Emilia Lupulescu
A94 Severe complications of varicella requiring hospitalization in previously healthy children in Brașov county
Ligia Rodina, Maria Elena Cocuz
A95 Clinical forms of Clostridium difficile colitis in children
Gheorghiță Jugulete, Adina Stăncescu, Cristina Elena Popescu, Luminița Marin, Diana Zaharia, Cristina Dumitrescu, Endis Osman
A96 Community-acquired pneumonia – demographic, clinical and etiological aspects
Irina Niculescu, Augustin Cupșa, Iulian Diaconescu, Florentina Dumitrescu, Livia Dragonu, Andreea Stoian, Lucian Giubelan, Cristina Roskanovic
A97 Acute myocarditis in an adult patient with chickenpox - Case report
Ramona-Alexandra Zamfir, Mihaela Ionica, Otilia-Elisabeta Benea
A98 Caustic oropharyngeal wound with acute group F streptococcal superinfection mimicking diphtheria – case report and differential diagnosis
Maria-Cristina Sîrbu, AnaMaria Dobrotă, Alina Cristina Neguț, Roxana Duda, Rodica Bacruban, Daniela Pițigoi, Cristiana Cerasella Dragomirescu, Daniela Tălăpan, Olga Dorobăț, Adrian Streinu-Cercel, Anca Streinu-Cercel
A99 Clostridium difficile infection in HIV-positive patients admitted in the National Institute for Infectious Diseases “Prof. Dr. Matei Balș” in 2015
Mihaela Ionica, Ramona-Alexandra Zamfir, Alina Cozma, Otilia Elisabeta Benea
A100 Title: Epidemiology of Candida oral infections (stomatitis) in Romania
Sergiu Fendrihan, Ecaterina Scortan, Mircea Ioan Popa
A101 Anthrax case series in south-eastern Romania
Corneliu P Popescu, Șerban N Benea, Andra E Petcu, Adriana Hristea, Adrian Abagiu, Iuliana A Podea, Raluca E Jipa, Georgeta Ducu, Raluca M Hrișcă, Dragoș Florea, Manuela Nica, Eliza Manea, Simona Merișor, Cristian M Nicolae, Simin A Florescu, Irina M Dumitru, Emanoil Ceaușu, Sorin Rugină, Ruxandra V Moroti
A102 Knowledge, risk perception and attitudes of healthcare workers at the National Institute for Infectious Diseases “Prof. Dr. Matei Balș” regarding Ebola
Daniela Pițigoi, Teodora Ionescu, Oana Săndulescu, Maria Nițescu, Bogdan Nițescu, Iulia Monica Mustaţă, Sorina Claudia Boldeanu, Florentina Furtunescu, Adrian Streinu-Cercel
A103 A case of abdominopelvic actinomycosis with successful short-term antibiotic treatment
Diana Gabriela Iacob, Simona Alexandra Iacob, Mihaela Gheorghe
A104 A case of pneumonia caused by Raoultella planticola
Iulian Diaconescu, Irina Niculescu, Floretina Dumitrescu, Lucian Giubelan
A105 Vitamin D deficiency and sepsis in childhood
Adriana Slavcovici, Raluca Tripon, Roxana Iubu, Cristian Marcu, Mihaela Sabou, Monica Muntean
A106 The clinical and epidemiological aspects and prophylaxis of Lyme disease among patients who presented with tick bites to the Clinical Infectious Disease Hospital “Toma Ciorbă”
Ion Chiriac, Tiberiu Holban, Liviu Tazlavanu
A107 Drug-resistant tuberculosis in HIV infected patients
Raluca Jipa, Eliza Manea, Roxana Cernat, Kezdi Iringo, Andrei Vâță, Manuela Arbune, Teodora Moisil, Adriana Hristea
A108 Kidney injury molecule-1 and urinary tract infections
Corina-Daniela Ene, Ilinca Nicolae, Roxana Simona Georgescu
A109 The impact of microbiological agents on serum gangliosides in patients with benign prostate hyperplasia
Corina-Daniela Ene, Cosmin-Victor Ene, Roxana Simona Georgescu, Marilena Ciortea , Lucreția Dulgheru, Ilinca Nicolae
A110 Toxocariasis - the experience of the Iași Infectious Diseases Hospital between 2013–2015
Mihaela Cătălina Luca, Ioana-Alina Harja-Alexa, Roxana Nemescu, Mădălina Popazu, Andrei Ștefan Luca
A111 Species of anaerobic Gram-positive cocci involved in odontogenic abscesses
Gabriela Bancescu, Bogdan Dabu, Adrian Bancescu
A112 Clostridium difficile infection recurrences
Eliza Manea, Raluca Jipa, Adriana Hristea
A113 Differential diagnosis of staphylococcal and tuberculous osteodiscitis – case report
Adina Elena Ilie, Săftica-Mariana Pohrib, Alina Cristina Neguț, Maria-Sabina Tache, Maria Magdalena Moțoi, Oana Săndulescu, Ion Aurel Iliescu, Adrian Streinu-Cercel
A114 Severe clinical forms of respiratory syncytial virus infections
Cristina Tecu, Maria-Elena Mihai, Mihaela Lazăr, Carmen Cherciu, Alina Ivanciuc, Daniela Pițigoi, Emilia Lupulescu
A115 Acinetobacter baumannii postoperative sepsis associated with Clostridium difficile enterocolitis in an immune suppressed elderly patient
Mirela Paliu, Manuela Curescu, Bianca Cerbu, Iosif Marincu
A116 Risk factors and their impact on psychopathology and quality of life among people living with HIV/AIDS in Romania
Fulvia Ursoiu, Mirandolina Prișcă, George Ciprian Pribac
A117 Antivirals susceptibility of influenza viruses circulating in Romania
Maria Elena Mihai, Carmen Maria Cherciu, Alina Elena Ivanciuc, Cristina Tecu, Emilia Lupulescu
A118 Retrospective study of hospitalized cases of sepsis at the Hospital Clinic of Infectious Diseases “Toma Ciorbă”
Irina Bunescu, Tiberiu Holban, Ana Pasnin, Stela Semeniuc, Raisa Popovici, Galina Chiriacov
doi:10.1186/s12879-016-1877-4
PMCID: PMC5103241
24.  Clinicoradiological Profile of Lower Lung Field Tuberculosis Cases among Young Adult and Elderly People in a Teaching Hospital of Madhya Pradesh, India 
Journal of Tropical Medicine  2015;2015:230720.
Aim. To study the clinical and radiological features of lower lung field tuberculosis (LLFTB) in relation to the patients of nonlower lung field tuberculosis (non-LLFTB). Material and Methods. All the patients of lower lung field tuberculosis defined by the lesions below an arbitrary line across the hila in their chest X-rays were included in the study. Their sputum for acid fast bacilli, HIV, blood sugar, and other relevant investigations were performed. Results. The total of 2136 cases of pulmonary tuberculosis was studied. Among them 215 (10%) cases of patients were diagnosed as the case of lower lung field tuberculosis. Females (62%) were more commonly affected. Most common clinical feature in non-LLFTB was cough (69%) followed by fever (65%), chest pain (54.7%), and weight loss (54.4%). Chest X-ray showed predominance of right side (60.9%) in cases of LLFTB. The relative risk of having the LLFTB in diabetes patients, HIV seropositive patients, end stage renal disease patients, and patients on corticosteroid therapy was high. Conclusion. Lower lung field tuberculosis is not an uncommon entity. It is more common in diabetes, HIV positive, end stage renal disease, and corticosteroid treated patients. Clinical and radiological features are different from upper lobe tuberculosis patients.
doi:10.1155/2015/230720
PMCID: PMC4562182  PMID: 26379713
25.  Chest Radiographic Patterns and the Transmission of Tuberculosis: Implications for Automated Systems 
PLoS ONE  2016;11(4):e0154032.
Background
Computer-aided detection to identify and diagnose pulmonary tuberculosis is being explored. While both cavitation on chest radiograph and smear-positivity on microscopy are independent risk factors for the infectiousness of pulmonary tuberculosis it is unknown which radiographic pattern, were it detectable, would provide the greatest public health benefit; i.e. reduced transmission. Herein we provide that evidence.
Objectives
1) to determine whether pulmonary tuberculosis in a high income, low incidence country is more likely to present with “typical” adult-type pulmonary tuberculosis radiographic features and 2) to determine whether those with “typical” radiographic features are more likely than those without such features to transmit the organism and/or cause secondary cases.
Methods
Over a three-year period beginning January 1, 2006 consecutive adults with smear-positive pulmonary tuberculosis in the Province of Alberta, Canada, were identified and their pre-treatment radiographs scored by three independent readers as “typical” (having an upper lung zone predominant infiltrate, with or without cavitation but no discernable adenopathy) or “atypical” (all others). Each patient’s pre-treatment bacillary burden was carefully documented and, during a 30-month transmission window, each patient’s transmission events were recorded. Mycobacteriology, radiology and transmission were compared in those with “typical” versus “atypical” radiographs.
Findings
A total of 97 smear-positive pulmonary tuberculosis cases were identified, 69 (71.1%) with and 28 (28.9%) without “typical” chest radiographs. “Typical” cases were more likely to have high bacillary burdens and cavitation (Odds Ratios and 95% Confidence Intervals: 2.75 [1.04–7.31] and 9.10 [2.51–32.94], respectively). Typical cases were also responsible for most transmission events—78% of tuberculin skin test conversions (p<0.002) and 95% of secondary cases in reported close contacts (p<0.01); 94% of secondary cases in “unreported” contacts (p<0.02).
Conclusion
As a group, smear-positive pulmonary tuberculosis patients with typical radiographic features constitute the greatest public health risk. This may have implications for automated detection systems.
doi:10.1371/journal.pone.0154032
PMCID: PMC4841548  PMID: 27105337

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