Lege Artis Medicinae

[Current status of the laboratory diagnosis of tuberculosis in Hungary]

KÖDMÖN Csaba, SZABÓ Nóra, NAGY Erzsébet

FEBRUARY 20, 2012

Lege Artis Medicinae - 2012;22(02)

[In the past decade, the epidemiological status of tuberculosis has significantly improved in Hungary. The incidence is today lower than 20 per 100 000 inhabitant, therefore, the laboratory network performing diagnosis needs to look for new challenges. As the yearly number of cases decreases, less examinations will be needed, but a greater emphasis should be placed on shortening the time needed for diagnosis, more efficient culturing, resistance tests and molecular typing performed for epidemiological purposes. Our aim is to provide an overview of the status of the diagnostic network of tuberculosis in Hungary and the future challenges it faces, on the basis of data published by the National Korányi Institute of TBC and Pulmonology and the European Centre for Disease Prevention and Control.]

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[INTRODUCTION - Large hiatal hernias may result in cardiac space-occupying lesions. Our case study discusses the clinical aspects and the possible diagnostic approaches for such large hiatal hernias that cause cardiac compression. CASE REPORT - In an elderly patient with no cardiovascular symptoms, transthoracic echocardiography revealed a left atrial space-occupying mass. The diagnosis regarding the origin of the cardial mass was clarified by a glass of soda water drunk by the patient during echocardiography, as it resulted in a decrease in the inhomogenous echodensity of the mass and the appearance of “contrast bubbles” within it. This phenomenon suggested the presence of a large hiatal hernia compressing the heart, which was confirmed by gastroscopy and upper gastrointestinal barium examination. CONCLUSION - Drinking soda water during transthoracic echocardiography can help to diagnose lesions that look like intracardial tumours.]

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