Mycobacterium tuberculosis is the bacterium that as a single agent is known to cause the infection with the most morbidity and mortality around the world. It is known to cause pulmonary infection in immunocompetent patient, but its dissemination outside the lungs has been linked to a high degree of cellular immunosuppression as seen in the advance stages of human immunodeficiency virus infection, and after chemotherapy. Despite extensive research, screening, education, and continuous efforts to try to eradicate and control the infection, tuberculosis is still one of the most prevalent infections throughout the world. Even the cases of extra pulmonary dissemination are seen to have increased. Extra pulmonary tuberculous dissemination has a very variable presentation that depends on the organ involved. The diagnosis is difficult and many times a long time passes between diagnosis and initial presentation. In this chapter, we will review how tuberculosis infection presents when the bacilli invades any tissue outside the pulmonary parenchyma, what the literature recommends for the proper work up and diagnosis, and general treatment for major organ system infection.
Part of the book: Role of Microbes in Human Health and Diseases
History hallmarks different out brakes events during the last century. Being caught in the in the middle of the catastrophic COVID-19 pandemic, that initiated in 2019 makes possible to forget other causalities. Tuberculosis makes the case. The pathogen has been present more than hundredth years. Relevance rest in worldwide prevalence, pathogen spread, treatment resistance and the need for eradication. Drug treatment resistance is considered as one of the criteria to prioritize a country in the World Health Organization’s intention to eradicate tuberculosis infection in the world. For decades in Latin America, including the Caribbean, there have been a persistent high rate of drug resistance with an overall prevalence to one or more drug rounds 13.0%. Approximately 30% of previously treated cases have a multidrug resistance. In this chapter, we intend to review the epidemiology of resistant tuberculosis, and the causes of resistance associated to the community of people in the Latin American and the Caribbean. We intend to describe the genetic response of Mycobacterium tuberculosis from its migratory journey throughout decades from areas of Europa and Asia to Latin America, its genetic transformation secondary to inadequate drug exposure and the characteristics of the infected host, and how a change in the healthcare system and tuberculosis control strategies access are needed to change the surge of multidrug resistance tuberculosis.
Part of the book: Molecular Epidemiology Study of Mycobacterium Tuberculosis Complex
Actinomycosis is a filamentous bacterium that forms part of the normal human flora of the gastrointestinal, oropharynx and female genitalia. This indolent infection is characterized by abscess formation, widespread granulomatous disease, fibrosis, cavitary lung lesions and mass-like consolidations, simulating an active malignancy or systemic inflammatory diseases. It is subacute, chronic and variable presentation may delay diagnosis due to its capability to simulate other conditions. An accurate diagnostic timeline is relevant. Early diagnosis of pulmonary actinomycosis decreases the risk of indolent complications. Proper treatment reduces the need for invasive surgical methods. Actinomycosis can virtually involve any organ system, the infection spread without respecting anatomical variables as metastatic disease does, making malignancy an important part of the differential diagnosis. As it is normal gastrointestinal florae, it is difficult to cultivate, and share similar morphology to other organisms such as Nocardia and fungus. It is often difficult to be identified as the culprit of disease. Its true imitator capability makes this infectious agent a remarkable organism within the spectra of localized and disseminated disease. In this chapter, we will discuss different peculiarities of actinomycosis as an infectious agent, most common presentation in different organ systems, and challenging scenarios.
Part of the book: Actinobacteria
There are multiple well-recognized environmental factors that contribute to asthma exacerbation. Exposures to many of them will get unrecognized and most of the time will remain constant without knowing it is the causative agent. For an early identification of exposures and causative agents, a systematic approach needs to be taken in consideration by the encountering physician. Multiple questionnaires had been implementing and discussing organic and inorganic factors as well intrinsic and extrinsic factors. It is well-recognized that environmental exposures can cause worsening of asthma, other allergic conditions and even more severe pulmonary diseases. Asthma is a very prevalent disease with increased incidence nowadays. In the last decade, multiple new medications had been discovered for the treatment of moderate-to-severe persistent asthma, which most of them target the cellular component of the disease such as eosinophils and specific Immunoglobins. In the era of personalized medicine, environmental and occupational factors in asthma are key players that need to be recognized early in this patient population. In this chapter will go over model of effects, mechanism of action of these environmental factors, recognition, course of action and management of this patient population.
Part of the book: New Perspectives on Asthma