{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T01:35:49Z","timestamp":1772156149358,"version":"3.50.1"},"reference-count":28,"publisher":"Microbiology Society","issue":"9","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction.<\/jats:bold>\n                    <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                    (MTB) infections continue to have a high mortality and morbidity burden globally. Interferon-gamma release assays such as Quantiferon Gold Plus (QFG-Plus) aid in diagnosis of latent TB but diagnosis of pleural TB remains challenging. We present a case of active pleural MTB infection with reversion from positive to negative of IGRA result as well as negative Xpert MTB\/RIF Ultra PCR result from tissues obtained from pleural biopsy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case summary.<\/jats:bold>\n                    A 52-year-old otherwise healthy male presented in August 2022 with a 2\u2009week history of pleuritic chest pain associated with modest elevation in inflammatory markers. The patient had had a positive QFG-Plus result in 2018, however QFG-Plus during this admission was negative. Computed-tomography pulmonary angiogram and needle thoracocentesis showed an exudative left pleural effusion with predominant lymphocytes. The patient\u2019s symptoms failed to resolve with empiric antimicrobial therapy for community-acquired pneumonia. Broncho-alveolar lavage as well as biopsies of pleural tissues via video-assisted thoracoscopic surgery from the left lower lobe yielded negative results on routine microbiological culture as well as Xpert Ultra PCR. Growth of acid-fast bacilli was noted from mycobacterial cultures of pleural tissues which was identified as MTB.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion.<\/jats:bold>\n                    Despite significant technological advances, microbiological diagnosis of MTB infections remains challenging. We document QFG-Plus reversion during development from latent to active pleural TB. Decline in the ability of CD4\n                    <jats:sup>+<\/jats:sup>\n                    and CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cells to produce interferon gamma in response to TB antigens (ESAT-6 and CFP-10) was likely associated with loss of host control of latent MTB. This case serves as a reminder that despite exhaustive testing with state-of-art diagnostic platforms, MTB infections can still elude discovery.\n                  <\/jats:p>","DOI":"10.1099\/acmi.0.000737.v3","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T09:19:47Z","timestamp":1725527987000},"source":"Crossref","is-referenced-by-count":0,"title":["A case of pleural Mycobacterium tuberculosis infection with reversion of Quantiferon Gold Plus results from positive to negative"],"prefix":"10.1099","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0693-7788","authenticated-orcid":false,"given":"N.","family":"Goire","sequence":"first","affiliation":[{"name":"Microbiology Department, Australian Clinical Laboratories, Clayton, Victoria, Australia"},{"name":"University of Wollongong Faculty of Health and Behavioural Sciences: University of Wollongong, Wollongong, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.S.","family":"Suchard","sequence":"additional","affiliation":[{"name":"Chemical Pathology Department, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa"},{"name":"Microbiology Department, Australian Clinical Laboratories, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Barling","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Bendigo Hospital, Bendigo Health, Bendigo, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Fernando","sequence":"additional","affiliation":[{"name":"Histopathology Department, Australian Clinical Laboratories, Bendigo, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Dreyer","sequence":"additional","affiliation":[{"name":"Microbiology Department, Australian Clinical Laboratories, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.A.","family":"Mahony","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Austin Hospital, Heidelberg, Victoria, Australia"},{"name":"Infectious Diseases Unit, Bendigo Health, Bendigo, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","volume-title":"Global Tuberculosis Report 2022","year":"2022"},{"key":"R2","article-title":"Tuberculosis (TB)- Better Health Channel Victoria","year":"2023"},{"key":"R3","first-page":"82","article-title":"Tuberculosis notifications in Australia, 2008 and 2009","volume":"36","author":"Barry","year":"2012","journal-title":"Commun Dis Intell Q 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