Tropical/Infectoparasitary Dermatology
Diagnosis of cutaneous tuberculosis (lymph node scrofuloderma) using the Xpert MTB/RIF® method
Lilian Lemos Costa, John Verrinder Veasey
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Dermatology Clinic, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
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"tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "85" "paginaFinal" => "87" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 853 "Ancho" => 2920 "Tamanyo" => 174812 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Confluent rash presented by the patient nine days after the onset of respiratory symptoms. The skin lesions persisted for three days, and the pruritus improved with the use of antihistamines. (A) Lesions on the forearm were the first to appear, with macular characteristics; (B) On the lower limbs, the lesions were maculopapular, with the formation of plaques similar to urticaria. *The photos were taken by the patient due to social isolation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Isabelle Pastor Bandeira, Beatriz Sordi Chara, Giovani Meneguzzi de Carvalho, Marcus Vinícius Magno Gonçalves" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Isabelle" "apellidos" => "Pastor Bandeira" ] 1 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Sordi Chara" ] 2 => array:2 [ "nombre" => "Giovani" "apellidos" => "Meneguzzi de Carvalho" ] 3 => array:2 [ "nombre" => "Marcus Vinícius" "apellidos" => "Magno Gonçalves" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S266627522030357X" "doi" => "10.1016/j.abdp.2020.10.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S266627522030357X?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620303056?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000001/v3_202102051036/S0365059620303056/v3_202102051036/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0365059620303202" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.08.006" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "299" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "rev" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "Plasmacytoid dendritic cells in dermatology" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "81" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1406 "Ancho" => 2500 "Tamanyo" => 232037 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Plasmacytoid dendritic cells (pDCs): relevant link between innate and adaptive immunity. Adapted from Mitchell et al., 2018 and Swiecki et al., 2015.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,10</span></a> pDC, plasmacytoid dendritic cell; MHC, major histocompatibility complex; CD, cluster of differentiation; Treg, T-regulatory lymphocyte; TH, T-helper lymphocyte; TGF-β, transforming growth factor beta; IL, interleukin; IDO, indoleamine-2,3-dioxygenase; ICOSL, inducible costimulator ligand; TRAIL, tumor necrosis factor-related apoptosis-inducing ligand; IFN-α, interferon alpha; BAFF, B cell-activating factor of the TNF family; APRIL, a proliferation-inducing ligand; NK, natural killer.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Natasha Favoretto Dias de Oliveira, Claudia Giuli Santi, Celina Wakisaka Maruta, Valeria Aoki" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Natasha Favoretto" "apellidos" => "Dias de Oliveira" ] 1 => array:2 [ "nombre" => "Claudia Giuli" "apellidos" => "Santi" ] 2 => array:2 [ "nombre" => "Celina Wakisaka" "apellidos" => "Maruta" ] 3 => array:2 [ "nombre" => "Valeria" "apellidos" => "Aoki" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275220303659" "doi" => "10.1016/j.abdp.2020.08.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220303659?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620303202?idApp=UINPBA00008Z" "url" => "/03650596/0000009600000001/v3_202102051036/S0365059620303202/v3_202102051036/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Tropical/Infectoparasitary Dermatology</span>" "titulo" => "Diagnosis of cutaneous tuberculosis (lymph node scrofuloderma) using the Xpert MTB/RIF® method" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "82" "paginaFinal" => "84" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Lilian Lemos Costa, John Verrinder Veasey" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Lilian Lemos" "apellidos" => "Costa" ] 1 => array:4 [ "nombre" => "John Verrinder" "apellidos" => "Veasey" "email" => array:1 [ 0 => "johnveasey@uol.com.br" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Dermatology Clinic, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 599 "Ancho" => 1255 "Tamanyo" => 76283 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Materials for analysis by the Xpert MTB/RIF® method. (A), GeneXpert® device. (B), Buffer solution for treatment of the sample and cartridge for containing the material and reagents to be processed in the device.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cutaneous tuberculosis (CTB) accounts for approximately 1%−2% of tuberculosis cases.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Scrofuloderma is the most common form of CTB in developing countries such as Brazil, characterized by subcutaneous nodules with fistulas and secretion output.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The diagnosis of tuberculosis is confirmed by evidence of the bacillus, usually <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> (MTB), a challenging situation for cases of CTB, since the classic diagnostic methods have less sensitivity and specificity for skin presentations in relation to the pulmonary form.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This led the World Health Organization (WHO) to recommend the use of polymerase chain reaction (PCR) in the diagnosis of this infection; the Xpert MTB/RIF® is one of the devices indicated.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> It is an automated, fast, semi-quantitative PCR method that simultaneously detects microorganisms of the MTB complex and the resistance of the agent to rifampicin in liquid clinical samples over a period of two hours. While the use of this method in samples of pulmonary tuberculosis materials is well established, its use in extrapulmonary infections has been poorly described.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The authors report the case of a 19-year-old man, born in Luanda, Angola and living in São Paulo, Brazil for one year, who presented painful nodules with progressive growth for five months. He denied any systemic or respiratory symptoms. On physical examination, nodules and abscesses were noted on the cervical and thoracic regions, with fistulization and discharge of secretion (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). He brought previous exams to the consultation, indicating non-reactive serology for hepatitis B, C, HIV, and HTLV 1 and 2, as well as a chest X-ray with no evidence of pulmonary involvement. The authors opted for puncture and aspiration of one of the cervical lesions for diagnostic analysis with Xpert MTB/RIF®, which showed a positive result for the presence of a rifampicin-sensitive MTB strain (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">While samples of pulmonary tuberculosis (sputum) show a sensitivity of 89% with the referred method, the sensitivity of the analysis of lymph node aspirate reaches 97%.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,5,8</span></a> In a study conducted in Ethiopia, 15 cases of lymph node aspirate were analyzed by Xpert MTB/RIF®, being positive in 33% of cases, while fluorescence microscopy showed the bacillus in only 6.7%.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Another meta-analysis study indicated a different sensitivity for samples from different locations, with 83.1% in puncture of scrofuloderma, 80.5% in meningoencephalic tuberculosis, and only 46.4% in pleural fluid.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Another relevant finding obtained by this method is information about the resistance of the bacillus to rifampicin, a bactericidal drug of great importance in the treatment of CTB. It is estimated that currently about 3.5% of new tuberculosis cases and 18% of previously treated cases are caused by rifampin-resistant MTB.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Ideally, a PCR exam for the detection and identification of MTB should be accessible to most healthcare services in Brazil. Some already have the Xpert MTB/RIF® method for analyzing sputum samples, which can also be used to analyze other liquid materials. The present cases illustrates the benefit of this method in obtaining a rapid diagnosis using material from puncture and aspiration of a lymph node; the identification of antimicrobial sensitivity to rifampicin allowed an early treatment.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Financial support</span><p id="par0030" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Authors’ contributions</span><p id="par0035" class="elsevierStylePara elsevierViewall">Lilian Lemos Costa: Approval of the final version of the manuscript; drafting and editing of the manuscript; collection, analysis, and interpretation of data; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical review of the literature; critical review of the manuscript.</p><p id="par0040" class="elsevierStylePara elsevierViewall">John Verrinder Veasey: Approval of the final version of the manuscript; design and planning of the study; drafting and editing of the manuscript; collection, analysis, and interpretation of data; effective participation in research orientation; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical review of the literature; critical review of the manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:3 [ "identificador" => "xres1461417" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1331601" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors’ contributions" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-09-10" "fechaAceptado" => "2020-01-13" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1331601" "palabras" => array:6 [ 0 => "Diagnosis" 1 => "Diagnostic tools" 2 => "Mycobacterium tuberculosis" 3 => "Polymerase chain reaction" 4 => "Rifampicin" 5 => "Tuberculosis, cutaneous" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cutaneous tuberculosis is a rare infection that is difficult to diagnose, because it shows less sensitivity and specificity in classic complementary exams when compared with the pulmonary form. The Xpert MTB/RIF® method offers an early diagnosis that identifies the DNA of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> and the main mutations that give the bacterium resistance to rifampicin. The authors present a case of scrofuloderma whose diagnosis was quickly obtained through the secretion of a cervical lesion, allowing an early diagnosis and the initiation of appropriate treatment.</p></span>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Costa LL, Veasey JV. Diagnosis of cutaneous tuberculosis (lymph node scrofuloderma) using the Xpert MTB/RIF® method. An Bras Dermatol. 2021;96:82–84.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Dermatology Clinic, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 557 "Ancho" => 1255 "Tamanyo" => 83460 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical aspect of the patient. (A − B) dermatosis located on the right side of the cervical and upper thoracic regions characterized by cold and painless abscesses up to 5 cm in diameter, some with fistulization and ulcers.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1188 "Ancho" => 905 "Tamanyo" => 114210 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Collection of cervical abscess material by puncture with a thick needle.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 599 "Ancho" => 1255 "Tamanyo" => 76283 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Materials for analysis by the Xpert MTB/RIF® method. (A), GeneXpert® device. (B), Buffer solution for treatment of the sample and cartridge for containing the material and reagents to be processed in the device.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous tuberculosis: epidemiologic, etiopathogenic and clinical aspects − Part I" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.B. Santos" 1 => "A.R. Figueiredo" 2 => "C.E. Ferraz" 3 => "M.H. Oliveira" 4 => "P.G. Silva" 5 => "V.L.S. de Medeiros" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "An Bras Dermatol." "fecha" => "2014" "volumen" => "89" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous tuberculosis: diagnosis, histopathology and treatment − Part II" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.B. Santos" 1 => "A.R. Figueiredo" 2 => "C.E. Ferraz" 3 => "M.H. Oliveira" 4 => "P.G. Silva" 5 => "V.L.S. de Medeiros" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "An Bras Dermatol." "fecha" => "2014" "volumen" => "89" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of GeneXpert MTB/RIF for detection of Mycobacterium tuberculosis complex and rpo B gene in respiratory and non-respiratory clinical specimens at a tertiary care teaching hospital in Saudi Arabia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Somily" 1 => "M.A. Barry" 2 => "H.A. Habib" 3 => "F.E. Alotaibi" 4 => "F.A. Al-Zamil" 5 => "M.A. Khan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.15537/smj.2016.12.15506" "Revista" => array:6 [ "tituloSerie" => "Saudi Med J." "fecha" => "2016" "volumen" => "37" "paginaInicial" => "1404" "paginaFinal" => "1407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27874159" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid implementation of the Xpert MTB/RIF diagnostic test" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2011" "editorial" => "WHO" "editorialLocalizacion" => "Geneva" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic accuracy of the Xpert MTB/RIF assay for extrapulmonary and pulmonary tuberculosis when testing non − respiratory samples: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Maynard-Smith" 1 => "N. Larke" 2 => "J.A. Peters" 3 => "S.D. Lawn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12879-014-0709-7" "Revista" => array:5 [ "tituloSerie" => "BMC Infect Dis." "fecha" => "2014" "volumen" => "14" "paginaInicial" => "709" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25599808" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of Extrapulmonary Tuberculosis Using Gene Xpert MTB/RIF Assay and Fluorescent Microscopy and Its Risk Factors at Dessie Referral Hospital, Northeast Ethiopia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Metaferia" 1 => "A. Seid" 2 => "G.M. Fenta" 3 => "D. Gebretsadik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2018/8490614" "Revista" => array:4 [ "tituloSerie" => "Biomed Res Int." "fecha" => "2018" "volumen" => "2018" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30622964" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gene Xpert MTB/RIF assay for the diagnosis of intra-ocular tuberculosis from vitreous fluid samples" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Sharma" 1 => "V. Gupta" 2 => "A. Sharma" 3 => "R. Singh" 4 => "M. Sharma" 5 => "K. Aggarwal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Tuberculosis (Edinb)." "fecha" => "2017" "volumen" => "102" "paginaInicial" => "1" "paginaFinal" => "2" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of the analytical performance of the Xpert MTB/RIF assay" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Blakemore" 1 => "E. Story" 2 => "D. Helb" 3 => "J. Kop" 4 => "P. Banada" 5 => "R. Michelle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Cin Microbiol." "fecha" => "2010" "volumen" => "48" "paginaInicial" => "2495" "paginaFinal" => "2501" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Xpert MTB/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.M. Denkinger" 1 => "S.G. Schumacher" 2 => "C.C. Boehme" 3 => "N. Dendukuri" 4 => "M. Pai" 5 => "K.R. Steingart" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00007814" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J." "fecha" => "2014" "volumen" => "44" "paginaInicial" => "435" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24696113" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global Tuberculosis Report 2018" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2018" "editorial" => "WHO" "editorialLocalizacion" => "Geneva" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009600000001/v3_202102051036/S0365059620303044/v3_202102051036/en/main.assets" "Apartado" => array:4 [ "identificador" => "80635" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Tropical/Infectoparasitary Dermatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009600000001/v3_202102051036/S0365059620303044/v3_202102051036/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620303044?idApp=UINPBA00008Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 24 | 8 | 32 |
| 2024 October | 134 | 74 | 208 |
| 2024 September | 189 | 103 | 292 |
| 2024 August | 185 | 117 | 302 |
| 2024 July | 171 | 127 | 298 |
| 2024 June | 144 | 86 | 230 |
| 2024 May | 162 | 86 | 248 |
| 2024 April | 114 | 93 | 207 |
| 2024 March | 109 | 87 | 196 |
| 2024 February | 93 | 92 | 185 |
| 2024 January | 67 | 72 | 139 |
| 2023 December | 55 | 66 | 121 |
| 2023 November | 64 | 80 | 144 |
| 2023 October | 59 | 86 | 145 |
| 2023 September | 65 | 86 | 151 |
| 2023 August | 52 | 43 | 95 |
| 2023 July | 55 | 33 | 88 |
| 2023 June | 50 | 40 | 90 |
| 2023 May | 52 | 32 | 84 |
| 2023 April | 39 | 13 | 52 |
| 2023 March | 59 | 42 | 101 |
| 2023 February | 49 | 41 | 90 |
| 2023 January | 43 | 57 | 100 |
| 2022 December | 44 | 44 | 88 |
| 2022 November | 65 | 49 | 114 |
| 2022 October | 73 | 58 | 131 |
| 2022 September | 49 | 61 | 110 |
| 2022 August | 43 | 54 | 97 |
| 2022 July | 40 | 54 | 94 |
| 2022 June | 46 | 55 | 101 |
| 2022 May | 43 | 53 | 96 |
| 2022 April | 52 | 51 | 103 |
| 2022 March | 46 | 71 | 117 |
| 2022 February | 23 | 37 | 60 |
| 2022 January | 62 | 75 | 137 |
| 2021 December | 37 | 56 | 93 |
| 2021 November | 47 | 59 | 106 |
| 2021 October | 63 | 97 | 160 |
| 2021 September | 41 | 61 | 102 |
| 2021 August | 64 | 60 | 124 |
| 2021 July | 48 | 56 | 104 |
| 2021 June | 64 | 47 | 111 |
| 2021 May | 98 | 83 | 181 |
| 2021 April | 180 | 279 | 459 |
| 2021 March | 152 | 93 | 245 |
| 2021 February | 63 | 28 | 91 |
| 2021 January | 34 | 12 | 46 |
| 2020 December | 10 | 6 | 16 |
| 2020 November | 1 | 2 | 3 |
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