Hospital Universitario Dr José Eleuterio Gonzalez

Ovarian tuberculosis is a rare manifestation of extrapulmonary tuberculosis and may closely resemble advanced ovarian carcinoma due to overlapping clinical, biochemical, and radiological features. We report the case of an 18-year-old female who presented with progressive abdominal distension, severe hypogastric pain, and unintentional weight loss. Imaging revealed a left adnexal mass with ascites and retroperitoneal lymphadenopathy suggestive of stage IIIC ovarian carcinoma. Serum CA-125 was markedly elevated (637.4 U/mL). Prior to initiation of chemotherapy, an image-guided TRUCUT biopsy demonstrated chronic granulomatous inflammation with acid-fast bacilli. Ziehl-Neelsen staining was positive, QuantiFERON-TB Gold assay was positive, and culture of the adnexal lesion confirmed Mycobacterium tuberculosis. The patient was treated with first-line anti-tuberculous therapy and showed clinical and radiological improvement. This case highlights the importance of considering tuberculosis in the differential diagnosis of adnexal masses with elevated CA-125, particularly in endemic regions, and emphasizes the value of histopathological confirmation to prevent misdiagnosis and avoid unnecessary oncologic treatment.

Rodrigo Elizondo-Omaña was not included as an author in the original publication [...].

Edgar Ramírez-Vázquez1, Fernando Tienda-López2, Diego Alejandro Ortega-Moreno2, Emanuel Navarrete-Juárez2, David Loaiza-Pérez2, Horacio Chapa-Martínez2, Xavier González-Ballesteros3, Luis Huerta-Díaz2, Homero Nañez-Terrero1, Fernando Góngora-Rivera1,2. 1 Internal Medicine department, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. 2Neurology department, Hospital Universitario “Dr. José Eleuterio González”, Universidad Aut& #x00F3;noma de Nuevo León, Monterrey, Nuevo León, México. 3 Radiology department, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. Introduction: Intracranial arterial calcifications (IAC) are frequently observed as incidental findings on non-enhanced computerized tomography (CT) in patients with acute ischemic stroke (AIS). Although IAC reflects the underlying atherosclerotic burden, its prognostic significance remains uncertain. This study aimed to evaluate the association between IAC volume and short- and intermediate-term outcomes in AIS. Methods: We conducted a retrospective study of consecutive patients with AIS admitted between January 2017 and March 2018, using data from a prospectively maintained stroke registry. IAC volume was quantified through semi-automated segmentation of CT scans. Patients were stratified by IAC severity, with severe IAC defined as volumes in the highest quartile (≥245.8 mm3). Functional outcome was assessed using the modified Rankin Scale (mRS) at discharge and 90-day follow-up. Multivariable logistic regression models were constructed to evaluate associations with poor outcome (mRS >2) and mortality. Results: A total of 182 patients were included. IAC was identified in 85.2%, with a median volume of 105.3 mm3. Severe IAC was significantly associated with poor functional outcome at discharge (aOR 3.5, 95% CI 1.3–9.7, p = 0.014), but not at 90 days. Additionally, severe IAC showed increased odds of 90-day mortality when adjusted for age and sex (aOR 1.9, 95% CI 1.1–3.3, p = 0.02), although this association was not sustained in fully adjusted models. Conclusion: Higher IAC volumes were independently associated with worse short-term outcomes in AIS. These findings support the potential utility of IAC as a readily accessible imaging biomarker for early prognostic stratification.

The aim of this study was to evaluate the performances of Anyplex® MTB/NTM Real-time Detection and Xpert MTB/RIF Ultra for tuberculosis (TB) disease in people living with Human Immunodeficiency Virus (PLHIV) with low CD4+T lymphocyte cell (CD4) count. A retrospective observational study included respiratory and non-respiratory specimens from PLHIV stratified based on their CD4 count (<200 vs.≥200 cells/µL) using Anyplex® MTB/NTM Real-time Detection or Xpert® MTB/RIF Ultra. In PLHIV with low CD4 count (<200 cells/µL), Anyplex demonstrated comparable sensitivity (81.4% vs. 81.8%) and specificity (78.7% vs. 78.5%) to Xpert for MTC detection in respiratory samples, but lower sensitivity (81.8% vs. 100%) and higher specificity (83.3% vs. 66.6%) than Xpert in non-respiratory samples. Whereas the two methodologies showed similar MTC diagnostic performance in respiratory samples from PLHIV with low CD4 levels, Anyplex showed higher specificity and lower sensitivity than Xpert in non-respiratory samples.