Department of Medicine, Kasturba Medical College, Manipal, India.
Braz J Infect Dis. 2009 Oct;13(5):383-6. doi: 10.1590/S1413-86702009000500014.
Disseminated tuberculosis in HIV infection involves multiple organs. Pulmonary and lymph node involvement are the commonest form of tuberculosis in HIV infection [1, 2]. Other forms of tuberculosis in the absence of lung and lymph node involvement are rare. Various forms of abdominal [3, 4] and neurological [5, 6] tubercular involvement in HIV infection have been reported. But tuberculosis presenting simultaneously with mesenteric and brain abscess has not been reported yet. We report a case of disseminated tuberculosis presenting as mesenteric and cerebral abscess in a HIV case without involving lung and lymph nodes. Bone marrow smears and fine needle aspiration cytology (FNAC) from mesenteric lesion were positive for acid fast bacilli (AFB) and the diagnosis of tuberculosis was confirmed by positive polymerase chain reaction (PCR). He responded well to treatment with anti tubercular drugs.
HIV 感染相关性播散性结核累及多个器官。肺及淋巴结受累是 HIV 感染相关性结核最常见的形式[1,2]。无肺及淋巴结受累的其他形式结核较为少见。HIV 感染相关性各种形式的腹部[3,4]和神经[5,6]结核已有报道。但同时合并肠系膜和脑脓肿的结核尚未有报道。我们报道了一例 HIV 患者,无肺及淋巴结受累,表现为肠系膜和脑脓肿的播散性结核。肠系膜病变的骨髓涂片和细针抽吸细胞学(FNAC)检查抗酸杆菌(AFB)阳性,聚合酶链反应(PCR)阳性,诊断为结核。他对抗结核药物治疗反应良好。