Evaluation of afb/fungal bodies in chronic granulomatous inflammation cases in Hospital Serdang from 2009 until 2012

Azizi, Nuratikah (2013) Evaluation of afb/fungal bodies in chronic granulomatous inflammation cases in Hospital Serdang from 2009 until 2012. [Project Paper] (Submitted)

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Abstract

A second year (Package 11) project dissertation. Project paper (Doctor of Medicine (MD)) - Universiti Putra Malaysia, 2013. Introduction: Granulomatous inflammation is a common histopathology diagnosis that can be due to multifactorial causes. Two most common causes of granulomatous inflammation are tuberculosis and fungal infection. However, the histopathologic features of granulomatous inflammation usually differ depending on its underlying causes. Objective: To evaluate granulomatous inflammation on histologic specimen. The distribution of sociodemographic (age, gender, race) and clinicopathologic (type of granuloma, site of tissue sample) parameters of the patients was determined. Besides, the frequency of positive acid fast bacilli (AFB) and fungal infection was also determined. Relationship between histopathologic features with acid fast bacilli (AFB)/ fungal bodies was investigated. The sensitivity and specificity of Ziehl-Neelsen (ZN) Stain and fungal stain (GMS/PAS) were also determined in this study. Method: Subjects comprised of cases that have been diagnosed with chronic granulomatous inflammation in Hospital Serdang in 2009 to 2012 that were obtained from the list of medical records using a standardized pro forma. Data was analyzed by SPSS version 20. Age of patient was presented as mean and standard deviation. Gender, positive cases of AFB, and positive cases of fungus was presented as frequency and Chi square test was used to determine the association between the parameters. Result: Most of the respondents are females (51 %) and majority of the respondents were Malays (63%). Most of the cases presented with necrotizing granulomatous inflammation (81 %). Besides that, majority of tissue sample are obtained from lymph node (37%). 44 of the cases was positive Acid Fast Bacilli while ]4 cases was positive fungus. There was significant relationship between Langhan's giant cells with tuberculosis and fungal infection (p=O.OO 1). While, there was no significant relationship between caseous necrosis with tuberculosis and fungal infection (p=0.687). The sensitivity of Ziehl-Neelsen's stain is 51.16% and the specificity is 100%. The sensitivity of fungal stain calculated in the data is 92.6% while the specificity is 97.7%. Conclusion: There was significant relationship between Langhan's giant cell with tuberculosis and fungal infection in term of histopathologic features. Ziehl-Neelsen's stain was still lack of sensitivity in detecting the presence of acid fast bacilli (AFB). On the other hand, fungal stain has a higher sensitivity as compared to Ziehl-Neelson's stain. Keywords: granulomatous inflammation, Acid Fast Bacilli, fungal infection, histopathologic features, Langhan's giant cell, caseous necrosis, sensitivity, specificity, Ziehl-Neelsen's stain, fungal stain

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Ms Nabilah Rozali
Date Deposited:	22 Nov 2022 06:26
Last Modified:	22 Nov 2022 06:26
URI:	http://psaspb.upm.edu.my/id/eprint/194

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