Infect Chemother.  2009 Dec;41(6):366-370. 10.3947/ic.2009.41.6.366.

AIDS Diagnosed in the Course of Managing Duodenal Fistula Caused by Tuberculosis: A Case Report

• Kim HK
• Choi SU
• Ahn JY
• Park SJ
• Kim YK
• Kim S
• Cho JH

• KMID: 2285044
• DOI: http://doi.org/10.3947/ic.2009.41.6.366

Abstract

Extrapulmonary tuberculosis, such as intestinal tuberculosis, has become more common with the increase in human immunodeficiency virus infection. However, the diagnosis and treatment of intestinal tuberculosis are often delayed because the symptoms are nonspecific and diverse. We experienced a case of AIDS with intestinal tuberculosis that manifested as a duodenal fistula. The presence of AIDS should be suspected in patients who have extrapulmonary tuberculosis with atypical presentations.

Keyword

Acquired immunodeficiency syndrome; Tuberculosis; Gastrointestinal; Intestinal fistula

MeSH Terms

Acquired Immunodeficiency Syndrome
Fistula
HIV
Humans
Intestinal Fistula
Tuberculosis

Figure

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  Figure 1 Small bowel series. Small bowel series show leakage of contrast media between the 2nd and 3rd portion of the duodenum.

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  Figure 2 Gastroduodenoscopy. Gastroduodenoscopy shows an ulcer with broad base which has an irregular and dirty margin on the 2nd portion of duodenum.

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  Figure 3 Histologic findings of duodenal ulcer. A) Few granulomas composed of epithelioid histiocytes with/without tiny central necrosis are shown in submucosa and lamina propria (H&E stain, ×100). B) Acid-fast bacilli are found with acid fast staining (Ziehl-Neelsen stain, ×400).

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  Figure 4 Abdominopelvic computed tomography. Abdominopelvic computed tomography shows many rim-enhancing nodules along hepatoduodenal ligament, portocaval space, celiac axis, retrocaval space, aortocaval space, mesenteric root, and mesentery.

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