Professional paper
Human immunodeficiency virus infection and intestinal tuberculosis: a case report
D. Rafanelli
A. Šalamon
T. Maretić
M. Ožegović
Z. Čulig
D. Lukas
J. Begovac
Abstract
We present a case of a thirty-two-year-old HIV infected patient who presented with a 5 months history of weight loss, fever and diarrhea. Four days before admission he started to experience abdominal pain. On admission to the hospital the patient had no fever was pale, cachectic and immobile. The abdomen was diffusely tender on palpation. His general condition was poor. Achest X-ray upon the admission showed bilateral inhomogenous infiltrations. The patient developed clear signs of acute abdomen. Surgery was performed and multiple perforations of the small and large intestine were found together with a stercoral peritonitis. The terminal ileum was partially removed, a right hemicolectomy with a terminoterminal ileotransversal anastomosis and a jejunostomy were performed. Patohistological examination of the intestine revealed granulomatous inflammation of the small and large intestine areas of caseous necrosis. The CD4 lymphocyte count was 11 per microliter and the plasma HIV viral load measured by PCR showed 1 480 000 copies per milliliter. The patient was successfully treated with antituberculous drugs and other antimicrobials together with antiretrovirals. Parenteral and enteral alimentation was also given. The temporary jejunostomy was closed three months after the first operation. Eight months after the operation the patients regained his normal body weight (weight gain: 35 kg). HIV1 RNA was at that time undetectable and his CD4+ lymphocyte count was 163/μL.
Keywords
HIV; AIDS; intestinal tuberculosis; intestinal perforation; HAART
Hrčak ID:
12745
URI
Publication date:
17.3.2005.
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