Cerigo HS, Brau N, Simberkoff M, Flomenberg P; International Conference on AIDS.
Int Conf AIDS. 1990 Jun 20-23; 6: 246 (abstract no. Th.B.497).
New York Veterans Administration Medical Center (NYVA), New York, NY, USA
OBJECTIVE: To describe tuberculous abscesses in 5 AIDS patients out of a total of 45 patients with Mycobacterium tuberculosis (TB) infection and AIDS seen at the NYVA during the years 1988 and 1989. METHODS: Charts were reviewed for clinical and laboratory presentation, CT scans, TB cultures, treatment, and response to therapy. RESULTS: Patients ranged in age from 32-53 years; 2/5 had prior diagnoses of AIDS and 3 had extrapulmonary TB as their AIDS-defining illness; 2/5 developed abscesses while on TB therapy. The locations of the abscesses were defined by CT scan appearance, and all had positive aspirates for TB on smear and culture. One CT scan revealed a 3X4 cm abscess in the right lobe of the liver with a large fluid collection in the porta hepatis and a 3X6X11 cm subcutaneous collection in the right thoracic wall. Despite drainage and anti-TB therapy the patient developed a tuberculous empyema, pneumothoraces, and died. In the other 4 patients, locations of abscesses were: peripancreatic (1), mediastinal/neck (2), and psoas/pelvic (1). In these 4, 2 responded to TB chemotherapy alone (peripancreatic and mediastinal); 1 responded to drainage of 1200cc from a psoas/pelvic abscess and chemotherapy; 1 patient with a mediastinal abscess died despite anti-TB therapy alone. CONCLUSIONS: In HIV-infected patients, abscesses are a common presentation of TB infection or may develop during anti-TB therapy. Prompt diagnosis and drainage may improve outcome.
Publication Types:
Keywords:
- Abdominal Abscess
- Abscess
- Acquired Immunodeficiency Syndrome
- Drainage
- HIV Infections
- HIV Seropositivity
- Humans
- Mediastinal Diseases
- Mycobacterium tuberculosis
- Tuberculosis
- surgery
- therapy
Other ID:
UI: 102182079
From Meeting Abstracts