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Mohd Zamri MI, Bibi Samri S, Chea LC, Mohd Taib NH, Wan Abdul Rahman WF. 'Not your average breast lump!'-Primary tuberculosis mimicking chronic abscess: A rare case report. Radiol Case Rep 2024; 19:3591-3595. [PMID: 38903610 PMCID: PMC11186961 DOI: 10.1016/j.radcr.2024.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 06/22/2024] Open
Abstract
Primary breast tuberculosis is a rare disease under extrapulmonary tuberculosis category. It tends to affect females of reproductive age rather than postmenopausal women or prepubescent girls. This rare form of disease poses a challenge in diagnosing as imaging can mimic the appearance of both benign and malignant breast lesions. We describe a case of primary breast tuberculosis in a young female who presented with a persistent left breast lump. and was diagnosed with chronic left breast abscess. Histopathological examination of the lesion was consistent with granulomatous mastitis, secondary to mycobacterium tuberculosis infection. The patient was treated with a 6-month course of anti-tuberculosis drug with complete resolution of the symptoms and the left breast lesion on serial ultrasound imaging.
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Affiliation(s)
- Mohamad Irfan Mohd Zamri
- Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
| | - Shafora Bibi Samri
- Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
| | - Lau Chiew Chea
- Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
| | - Nur Hartini Mohd Taib
- Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
| | - Wan Faiziah Wan Abdul Rahman
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan 16150, Malaysia
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2
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Babamahmoodi F, Babamahmoodi A, Barzegar R, Sadr M, Rezaei M, Marjani M. Breast Tuberculosis in Iran: A Comprehensive Review. Int J Mycobacteriol 2024; 13:1-6. [PMID: 38771272 DOI: 10.4103/ijmy.ijmy_32_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/27/2024] [Indexed: 05/22/2024] Open
Abstract
ABSTRACT Tuberculosis (TB) remains a significant global health concern and kills millions of people every year. While TB can affect any organ in the body, breast TB is relatively uncommon. This study presents a comprehensive review of literature spanning 23 years, with a focus on cases of breast TB in Iran. Among the 96 cases found, the majority (89.6%) fell within the age range of 20-60, with a striking prevalence among women (98.9%). Common symptoms included pain and palpable mass, each presenting in approximately 60.4% of cases. Notably, only a quarter of patients had a confirmed history of exposure to a known TB case. Left breast involvement was more prevalent (58.3%), with ipsilateral lymph node enlargement observed in 40.6% of cases. Given the clinical presentation of breast TB, which often leads to misdiagnosis, a significant proportion of cases (68.7%) were diagnosed through excisional biopsy. Following a standard 6-month regimen of anti-TB drugs, relapse occurred in only 4.2% of cases. This study highlights the need for heightened awareness and vigilance in diagnosing breast TB, especially in regions with a high burden. Although breast TB poses diagnostic challenges, with prompt identification and treatment, the prognosis is generally favorable, with a low incidence of relapse.
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Affiliation(s)
- Farhang Babamahmoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolreza Babamahmoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rahim Barzegar
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Makan Sadr
- Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Rezaei
- Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Marjani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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3
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Scott DM. Inflammatory diseases of the breast. Best Pract Res Clin Obstet Gynaecol 2021; 83:72-87. [PMID: 34991976 DOI: 10.1016/j.bpobgyn.2021.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022]
Abstract
Inflammatory disorders of the breast are common benign breast conditions. Lactational mastitis occurs in breastfeeding women and may be associated with breast abscess in severe cases. Non-lactational inflammatory disorders are less common and include idiopathic granulomatous mastitis, periductal mastitis, and tuberculous mastitis. While these disorders have some similarities in their presentation, each disorder requires a specific treatment regimen for resolution, and correct diagnosis is crucial for appropriate treatment. In this chapter, we will review the presentation, diagnosis, and management of each of these distinct clinical entities.
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Affiliation(s)
- Dana Marie Scott
- Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, CT, USA.
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Ghalleb M, Seghaier S, Adouni O, Bouaziz H, Bouida A, Hassouna JB, Chargui R, Rahal K. Breast tuberculosis: a case series. J Med Case Rep 2021; 15:73. [PMID: 33608057 PMCID: PMC7896393 DOI: 10.1186/s13256-020-02646-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/21/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND AIM Breast tuberculosis is a rare disease, even in endemic areas. The diagnosis can be challenging, as it can mimic breast cancer. We aim to report our experience and discuss diagnoses and management modalities. RESULTS We encountered twelve cases of breast tuberculosis in our institution from 2004 to 2019. The average age of our Caucasian North African patients was 42 years old (22-63). The classic presentation was a breast lump found in half of the cases. On physical examination, we suspected breast carcinoma in seven patients. The average size of the tumors was 39 mm (15-80 mm). Nine patients had a mammogram. In five cases, there was a suspicious breast mass mimicking a malignant tumor with an average size of 33 mm (25-60 mm). A ultrasonography was performed in 6 cases and revealed a suspicious ill-circumscribed nodule in four patients with an average size of 37.5 mm (10-60 mm). Five patients had a lumpectomy, and seven women underwent drainage of the abscess and the biopsy of its hull. The association of epithelioid cell granulomas and caseous necrosis was mandatory for the histological diagnosis of tuberculosis. All of them had an antitubercular therapy. The median period of follow-up was of 43 months (3-156 months). One patient presented with a recurrent abscess of the breast. CONCLUSION Our study found that clinical examination and radiological imaging were not specific. Positive cultures for Koch bacillus or histological confirmation are mandatory for the diagnosis. A meta-analysis of the existing cases is needed.
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Affiliation(s)
- M. Ghalleb
- Surgical Oncology Department, Institute Salah Azaiez of Oncology, Tunis, Tunisia
- Faculté de Médecine de Tunis, Institut Salah Azaiz, Université Tunis el Manar, Boulevard Avril 1938, 1006 Tunis, Tunisia
| | - S. Seghaier
- Surgical Oncology Department, Institute Salah Azaiez of Oncology, Tunis, Tunisia
- Faculté de Médecine de Tunis, Institut Salah Azaiz, Université Tunis el Manar, Boulevard Avril 1938, 1006 Tunis, Tunisia
| | - O. Adouni
- Immuno-Histo-Cytology Department, Institute Salah Azaiez of Oncology, Tunis, Tunisia
- Faculté de Médecine de Tunis, Institut Salah Azaiz, Université Tunis el Manar, Boulevard Avril 1938, 1006 Tunis, Tunisia
| | - H. Bouaziz
- Surgical Oncology Department, Institute Salah Azaiez of Oncology, Tunis, Tunisia
- Faculté de Médecine de Tunis, Institut Salah Azaiz, Université Tunis el Manar, Boulevard Avril 1938, 1006 Tunis, Tunisia
| | - A. Bouida
- Surgical Oncology Department, Institute Salah Azaiez of Oncology, Tunis, Tunisia
- Faculté de Médecine de Tunis, Institut Salah Azaiz, Université Tunis el Manar, Boulevard Avril 1938, 1006 Tunis, Tunisia
| | - J. Ben Hassouna
- Surgical Oncology Department, Institute Salah Azaiez of Oncology, Tunis, Tunisia
- Faculté de Médecine de Tunis, Institut Salah Azaiz, Université Tunis el Manar, Boulevard Avril 1938, 1006 Tunis, Tunisia
| | - R. Chargui
- Surgical Oncology Department, Institute Salah Azaiez of Oncology, Tunis, Tunisia
- Faculté de Médecine de Tunis, Institut Salah Azaiz, Université Tunis el Manar, Boulevard Avril 1938, 1006 Tunis, Tunisia
| | - K. Rahal
- Surgical Oncology Department, Institute Salah Azaiez of Oncology, Tunis, Tunisia
- Faculté de Médecine de Tunis, Institut Salah Azaiz, Université Tunis el Manar, Boulevard Avril 1938, 1006 Tunis, Tunisia
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5
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Baykan AH, Sayiner HS, Inan I, Aydin E, Erturk SM. Primary breast tuberculosis: imaging findings of a rare disease. Insights Imaging 2021; 12:19. [PMID: 33587199 PMCID: PMC7884561 DOI: 10.1186/s13244-021-00961-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/04/2021] [Indexed: 11/23/2022] Open
Abstract
Breast tuberculosis is a rare form of extrapulmonary tuberculosis which tends to affect females of reproductive age, and is much rarer in males, postmenopausal women, and pre-pubescent girls. It is difficult to diagnose because it can mimic benign conditions such as a fibroadenoma, as well as malignant diseases like a carcinoma. It is also particularly difficult to distinguish breast tuberculosis from granulomatous mastitis, so other possible diagnoses should be ruled out first. The diagnosis of breast tuberculosis has three essential pillars: clinical examination, radiological evaluations, and histopathological sampling. Radiological evaluations are not only critical in diagnosis but are also important in the planning of the treatment and during the follow-up. This paper aims to review the imaging findings and the differential diagnosis of breast tuberculosis.
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Affiliation(s)
- Ali H Baykan
- Department of Radiology, Faculty of Medicine, Adiyaman University, Yunus Emre Mahallesi 1164 Sokak No:13, 02200, Merkez/Adiyaman, Turkey.
| | - Hakan S Sayiner
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Ibrahim Inan
- Department of Radiology, Biruni University Hospital, Istanbul, Turkey
| | - Elcin Aydin
- Zubeyde Hanim Hospital Izmir, Faculty of Medicine, Baskent University, Izmir, Turkey
| | - Sukru M Erturk
- Department of Radiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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6
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Nikonajad A, Azimi SA, Allami A, Qasemi Bargi R, Tabarraei A. Epidemiology of extrapulmonary tuberculosis in Northeast of Iran. MEDICAL LABORATORY JOURNAL 2021. [DOI: 10.29252/mlj.15.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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7
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Zhang W, Zhang Y, Yang G, Yu T. Features of breast tuberculosis determined by ultrasound imaging: report of 45 cases. J Int Med Res 2020; 48:300060520910891. [PMID: 32727242 PMCID: PMC7394031 DOI: 10.1177/0300060520910891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to characterize the ultrasound (US) imaging features of breast tuberculosis (BTB) to clarify the process of disease progression and provide valuable clinical information. Methods We retrospectively reviewed 45 patients with pathologically or GeneXpert-confirmed BTB from January 2010 to December 2017. We assessed the US features of target lesions including size, shape, orientation, margin, echogenicity, calcification, posterior acoustic features, and blood-flow signal. Results The patients were classified with nodular (55.5%, 25/45), abscess (15.6%, 7/45), or sinus (28.9%, 13/45) type according to their US features. Forty lesions (88.9%, 40/45) extended in a parallel orientation and five extended in a non-parallel orientation. Calcifications were found in eight cases, including six macrocalcifications and two microcalcifications. Enlarged axillary lymph nodes were observed in three cases (6.7%, 3/45). In addition, 44 of the 45 cases (97.8%, 44/45) exhibited hypovascularity or avascularity according to color Doppler flow imaging (CDFI). Conclusion BTB lesions can be classified as nodular, abscess, or sinus type according to their US imaging features. Poor blood supply detected by CDFI might be a common US feature of BTB. Characterization of its US features may facilitate the clinical diagnosis of BTB.
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Affiliation(s)
- Wenzhi Zhang
- Department of Ultrasonography, Chinese and Western Hospital of Zhejiang Province (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China
| | - Ying Zhang
- Department of Ultrasonography, Chinese and Western Hospital of Zhejiang Province (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China
| | - Gaoyi Yang
- Department of Ultrasonography, Chinese and Western Hospital of Zhejiang Province (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China
| | - Tianzhuo Yu
- Department of Ultrasonography, Chinese and Western Hospital of Zhejiang Province (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China
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8
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Quaglio G, Pizzol D, Isaakidis P, Bortolani A, Tognon F, Marotta C, Di Gennaro F, Putoto G, Olliaro PL. Breast Tuberculosis in Women: A Systematic Review. Am J Trop Med Hyg 2020; 101:12-21. [PMID: 31115305 DOI: 10.4269/ajtmh.19-0061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Breast tuberculosis (TB) is rarely reported and poorly described. This review aims to update the existing literature on risk factors, clinical presentations, constitutional symptoms, diagnostic procedures, and medical and surgical treatments for breast TB. In all, 1,478 cases of breast TB were collected. Previous history of TB was reported in 19% of cases. The most common clinical appearance of the lesion was breast lump (75%). The most common associated finding was axillary lymphadenitis (33%) followed by sinus or fistula (24%). The most common symptoms were pain and fever, reported in 42% and 28% of cases, respectively. The most used diagnostic method was fine-needle aspiration cytology (32%), followed by biopsy (27%), acid-fast bacteria Ziehl-Neelsen stain (26%), culture (13%), and polymerase chain reaction (2%). These tested positive in 64%, 93%, 27%, 26%, and 58% of cases, respectively. The majority (69%) of patients received a 6-month anti-TB treatment (isoniazid, rifampicin, pyrazinamide, and ethambutol). Surgery consisted of excision in 39% of cases, drainage in 23%, and mastectomy in 5%. The great majority of patients had a positive outcome. It often mimics breast cancer, which makes it difficult to diagnose. Most patients, when diagnosed in time, respond to antitubercular therapy alone.
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Affiliation(s)
- Gianluca Quaglio
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, University of Maastricht, Maastricht, The Netherlands.,Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy.,European Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa CUAMM, Beira, Mozambique
| | - Petros Isaakidis
- Médecins Sans Frontières, Southern Africa Medical Unit (SAMU), Cape Town, South Africa
| | - Arianna Bortolani
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Francesca Tognon
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Claudia Marotta
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | | | - Giovanni Putoto
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Piero L Olliaro
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Special Programme for Research and Training in Tropical Diseases, World Health Organization (WHO/TDR), Geneva, Switzerland
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9
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Russu MC, Nastasia Ş, Degeratu D, Stănculescu RV. Breast and Cervix Uteri: Rare Locations for Mycobacterium Tuberculosis Infections and Complications-Cases Report and Literature Review. Tuberculosis (Edinb) 2018. [DOI: 10.5772/intechopen.75044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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10
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Golsha R, Mehravar F, Alinezhad Esboie A, Rafiee S, Rafiee S. The Epidemiology of Skeletal Tuberculosis in Northeast of Iran: A Review of 229 Cases. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:380-385. [PMID: 30046206 PMCID: PMC6055207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The incidence of tuberculosis (TB) has increased in recent years in both developed and developing countries. Skeletal tuberculosis occurs in approximately 1% of patients with tuberculosis. The present study aimed to evaluate the epidemiology of skeletal tuberculosis in Golestan province in northeastern Iran during 2005-2014. METHODS In the present retrospective study, the epidemiology of skeletal tuberculosis was studied in 229 skeletal tuberculosis patients who were diagnosed during 2005-2014. The prevalence rate of skeletal TB has been reported according to demographic and clinical features. RESULTS Over the 10-year period of this study, 229 known skeletal TB cases were identified in which 56.3% were male. The mean age of the patients was 44.0±17.7 (range 7-87). All of the patients were new cases. Most of the patients (56.8%) were from the rural areas and most were diagnosed by the private healthcare system (63.8%). The highest rate of skeletal TB was seen in 2013 (15.3%). Spinal TB (81.2%) scored the highest rate and pain (96.9%) was the most prevalent symptom of skeletal TB. CONCLUSION The findings suggest that skeletal tuberculosis in northeastern Iran should always be considered as a differential diagnosis for fever and pain on the spinal column. Due to the high level of tuberculosis in the Golestan province (Iran), further research on continued awareness of skeletal TB is stressed.
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Affiliation(s)
- Roghie Golsha
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Mehravar
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Alinezhad Esboie
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sara Rafiee
- Department of Chemistry, University of Mazandaran (MUZ), Mazandaran, Iran
| | - Soheil Rafiee
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
,Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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11
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Efared B, Sidibé IS, Erregad F, Hammas N, Chbani L, El Fatemi H. Breast tuberculosis: a report of five cases. Trop Med Health 2017; 45:40. [PMID: 29255377 PMCID: PMC5729462 DOI: 10.1186/s41182-017-0081-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/30/2017] [Indexed: 01/17/2023] Open
Abstract
Background Breast tuberculosis is a rare form of extrapulmonary tuberculosis with clinical and radiological misleading presentations. We report herein a retrospective study of clinicopathological features of five cases of breast tuberculosis collected at Hassan II University Hospital of Fès, Morocco, a country where tuberculosis is endemic. Case presentation The mean age was 40.6 years (range of 21–59 years). Two patients presented with abscessed lesions, and three cases presented with breast lumps with a suspicion of malignancy on imaging techniques. The diagnosis has been made on histological specimens (3 biopsy specimens, 1 excisional biopsy, and 1 lumpectomy). All patients have been successfully treated after the completion of the standard antibiotherapy. Conclusions Our current study shows that the breast is rarely affected by tuberculosis even in endemic area. The clinical presentation is often misleading, and the histopathological analysis constitutes a valuable diagnostic tool. The prognosis of breast tuberculosis is good after treatment by a standard antibiotherapy.
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Affiliation(s)
- Boubacar Efared
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | - Ibrahim S Sidibé
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | | | - Nawal Hammas
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Laila Chbani
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Hinde El Fatemi
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
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12
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Abstract
The issue of tuberculosis during pregnancy is not simply a historical inquiry but rather an increasingly familiar clinical problem facing industrial nations as well as the developing countries of the world. This review focuses on the maternal aspects of tuberculous infection, as well as transmission to the fetus and newborn.
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13
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Prevalence of asthma symptoms in Golestan schoolchildren aged 6-7 and 13-14 years in Northeast Iran. Front Med 2016; 10:345-50. [PMID: 27527365 DOI: 10.1007/s11684-016-0462-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
Asthma is the most common chronic disease among children, and its incidences are often imminent among elementary schoolchildren. This study aimed to examine the prevalence of asthma symptoms in Golestan schoolchildren aged 6-7 and 13-14 years in Northeast Iran. The prevalence rate was compared according to age group (aged 6-7 years vs. aged 13-14 years) and gender (male vs. female). In this cross-sectional study, 1706 Iranian schoolchildren aged 6-7 and 13-14 years in Golestan Province were enrolled. Participants completed questionnaires between February and July 2014. Asthma symptoms were assessed using the questionnaire of the International Study of Asthma and Allergies in Childhood protocol in Persian. The logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the asthma symptoms for each of the gender and age groups. The prevalence rates of "current asthma" symptoms and "asthma ever" in all the children were estimated as 9.5% and 7.5%, respectively. The prevalence of asthma ("asthma ever" and "wheezing in the past 12 months") in junior high schoolchildren (aged 13-14 years) is higher than that in elementary schoolchildren (aged 6-7 years) (P < 0.05). The prevalence of the severity of wheezing in girls is lower than that in boys (OR = 1.7, 95%CI = 1.06-2.96, P = 0.02). Asthma is still a major public health problem. This study shows that the prevalence of the asthma symptoms in boys is lower than that in girls in both age groups, and the severity of asthma in girls is higher than that in boys aged 13-14 years.
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14
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Clinical, diagnostic and therapeutic management of patients with breast tuberculosis: Analysis of 46 Cases. Kaohsiung J Med Sci 2016; 32:27-31. [PMID: 26853172 DOI: 10.1016/j.kjms.2015.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/04/2015] [Accepted: 12/18/2015] [Indexed: 02/06/2023] Open
Abstract
Breast tuberculosis is a rare form of extrapulmonary tubercular infection. Our aim is to highlight the nonspecific clinical presentations, diagnostic difficulties and therapeutic approaches of mammarian tuberculosis. Forty-six patients diagnosed with breast tuberculosis between 2005 and 2015 were reviewed retrospectively. Clinical features, all diagnostic methods, and the outcomes of treatment were analysed. All cases were female with a mean age of 36.4 years. Breast mass and pain were the most common complaints. While 34.8% of the cases had a physical examination with suspicions for malignancy, 43.5% of the patients had Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 lesions suggested malignancy radiologically. Definitive diagnosis was based on histopathologic examination through core needle biopsy (n = 29), excisional biopsy (n = 12), and open biopsy (n = 5) taken from the abscess wall during drainage. Standard antiTB therapy for 6 months was given to all cases. Thirty-three patients recovered with standard 6-month therapy while extended treatment for 9-12 months was needed in 13 (28.2%) cases. Surgery was carried out in 17 cases. Two patients developed recurrence. Breast tuberculosis can be easily confused with breast cancer, suppurative abscess, and other causes of granulomatous mastitis, both clinically and radiologically. A multidisciplinary approach is required to prevent diagnostic delays and unnecessary surgical interventions. Although antiTB therapy is the mainstay treatment of breast TB, surgery is usually indicated in patients refractory to medical treatment.
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