| Registro completo |
| Provedor de dados: |
BJID
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| País: |
Brazil
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| Título: |
Case report of lymph nodal, hepatic and splenic tuberculosis in an HIV-positive patient
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| 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
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| Data: |
2006-04-01
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| Ano: |
2006
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| Palavras-chave: |
Tuberculosis
HIV
Treatment
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| 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.
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| Tipo: |
Info:eu-repo/semantics/report
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| Idioma: |
Inglês
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| Identificador: |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702006000200014
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| Editor: |
Brazilian Society of Infectious Diseases
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| Relação: |
10.1590/S1413-86702006000200014
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| Formato: |
text/html
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| Fonte: |
Brazilian Journal of Infectious Diseases v.10 n.2 2006
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| Direitos: |
info:eu-repo/semantics/openAccess
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