, 2009; Cutrufello et al., 2010). PCR has been demonstrated as an extremely useful technique for an early diagnosis of intraocular TB since it can be performed with very small sample sizes obtained from eyes and the clinical improvement with ATT has been observed in most of the patients with positive PCR (Cheng et al.,
2004; Gupta et al., 2007). A nested PCR targeting MPB-64 protein gene was earlier demonstrated in formalin-fixed paraffin-embedded tissue of epiretinal membrane (Madhavan et al., 2000). This assay could detect 0.25 fg of DNA, and the quantity is sensitive RXDX-106 mouse enough to detect a single bacillus in epiretinal membrane from Eales’disease, however, lesser sensitivity was observed with the same nested PCR assay in vitreous samples (Madhavan et al., 2002; Table 1). Recently, the utility of real-time PCR based on IS6110 or MPT-64 protein gene target has been explored in the diagnosis of ocular TB with promising results (Sharma et al., 2011c; Wroblewski et al., 2011). In addition,
M. tuberculosis could be detected in corneas from donors using PCR assay, and such findings may be used to re-evaluate criteria for suitability of donors with active TB, and further studies should be carried out to investigate whether recipients with PCR-positive corneas would eventually lead Smad inhibitor to disease transmission (Catedral et al., 2010). Pericardial TB is the most common cause of pericarditis in African and Asian countries (Cherian, 2004). It arises secondary to contiguous spread from mediastinal nodes, lungs or during miliary dissemination (Golden & Vikram, 2005). The elevated levels of ADA and IFN-γ have been documented in pericardial TB (Burgess et al., 2002), but these assays have limitations as detailed earlier in pleural
TB. The utility of conventional PCR as well as nested PCR has been described for the diagnosis of acute pleuropericardial TB and chronic constrictive pericarditis (Tzoanopoulos et al., 2001; Zamirian et al., 2007). The clinical find more diagnosis of thyroid TB is rarely investigated unless there is multinodular goitre, abscess or chronic sinus in the gland (Bulbuloglu et al., 2006). The diagnosis of primary thyroid TB is mostly dependent on chest X-ray and ultrasonography; however, these methods usually fail (Ghosh et al., 2007). Multiplex PCR targeting IS6110, 65 kDa and dnaJ genes has been established to confirm thyroid TB (Ghosh et al., 2007). TB mastitis or breast TB is a rare presentation of EPTB even in endemic countries. The most common clinical presentation of breast TB is usually a solitary, ill-defined, unilateral hard lump situated in the central or upper outer quadrant of the breasts (Baharoon, 2008). Mycobacterium tuberculosis bacilli can reach breasts through lymphatic, haematogenous or contiguous seeding (Sharma & Mohan, 2004).