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PubMed1996

Tubercular splenic abscesses in a patient with AIDS.

Opportunistic infections are common in patients with AIDS. There is an increasing incidence of tuberculosis, especially extrapulmonary tuberculosis. Splenic abscesses is one such, though rare, extrapulmonary manifestation. We report such a case discuss the diagnosis and treatment in these cases.

AIDS-Related Opportunistic Infections↗
PubMed1990

[Chronic myeloproliferative syndromes and tuberculosis: apropos of 3 cases].

We report 3 patients with chronic myeloproliferative syndromes and active tuberculous infection. The first patient had chronic myelocytic leukemia. In this patient, primary tuberculosis was localized in the lung. In spite of tuberculostatic treatment, he developed laterocervical lymphadenopathy and a tuberculous abscess in right lower limb. The second patient had agnogenic myeloid metaplasia. In this patient splenic tuberculosis (TBC) with subsequent pulmonary involvement were diagnosed. The third patient had idiopathic thrombocytopenia with pulmonary tuberculous infection. In two patients, tuberculosis was diagnosed some time after the diagnosis of hematologic disease, while in the third one both conditions were simultaneously identified. One of the patients died of complications of alkylating therapy, and the other two are still alive. In none of the three patients there has been evidence of active tuberculous infection after therapy, although their course has been slow and two have required associated surgery to eradicate the infection. We review the hematologic conditions which can develop during tuberculosis, the incidence of this infection during chronic myeloproliferative syndromes, the possible pathogenetic relation between both conditions, and the clinical presentation of tuberculosis in these patients, which usually is disseminated in character.

Female↗
PubMed1991

[Abdominal tuberculosis in patients with acquired immunodeficiency syndrome].

BACKGROUND: In individuals with HIV infection, extrapulmonary forms of tuberculosis are considered as opportunistic infections and are included in the diagnosis of AIDS. They often have atypical clinical features. Abdominal participation is uncommon and its diagnosis may be difficult. METHODS: The clinical, radiological and pathological features of patients with a diagnosis of AIDS with abdominal tuberculosis in a series of 254 AIDS cases in a general hospital from 1984 to October 1990 were reviewed. RESULTS: Tuberculosis developed in 104 (41%) of AIDS patients. In 25 (24%) the disease was exclusively pleuropulmonary and in 79 (76%) extrapulmonary tuberculosis was present, either alone or in association. Extrapulmonary tuberculosis was the first opportunistic infection in 66 AIDS cases (26%). The abdominal participation was demonstrated in 19 patients, with the following localizations: lymph nodes (9), liver (8), spleen (5), ileum (1) and peritoneum (1). Four patients with splenic tuberculosis also had multifocal nodular lesions. CONCLUSIONS: Abdominal participation was found in 19 of the 104 AIDS patients with tuberculosis (18%). Lymph node involvement was the most common type. Hepatosplenic tuberculosis had a miliary form or showed multifocal images in echography or computed tomography.

Abdomen↗
PubMed1979

Diagnostic and therapeutic aspects of splenectomy in syndromes associated with hypersplenia.

The value of splenectomy is assessed from diagnostic and therapeutic viewpoints in a series of 80 patients with various syndromes marked by hypersplenia. In the congestive type of splenomegaly, splenectomy resulted in complete normalization of the blood picture in all cases but one, and in primary splenic congestion it even proved curative in the majority of the cases. In leukaemia, non-Hodgkin's lymphomas, in myelofibrosis, and first of all in immuncytopenia, splenectomy was also of benefit, and had generally a palliative effect in non-autoimmune hypersplenia as well. In non-haematological syndromes associated with hypersplenia, namely, splenic tuberculosis, Boeck's sarcoid, SLE, haemorchromatosis and splenic vein thrombosis, splenectomy had generally a palliative, and combined with other therapeutic measures, a curative effect, depending on the primary disease. In a number of patients with hypersplenia associated with splenomegaly, it was only with the aid of splenectomy that the primary disease could be diagnosed.

Diagnosis, Differential↗