Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Matters of the heart: A scoping review toward better management of nontuberculous mycobacterial infections of cardiac devices","authors":"Rattanaporn Mahatanan ,&nbsp;Maria Alkozah ,&nbsp;Devin Lee ,&nbsp;Anais A. Ovalle ,&nbsp;Natalie B.V. Riblet ,&nbsp;Elizabeth A. Talbot","doi":"10.1016/j.jctube.2025.100521","DOIUrl":"10.1016/j.jctube.2025.100521","url":null,"abstract":"<div><h3>Background</h3><div>Implantable cardiac device-related (ICDR) nontuberculous mycobacteria (NTM) infections are increasingly reported in the literature, but guidelines for optimal management are lacking.</div></div><div><h3>Methods</h3><div>We searched Medline, Embase, and Scopus from inception to 1/20/2022 for cases of ICDR NTM infection. Cardiac devices include but are not limited to prosthetic valves, cardiovascular implantable device (CIED), and left ventricular-assist devices (LVAD). We categorized outcomes as death, failure, relapse, cure, and treatment complete.</div></div><div><h3>Main results</h3><div>A total of 81 articles met our inclusion criteria, representing 122 patients. Eleven different NTM species were reported, with rapidly growing mycobacteria (RGM) including <em>M. fortuitum, M. chelonae,</em> and <em>M. abscessus</em> comprising approximately 60 % of the identified organisms. Prosthetic heart valves (N = 61; 50 %) and CIED (N = 46; 38 %) were the most frequently associated cardiac devices. Favorable outcomes, defined as treatment complete and cure, were significantly associated with device removal after adjusting for age, gender, and device type (aOR 3.45, 95 %CI 1.30–9.14).</div></div><div><h3>Conclusion</h3><div>We found that patients who underwent device removal had better outcomes than those with retained devices. Device removal should be strongly considered when possible.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100521"},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the global Response to Tuberculosis: Insights from the 2024 WHO global TB report","authors":"Fatemeh Estaji ,&nbsp;Ali Kamali ,&nbsp;Masoud Keikha","doi":"10.1016/j.jctube.2025.100522","DOIUrl":"10.1016/j.jctube.2025.100522","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100522"},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of extensive drug resistance by the Xpert MTB/XDR assay in multidrug resistant tuberculosis cases at a tertiary care centre in northern India, and therapeutic decision making for the six-month BPaLM regimen","authors":"Richa Misra ,&nbsp;Parijat Das ,&nbsp;Alok Nath ,&nbsp;Zafar Neyaz","doi":"10.1016/j.jctube.2025.100520","DOIUrl":"10.1016/j.jctube.2025.100520","url":null,"abstract":"<div><div>The Xpert MTB/XDR assay has been approved by World Health Organization (WHO) as a reflex test on sputum samples after testing for rifampicin resistance. Recently, the Union Health Ministry of India in September 2024 approved the introduction of the six-month BPaLM regimen under its National TB Elimination Program (NTEP). In this study, the Xpert MTB/XDR assay was used to detect extensive drug resistance in pulmonary and extra-pulmonary tuberculosis patients with positive result for MTBC, and RIF resistance by the Xpert MTB/RIF ULTRA assay. We also aimed to assess the eligibility of patients for the BPaLM regimen based on the drug susceptibility profile of this test in a high burden Indian setting.</div><div>We conducted a single centre prospective cohort study between January 2023 to August 2024 on 42 old, and 68 new patients presenting with MDR/RR tuberculosis. A total of 110 samples (82 pulmonary and 28 extra pulmonary samples) were included in the study. The Xpert MTB/XDR assay was used to determine the susceptibilities to isoniazid, fluoroquinolones, amikacin, kanamycin, capreomycin, and ethionamide.</div><div>Out of 110 samples processed, 13 samples were ‘not detected’ by the assay while three gave invalid results. Resistance to isoniazid, fluoroquinolones, amikacin, kanamycin, capreomycin and ethionamide was detected in 85/94 cases (90·42%), 74/94 cases (78·72%), 08/94 cases (8·5%), 13/94 cases (13·83%), 08/94 cases (8·5%), and 14/94 cases (14·89%) respectively.</div><div>With the updated definitions of drug-resistant TB and high burden of fluoroquinolone resistance the Xpert MTB/XDR assay has a limited application in India.</div><div>Detection of extensive drug resistance by the Xpert MTB/XDR assay in multidrug resistant tuberculosis cases at a tertiary care centre in northern India, and therapeutic decision making for the six-month BPaLM regimen.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100520"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost effectiveness analysis of expanding tuberculosis preventive therapy to household contacts aged 5–14 years in the Philippines","authors":"Ghassan Ilaiwy ,&nbsp;Jessica Keim-Malpass ,&nbsp;Romella Tuppal ,&nbsp;Alexander F. Ritua ,&nbsp;Flordeliza R. Bassiag ,&nbsp;Tania A. Thomas","doi":"10.1016/j.jctube.2025.100519","DOIUrl":"10.1016/j.jctube.2025.100519","url":null,"abstract":"<div><h3>Background</h3><div>Children aged 5–14 years who are household contacts (HHCs) of index people with active TB disease (PWTB) have limited coverage for TB preventive therapy (TPT) due to variable uptake of the national guideline recommendations in the Philippines. We conducted a cost-effectiveness analysis evaluating the expansion of TB infection (TBI) testing and treatment among pediatric (5–14 years) HHCs of index PWTB in the Philippines to assist the National TB program in choosing the most cost-effective testing and treatment strategy for TBI among HHCs of index PWTB.</div></div><div><h3>Methods</h3><div>Using a Markov state transition model, eligible HHCs age 5–14 years are screened for TBI with either the tuberculin skin test (TST) or interferon gamma release assay (IGRA). Those who test positive are then simulated to receive one of the following TPT strategies: 6 months of daily isoniazid (6H), 3 months of weekly isoniazid and rifapentine (3HP), 3 months of daily isoniazid plus rifampicin (3HR) and the current practice of no testing or treatment for TBI (NTT). The analysis assesses the projected cost and quality-adjusted life years (QALY) gained for every strategy from the perspective of the Philippines public healthcare system over a time horizon of 20 years. The total cost and gain in QALYs are presented as an incremental cost-effectiveness ratio (ICER) comparing cost per QALY gained for each strategy over NTT.</div></div><div><h3>Results</h3><div>Our model estimates that expanding TPT coverage to HHCs aged 5–14 years would be cost-effective with incremental cost-effectiveness ratios (ICERs) ranging from 1,024 $/QALY gained when using TST and 6H (Uncertainty range: 497–––2,334) to 2,293 $/QALY gained when IGRA and 3HR are used (Uncertainty range: 1,140 – 5,203). These findings were robust to sensitivity analyses over a wide range of parameter values.</div></div><div><h3>Conclusion</h3><div>Expanding TPT coverage to HHCs aged 5–14 years is cost-effective when using TST and 6H closely followed by a strategy combining TST and 3HP.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100519"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy study of STANDARD TB-Feron FIA and STANDARD TB-Feron ELISA tests for tuberculosis infection diagnosis in Eastern European setting","authors":"Valeriu Crudu ,&nbsp;Dumitru Chesov ,&nbsp;Alexandru Codreanu ,&nbsp;Nadejda Turcanu ,&nbsp;Nelly Ciobanu ,&nbsp;Liuba Nepoliuc ,&nbsp;Doina Rusu","doi":"10.1016/j.jctube.2025.100518","DOIUrl":"10.1016/j.jctube.2025.100518","url":null,"abstract":"<div><h3>Introduction</h3><div>Tuberculosis infection (TBI) is diagnosed based on a positive immune response to <em>M. tuberculosis</em> antigens. This study aimed to evaluate both the qualitative and quantitative performance of two novel IGRA-based tests, the STANDARD E TB-Feron ELISA (TB-Feron-ELISA) and the STANDARD F TB-Feron FIA (IFN-γ) (TB-Feron-FIA), and compare their results to those of QuantiFERON-TB Gold Plus (QuantiFERON).</div></div><div><h3>Methods</h3><div>At Chiril Draganiuc Phthisiopneumology Institute in the Republic of Moldova, we prospectively enrolled three cohorts of adults: healthy individuals with no known close contact with TB, patients with active tuberculosis (TB), and individuals with a history of TB. The active TB and past TB cohorts were used to assess the tests’ sensitivity, while the healthy group was used to evaluate specificity. Both qualitative and quantitative results from the TB-Feron ELISA and TB-Feron FIA were compared with those of QuantiFERON.</div></div><div><h3>Results</h3><div>The TB-Feron-FIA demonstrated a sensitivity of 80.58 % (95 %CI: 71.90–87.06) in the active TB cohort and 82.93 % (95 %CI: 68.74–91.47) in the past TB cohort, with a specificity of 85.19 % (95 % CI: 73.40–92.30). The TB-Feron-ELISA showed a sensitivity of 80.58 % (95 %CI: 71.90–87.06) in the active TB cohort and 78.57 % (95 %CI: 64.06–88.29) in the past TB cohort, with a specificity of 85.19 % (95 %CI: 73.40–92.30). The agreement coefficient (κ) with QuantiFERON was 0.766 (95 %CI: 0.689–0.843) for TB-Feron-FIA and 0.809 (95 %CI: 0.739–0.880) for TB-Feron-ELISA.</div></div><div><h3>Conclusions</h3><div>Both the TB-Feron-ELISA and TB-Feron-FIA demonstrated good diagnostic accuracy for identifying individuals with TBI, comparable to the performance of QuantiFERON.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100518"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study","authors":"Francesco Di Gennaro ,&nbsp;Giacomo Guido ,&nbsp;Sergio Cotugno ,&nbsp;Francesco Cavallin ,&nbsp;Mariantonietta Pisaturo ,&nbsp;Lorenzo Onorato ,&nbsp;Federica Zimmerhofer ,&nbsp;Luca Pipitò ,&nbsp;Giuseppina De Iaco ,&nbsp;Giuseppe Bruno ,&nbsp;Massimo Fasano ,&nbsp;Agostina Pontarelli ,&nbsp;Annarita Botta ,&nbsp;Tiziana Iacovazzi ,&nbsp;Rossana Lattanzio ,&nbsp;Virginia Di Bari ,&nbsp;Gianfranco Panico ,&nbsp;Raffaella Libertone ,&nbsp;Caterina Monari ,&nbsp;Alessia Musto ,&nbsp;Annalisa Saracino","doi":"10.1016/j.jctube.2025.100517","DOIUrl":"10.1016/j.jctube.2025.100517","url":null,"abstract":"<div><h3>Background</h3><div>Identifying accessible and reliable biomarkers for tuberculosis (TB) severity is crucial for improving patient management. This study evaluates hematological findings as potential indicators of TB severity in a large multicenter Italian cohort.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter, cross-sectional study analyzed hematological parameters (hemoglobin, white blood cells, inflammatory indices, hepatorenal function, albuminuria) in 577 TB patients from 10 Italian centers (2018–2023). Severe TB was defined by at least two criteria: TIMIKA score &gt; 60, sputum conversion time &gt; 21 days, or need for oxygen supplementation. Statistical analyses included receiver operating characteristic curve (AUC) evaluation, calibration curves, and clinical utility.</div></div><div><h3>Results</h3><div>Of the patients, 30.3 % were classified as severe, 60.2 % as non-severe, and 9.5 % as uncertain. AUC values for predicting severe TB ranged from 0.51 to 0.56 across hematological variables. Anemia and elevated CRP demonstrated sensitivities of 0.71 and 0.74, respectively. Models using continuous or categorical hematological variables achieved AUCs of 0.61 and 0.65, showing poor calibration and limited clinical utility in the 30–60 % threshold range.</div></div><div><h3>Conclusions</h3><div>Hematological markers, while rapid and cost-effective, demonstrated limited discriminative ability for TB severity. Further studies are required to develop reliable predictive models, integrating additional clinical and molecular data.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100517"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning analysis for predicting acid-fast bacilli results in tuberculosis sputum tests: Comment","authors":"Hinpetch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.jctube.2025.100516","DOIUrl":"10.1016/j.jctube.2025.100516","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100516"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse drug reactions and contributing factors in patients with drug-resistant tuberculosis: A 7-year retrospective cohort study in Addis Ababa, Ethiopia","authors":"Bisrat Solomon ,&nbsp;Yimtubezinash Woldeamanuel ,&nbsp;Tigest Ajeme ,&nbsp;Mbazi Senkoro ,&nbsp;Tsegahun Manyazewal","doi":"10.1016/j.jctube.2025.100515","DOIUrl":"10.1016/j.jctube.2025.100515","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Drug-resistant tuberculosis poses a major global public health threat, with adverse drug reactions complicating treatment and contributing to mortality. In Ethiopia, although many patients with drug-resistant tuberculosis are receiving treatment, studies on adverse drug reactions and their contributing factors remain limited. This study aimed to assess the incidence of adverse drug reactions and contributing factors in patients on drug-resistant tuberculosis treatment in Addis Ababa, Ethiopia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A facility-based, retrospective cohort study was conducted on patients with drug-resistant tuberculosis who were followed up in two major drug-resistant tuberculosis treatment sites, St. Peter’s Specialized Hospital and the ALERT Comprehensive Specialized Hospital, in the years of 2017 to 2023. Records of the patients were reviewed throughout their treatment time. Information on any adverse drug reaction diagnosis, laboratory findings, clinical observations, type of second-line regimen, type and nature of the drug-resistant tuberculosis, presence of comorbidities such as Human Immune deficiency Virus, hypertension, diabetes mellitus, chronic obstructive pulmonary diseases, and asthma, and sociodemographic characteristics were abstracted from patients’ charts and registries. The World Health Organization − Uppsala Monitoring Center (WHO-UMC) system was employed for standardized causality assessment of adverse drug reactions. Multivariate Cox regression analysis was employed to identify factors associated with adverse drug reactions. Survival among predictor variables was assessed using Kaplan-Meier (KM) curves. Adjusted hazard ratios (AHR) with their corresponding 95 % confidence intervals (CI) were estimated, and statistical significance was declared for a p-value &lt; 0.05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result&lt;/h3&gt;&lt;div&gt;A total of 292 patients with drug-resistant tuberculosis were included. The overall incidence of adverse drug reaction was 8.10 per 100 person-month (PM) (95 % CI: 7.02–9.36) during a total follow-up time of 2294 months. The most frequently reported adverse drug reactions were gastrointestinal disturbance (31.9 %), followed by peripheral neuropathy (21.9 %), and arthralgia (17.5 %). Factors associated with adverse drug reactions were hospitalization (AHR = 1.53, 95 % CI: 1.10–2. 13), baseline anemia (AHR = 1.58, 95 % CI: 1.16–2.17), the age group of 25–49 years (AHR = 1.53, 95 % CI: 1.05–2.21), and age greater than or equal to 50 years (AHR = 1.87, 95 % CI: 1.19–2.93). Good treatment outcome was observed in 76 % of cases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In this study involving patients with drug resistant tuberculosis, over half of the participants encountered at least one adverse drug reactions. Patient admission, baseline anemia, and older age were identified as major factors associated with adverse drug reaction during multidrug resistant tuberculosis treatment. Particular em","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100515"},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis and drug resistance in a region of Southern Italy among native and foreign-born populations: A twelve-year province-based study","authors":"Salvatore Rotundo ,&nbsp;Salvatore Nisticò ,&nbsp;Helen Linda Morrone ,&nbsp;Luigia Gallo ,&nbsp;Saveria Dodaro ,&nbsp;Carmelo Papola ,&nbsp;Pasquale Minchella ,&nbsp;Giovanni Matera ,&nbsp;Francesca Greco ,&nbsp;Luigi Principe ,&nbsp;Lorenzo Antonio Surace ,&nbsp;Francesco Lucia ,&nbsp;Francesca Serapide ,&nbsp;Alessandro Russo ,&nbsp;Carlo Torti ,&nbsp;Enrico Maria Trecarichi ,&nbsp;the Calabria TB group","doi":"10.1016/j.jctube.2025.100512","DOIUrl":"10.1016/j.jctube.2025.100512","url":null,"abstract":"<div><div>Tuberculosis (TB) remains a significant global health challenge, with the World Health Organization (WHO) aiming for a 95% reduction in TB deaths by 2030. Disparities in TB detection persist, particularly regarding gender, immigration status, and resistance patterns. In Calabria, Italy—a key entry point for migrants from high-TB-incidence regions—TB poses a notable public health risk. This multicenter, retrospective study examines newly diagnosed TB cases in Calabria from 2012 to 2023, focusing on rifampicin-resistant TB (RR-TB).</div><div>During this period, 800 TB cases were diagnosed, with 270 (33.7 %) in native-born Italians and 530 (66.2 %) in foreign-born individuals, showing significant differences in age (p &lt; 0.001) and gender (p = 0.013). Among 685 patients of this cohort with available HIV status, 24 (3.5 %) were people living with HIV (PLWH), primarily from Africa, and diagnosed at higher rates of RR-TB (p &lt; 0.001). TB cases varied by province, correlating with specific birthplaces. A total of 27 (3.4 %) RR-TB cases were identified, with heightened resistance to multiple drugs. Among these strains, 20 (74.1 %) were isoniazid-resistant (MDR-TB).</div><div>This study underscores the need for comprehensive TB control strategies, especially regarding co-infection with HIV and the emergence of drug-resistant strains, emphasizing the importance of early detection and tailored management in Southern Italy.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"38 ","pages":"Article 100512"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perforating ENL: A variant of type 2 lepra reaction","authors":"Bhakti Sarda ,&nbsp;Bhushan Madke ,&nbsp;Vikrant Saoji ,&nbsp;Ambika Kondalkar","doi":"10.1016/j.jctube.2024.100507","DOIUrl":"10.1016/j.jctube.2024.100507","url":null,"abstract":"<div><div>Lepra reactions are acute episodic inflammatory reactions that occur during illness due to abrupt changes in the body’s immunological response against Mycobacterium leprae. These are of two types, type 1 and type 2. Type 2 reaction is also called Erythema Nodosum Leprosum (ENL).</div><div>The common skin lesion in ENL is a red, tender, raised lesion. Subcutaneous nodules can also appear. The skin lesions may present as vesicles, pustules, or bulla. They can also develop ulcers and become necrotic. Some patients may experience skin lesions that resemble those seen in erythema multiforme. A rare desquamative rash may occur, which needs to be differentiated from a drug-related rash. Healing lesions may leave scars that may become inflamed during ENL flare-ups. In rare instances, there may be no skin lesions suggesting ENL.</div><div>Reactive perforating type of erythema nodosum leprosum (ENL) is a rare type 2 lepra reaction occurrence, observed in lepromatous leprosy and borderline lepromatous cases. It is linked with the involvement of several organs, so if diagnosis and treatment are delayed, it can result in complications and a grim prognosis.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"38 ","pages":"Article 100507"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}