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Shetty AP, Viswanathan VK, Rajasekaran S. Cervical spine TB - Current concepts in management. J Orthop Surg (Hong Kong) 2021; 29:23094990211006936. [PMID: 34711081 DOI: 10.1177/23094990211006936] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Cervical tubercular disease (CTB) is a rare pathology and constitutes 3-5% of all spinal TB. It includes atlantoaxial TB and sub-axial TB. As the literature evidence on this subject is scarce, majority of issues concerning CTB are still controversial. The current narrative review comprehensively discusses the various aspects related to CTB. Literature search: An elaborate search was made using keywords cervical tuberculosis, atlantoaxial tuberculosis, sub-axial tuberculosis, and cervico-thoracic tuberculosis, on pubmed and google (scholar.google.com) databases on 2 December 2020. We identified crucial questions regarding CTB and included relevant articles pertaining to them. RESULTS The initial search using keywords cervical tuberculosis, atlantoaxial tuberculosis, sub-axial tuberculosis, and cervico-thoracic tuberculosis yielded 4128, 76, 3 and 9 articles on 'pubmed' database, respectively. A similar search using the aforementioned keywords yielded 1,96,000, 2130, 117 and 728 articles on 'google scholar' database. The initial screening resulted in the identification of 178 articles. Full manuscripts were obtained for these articles and thoroughly scrutinised at the second stage. Review articles, randomised controlled trials and level 1 studies were given preference. Overall, 41 articles were included. CONCLUSION AATB and SACTB constitute 0.3 to 1% and 3% of spinal TB, respectively. The incidence of neuro-deficit in CTB is significantly more than other spinal TB. The general principles of management of CTB are similar to spinal TB elsewhere and medical therapy remains the cornerstone. Surgery is advocated in specific scenarios involving gross neuro-deficit, later stages of disease with significant bony/ligamentous disruptions, altered sagittal balance, drug resistance, and poor response to medications. The surgical approaches for AATB include anterior-alone, posterior-alone and combined approaches, although posterior access is the most preferred. Most of the studies on SACTB have supported the role of anterior approach. Additionally, posterior stabilisation may be necessary in specific scenarios. The overall long-term outcome in CTB is favourable.
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Affiliation(s)
- Ajoy Prasad Shetty
- Department of Spine surgery, 76290Ganga Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
| | | | - S Rajasekaran
- Department of Spine surgery, 76290Ganga Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
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Hussein MT, Yousef LM, Ali AT. Detection of latent tuberculosis infection in hemodialysis patients: Comparison between the quantiferon-tuberculosis gold test and the tuberculin skin test. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2017. [DOI: 10.4103/ejb.ejb_19_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhu C, Liu Z, Li Z, Mei S, Hu Z. The performance and limitation of T-SPOT.TB for the diagnosis of TB in a high prevalence setting. J Thorac Dis 2014; 6:713-9. [PMID: 24976994 DOI: 10.3978/j.issn.2072-1439.2014.04.38] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 04/15/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Tuberculosis (TB) diagnosis remains difficulty. The previous reports have shown that the T-SPOT.TB assay may be a more promising diagnostic tool for TB, however, it needs a further study to evaluate the diagnostic value of T-SPOT.TB for the specific populations in a high prevalence setting. METHODS In this present study, we conducted stratified and comparable analyses to explore the clinical value and the limitation of T-SPOT.TB assay in TB diagnosis in a high TB prevalence setting, Southern China. A total of 413 subjects including 163 pulmonary TB (PTB), 39 extrapulmonary TB (EPTB), 106 non-TB pulmonary diseases (NTBPDs), 20 medical staff and 85 healthy controls were included in the study. RESULTS According to T-SPOT.TB, there had a high incidence of latent TB infection (LTBI) in general population in Southern China, especially in the NTBPDS and medical staff. The T-SPOT.TB had a high performance in the diagnosis of active TB (ATB) in a lower risk of TB infection population such as the general population, however, the T-SPOT.TB for the diagnosis of ATB in the high risk of TB infection populations involving close contacts such as the patients with pulmonary diseases (PD) or medical staff isn't reliable due to the interference by LTBI. Under this condition, the value of rule-out of the assay was seemed to be better than that of rule-in. We believed that the T-SPOT.TB is suitable for screening both the EPTB and the ATB combined with diabetes mellitus (DM). However, we found that the sensitivity of T-SPOT.TB in sputum smear-negative population wasn't as high as that in smear-positive population. CONCLUSIONS The T-SPOT.TB testing results should be interpreted with caution combined with subject's characteristics in a high prevalence setting.
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Affiliation(s)
- Changtai Zhu
- 1 Department of Transfusion, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China ; 2 Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 3 Department of Laboratory Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China ; 4 Department of Emergency Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China
| | - Zhonghua Liu
- 1 Department of Transfusion, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China ; 2 Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 3 Department of Laboratory Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China ; 4 Department of Emergency Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China
| | - Zhiqiang Li
- 1 Department of Transfusion, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China ; 2 Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 3 Department of Laboratory Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China ; 4 Department of Emergency Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China
| | - Shencong Mei
- 1 Department of Transfusion, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China ; 2 Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 3 Department of Laboratory Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China ; 4 Department of Emergency Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China
| | - Zhongyi Hu
- 1 Department of Transfusion, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China ; 2 Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 3 Department of Laboratory Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China ; 4 Department of Emergency Medicine, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China
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Peyrethon C, Marande JL. Conduite à tenir par un service de santé au travail après signalement d’un cas de tuberculose. ARCH MAL PROF ENVIRO 2012. [DOI: 10.1016/j.admp.2012.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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5
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Yang FF, Tu ZQ, Fang YM, Li Y, Peng Y, Dong T, Wang C, Lin SX, Zhan NY, Ma ZM, Feng YZ, Tan SY, Lai XM. Monitoring of peptide-specific and gamma interferon-productive T cells in patients with active and convalescent tuberculosis using an enzyme-linked immunosorbent spot assay. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:401-10. [PMID: 22237892 PMCID: PMC3294602 DOI: 10.1128/cvi.05544-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 12/27/2011] [Indexed: 11/20/2022]
Abstract
To establish a high-efficiency gamma interferon-specific enzyme-linked immunosorbent spot assay (IFN-γ ELISPOT assay) for detection of tuberculosis (TB), peptides (E6, E7, and C14) and peptide mixtures (E6 plus E7 and E6 plus E7 plus C14) were used to monitor peripheral blood (PBL) samples from patients with pulmonary TB (PTB), as well as control samples. The positive detection rates of the five IFN-γ ELISPOT assays were 78.38%, 74.86%, 55.83%, 90.43%, and 91.51%, respectively, and there were similar detection rates between the two combined peptide mixture IFN-γ ELISPOT assays and the tuberculin skin test (TST) (90.62% versus 95.59%). No significant difference was found between the detection rates of the two combined peptide mixture IFN-γ ELISPOT assays and the T-SPOT.TB assay for 86 patients with PTB (P > 0.05), but the median number of spot-forming cells/10(6) cells (SFP value) for positive results was higher by the former than by the latter assay (P < 0.05). In contrast, the 29.93% positive detection rate and median SFP value of 482 by the two combined peptide mixture IFN-γ ELISPOT assays were significantly higher than the corresponding values of 14.29% and 152 by T-SPOT.TB assay for the same 147 community donors (P < 0.05). For nine PTB patients tracked, the SFP value of 7 for the two peptide mixture IFN-γ ELISPOT assays began to decrease from the second month after regular treatment. A relatively low, almost normal, SFP level was reached and maintained after the third or fourth month. Two in-house IFN-γ ELISPOT assays and the T-SPOT.TB assay could reduce the false-positive and false-negative detection rates of TST and sputum acid-fast staining. Therefore, these two combined peptide mixture IFN-γ ELISPOT assays have a potential advantage, beyond their greater specificity and sensitivity, for use in screening and detection of active TB infection (TBI) and latent TB infection (LTBI) in China.
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Affiliation(s)
- Fang-Fang Yang
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Zhi-Quan Tu
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yi-Min Fang
- Guangzhou Chest Hospital, Guangzhou, People's Republic of China
| | - Yan Li
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yi Peng
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Tao Dong
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Cong Wang
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Shu-Xian Lin
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Neng-Yong Zhan
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Zhi-Ming Ma
- Guangzhou Chest Hospital, Guangzhou, People's Republic of China
| | - Yong-Zhong Feng
- Guangzhou Chest Hospital, Guangzhou, People's Republic of China
| | - Shou-Yong Tan
- Guangzhou Chest Hospital, Guangzhou, People's Republic of China
| | - Xiao-Min Lai
- Department of Microbiology, Ministry of Education Key Laboratory of Tropical Diseases Control, Guangdong Provincial Department of Education Key Laboratory of Functional Molecules from Marine Microorganisms, Guangdong Provincial Research Center for Severe Infectious Disease Prevention and Control Technology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
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Fraisse P. Diagnostic des infections tuberculeuses latentes (sujets sains, sujets immunodéprimés ou amenés à l’être). Rev Mal Respir 2012; 29:277-318. [DOI: 10.1016/j.rmr.2011.05.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 05/11/2011] [Indexed: 01/30/2023]
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Ninet B, Roux-Lombard P, Schrenzel J, Janssens JP. Nouveaux tests pour le diagnostic de la tuberculose. Rev Mal Respir 2011; 28:823-33. [DOI: 10.1016/j.rmr.2010.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 12/14/2010] [Indexed: 11/26/2022]
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Blanc FX, Janssens JP, Underner M. Tuberculose et mycobactérioses non tuberculeuses : la pneumologie aux avant-postes. Rev Mal Respir 2011; 28:404-6. [DOI: 10.1016/j.rmr.2011.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 03/08/2011] [Indexed: 11/26/2022]
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Diagnostic des uvéites tuberculeuses : intérêt des tests interférons gamma. Rev Mal Respir 2011; 28:317-21. [DOI: 10.1016/j.rmr.2011.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 09/01/2010] [Indexed: 12/19/2022]
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10
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Segall L, Covic A. Diagnosis of Tuberculosis in Dialysis Patients: Current Strategy. Clin J Am Soc Nephrol 2010; 5:1114-22. [DOI: 10.2215/cjn.09231209] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Affiliation(s)
- H Harmouche
- Service de médecine interne, hôpital Ibn Sina, 10000 Rabat, Maroc
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Bocchino M, Bellofiore B, Matarese A, Galati D, Sanduzzi A. IFN-gamma release assays in tuberculosis management in selected high-risk populations. Expert Rev Mol Diagn 2009; 9:165-77. [PMID: 19298140 DOI: 10.1586/14737159.9.2.165] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tuberculosis (TB) is the most deadly infectious disease in the world. TB control relies on passive case findings and targeted treatment of latently infected individuals at high risk of disease progression. Tuberculin skin testing (TST) is conventionally used for detection of TB infection. Recently, blood assays measuring the release of IFN-gamma by TB-specific effector memory T cells have been developed to overcome TST limitations. Overall, IFN-gamma release assays are more specific than TST, more sensitive in detecting active TB and correlate better with TB exposure in immune-competent patients, at least in low-burden settings. There are three US FDA-approved assays commercially available: the ELISpot-based assay T-SPOT.TB (Oxford Immunotech, UK) and two ELISA-based formats, QuantiFERON TB Gold (QFT) and QFT-in tube (Cellestis, Australia). Recent international guidelines and consensus statements recommend the use of IFN-gamma release assays at different levels in TB management. However, conclusive evidence-based information targeting populations at high TB risk, including HIV-infected individuals, children and patient candidates for biotherapy with TNF-alpha blockers, are lacking. The aim of this review is to focus our attention on studies addressing the performance of commercial IFN-gamma release assays in clinical management of TB infection in these highly selected settings to provide a more comprehensive picture of the actual scenario and to identify areas to be investigated further.
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Affiliation(s)
- Marialuisa Bocchino
- Department of Clinical and Experimental Medicine, University of Naples FEDERICO II, Monaldi Hospital, Naples, Italy.
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Okamba P, Staal A, Tabary T, Le Ber V, Panter-Brick B, Boyer C, Rio Y. Signification de Quantiféron TB Gold en tube en dépistage de la tuberculose parmi le personnel hospitalier en cas d’intradermoréactions positives très anciennes ou récentes. ACTA ACUST UNITED AC 2008; 56:467-70. [DOI: 10.1016/j.patbio.2008.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Accepted: 07/03/2008] [Indexed: 10/21/2022]
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Lagrange PH, Herrmann JL. Diagnosing latent tuberculosis infection in the HIV era. Open Respir Med J 2008; 2:52-9. [PMID: 19343092 PMCID: PMC2606646 DOI: 10.2174/1874306400802010052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Revised: 05/02/2008] [Accepted: 05/07/2008] [Indexed: 11/30/2022] Open
Abstract
Tuberculin skin testing (TST) and Interferon-gamma (IFNγ)release assays (IGRAs) are presently the only available assays for the detection of Mycobacterium tuberculosis infected individuals. IGRAs might progressively replace TST, as numerous published reports establish their higher specificity and similar sensitivity when tested in BCG vaccinated, immunocompetent individuals or in populations who may have been in contact with atypical mycobacteria. However, few published reports have commented on their role in TB diagnosis in immunocompromised individuals (HIV, immunosuppressive therapy, cancer…). It is the purpose of this report to review IGRAs published studies in HIV individuals in endemic and non endemic area for tuberculosis (TB). IGRAs were tested in the presence or absence of active TB but correlated to duration of exposure. In newly diagnosed active TB, IGRAs demonstrated a similar sensitivity to TST. In TB non infected individuals, TST and IGRAs also gave similar values when categorization of individuals was correlated to the risk of infection. A higher number of positive IGRAs was observed in individuals from TB endemic areas, in similar proportions to immunocompetent individuals. Comparison between the two IGRAs: QuantiFERON-TB Gold® (QF-TB, Cellestis, Australia) and T-SPOT-TB® (Oxford Immunotec, UK), and against TST, in the same HIV population demonstrates a higher sensitivity of T-SPOT-TB and TST than QF-TB. Indeterminate results, which correspond to the absence of a positive T-cell IFNγ response towards phytohemaglutinin (PHA), is a key point when comparing both IGRAs. This PHA control is indicative of the level of immunosuppression observed in the tested individual. QF-TB seems to present, in HIV populations, more indeterminate results than T-SPOT-TB. The calibration and/or concentration of PBMC on nitrocellulose membrane for the T-SPOT-TB, as compared to a whole blood assay, might explain this difference, with less indeterminate results with the T-SPOT-TB assay. Neither assay is able to differentiate active TB from latent TB infection (LTBI). Several laboratories have tried new antigenic epitopes to solve this issue. It is of importance that these studies need to be repeated on a larger scale by others to validate their results. Two blood assays might add information characterising the evolution from LTBI to active TB: either by losing protective immunity, as demonstrated by the whole blood killing assay, or by evaluating the kinetics of the antibodies synthesized against M. tuberculosis specific antigens. In conclusion, longitudinal studies are still needed to validate IGRAs and other assays and to define their respective predictive values.
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Bergeron A, Herrmann JL. Screening for tuberculosis before TNFalpha antagonist initiation: are current methods good enough? Joint Bone Spine 2007; 75:112-5. [PMID: 18178504 DOI: 10.1016/j.jbspin.2007.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Accepted: 09/25/2007] [Indexed: 01/04/2023]
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