[Intestinal tuberculosis in acquired immunodeficiency syndrome]

Area of Science:

• Infectious Diseases
• Gastroenterology
• Immunology

Background:

• Tuberculosis (TB) remains a significant opportunistic infection in individuals with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS).
• Disseminated TB can manifest with diverse gastrointestinal (GI) symptoms, posing diagnostic challenges.
• Co-infection with HIV and TB increases the risk of severe TB manifestations and mortality.

Observation:

• A homosexual male patient diagnosed with AIDS presented with micronodular fibrosis and a history of Candida esophagitis.
• The patient developed disseminated tuberculosis with peritoneal and intestinal involvement.
• Diagnosis was confirmed via colonoscopy of a rectum-sigmoid ulcer, revealing acid-alcohol resistant bacilli (AARB) identified as Mycobacterium tuberculosis.

Findings:

• The case illustrates a rare presentation of disseminated intestinal tuberculosis in an advanced HIV/AIDS patient.
• Ziehl-Nielsen staining of biopsy samples was crucial for identifying Mycobacterium tuberculosis.
• The patient's condition rapidly deteriorated due to uncompensated cirrhosis, leading to a fatal outcome despite treatment.

Implications:

• This case underscores the importance of considering disseminated TB in HIV-infected individuals presenting with GI symptoms.
• Early and accurate diagnosis of intestinal TB is critical for timely intervention in immunocompromised patients.
• Understanding the clinical characteristics and challenges in managing intestinal TB in HIV patients is vital for improving patient outcomes.