Data/hora: 09/06/2024 02:18:17

Provedor de dados: | 55
País: | Brazil
Título: | Case report of lymph nodal, hepatic and splenic tuberculosis in an HIV-positive patient
Autores: | Barone,Bianca; Kreuzig,Patrícia Lago; Gusmão,Patricia Medeiros; Chamié,Daniel; Bezerra,Sabrina; Pinheiro,Pedro; Coscarelli,Pedro; Paiva,Daurita; Fonseca,Leila; Marsico,Anna; Cirigliano,André; Perez,Mário.
Data: | 2006-04-01
Ano: | 2006
Palavras-chave: | Tuberculosis; HIV; Treatment.
Resumo: | 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/ CT, or fine needle aspiration, are usually necessary for investigation and differential diagnosis. Often, lesion regression after anti-tuberculosis regimens can be seen, and splenectomy is restricted to complicated or refractory disease.
Tipo: | Info:eu-repo/semantics/report
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702006000200014
Editor: | Brazilian Society of Infectious Diseases
Relação: | 10.1590/S1413-86702006000200014
Formato: | text/html
Fonte: | Brazilian Journal of Infectious Diseases  v.10 n.2 2006
Fonte: | info:eu-repo/semantics/openAccess