Case report of lymph nodal, hepatic and splenic tuberculosis in an HIV-positive patient



Título del documento: Case report of lymph nodal, hepatic and splenic tuberculosis in an HIV-positive patient
Revista: The brazilian journal of infectious diseases
Base de datos: PERIÓDICA
Número de sistema: 000291052
ISSN: 1413-8670
Autores: 1







2
3

Instituciones: 1Universidade do Estado do Rio de Janeiro, Hospital Universitario Pedro Ernesto, Rio de Janeiro. Brasil
2Universidade Federal do Rio de Janeiro, Instituto de Microbiologia, Rio de Janeiro. Brasil
3Universidade Federal do Rio de Janeiro, Instituto de Doencas Toracicas, Rio de Janeiro. Brasil
Año:
Periodo: Abr
Volumen: 10
Número: 2
Paginación: 149-153
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Experimental
Resumen en inglés We describe a case of a male patient, 38 years old, HIV-positive (most recent CD4 count about 259/mm³), with abdominal pain, nausea, vomiting, anorexia, weight loss, and vespertine high fever with chills. His hemogram showed normocytic and normochromic anemia, with a high erythrocyte sedimentation rate (ESR) and gross granulations in the neutrophils. Transaminases were normal. Bone marrow biopsy evidenced a chronic disease anemia pattern and a lack of infectious agents. Abdominal ultrasound examination showed a normal-size spleen, which exhibited heterogeneous parenchyma and multiple small hypoechoic images, together with small ascites, peripancreatic and para-aortic lymphadenopathy. These findings were confirmed by abdominal CT. The liver was normal in size, but had a hyperechoic image, which was not visualized on CT. Histopathological analysis of one of the multiple abdominal lymph nodes obtained by laparoscopic biopsy exhibited a chronic granulomatous inflammatory process, with caseous necrosis. Tissue sections were positive for BAAR (acid-alcohol-resistant bacillus), and the cultures were positive for Mycobacterium tuberculosis. Anti-tuberculosis treatment was begun, and the patient evolved with improvement of his general state, fever remission and weight gain. Splenic tuberculosis is a rare disease, occurring predominantly in patients in late stages of AIDS and/or disseminated tuberculosis. It is a difficult diagnosis, since there are no specific findings. Hence, complementary examinations, such as abdominal ultrasound..
Disciplinas: Medicina
Palabras clave: Microbiología,
Neumología,
Terapéutica y rehabilitación,
Inmunología,
Tuberculosis,
VIH,
Tratamiento
Keyword: Medicine,
Microbiology,
Pneumology,
Therapeutics and rehabilitation,
Immunology,
Tuberculosis,
HIV,
Treatment
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