Stoica C.C.,Victor Babes Clinical Hospital of Infectious Diseases and Pneumology |
Nitu M.,University of Medicine and Pharmacy of Craiova |
Grecu V.I.,Victor Babes Clinical Hospital of Infectious Diseases and Pneumology |
Veselu I.L.,Victor Babes Clinical Hospital of Infectious Diseases and Pneumology |
And 4 more authors.
Archives of the Balkan Medical Union | Year: 2016
Introduction: Mycobacterium tuberculosis can be located in every organ of the human body developing specific tuberculosis histopathological aspects. Hepatic and splenic tuberculosis may be suspected in immunocompromised patients with hepatomegaly and splenomegaly, fever and elevated liver enzymes. Diagnosis is confirmed by culture of a pathological sample or by histological examination of a biopsy of the affected tissue or organ for M. tuberculosis. Case report: 21 years old female known with HIV Infection Category C3 (CD4 -10 cells / mm3), treated with antiretroviral therapy (ART) since November 2014, diagnosed in January 2015 with Progressive Multifocal Leukoencephalopathy, tetra-ataxia, tetra paresis and secondary epilepsy with repeated admissions to an Infectious Department of our hospital for prolonged febrile syndrome, nausea and weight loss is thoroughly investigated for hepatosplenic abscesses identified by CT-scan. In May 2015 a liver biopsy performed in a Hospital in Bucharest and Real Time PCR identified M. tuberculosis 610,000 copies/ml and Rifampicin resistance gene present. Culture confirmed M. tuberculosis. Extended DST (after 60 days) revealed sensitivity just for Ethionamide - tuberculosis XDR (extensively resistant). Initial treatment with tuberculosis drugs according to regimen WHO category 1 was individualized for the identified resistances. ART was also modified because of resistance to Rifampicin. Her condition slowly improved with fever remission and improvement of biological inflammatory syndrome and neurological manifestations associating physical therapy and specialized treatment. Conclusions: Extremely rare and very serious case of XDR TB with atypical localizations due to marked immunodeficiency. It represents a therapeutic challenge involving a multidisciplinary team and prolonged admissions in many specialized departments. Copyright © 2016 CELSIUS.
Streinu-Cercel A.,National Institute For Infectious Diseases Prof Dr Matei Bals |
Streinu-Cercel A.,Carol Davila University of Medicine and Pharmacy |
Sandulescu O.,National Institute For Infectious Diseases Prof Dr Matei Bals |
Sandulescu O.,Carol Davila University of Medicine and Pharmacy |
And 30 more authors.
GERMS | Year: 2017
Background HCV direct-acting antivirals (DAAs) have made treatment easier for both patients and healthcare practitioners, but have also brought new challenges in terms of patient management and monitoring prior to, during, and after treatment. Methods To sum up and unify the clinical experience of Romanian DAA prescribing physicians, we have organized a Consensus Meeting in November 2016 in Bucharest, Romania. Consensus Statement The Consensus Meeting has provided expert answers to ten significant questions regarding HCV infection, namely: How do we diagnose patients with HCV infection? How do we stage liver disease in patients with HCV infection? How do we monitor patients with HCV infection prior to treatment? Which patients with HCV infection do we treat? When do we start treatment for HCV infection? What regimens do we use for treating HCV infection? How do we monitor patients with HCV infection during treatment? What adverse events should we expect during treatment of HCV infection and how do we prevent/manage them? How do we monitor patients with HCV infection after treatment? How do we expect the landscape of HCV to change in the following years?. © GERMS 2017.