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Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy
Tuberculosis (TB) has long been known as an acquired immunodeficiency syndrome (AIDS) defining illness in human immunodeficiency virus (HIV) patients, causing reciprocal advantage for both pathogens throughout the course of the disease, not just constituting a burden for the patient, but also impact...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312766/ https://www.ncbi.nlm.nih.gov/pubmed/34336428 http://dx.doi.org/10.7759/cureus.15925 |
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author | Garcia Rivera, Mirian V Aponte, Angel Ko, War War |
author_facet | Garcia Rivera, Mirian V Aponte, Angel Ko, War War |
author_sort | Garcia Rivera, Mirian V |
collection | PubMed |
description | Tuberculosis (TB) has long been known as an acquired immunodeficiency syndrome (AIDS) defining illness in human immunodeficiency virus (HIV) patients, causing reciprocal advantage for both pathogens throughout the course of the disease, not just constituting a burden for the patient, but also impacting public health globally. We report a case of a 42-year-old man who presented with shortness of breath, generalized lymphadenopathy and weight loss. Subsequently diagnosed with HIV/AIDS and generalized ganglionar TB. Initial computed tomography (CT) of the chest showed extensive mediastinal involvement with large right loculated pleural effusion, with growth of acid-fast bacilli (AFB) on culture. Biopsy of lymph nodes confirmed pathologic changes correlating with M. tuberculosis (Caseating granulomatous inflammation), ruling out the possibility of lymphoproliferative disorder. Multiple factors contribute to the immune system decline in AIDS patients, moreover the rapid depletion of Tuberculosis antigen-specific CD4+ T before generalized CD4+T cells. Early assessment for the presence of co-infection and guidance of targeted therapy is critical for management and an important factor in the expected recovery of such patients. Therefore, understanding the pathogenesis of the co-infection, diagnostic approach, possible complications, and the action of concurrent therapy highly active antiretroviral therapy (HAART)/anti-Tuberculosis treatment as well as drug cytotoxicity is paramount. |
format | Online Article Text |
id | pubmed-8312766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-83127662021-07-29 Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy Garcia Rivera, Mirian V Aponte, Angel Ko, War War Cureus Internal Medicine Tuberculosis (TB) has long been known as an acquired immunodeficiency syndrome (AIDS) defining illness in human immunodeficiency virus (HIV) patients, causing reciprocal advantage for both pathogens throughout the course of the disease, not just constituting a burden for the patient, but also impacting public health globally. We report a case of a 42-year-old man who presented with shortness of breath, generalized lymphadenopathy and weight loss. Subsequently diagnosed with HIV/AIDS and generalized ganglionar TB. Initial computed tomography (CT) of the chest showed extensive mediastinal involvement with large right loculated pleural effusion, with growth of acid-fast bacilli (AFB) on culture. Biopsy of lymph nodes confirmed pathologic changes correlating with M. tuberculosis (Caseating granulomatous inflammation), ruling out the possibility of lymphoproliferative disorder. Multiple factors contribute to the immune system decline in AIDS patients, moreover the rapid depletion of Tuberculosis antigen-specific CD4+ T before generalized CD4+T cells. Early assessment for the presence of co-infection and guidance of targeted therapy is critical for management and an important factor in the expected recovery of such patients. Therefore, understanding the pathogenesis of the co-infection, diagnostic approach, possible complications, and the action of concurrent therapy highly active antiretroviral therapy (HAART)/anti-Tuberculosis treatment as well as drug cytotoxicity is paramount. Cureus 2021-06-25 /pmc/articles/PMC8312766/ /pubmed/34336428 http://dx.doi.org/10.7759/cureus.15925 Text en Copyright © 2021, Garcia Rivera et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Garcia Rivera, Mirian V Aponte, Angel Ko, War War Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy |
title | Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy |
title_full | Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy |
title_fullStr | Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy |
title_full_unstemmed | Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy |
title_short | Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy |
title_sort | coinfection of tuberculosis in an undiagnosed hiv, aids patient presenting with shortness of breath, constitutional symptoms and lymphadenopathy |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312766/ https://www.ncbi.nlm.nih.gov/pubmed/34336428 http://dx.doi.org/10.7759/cureus.15925 |
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