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[Splenic abscesses caused by Mycobacterium tuberculosis in AIDS]
A Salazar1, J Carratalá, M Santín
1Servicio de Enfermedades Infecciosas, Hospital de Bellvitge-Prínceps d'Espanya, Universidad de Barcelona.
Enfermedades Infecciosas Y Microbiologia Clinica
|March 1, 1994
Summary
Splenic tuberculosis is a rare manifestation of HIV infection, often presenting as the first sign of AIDS. Early diagnosis and treatment with anti-tuberculous drugs, potentially including glucocorticoids, can be effective.
Area of Science:
- Infectious Diseases
- Immunology
- Radiology
Background:
- Extrapulmonary tuberculosis is common in patients with HIV infection, affecting up to 70%.
- Abdominal tuberculosis typically involves lymph nodes, with splenic involvement being infrequent.
- Splenic tuberculosis is an uncommon presentation in the context of Acquired Immunodeficiency Syndrome (AIDS).
Observation:
- Two cases of splenic tuberculosis were identified in 557 patients diagnosed with AIDS.
- Splenic tuberculosis presented as the initial manifestation of AIDS in these patients.
- Radiological findings included polyadenopathies and enhanced lymph nodes on gallium-67 scans, with splenic lesions on ultrasound and CT.
Findings:
- Diagnosis was confirmed by isolating Mycobacterium tuberculosis from blood cultures.
- One patient responded rapidly to tuberculostatic drugs.
- The second patient showed a favorable response upon the addition of glucocorticoids to the treatment regimen.
Implications:
- The consistent clinical and radiological presentation suggests empiric anti-tuberculous treatment can be initiated.
- Glucocorticoid therapy may be beneficial for patients with a slow response to standard tuberculostatic drugs.
- This approach may help avoid the need for splenectomy in managing splenic tuberculosis in AIDS patients.