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[HIV infection, fever and cholestasis]
S Giezendanner1, G Zala, J Jost
1Departement für Innere Medizin, Universitätsspital Zürich.
Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|June 14, 1994
Summary
Cytomegalovirus infection caused HIV-related cholangiopathy in an AIDS patient, presenting with jaundice and biliary tract lesions. Ganciclovir treatment showed partial effectiveness in improving jaundice.
Area of Science:
- Hepatology
- Infectious Diseases
- Gastroenterology
Background:
- Acquired immunodeficiency syndrome (AIDS) can manifest with opportunistic infections affecting the biliary system.
- Cholangiopathy in HIV patients presents diagnostic challenges and requires prompt identification of the causative agent.
Observation:
- A 35-year-old female with AIDS presented with fever, jaundice, and cough.
- Ultrasound revealed thickened intra- and extrahepatic bile ducts and gallbladder wall.
- Endoscopic retrograde cholangiography showed sclerosing cholangitis-like lesions.
Findings:
- The patient was diagnosed with HIV-related cholangiopathy.
- Liver biopsy confirmed cytomegalovirus (CMV) infection.
- CMV early antigen was detected in liver tissue.
Implications:
- This case highlights CMV cholangiopathy as a significant complication in advanced HIV.
- Early diagnosis and antiviral therapy (ganciclovir) can improve cholestasis and jaundice.
- Further research into managing opportunistic infections in immunocompromised patients is warranted.