Richter C, Kox L F, Van Leeuwen J V, Mtoni I, Kolk A H
Department of Medicine, Muhimbili Medical Centre, Dar es Salaam, Tanzania.
Eur J Clin Microbiol Infect Dis. 1996 Oct;15(10):813-7. doi: 10.1007/BF01701525.
In 191 Tanzanian patients admitted to hospital with suspected extrapulmonary tuberculosis (TB), TB was diagnosed in 158 patients; the remaining 33 patients had neither microbiological nor clinical evidence of TB. Mycobacterium tuberculosis was detected in the blood of 25 patients, in 92% by a polymerase chain reaction (PCR) technique and in 52% by culture of buffy coat cells. The presence of mycobacterial DNA or Mycobacterium tuberculosis bacteria in peripheral blood (positive culture) was significantly associated with HIV infection; it was detected in 22 (21.4%) of 103 HIV-seropositive patients compared to only 3 (3.5%) of 55 HIV-seronegative patients (p < 0.009). In two-thirds of the patients with mycobacteraemia, TB can be detected by simple smears from other organ sites. In patients with suspected extrapulmonary tuberculosis in whom smears from the infected site are negative or not available, PCR on blood will confirm the diagnosis within 24 hours in one third of the cases.
在191名因疑似肺外结核入院的坦桑尼亚患者中，158例被诊断为结核病；其余33例患者既无结核病的微生物学证据，也无临床证据。在25例患者的血液中检测到结核分枝杆菌，92%通过聚合酶链反应（PCR）技术检测到，52%通过血沉棕黄层细胞培养检测到。外周血中存在分枝杆菌DNA或结核分枝杆菌（培养阳性）与HIV感染显著相关；在103例HIV血清学阳性患者中有22例（21.4%）检测到，而在55例HIV血清学阴性患者中仅3例（3.5%）检测到（p<0.009）。在三分之二的菌血症患者中，通过其他器官部位的简单涂片即可检测到结核病。对于疑似肺外结核且感染部位涂片阴性或无法获得涂片的患者，三分之一的病例中血液PCR检测可在24小时内确诊。
