NEJM â Collection Updates for Tuberculosis

IMAGES IN CLINICAL MEDICINE: Tuberculous Abscess Manifesting as Unilateral Gynecomastia

Jansen Koh, M.R.C.P. and Augustine Tee, M.R.C.P. — Thu, 03Â DecÂ 2009 00:00:00 -05:00

A 74-year-old man was admitted to our hospital after presenting with fever, nonproductive cough, and a 2-month history of enlargement of the left breast. Examination showed gynecomastia on the left...

IMAGES IN CLINICAL MEDICINE: Infection 57 Years after Plombage

Shimpei Gotoh, M.D. and Naohiko Chohnabayashi, M.D., Ph.D. — Thu, 04Â JunÂ 2009 00:00:00 -05:00

An 86-year-old man was hospitalized for repeated episodes of septic shock due to methicillin-resistant Staphylococcus aureus (MRSA) pneumonia; he ultimately died of pseudomonal sepsis and pneumonia. In 1948, the patient...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: The Granuloma in Tuberculosis â Friend or Foe?

Eric J. Rubin, M.D., Ph.D. — Thu, 04Â JunÂ 2009 00:00:00 -05:00

Granulomas are cellular aggregates that are the pathologic hallmarks of tuberculosis. These chronic inflammatory lesions have long been considered to be necessary for containment of infection. A recent study by...

EDITORIAL: Unorthodox Approach to the Development of a New Antituberculosis Therapy

Clifton E. Barry III, Ph.D. — Thu, 04Â JunÂ 2009 00:00:00 -05:00

The development of TMC207 represents an important advance in the chemotherapy of tuberculosis. It is perhaps most amazing because of the defiantly unconventional nature of the effort. At virtually every...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 18-2009 â A 24-Year-Old Woman with AIDS and Tuberculosis with Progressive Cough, Dyspnea, and Wasting

Douglas Wilson, M.B., Ch.B., RocÃo M. Hurtado, M.D., and Subba Digumarthy, M.D. — Thu, 04Â JunÂ 2009 00:00:00 -05:00

Dr. Anne Griffin (Medicine and Pediatrics): A 24-year-old woman with the acquired immunodeficiency syndrome (AIDS) and pulmonary tuberculosis was admitted to a hospital in South Africa that is affiliated with...

IMAGES IN CLINICAL MEDICINE: Plombage Cavities

Ioannis Dimarakis, Ph.D., M.R.C.S. and Jonathan Anderson, F.R.C.S. — Thu, 04Â JunÂ 2009 00:00:00 -05:00

A 73-year-old woman receiving chemotherapy for advanced breast cancer was referred for treatment of a nontuberculous empyema of the thoracic cavity (left side), which had not responded to treatment with...

ORIGINAL ARTICLE: Overseas Screening for Tuberculosis in U.S.-Bound Immigrants and Refugees

Thu, 04Â JunÂ 2009 00:00:00 -05:00

Background: In 2007, a total of 57.8% of the 13,293 new cases of tuberculosis in the United States were diagnosed in foreign-born persons, and the tuberculosis rate among foreign-born persons...

ORIGINAL ARTICLE: The Diarylquinoline TMC207 for Multidrug-Resistant Tuberculosis

Thu, 04Â JunÂ 2009 00:00:00 -05:00

Background: The diarylquinoline TMC207 offers a new mechanism of antituberculosis action by inhibiting mycobacterial ATP synthase. TMC207 potently inhibits drug-sensitive and drug-resistant Mycobacterium tuberculosis in vitro and shows bactericidal activity...

PERSPECTIVE: The Global Burden of Tuberculosis â Combating Drug Resistance in Difficult Times

Thu, 04Â JunÂ 2009 00:00:00 -05:00

According to the 13th annual tuberculosis report of the World Health Organization (WHO) â published on World TB Day, March 24, 2009 â there were an estimated 9.27 million new...

BOOK REVIEW:

Thu, 01Â JanÂ 2009 00:00:00 -05:00

It is the year 1908. In the United States, more than 150,000 people will die from tuberculosis. If you contract tuberculosis, your best hope is to be shipped off to...

CORRESPONDENCE: Emergence of Extensive Drug Resistance during Treatment for Multidrug-Resistant Tuberculosis

Thu, 27Â NovÂ 2008 00:00:00 -05:00

To the Editor: We report the development of fluoroquinolone-resistant tuberculosis and extensively drug-resistant tuberculosis during second-line treatment for multidrug-resistant tuberculosis in Karakalpakstan, Uzbekistan. Eighty-seven patients were treated with a regimen...

CORRESPONDENCE: Treatment Outcomes in Extensively Resistant Tuberculosis

Edward D. Chan, M.D., Matthew J. Strand, Ph.D., and Michael D. Iseman, M.D. — Thu, 07Â AugÂ 2008 00:00:00 -05:00

To the Editor: Extensively drug-resistant tuberculosis, which is defined as tuberculosis that is resistant to rifampin, isoniazid, a fluoroquinolone, and a second-line injectable agent, poses a major challenge for global...

EDITORIAL: Facing Extensively Drug-Resistant Tuberculosis â A Hope and a Challenge

Mario C. Raviglione, M.D. — Thu, 07Â AugÂ 2008 00:00:00 -05:00

As of June 2008, a total of 49 countries worldwide reported to the World Health Organization (WHO) at least one case of extensively drug-resistant tuberculosis. Since its first description in...

ORIGINAL ARTICLE: Comprehensive Treatment of Extensively Drug-Resistant Tuberculosis

Thu, 07Â AugÂ 2008 00:00:00 -05:00

Background: Extensively drug-resistant tuberculosis has been reported in 45 countries, including countries with limited resources and a high burden of tuberculosis. We describe the management of extensively drug-resistant tuberculosis and...

CLINICAL PROBLEM-SOLVING: An Unintended Consequence â A 79-year-old man with a 5-month history of fatigue and 20-lb (9-kg) weight loss presented to his local physician

Thu, 03Â AprÂ 2008 00:00:00 -05:00

A 79-year-old man with a 5-month history of fatigue and 20-lb (9-kg) weight loss presented to his local physician. The patient also reported intermittent episodes of high temperature, night sweats,...

SPECIAL ARTICLE: A Nationally Representative CaseâControl Study of Smoking and Death in India

Thu, 13Â MarÂ 2008 00:00:00 -05:00

Background: The nationwide effects of smoking on mortality in India have not been assessed reliably.

Methods: In a nationally representative sample of 1.1 million homes, we compared the prevalence of smoking...

PERSPECTIVE: Worlds Apart â Tuberculosis in India and the United States

Thu, 13Â MarÂ 2008 00:00:00 -05:00

The British Romantic poet John Keats, trained as a physician and licensed by the Society of Apothecaries, gave himself this accurate prognosis in 1820 after an episode of hemoptysis. He...

PERSPECTIVE: Tuberculosis in Africa â Combating an HIV-Driven Crisis

Thu, 13Â MarÂ 2008 00:00:00 -05:00

Africa is facing the worst tuberculosis epidemic since the advent of the antibiotic era. Driven by a generalized human immunodeficiency virus (HIV) epidemic and compounded by weak health care systems,...

IMAGES IN CLINICAL MEDICINE: Cerebral Tuberculoma

Juan Carlos CataÃ±o, M.D. — Thu, 22Â NovÂ 2007 00:00:00 -05:00

A 29-year-old homeless man was admitted to the hospital after being stabbed in the chest. A hemothorax was diagnosed, and a chest tube was placed. One day after admission, he...

IMAGES IN CLINICAL MEDICINE: Tracheal Bronchus

Baris Bakir, M.D. and Ege Terzibasioglu, M.D. — Thu, 25Â OctÂ 2007 00:00:00 -05:00

A 9-year-old girl with recurrent respiratory infection presented for evaluation for possible active tuberculosis. Multislice computed tomography of the chest showed no evidence of active tuberculosis, but there was an...

PERSPECTIVE: Legal Power and Legal Rights â Isolation and Quarantine in the Case of Drug-Resistant Tuberculosis

Thu, 02Â AugÂ 2007 00:00:00 -05:00

The recent case of Atlanta attorney Andrew Speaker has focused attention on the role of compulsory isolation and quarantine in tuberculosis control. In May, after being diagnosed with a drug-resistant...

PERSPECTIVE: Tuberculosis and HIV in India

Thu, 22Â MarÂ 2007 00:00:00 -05:00

Tuberculosis is the most common HIV-related opportunistic infection in India, and caring for patients with both diseases is a major public health challenge. India has about 1.8 million new cases...

PERSPECTIVE: XDR Tuberculosis â Implications for Global Public Health

Thu, 15Â FebÂ 2007 00:00:00 -05:00

In early 2005, physicians at a rural hospital in KwaZulu-Natal, a province of South Africa, were concerned by a high rate of rapid death among patients infected with the human...

EDITORIAL: Rapid Detection of Tuberculosis and Drug-Resistant Tuberculosis

Michael D. Iseman, M.D., and Leonid B. Heifets, M.D. — Thu, 12Â OctÂ 2006 00:00:00 -05:00

Tuberculosis remains one of the major unresolved global health problems, and the situation is worsening in many parts of the world, primarily because of the association between tuberculosis and the...

ORIGINAL ARTICLE: Microscopic-Observation Drug-Susceptibility Assay for the Diagnosis of TB

Thu, 12Â OctÂ 2006 00:00:00 -05:00

Background: New diagnostic tools are urgently needed to interrupt the transmission of tuberculosis and multidrug-resistant tuberculosis. Rapid, sensitive detection of tuberculosis and multidrug-resistant tuberculosis in sputum has been demonstrated in...

PERSPECTIVE: Transmission of from Health Care Workers

Thu, 13Â JulÂ 2006 00:00:00 -05:00

The Centers for Disease Control and Prevention (CDC) recently reported the transmission of Mycobacterium tuberculosis from a health care worker to patients in New York City.1 Several aspects of the...

IMAGES IN CLINICAL MEDICINE: Scrofula

Sakib K. Khalid, M.D. and Omar Jassim, M.D. — Thu, 04Â MayÂ 2006 00:00:00 -05:00

A 39-year-old Zambian man who was visiting the United States presented with a three-week history of a draining neck mass and a three-month history of swelling on the left side...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 12-2006 â A 37-Year-Old Man with Hemoptysis and a Pulmonary Infiltrate

Fiona K. Gibbons, M.D., John A. Branda, M.D., and Jo-Anne O. Shepard, M.D. — Thu, 20Â AprÂ 2006 00:00:00 -05:00

Dr. Michael D. Howell (Pulmonary and Critical Care Unit): A 37-year-old man was seen in the pulmonary clinic of this hospital because of blood-streaked sputum and an abnormal result on...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 3-2006 â A 63-Year-Old Woman with Jaundice and a Pancreatic Mass

Robert H. Schapiro, M.D., Michael M. Maher, M.D., and Joseph Misdraji, M.D. — Thu, 26Â JanÂ 2006 00:00:00 -05:00

A 63-year-old woman was admitted to the hospital for evaluation of a pancreatic mass.

Four months before admission, the patient noticed dysuria and dark urine. The results of urinalysis showed 3+...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Rational Vaccine Development â A New Trend in Tuberculosis Control

Gilla Kaplan, Ph.D. — Thu, 13Â OctÂ 2005 00:00:00 -05:00

Viable Mycobacterium bovis bacille CalmetteâGuÃ©rin (BCG) is one of the most widely used vaccines to control tuberculosis. Administered as a single shot to newborns, it prevents severe disease and reduces...

EDITORIAL: Enlightened Self-Interest and the Control of Tuberculosis

Barry R. Bloom, Ph.D., and Joshua A. Salomon, Ph.D. — Thu, 08Â SepÂ 2005 00:00:00 -05:00

Given the great humanitarian tradition of the United States, it is curious that no category of government spending ranks below foreign aid in polls of the American public.1 Americans are...

SPECIAL ARTICLE: Domestic Returns from Investment in the Control of Tuberculosis in Other Countries

Thu, 08Â SepÂ 2005 00:00:00 -05:00

Background: We hypothesized that investments to improve the control of tuberculosis in selected high-incidence countries would prove to be cost saving for the United States by reducing the incidence of...

IMAGES IN CLINICAL MEDICINE: Tuberculosis Empyema Necessitatis

Kongkrit Chaiyasate, M.D. and John Hramiec, M.D. — Thu, 03Â MarÂ 2005 00:00:00 -05:00

An 18-year-old man with no clinically significant medical history presented with a six-month history of an increasing mass on the left side of his back (Panel A). About three days...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Toward a New Therapy for Tuberculosis

Eric J. Rubin, M.D., Ph.D. — Thu, 03Â MarÂ 2005 00:00:00 -05:00

It is often tempting to abandon old ways for glamorous new ones. Such is certainly the case for antibiotic development. However, a recent study by Andries and colleagues1 shows that...

CLINICAL PROBLEM-SOLVING: On the Threshold â A Diagnosis of Exclusion

Peter Clarke, M.D., Susan Glick, M.D., and Brendan M. Reilly, M.D. — Thu, 03Â MarÂ 2005 00:00:00 -05:00

A 48-year-old airline mechanic from Belize presented to the emergency department with fever and altered mental status. Two weeks earlier, fever, myalgias, and dry cough had developed. His maximal daily...

EDITORIAL: Adjunctive Steroids for Tuberculous Meningitis â More Evidence, More Questions

Vincent Quagliarello, M.D. — Thu, 21Â OctÂ 2004 00:00:00 -05:00

Tuberculosis continues to plague global health. The World Health Organization (WHO) has estimated an annual incidence of 8.8 million cases of tuberculosis worldwide, with 1.8 million deaths. Most of the...

ORIGINAL ARTICLE: Dexamethasone for the Treatment of Tuberculous Meningitis in Adolescents and Adults

Thu, 21Â OctÂ 2004 00:00:00 -05:00

Background: Tuberculous meningitis kills or disables more than half of those affected with the disease. Previous studies have been too small to determine whether adjunctive treatment with corticosteroids can reduce...

PERSPECTIVE: Tuberculous Meningitis

Peter R. Donald, M.D., and Johan F. Schoeman, M.D. — Thu, 21Â OctÂ 2004 00:00:00 -05:00

As is vividly illustrated by the report by Thwaites et al. in this issue of the Journal (pages 1741â1751), tuberculous meningitis continues to exact a devastating toll in developed and...

CLINICAL PROBLEM-SOLVING: Footprints

Sigall Kassutto, M.D., and Johanna P. Daily, M.D. — Thu, 30Â SepÂ 2004 00:00:00 -05:00

A 42-year-old woman with a history of asthma and the irritable bowel syndrome presented with pain and swelling of her feet and ankles that were associated with a rash on...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2004 â A 30-Year-Old Woman with a Pericardial Effusion

Thu, 15Â JulÂ 2004 00:00:00 -05:00

A 30-year-old woman was admitted to the hospital because of fever, cough, shortness of breath, and a pericardial effusion.

Approximately one month earlier, the woman had noticed an increased heart rate...

PERSPECTIVE: âMedicine Is My Lawful Wifeâ â Anton Chekhov, 1860â1904

Robert S. Schwartz, M.D. — Thu, 15Â JulÂ 2004 00:00:00 -05:00

One hundred years ago, on July 15, Russia's most famous physician, Anton Pavlovich Chekhov, died of tuberculosis at 44 years of age in Badenweiler, Germany. His body was shipped to...

CLINICAL PROBLEM-SOLVING: Forgotten but Not Gone

Ashish K. Jha, M.D., Kaveh G. Shojania, M.D., and Sanjay Saint, M.D., M.P.H. — Thu, 03Â JunÂ 2004 00:00:00 -05:00

A 74-year-old man was brought to the emergency department after being found confused and incapacitated at home. The patient lived in a residential hotel and had previously been healthy and...

SPECIAL ARTICLE: Priorities for the Treatment of Latent Tuberculosis Infection in the United States

C. Robert Horsburgh, Jr., M.D. — Thu, 13Â MayÂ 2004 00:00:00 -05:00

Background: The prevention of active tuberculosis through the treatment of latent tuberculosis infection is a major element of the national strategy for eliminating tuberculosis in the United States. Targeted treatment...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 8-2004 â A 28-Year-Old Man with Abdominal Pain, Fever, and a Mass in the Region of the Pancreas

William R. Brugge, M.D., Peter R. Mueller, M.D., and Joseph Misdraji, M.D. — Thu, 11Â MarÂ 2004 00:00:00 -05:00

A 28-year-old man was admitted to the hospital because of abdominal pain and fever.

The patient had been well until 10 days earlier, when mild epigastric pain developed. Two days before...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 40-2003 â A 14-Month-Old Boy with Recurrent Abdominal Distention and Diarrhea

Benjamin D. Gold, M.D., Sjirk J. Westra, M.D., and Fiona M. Graeme-Cook, M.D. — Thu, 25Â DecÂ 2003 00:00:00 -05:00

A 14-month-old boy was admitted to the hospital because of recurrent abdominal distention, vomiting, and diarrhea.

The boy had been born at another hospital at 34 weeks' gestation and weighed 2.56...

REVIEW ARTICLE: Molecular Epidemiology of Tuberculosis

Peter F. Barnes, M.D., and M. Donald Cave, Ph.D. — Thu, 18Â SepÂ 2003 00:00:00 -05:00

The ability to discern the molecular âfingerprintâ (genotype) of Mycobacterium tuberculosis isolates has revolutionized our understanding of the transmission of tuberculosis. In this review, we summarize the main methods of...

IMAGES IN CLINICAL MEDICINE: Broncholithiasis

Marianne Meyer, M.D. and Anthony O'Regan, M.D. — Thu, 23Â JanÂ 2003 00:00:00 -05:00

A 42-year-old man presented with hemoptysis after a bicycle accident. Computed tomographic scanning revealed a calcified mediastinal lymph node close to the right mainstem bronchus (Panel A, arrow). Fiberoptic bronchoscopy...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 1-2003 â A 43-Year-Old Man with Fever and Night Sweats

Thu, 09Â JanÂ 2003 00:00:00 -05:00

A 43-year-old man was admitted to the hospital because of fever, night sweats, weight loss, and headache.

The patient had reportedly been well until 15 days earlier, when fever developed. A...

ORIGINAL ARTICLE: Community-Based Therapy for Multidrug-Resistant Tuberculosis in Lima, Peru

Thu, 09Â JanÂ 2003 00:00:00 -05:00

Background: Despite the prevalence of multidrug-resistant tuberculosis in nearly all low-income countries surveyed, effective therapy has been deemed too expensive and considered not to be feasible outside referral centers. We...

IMAGES IN CLINICAL MEDICINE: Tuberculous Mastoiditis and Cerebral Tuberculoma

Valerie A. Reid, M.R.C.P.I. and Joseph Keane, M.R.C.P.I. — Thu, 05Â DecÂ 2002 00:00:00 -05:00

Figure 1. A 57-year-old woman was admitted with progressive drowsiness and a change in mental status. A biopsy of an axillary node had been performed one week before admission because...

CLINICAL PRACTICE: Latent Tuberculosis Infection

Robert M. Jasmer, M.D., Payam Nahid, M.D., and Philip C. Hopewell, M.D. — Thu, 05Â DecÂ 2002 00:00:00 -05:00

Patient 1, a 44-year-old man who recently immigrated from Peru, is found to have induration of 16 mm in diameter on a tuberculin skin test. He received bacille CalmetteâGuÃ©rin (BCG)...

SPECIAL ARTICLE: Global Drug-Resistance Patterns and the Management of Latent Tuberculosis Infection in Immigrants to the United States

Thu, 05Â DecÂ 2002 00:00:00 -05:00

Background: In the United States, an increasingly disproportionate burden of tuberculosis among the foreign-born population has led to calls for improvements in the detection and treatment of latent infection in...

IMAGES IN CLINICAL MEDICINE: Tuberculosis with Atlantoaxial and Craniovertebral Pott's Disease

Ulrich Weber, M.D. and Hans ScherÃ¼bl, M.D. — Thu, 05Â DecÂ 2002 00:00:00 -05:00

Figure 1. A 17-year-old Ethiopian girl presented with a four-month history of fever, malaise, and weight loss, as well as head, neck, and back pain and a two-week history of...

EDITORIAL: A Milestone in Tuberculosis Control

Jeffrey M. Drazen, M.D. — Thu, 31Â OctÂ 2002 00:00:00 -05:00

This issue of the Journal contains a description of a remarkable tuberculosis-control program that was launched in India just over nine years ago.1 In the years since its inception, over...

SPECIAL ARTICLE: Controlling Tuberculosis in India

G.R. Khatri, M.D., D.P.H., and Thomas R. Frieden, M.D., M.P.H. — Thu, 31Â OctÂ 2002 00:00:00 -05:00

Background: Tuberculosis kills nearly 500,000 people in India each year. Until recently, less than half of patients with tuberculosis received an accurate diagnosis, and less than half of those received...

ORIGINAL ARTICLE: Changes in the Transmission of Tuberculosis in New York City from 1990 to 1999

Thu, 09Â MayÂ 2002 00:00:00 -05:00

Background: Over the past decade, there has been a reduction in the incidence of tuberculosis in New York City and in the United States. However, the reduction has been confined...

PERSPECTIVE: Tuberculosis â The Global View

Thu, 09Â MayÂ 2002 00:00:00 -05:00

It is a long-standing and unfortunate American tradition to blame outbreaks of infectious diseases on the foreign-born. This tendency remains evident today in the case of tuberculosis. After decades of...

ORIGINAL ARTICLE: Tuberculosis Associated with Infliximab, a Tumor Necrosis Factor Î±âNeutralizing Agent

Thu, 11Â OctÂ 2001 00:00:00 -05:00

Background: Infliximab is a humanized antibody against tumor necrosis factor Î± (TNF-Î±) that is used in the treatment of Crohn's disease and rheumatoid arthritis. Approximately 147,000 patients throughout the world...

EDITORIAL: The Major Infectious Diseases in the World â To Treat or Not to Treat?

Thu, 19Â JulÂ 2001 00:00:00 -05:00

In this issue of the Journal, TahaoÄlu and coworkers report on their experience in treating a cohort of patients infected with strains of Mycobacterium tuberculosis that are resistant to powerful...

REVIEW ARTICLE: Management of Tuberculosis in the United States

Peter M. Small, M.D., and Paula I. Fujiwara, M.D., M.P.H. — Thu, 19Â JulÂ 2001 00:00:00 -05:00

In the 1980s, after decades of steadily declining rates of tuberculosis, ambitious plans were made to eliminate the disease in the United States. Despite these plans, the control of tuberculosis...

ORIGINAL ARTICLE: The Treatment of Multidrug-Resistant Tuberculosis in Turkey

Thu, 19Â JulÂ 2001 00:00:00 -05:00

Background: We evaluated the results of treatment in 158 consecutive patients with multidrug-resistant tuberculosis who were treated at our center in Istanbul, Turkey.

Methods: A total of 21 female patients and...

OCCASIONAL NOTES: The Death of Young King Edward VI

Thu, 05Â JulÂ 2001 00:00:00 -05:00

Measles virus suppresses host immunity to tuberculosis, as may some types of live measles-virus vaccine.1 Tuberculosis and measles remain important factors in childhood morbidity and mortality, particularly in the developing...

SPECIAL ARTICLE: Global Trends in Resistance to Antituberculosis Drugs

Thu, 26Â AprÂ 2001 00:00:00 -05:00

Background: Data on global trends in resistance to antituberculosis drugs are lacking.

Methods: We expanded the survey conducted by the World Health Organization and the International Union against Tuberculosis and Lung...

ORIGINAL ARTICLE: Transmission of from a Cadaver to an Embalmer

Thu, 27Â JanÂ 2000 00:00:00 -05:00

The risk of acquiring tuberculosis varies according to occupation and is high among funeral-home workers.1 Embalmers are at particularly high risk for reactivity on tuberculin skin testing.2 The increased risk...

ORIGINAL ARTICLE: Extensive Transmission of from a Child

Thu, 11Â NovÂ 1999 00:00:00 -05:00

Background: and Methods: Young children rarely transmit tuberculosis. In July 1998, infectious tuberculosis was identified in a nine-year-old boy in North Dakota who was screened because extrapulmonary tuberculosis had been...

EDITORIAL: Exogenous Reinfection in Tuberculosis

Thu, 14Â OctÂ 1999 00:00:00 -05:00

Tuberculosis, like all infectious diseases, involves exposure to a pathogen resulting in an asymptomatic period of incubation or latency that may progress to active disease. Unlike most other infectious diseases,...

IMAGES IN CLINICAL MEDICINE: Tuberculous Meningitis

Jean-FranÃ§ois Viallard, M.D. and Patrick Blanco, M.D. — Thu, 14Â OctÂ 1999 00:00:00 -05:00

Figure 1. A 62-year-old previously healthy woman was admitted with a three-week history of fever, fatigue, night sweats, headache, and vomiting and a two-month history of progressive weight loss. She...

ORIGINAL ARTICLE: Exogenous Reinfection as a Cause of Recurrent Tuberculosis after Curative Treatment

Thu, 14Â OctÂ 1999 00:00:00 -05:00

Background: For decades it has been assumed that postprimary tuberculosis is usually caused by reactivation of endogenous infection rather than by a new, exogenous infection.

Methods: We performed DNA fingerprinting with...

ORIGINAL ARTICLE: Obstetrical Outcomes among Women with Extrapulmonary Tuberculosis

Thu, 26Â AugÂ 1999 00:00:00 -05:00

Background: The prevalence of tuberculosis, especially extrapulmonary tuberculosis, is increasing worldwide. Because information on the outcome of pregnancy among women with extrapulmonary tuberculosis is limited, we studied the course of...

EDITORIAL: Liberty and the Control of Tuberculosis

Thu, 04Â FebÂ 1999 00:00:00 -05:00

When there is a proven, effective treatment for a dangerous disease, most physicians will try hard to persuade their patients to accept that treatment even if it is unpleasant and...

REVIEW ARTICLE: Tuberculosis in Patients with Human Immunodeficiency Virus Infection

Diane V. Havlir, M.D., and Peter F. Barnes, M.D. — Thu, 04Â FebÂ 1999 00:00:00 -05:00

Tuberculosis remains an important problem in patients with human immunodeficiency virus (HIV) infection in the United States, with an estimated 6000 to 9000 new cases annually.1 The case rates are...

SPECIAL ARTICLE: The Use of Legal Action in New York City to Ensure Treatment of Tuberculosis

Thu, 04Â FebÂ 1999 00:00:00 -05:00

Background: and Methods: After an increase in the number of cases of tuberculosis, New York City passed regulations to address the problem of nonadherence to treatment regimens. The commissioner of...

EDITORIAL: The Global Threat of Drug-Resistant Tuberculosis

Thu, 04Â JunÂ 1998 00:00:00 -05:00

In this issue of the Journal, Pablos-MÃ©ndez et al., on behalf of the World Health OrganizationâInternational Union against Tuberculosis and Lung Diseases Working Group on Anti-Tuberculosis Drug Resistance Surveillance, report...

IMAGES IN CLINICAL MEDICINE: Vertebral Tuberculosis

Peter J. Jenks, M.D. and Bruce Stewart, M.D. — Thu, 04Â JunÂ 1998 00:00:00 -05:00

Figure 1. A 62-year-old man presented to the hospital with an inability to walk unaided. He had noticed progressive weakness of his legs over the previous two weeks and had...

ORIGINAL ARTICLE: Global Surveillance for Antituberculosis-Drug Resistance, 1994â1997

Thu, 04Â JunÂ 1998 00:00:00 -05:00

Background: Drug-resistant tuberculosis threatens efforts to control the disease. This report describes the prevalence of resistance to four first-line drugs in 35 countries participating in the World Health OrganizationâInternational Union...

EDITORIAL: The Evolving Relation between Humans and

Thu, 05Â MarÂ 1998 00:00:00 -05:00

Until the middle of this century, tuberculosis was, in Dickens's words, âa disease which medicine never cured, wealth warded off, or poverty could boast exemption from â which sometimes moves...

ORIGINAL ARTICLE: Variations in the Gene and Susceptibility to Tuberculosis in West Africans

Thu, 05Â MarÂ 1998 00:00:00 -05:00

Background: Genetic factors may affect the susceptibility to tuberculosis, but no specific genes governing susceptibility have been identified. In mice, natural resistance to infection with some mycobacteria is influenced by...

ORIGINAL ARTICLE: An Outbreak Involving Extensive Transmission of a Virulent Strain of

Thu, 05Â MarÂ 1998 00:00:00 -05:00

Background: and Methods: From 1994 to 1996, there was a large outbreak of tuberculosis in a small, rural community with a population at low risk for tuberculosis. Twenty-one patients with...

EDITORIAL: The Double Burden of HIV Infection and Tuberculosis in Sub-Saharan Africa

Thu, 18Â SepÂ 1997 00:00:00 -05:00

The World Health Organization (WHO) estimated that by June 1996 14 million people were living with human immunodeficiency virus (HIV) infection in sub-Saharan Africa. Although it contains only 10 percent...

ORIGINAL ARTICLE: A Trial of Three Regimens to Prevent Tuberculosis in Ugandan Adults Infected with the Human Immunodeficiency Virus

Thu, 18Â SepÂ 1997 00:00:00 -05:00

Background: Infection with the human immunodeficiency virus (HIV) greatly increases the risk of reactivation tuberculosis. We evaluated the safety and efficacy of three preventive-therapy regimens in a setting where exposure...

ORIGINAL ARTICLE: A Controlled Trial of Isoniazid in Persons with Anergy and Human Immunodeficiency Virus Infection Who Are at High Risk for Tuberculosis

Thu, 31Â JulÂ 1997 00:00:00 -05:00

Background: Patients with human immunodeficiency virus (HIV) infection and latent tuberculosis are at substantial risk for the development of active tuberculosis. As a public health measure, prophylactic treatment with isoniazid...

ORIGINAL ARTICLE: A Mutation in the Interferon-Î³ âReceptor Gene and Susceptibility to Mycobacterial Infection

Thu, 26Â DecÂ 1996 00:00:00 -05:00

Background: Genetic differences in immune responses may affect susceptibility to mycobacterial infection, but no specific genes have been implicated in humans. We studied four children who had an unexplained genetic...

ORIGINAL ARTICLE: Rifampin-Resistant Tuberculosis in a Patient Receiving Rifabutin Prophylaxis

Thu, 13Â JunÂ 1996 00:00:00 -05:00

Drug-resistant tuberculosis has become a major public health problem in the United States.12 In 1979 less than 1 percent of tuberculosis isolates from untreated patients in New York City were...

EDITORIAL: Airline Travel and Infection

Thu, 11Â AprÂ 1996 00:00:00 -05:00

Our fascination with the misadventures of travel dates back to the dawn of recorded history. Homer's epic tale of the 10-year wanderings of Odysseus returning home to Ithaca after the...

ORIGINAL ARTICLE: Transmission of Multidrug-Resistant during a Long Airplane Flight

Thu, 11Â AprÂ 1996 00:00:00 -05:00

Background: In April 1994, a passenger with infectious multidrug-resistant tuberculosis traveled on commercial-airline flights from Honolulu to Chicago and from Chicago to Baltimore and returned one month later. We sought...

EDITORIAL: Social Vulnerability and Death by Infection

Thu, 28Â MarÂ 1996 00:00:00 -05:00

Nearly a half-century after RenÃ© and Jean Dubos wrote these words,1 tuberculosis continues to cause more deaths worldwide than any other single microbe, though the human immunodeficiency virus (HIV) may...

ORIGINAL ARTICLE: Tuberculosis, AIDS, and Death among Substance Abusers on Welfare in New York City

Thu, 28Â MarÂ 1996 00:00:00 -05:00

Background: In New York City, the incidence of tuberculosis has more than doubled during the past decade. We examined the incidence of tuberculosis and the acquired immunodeficiency syndrome (AIDS) and...

NEJM â Collection Updates for Tuberculosis

IMAGES IN CLINICAL MEDICINE: Tuberculous Abscess Manifesting as Unilateral Gynecomastia

IMAGES IN CLINICAL MEDICINE: Infection 57 Years after Plombage

CLINICAL IMPLICATIONS OF BASIC RESEARCH: The Granuloma in Tuberculosis â Friend or Foe?

EDITORIAL: Unorthodox Approach to the Development of a New Antituberculosis Therapy

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 18-2009 â A 24-Year-Old Woman with AIDS and Tuberculosis with Progressive Cough, Dyspnea, and Wasting

IMAGES IN CLINICAL MEDICINE: Plombage Cavities

ORIGINAL ARTICLE: Overseas Screening for Tuberculosis in U.S.-Bound Immigrants and Refugees

ORIGINAL ARTICLE: The Diarylquinoline TMC207 for Multidrug-Resistant Tuberculosis

PERSPECTIVE: The Global Burden of Tuberculosis â Combating Drug Resistance in Difficult Times

BOOK REVIEW:

CORRESPONDENCE: Emergence of Extensive Drug Resistance during Treatment for Multidrug-Resistant Tuberculosis

CORRESPONDENCE: Treatment Outcomes in Extensively Resistant Tuberculosis

EDITORIAL: Facing Extensively Drug-Resistant Tuberculosis â A Hope and a Challenge

ORIGINAL ARTICLE: Comprehensive Treatment of Extensively Drug-Resistant Tuberculosis

CLINICAL PROBLEM-SOLVING: An Unintended Consequence â A 79-year-old man with a 5-month history of fatigue and 20-lb (9-kg) weight loss presented to his local physician

SPECIAL ARTICLE: A Nationally Representative CaseâControl Study of Smoking and Death in India

PERSPECTIVE: Worlds Apart â Tuberculosis in India and the United States

PERSPECTIVE: Tuberculosis in Africa â Combating an HIV-Driven Crisis

IMAGES IN CLINICAL MEDICINE: Cerebral Tuberculoma

IMAGES IN CLINICAL MEDICINE: Tracheal Bronchus

PERSPECTIVE: Legal Power and Legal Rights â Isolation and Quarantine in the Case of Drug-Resistant Tuberculosis

PERSPECTIVE: Tuberculosis and HIV in India

PERSPECTIVE: XDR Tuberculosis â Implications for Global Public Health

EDITORIAL: Rapid Detection of Tuberculosis and Drug-Resistant Tuberculosis

ORIGINAL ARTICLE: Microscopic-Observation Drug-Susceptibility Assay for the Diagnosis of TB

PERSPECTIVE: Transmission of from Health Care Workers

IMAGES IN CLINICAL MEDICINE: Scrofula

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 12-2006 â A 37-Year-Old Man with Hemoptysis and a Pulmonary Infiltrate

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 3-2006 â A 63-Year-Old Woman with Jaundice and a Pancreatic Mass

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Rational Vaccine Development â A New Trend in Tuberculosis Control

EDITORIAL: Enlightened Self-Interest and the Control of Tuberculosis

SPECIAL ARTICLE: Domestic Returns from Investment in the Control of Tuberculosis in Other Countries

IMAGES IN CLINICAL MEDICINE: Tuberculosis Empyema Necessitatis

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Toward a New Therapy for Tuberculosis

CLINICAL PROBLEM-SOLVING: On the Threshold â A Diagnosis of Exclusion

EDITORIAL: Adjunctive Steroids for Tuberculous Meningitis â More Evidence, More Questions

ORIGINAL ARTICLE: Dexamethasone for the Treatment of Tuberculous Meningitis in Adolescents and Adults

PERSPECTIVE: Tuberculous Meningitis

CLINICAL PROBLEM-SOLVING: Footprints

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2004 â A 30-Year-Old Woman with a Pericardial Effusion

PERSPECTIVE: âMedicine Is My Lawful Wifeâ â Anton Chekhov, 1860â1904

CLINICAL PROBLEM-SOLVING: Forgotten but Not Gone

SPECIAL ARTICLE: Priorities for the Treatment of Latent Tuberculosis Infection in the United States

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 8-2004 â A 28-Year-Old Man with Abdominal Pain, Fever, and a Mass in the Region of the Pancreas

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 40-2003 â A 14-Month-Old Boy with Recurrent Abdominal Distention and Diarrhea

REVIEW ARTICLE: Molecular Epidemiology of Tuberculosis

IMAGES IN CLINICAL MEDICINE: Broncholithiasis

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 1-2003 â A 43-Year-Old Man with Fever and Night Sweats

ORIGINAL ARTICLE: Community-Based Therapy for Multidrug-Resistant Tuberculosis in Lima, Peru

IMAGES IN CLINICAL MEDICINE: Tuberculous Mastoiditis and Cerebral Tuberculoma

CLINICAL PRACTICE: Latent Tuberculosis Infection

SPECIAL ARTICLE: Global Drug-Resistance Patterns and the Management of Latent Tuberculosis Infection in Immigrants to the United States

IMAGES IN CLINICAL MEDICINE: Tuberculosis with Atlantoaxial and Craniovertebral Pott's Disease

EDITORIAL: A Milestone in Tuberculosis Control

SPECIAL ARTICLE: Controlling Tuberculosis in India

ORIGINAL ARTICLE: Changes in the Transmission of Tuberculosis in New York City from 1990 to 1999

PERSPECTIVE: Tuberculosis â The Global View

ORIGINAL ARTICLE: Tuberculosis Associated with Infliximab, a Tumor Necrosis Factor Î±âNeutralizing Agent

EDITORIAL: The Major Infectious Diseases in the World â To Treat or Not to Treat?

REVIEW ARTICLE: Management of Tuberculosis in the United States

ORIGINAL ARTICLE: The Treatment of Multidrug-Resistant Tuberculosis in Turkey

OCCASIONAL NOTES: The Death of Young King Edward VI

SPECIAL ARTICLE: Global Trends in Resistance to Antituberculosis Drugs

ORIGINAL ARTICLE: Transmission of from a Cadaver to an Embalmer

ORIGINAL ARTICLE: Extensive Transmission of from a Child

EDITORIAL: Exogenous Reinfection in Tuberculosis

IMAGES IN CLINICAL MEDICINE: Tuberculous Meningitis

ORIGINAL ARTICLE: Exogenous Reinfection as a Cause of Recurrent Tuberculosis after Curative Treatment

ORIGINAL ARTICLE: Obstetrical Outcomes among Women with Extrapulmonary Tuberculosis

EDITORIAL: Liberty and the Control of Tuberculosis

REVIEW ARTICLE: Tuberculosis in Patients with Human Immunodeficiency Virus Infection

SPECIAL ARTICLE: The Use of Legal Action in New York City to Ensure Treatment of Tuberculosis

EDITORIAL: The Global Threat of Drug-Resistant Tuberculosis

IMAGES IN CLINICAL MEDICINE: Vertebral Tuberculosis

ORIGINAL ARTICLE: Global Surveillance for Antituberculosis-Drug Resistance, 1994â1997

EDITORIAL: The Evolving Relation between Humans and

ORIGINAL ARTICLE: Variations in the Gene and Susceptibility to Tuberculosis in West Africans

ORIGINAL ARTICLE: An Outbreak Involving Extensive Transmission of a Virulent Strain of

EDITORIAL: The Double Burden of HIV Infection and Tuberculosis in Sub-Saharan Africa

NEJM â Collection Updates for Tuberculosis

CLINICAL IMPLICATIONS OF BASIC RESEARCH: The Granuloma in Tuberculosis â Friend or Foe?

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 18-2009 â A 24-Year-Old Woman with AIDS and Tuberculosis with Progressive Cough, Dyspnea, and Wasting

PERSPECTIVE: The Global Burden of Tuberculosis â Combating Drug Resistance in Difficult Times

EDITORIAL: Facing Extensively Drug-Resistant Tuberculosis â A Hope and a Challenge

CLINICAL PROBLEM-SOLVING: An Unintended Consequence â A 79-year-old man with a 5-month history of fatigue and 20-lb (9-kg) weight loss presented to his local physician

SPECIAL ARTICLE: A Nationally Representative CaseâControl Study of Smoking and Death in India

PERSPECTIVE: Worlds Apart â Tuberculosis in India and the United States

PERSPECTIVE: Tuberculosis in Africa â Combating an HIV-Driven Crisis

PERSPECTIVE: Legal Power and Legal Rights â Isolation and Quarantine in the Case of Drug-Resistant Tuberculosis

PERSPECTIVE: XDR Tuberculosis â Implications for Global Public Health

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 12-2006 â A 37-Year-Old Man with Hemoptysis and a Pulmonary Infiltrate

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 3-2006 â A 63-Year-Old Woman with Jaundice and a Pancreatic Mass

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Rational Vaccine Development â A New Trend in Tuberculosis Control

CLINICAL PROBLEM-SOLVING: On the Threshold â A Diagnosis of Exclusion

EDITORIAL: Adjunctive Steroids for Tuberculous Meningitis â More Evidence, More Questions

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2004 â A 30-Year-Old Woman with a Pericardial Effusion

PERSPECTIVE: âMedicine Is My Lawful Wifeâ â Anton Chekhov, 1860â1904

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 8-2004 â A 28-Year-Old Man with Abdominal Pain, Fever, and a Mass in the Region of the Pancreas

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 40-2003 â A 14-Month-Old Boy with Recurrent Abdominal Distention and Diarrhea

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 1-2003 â A 43-Year-Old Man with Fever and Night Sweats

PERSPECTIVE: Tuberculosis â The Global View

ORIGINAL ARTICLE: Tuberculosis Associated with Infliximab, a Tumor Necrosis Factor Î±âNeutralizing Agent

EDITORIAL: The Major Infectious Diseases in the World â To Treat or Not to Treat?

ORIGINAL ARTICLE: Global Surveillance for Antituberculosis-Drug Resistance, 1994â1997

ORIGINAL ARTICLE: A Mutation in the Interferon-Î³ âReceptor Gene and Susceptibility to Mycobacterial Infection