Ory laboratory diagnosis are limited. Therefore, a high index of suspicion is required for early diagnosis. Miliary pattern on chest radiography is a common finding that has an important role in the early detection of the disease. Nevertheless, approximately 10%–15% of patients have normal chest radiography. Although abnormalities are present, basic hematologic and biochemical tests as well as tuberculin skin test are nonspecific for the diagnosis. Imaging studies are helpful adjunct tools for disseminated TB as they can help determine the involved sites and guide technicians to obtain appropriate specimens for diagnosis. Clinical confirmation of the diagnosis of disseminated TB is usually based on bacteriological or histological evidence. Response to first-line anti-TB drugs is good as evidenced by many reports. This review aims to present a current update on disseminated TB with emphasis on the diagnostic workup of this devastating condition....

Background and Objectives. Bacterial meningitis is a common medical condition in Qatar. The aim of this study was to describe the clinical characteristics of bacterial meningitis, the frequency of each pathogen, and its sensitivity to antibiotics and risk factors for death.Patients and Methods. This retrospective study was conducted at Hamad General Hospital between January 1, 2009, and December 31, 2013.Results. We identified 117 episodes of acute bacterial meningitis in 110 patients. Their mean age was26.4±22.3years (range: 2–74) and 81 (69.2%) of them were male patients. Fifty-nine episodes (50.4%) were community-acquired infection and fever was the most frequent symptom (94%), whereas neurosurgery is the most common underlying condition. Coagulase-negative staphylococci were the most common causative agent, of which 95% were oxacillin-resistant, while 63.3% ofAcinetobacterspp. showed resistance to meropenem. The in-hospital mortality was 14 (12%). Only the presence of underlying diseases, hypotension, and inappropriate treatment were found to be independent predictors of mortality.Conclusion. Acute bacterial meningitis predominantly affected adults and coagulase-negative staphylococci species were the common causative agent in Qatar with majority of infections occurring nosocomially. More than 90% of all implicated coagulase-negative staphylococci strains were oxacillin-resistant.

He use of more potent immunosuppressive therapy and the acquired immunodeficiency syndrome epidemic. The diagnosis of peritoneal TB is often challenging and cannot be made or excluded on the basis of clinical findings, which are quite protean and nonspecific. Blood biochemistry, complete blood cell count, and radiographic studies are of limited diagnostic value. Acid-fast smear of ascitic fluid has a low yield and cultures require weeks to give results and are positive in 2%–50% of diagnosed cases. Polymerase chain reaction analysis for rapid detection of bacillus tubercles in ascitic fluid has low yield, and the role of other biomarkers such as adenosine deaminase and gamma interferon is less well described and currently being evaluated as diagnostic tools. Laparoscopy with directed biopsy provides a rapid and correct diagnosis in 76%–100% of cases and should be performed early in suspected cases. Six-month therapy with the 4-drug regimen is effective in most of the patients, while the role of adjunctive corticosteroid therapy remains controversial....

We sought to evaluate the role of bronchoscopy-related procedures such as bronchoalveolar lavage (BAL), bronchial wash (BW), bronchial brush (B brush), transbronchial biopsy (TBB), and post-bronchoscopy sputum (PBS), alone or in combination, in the rapid diagnosis of negative sputum smear disseminated tuberculosis (TB). We performed a secondary post hoc analysis of data collected from our previous study entitled "Disseminated tuberculosis among adult patients admitted to Hamad General Hospital, Qatar: A five-year hospital-based study" with a modified objective. We identified 27 patients. BAL fluid was positive for acid-fast bacilli (AFB) smear in 7/27 (25.9%) patients and were culture-positive for Myobacterium tuberculosis in 17/27 (63.0%) cases, while BW collections were smear-positive in 9/27 (33.3%) cases and culture-positive for M. tuberculosis in 18/27 (66.7%) cases. TBB showed caseating granulomas in 10/16 (62.5%) cases and one case of non-caseating granuloma (6.3%). PBS was positive for AFB in 4/8 (50.0%) patients. The combination of these procedures enabled us to diagnose disseminated TB rapidly in 22 (81.5%) cases. Bronchoscopy proved to be an effective method for the rapid diagnosis of disseminated TB in patients in whom sputum smear microscopy was negative.

Introduction: This study was conducted at Hamad General Hospital to determine the incidence of fungal peritonitis and to describe its clinical and microbiological findings in patients undergoing continuous ambulatory peritoneal dialysis in Qatar. Methodology: The medical records of these patients between 1 January 2005 and 31 December 2008 were retrospectively reviewed and the collected data were analysed. Results: During the study period, 141 episodes of peritonitis were observed among 294 patients. In 14 of these episodes (9.9%), fungal peritonitis was reported in 14 patients with a rate of 0.05 episodes per patient year, while the bacterial peritonitis rate was 0.63 per patient year. Thirteen (93%) patients had one or more previous episodes of bacterial peritonitis that was treated with multiple broad-spectrum antibiotics, 11 (85%) had received broad-spectrum antibiotics within the preceding month, 12 (92%) within three months, and 8 (62%) within six months. Candida species were the only fungal species isolated from the dialysate with predominance of non-albicans Candida species (especially Candida parapsilosis). Therapeutic approach was immediate catheter removal, followed by systemic antifungal therapy and temporary haemodialysis. Nine patients (64.3%) were continued on haemodialysis, whereas five patients (35.7%) died. Conclusions: Prior antibiotic use was an important risk factor predisposing patients to the development of fungal peritonitis. Early detection of fungal peritonitis would lead to early institution of appropriate therapy and prevention of complications.