2
|
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.
Collapse
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
| |
Collapse
|
3
|
Kang W, Yu J, Du J, Yang S, Chen H, Liu J, Ma J, Li M, Qin J, Shu W, Zong P, Zhang Y, Dong Y, Yang Z, Mei Z, Deng Q, Wang P, Han W, Wu M, Chen L, Zhao X, Tan L, Li F, Zheng C, Liu H, Li X, A E, Du Y, Liu F, Cui W, Wang Q, Chen X, Han J, Xie Q, Feng Y, Liu W, Tang P, Zhang J, Zheng J, Chen D, Yao X, Ren T, Li Y, Li Y, Wu L, Song Q, Yang M, Zhang J, Liu Y, Guo S, Yan K, Shen X, Lei D, Zhang Y, Yan X, Li L, Tang S. The epidemiology of extrapulmonary tuberculosis in China: A large-scale multi-center observational study. PLoS One 2020; 15:e0237753. [PMID: 32822367 PMCID: PMC7446809 DOI: 10.1371/journal.pone.0237753] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/01/2020] [Indexed: 12/28/2022] Open
Abstract
Tuberculosis (TB) remains a serious global public health problem in the present. TB also affects other sites (extrapulmonary tuberculosis, EPTB), and accounts for a significant proportion of tuberculosis cases worldwide. In order to comprehensively understand epidemiology of EBTB in China, and improve early diagnosis and treatment, we conducted a large-scale multi-center observational study to assess the demographic data and the prevalence of common EPTB inpatients, and further evaluate the prevalence of EPTB concurrent with Pulmonary tuberculosis (PTB) and the associations between multiple EPTB types and gender-age group in China. All consecutive age≥15yr inpatients with a confirmed diagnosis of EPTB during the period from January 2011 to December 2017 were included in the study. The descriptive statistical analysis included median and quartile measurements for continuous variables, and frequencies and proportions with 95% confidence intervals (CIs) for categorical variables. Multinomial logistic regression analysis was used to compare the association of multiple EPTB types between age group and gender. The results showed that the proportion of 15–24 years and 25–34 years in EPTB inpatients were the most and the ratio of male: female was 1.51. Approximately 70% of EPTB inpatients were concurrent with PTB or other types of EPTB. The most common of EPTB was tuberculous pleurisy (50.15%), followed by bronchial tuberculosis (14.96%), tuberculous lymphadenitis of the neck (7.24%), tuberculous meningitis (7.23%), etc. It was found that many EPTB inpatients concurrent with PTB. The highest prevalence of EPTB concurrent with PTB was pharyngeal/laryngeal tuberculosis (91.31%), followed by bronchial tuberculosis (89.52%), tuberculosis of hilar lymph nodes (79.52%), tuberculosis of mediastinal lymph nodes (79.13%), intestinal tuberculosis (72.04%), tuberculous pleurisy (65.31%) and tuberculous meningitis (62.64%), etc. The results from EPTB concurrent with PTB suggested that females EPTB inpatients were less likely to be at higher risk of concurrent PTB (aOR = 0.819, 95%CI:0.803–0.835) after adjusted by age. As age increasing, the trend risk of concurrent PTB decreased (aOR = 0.994, 95%CI: 0.989–0.999) after adjusted by gender. Our study demonstrated that the common EPTB were tuberculous pleurisy, bronchial tuberculosis, tuberculous lymphadenitis of the neck, tuberculous meningitis, etc. A majority of patients with pharyngeal/laryngeal tuberculosis, bronchial tuberculosis, tuberculosis of hilar/mediastinal lymph nodes, intestinal tuberculosis, tuberculous pleurisy, tuberculous meningitis, etc. were concurrent with PTB. Female EPTB inpatients were less likely to be at higher risk of concurrent PTB, and as age increasing, the trend risk of concurrent PTB decreased. The clinicians should be alert to the presence of concurrent tuberculosis in EPTB, and all suspected cases of EPTB should be assessed for concomitant PTB to determine whether the case is infectious and to help for early diagnosis and treatment.
Collapse
Affiliation(s)
- Wanli Kang
- Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Jiajia Yu
- Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Jian Du
- Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Song Yang
- Chongqing Public Health Medical Center, Chongqing, China
| | | | - Jianxiong Liu
- Guang Zhou Chest Hospital, Guangzhou, Guangdong, China
| | - Jinshan Ma
- Chest Hospital of Xinjiang, Urumqi, Xinjiang, China
| | - Mingwu Li
- The Third People’s Hospital of Kunming, Kunming City, Yunnan Province, China
| | - Jingmin Qin
- Shandong provincial Chest Hospital, Jinan, Shandong, China
| | - Wei Shu
- Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
| | - Peilan Zong
- Jiangxi Chest (third people) Hospital, Nanchang City, Jiangxi Province, China
| | - Yi Zhang
- Chang Chun Infectious Diseases Hospital, Changchun City, Jilin Province, China
| | - Yongkang Dong
- Taiyuan Fourth People’s Hospital, Taiyuan City, Shanxi Province, China
| | - Zhiyi Yang
- Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China
| | | | - Qunyi Deng
- Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Pu Wang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenge Han
- Weifang NO.2 People’s Hospital, Shandong Province, China
| | - Meiying Wu
- The Fifth People’s Hospital of Suzhou, Suzhou City, Jiangsu Province, China
| | - Ling Chen
- Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China
| | - Xinguo Zhao
- The Fifth People’s Hospital of Wuxi, Wuxi, China
| | - Lei Tan
- TB Hospital of Siping City, Siping City, Jilin Province, China
| | - Fujian Li
- Baoding Hospital for Infectious Disease, Baoding City, Hebei Province, China
| | - Chao Zheng
- The First Affiliated of XiaMen University, Xiamen City, Fujian Province, China
| | | | - Xinjie Li
- Guang Zhou Chest Hospital, Guangzhou, Guangdong, China
| | - Ertai A
- Chest Hospital of Xinjiang, Urumqi, Xinjiang, China
| | - Yingrong Du
- The Third People’s Hospital of Kunming, Kunming City, Yunnan Province, China
| | - Fenglin Liu
- Shandong provincial Chest Hospital, Jinan, Shandong, China
| | - Wenyu Cui
- Chang Chun Infectious Diseases Hospital, Changchun City, Jilin Province, China
| | - Quanhong Wang
- Taiyuan Fourth People’s Hospital, Taiyuan City, Shanxi Province, China
| | | | | | - Qingyao Xie
- Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Yanmei Feng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenyu Liu
- Weifang NO.2 People’s Hospital, Shandong Province, China
| | - Peijun Tang
- The Fifth People’s Hospital of Suzhou, Suzhou City, Jiangsu Province, China
| | - Jianyong Zhang
- Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China
| | - Jian Zheng
- The Fifth People’s Hospital of Wuxi, Wuxi, China
| | - Dawei Chen
- Baoding Hospital for Infectious Disease, Baoding City, Hebei Province, China
| | - Xiangyang Yao
- The First Affiliated of XiaMen University, Xiamen City, Fujian Province, China
| | - Tong Ren
- Shenyang chest Hospital, Shenyang, China
| | - Yan Li
- Guang Zhou Chest Hospital, Guangzhou, Guangdong, China
| | - Yuanyuan Li
- Chest Hospital of Xinjiang, Urumqi, Xinjiang, China
| | - Lei Wu
- The Third People’s Hospital of Kunming, Kunming City, Yunnan Province, China
| | - Qiang Song
- Shandong provincial Chest Hospital, Jinan, Shandong, China
| | - Mei Yang
- Chongqing Public Health Medical Center, Chongqing, China
| | - Jian Zhang
- Chang Chun Infectious Diseases Hospital, Changchun City, Jilin Province, China
| | | | - Shuliang Guo
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kun Yan
- Weifang NO.2 People’s Hospital, Shandong Province, China
| | - Xinghua Shen
- The Fifth People’s Hospital of Suzhou, Suzhou City, Jiangsu Province, China
| | - Dan Lei
- Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China
| | - Yanli Zhang
- Baoding Hospital for Infectious Disease, Baoding City, Hebei Province, China
| | - Xiaofeng Yan
- Chongqing Public Health Medical Center, Chongqing, China
- * E-mail: (ST); (LL); (XY)
| | - Liang Li
- Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
- * E-mail: (ST); (LL); (XY)
| | - Shenjie Tang
- Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, China
- * E-mail: (ST); (LL); (XY)
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Efared B, Sidibé IS, Erregad F, Hammas N, Chbani L, El Fatemi H. Female genital tuberculosis: a clinicopathological report of 13 cases. J Surg Case Rep 2019; 2019:rjz083. [PMID: 30937159 PMCID: PMC6431246 DOI: 10.1093/jscr/rjz083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/02/2019] [Indexed: 11/14/2022] Open
Abstract
Female genital tuberculosis (FGTB) is a rare form of tuberculosis (TB) affecting women of reproductive age. The clinical presentation is often misleading. We retrospectively collected cases of female genital tuberculosis (FGTB) diagnosed from 2006 to 2016 at our pathology department. The mean age was 39.92 years (range of 18-74 years). Most patients had reproductive age, with 30.76% postmenopausal women. Seven cases (53.84%) were addressed for histopathological analysis for clinical malignant suspicion. The diagnosis was made on eight surgical specimens (61.53%). Nine patients (69.23%) had multifocal TB. The most involved genital organs were fallopian tubes (63.84%), followed by ovaries (46.15%), endometrium (38.46%) and the cervix (23.07%). The macroscopic aspects of all resected specimens did not show the classic appearance of caseous necrosis. We found that most patients with genital tuberculosis present with clinical suspicion of malignancy leading to aggressive surgical management.
Collapse
Affiliation(s)
- Boubacar Efared
- Department of Pathology, Faculté des Sciences de la Santé (FSS), Niamey, Niger.,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
| |
Collapse
|