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[Colonic tuberculosis as a cause of rectal bleeding in 2 patients with HIV infection]
E Pintor1, M V Piret, M Velasco
1Servicio de Medicina Interna III, Hospital Universitario San Carlos, Madrid.
Background:
Extrapulmonary tuberculosis is a relatively frequent disease in patients with HIV infection. This may be observed coinciding with pulmonary involvement or without diagnostic data of the same. Within extrapulmonary involvement, gastrointestinal involvement is one of the least frequently observed and its diagnosis is very difficult due to the scarce clinical suspicion because of the unspecific symptomatology.
Methods:
Segmentary colonic tuberculosis was diagnosed in two patients presenting rectal bleeding. The diagnosis was neither clinically nor endoscopically suspected and only histologic and microbiologic study of the biopsies led to establishment of the diagnosis. Pulmonary involvement was also seen in one of the 2 patients.
Results:
Medical treatment was initiated following the diagnosis. The evolution was good in one patient, while the other developed a picture of massive rectal bleeding requiring surgical resection following which the patient died due to complications.
Conclusions:
Colonic tuberculosis is an infrequent disease in patients with HIV infection. Only a high index of clinical suspicion along with adequate histopathologic and microbiologic study of all the colonic lesion biopsies can establish the real frequency of this disease in this group of patients.