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Tuberculous abscesses in patients with AIDS
H Lupatkin1, N Bräu, P Flomenberg
1Medical Service, New York Veterans Affairs Medical Center, New York 10010.
Abstract:
Five cases of large tuberculous abscesses in patients with AIDS were observed over a 2-year period at the New York Veterans Affairs Medical Center. These cases represent 11.6% of the 43 cases of tuberculosis diagnosed in patients with AIDS during that period. The abscesses were located in the liver, abdominal wall, psoas muscle, mediastinum, and peripancreatic area. All patients presented with localized pain or swelling, and four of five patients had fever. The diagnosis was made on the basis of detection of abscesses on computed tomography (CT) and the results of culture of abscess material obtained by CT-guided aspiration. CT-guided therapeutic drainage was performed in two cases. Despite administration of therapy, two of five patients died of tuberculous infection. Formation of tuberculous abscesses appears to be a common complication of tuberculosis in patients with AIDS. This diagnosis should be considered for patients with AIDS who have fever and localized pain or swelling.
Insights
Tuberculosis (TB) can cause large abscesses in patients with acquired immunodeficiency syndrome (AIDS). This complication, seen in over 11% of TB cases in AIDS patients, requires prompt diagnosis and consideration in those with localized symptoms.
Area of Science:
- Infectious Diseases
- Immunology
- Radiology
Background:
- Tuberculosis (TB) is a significant opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS).
- Large tuberculous abscesses are an uncommon but serious manifestation of TB in this population.
Observation:
- Five cases of large tuberculous abscesses were identified in patients with AIDS over two years.
- Abscesses occurred in various locations, including the liver, abdominal wall, psoas muscle, mediastinum, and peripancreatic area.
- Patients presented with localized pain/swelling and fever, with diagnosis confirmed by computed tomography (CT) and culture.
Findings:
- Tuberculous abscesses represented 11.6% of TB cases in the observed AIDS patient cohort.
- CT-guided aspiration and drainage were utilized for diagnosis and treatment.
- Despite treatment, two of five patients succumbed to the tuberculous infection.
Implications:
- Tuberculous abscess formation is a notable complication of TB in AIDS patients.
- Clinicians should consider tuberculous abscesses in AIDS patients presenting with fever and localized pain or swelling.
- Early diagnosis and management are crucial for improving outcomes in these complex cases.