[Tuberculosis of the pancreas in a HIV-seropositive patient].
A 34-year-old man from Nigeria who had resided permanently in the Netherlands for five years had experienced fever, upper abdominal pain and weight loss for several months. He did not give the impression of being ill. A CT scan gave cause to suspect pancreatitis. An HIV test gave a positive result. Puncture of the accumulated fluid around the pancreas led to the diagnosis 'tuberculosis' (infection by Mycobacterium tuberculosis). Once the patient had made a good recovery with antituberculosis therapy, antiretroviral therapy was initiated, whereupon the number of CD4+ cells in the blood increased. Extrapulmonal tuberculosis is not unusual in HIV seropositive patients from countries with a high prevalence of tuberculosis. However, in such patients isolated tuberculosis of the pancreas is unusual and has not previously been described in the Netherlands. The diagnosis can be established following a CT guided puncture; tuberculosis is instantly suspected if the Ziehl-Neelsen stains are positive and the diagnosis can then be confirmed by a polymerase chain reaction (PCR) analysis and by culturing. Anti-retroviral therapy is withheld until response to anti-tuberculosis treatment is satisfactory.
Verhave
J C
JC
Academisch Ziekenhuis, Postbus 30,001, 9700 RB Groningen.
van der Werf
T S
TS
Kleibeuker
J H
JH
van der Jagt
E J
EJ
Sprenger
H G
HG
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D000995:Antitubercular Agents / Q000008:administration & dosage*; D002985:Clinical Protocols; D000075202:Contraindications; D003937:Diagnosis, Differential; D019468:Disease Management; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010195:Pancreatitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology*; D014057:Tomography, X-Ray Computed; D014383:Tuberculosis, Endocrine / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy
D019380:Anti-HIV Agents; D000995:Antitubercular Agents