Intestinal perforation due to intestinal and colonic tuberculosis in a patient with HIV, a nearly lethal complication due to lack of adequate treatment and control in a limited resource country, a case report. (2019)

• Record Type: Journal Article
• Authors: Aguayo, William; Gálvez, Patricio; Acosta, Pablo; Rojas, Christian; Torres, Jose; Aguayo, Johan; Ayala, Jonathan; Camacho, Byron; Molina, Gabriel
• Is Part Of: International journal of surgery case reports. Volume 64(2019)
• Page Start: 45
• Page End: 49
• Publication Date: 2019
• Subjects: Tuberculosis -- HIV -- HIV/TB coinfection -- Intestinal tuberculosis; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2019.09.038
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: HIV and TB, are a lethal combination in resource-limited countries without adequate follow up. Intestinal perforation due to TB in an HIV patient is a rare complication and depends on the immune status of the host. If non-compliance is anticipated when treating TB and HIV, fully supervised therapy should be initiated. Abstract: Background: Coinfection involving Human Immunodeficiency Virus (HIV) and Mycobacterium tuberculosis are particularly problematic in resource-limited countries. When both pathogens are present, they accelerate the deterioration of immunological functions in the patient leading to premature death if left untreated. A close follow-up is essential in these high-risk subjects, as inadequate healthcare usually leads to further complications. Case presentation: We present a case of a 26-year-old woman with a past medical history of HIV infection. Nonetheless, she lacked adequate treatment and did not have sufficient medical supervision to control her disease. She presented to the emergency department with an acute abdomen and multiple bowel perforations that demanded intestinal resection. TB/HIV coinfection was detected and a final diagnosis of bowel perforation due to TB was established. Conclusions: A high index of suspicion is essential when approaching patients with HIV and acute abdominal pain. A thorough clinical history examination including past medical history, HIV/AIDS (Acquired immunodeficiency syndrome) progression status, and a careful clinical exam are paramount to an early diagnosis and timely medical treatment.