Mirage de tuberculose in the 21st century.

IF 1.3 Q4 RESPIRATORY SYSTEM Public Health Action Pub Date : 2024-06-01 DOI:10.5588/pha.24.0056
M B Kaelin, S Wieser, B Preiswerk, P W Schreiber, D Russenberger, P Kaiser, B Schulthess, J Nemeth
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Abstract

The occurrence of transient culture positivity for Mycobacterium tuberculosis (MTB), known as mirage de tuberculose, poses significant challenges in understanding its spectrum and implications. Here, we report a case of transient culture positivity, oscillating between detectable and non-detectable MTB cultures with minimal radiological features and review the literature on this phenomenon. The scarcity of scientific literature on this subject stems from the inherent impossibility of systematically studying mirage de tuberculose. Ethical and public health concerns prevent withholding treatment to monitor spontaneous reversion to negative cultures. Based on the literature, we estimate that mirage de tuberculose occurs in approximately one-third of individuals infected with MTB who exhibit no symptoms. Despite the inherently limited nature of these findings, they suggest that the significance of mirage de tuberculose may be greater than currently perceived. Managing cases of mirage de tuberculose presents formidable challenges from a public health perspective. Striking a balance between prompt treatment initiation to prevent transmission and the risk of unnecessary treatment requires careful consideration. In conclusion, mirage de tuberculose remains a poorly understood clinical entity with very limited literature available. Advancing research and interdisciplinary collaborations are essential to unravel the intricacies of this phenomenon and develop effective strategies to address its public health challenges.

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21 世纪结核病的幻影。
结核分枝杆菌(MTB)培养一过性阳性,即所谓的 "结核病海市蜃楼"(mirage de tuberculose),这种现象的出现为了解其谱和影响带来了巨大挑战。在此,我们报告了一例一过性培养阳性病例,该病例在可检测和不可检测的 MTB 培养物之间徘徊,且放射学特征极少,我们还回顾了有关这一现象的文献。有关这一主题的科学文献很少,这是因为不可能对结核病 "海市蜃楼 "进行系统研究。出于伦理和公共卫生方面的考虑,我们无法通过暂停治疗来监测培养结果自发转为阴性的情况。根据文献资料,我们估计约有三分之一的无症状 MTB 感染者会出现结核病海马。尽管这些发现本身具有局限性,但它们表明结核病海马的重要性可能比目前认为的要大。从公共卫生的角度来看,处理结核病海市蜃楼病例是一项艰巨的挑战。在及时开始治疗以防止传播与不必要的治疗风险之间取得平衡需要慎重考虑。总之,结核病 "海市蜃楼 "仍是一个鲜为人知的临床实体,现有文献非常有限。推进研究和跨学科合作对于揭示这一现象的复杂性和制定有效策略以应对其公共卫生挑战至关重要。
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来源期刊
Public Health Action
Public Health Action RESPIRATORY SYSTEM-
自引率
0.00%
发文量
29
期刊介绍: Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
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