Biomaterial Database

[Tuberculous pancreatic abscess as initial manifestation of acquired immunodeficiency syndrome (AIDS)]. 1998

I Ayala Hernández, and M Martínez González, and J Halabe Cherem

Departamento de Medicina Interna, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F.

BACKGROUND Tuberculosis is frequently the form of presentation of HIV infection, even in patients who have not developed AIDS. Nevertheless, pancreatic affection is rare, and focal pancreatic affection is even rarer. METHODS We present the case of a 49 years old man with antecedents of 25 heterosexual partners and exploratory laparotomy three years before because of an hepatic lesion during which he was multitransfunded. He had a one year history of fever, diaphoresis and abdominal pain, in whom ultrasonography detected an image compatible with pancreatic abscess, so he went through laparotomy for drainage; biopsy reported tuberculosis. He persisted with fever and abdominal pain, and a computed tomography scan demonstrated persistent pancreatic abscess. The determination of HIV antibodies was positive, and the CD4 count in 110/mm3. Antituberculous therapy was started and eight weeks later, the computed tomography showed improvement; also, he had clinical improvement. After a two-years follow up, he remains asymptomatic, only with antiretroviral therapy. CONCLUSIONS Pancreatic tuberculosis is an infrequent complication of this infection. It is considered the result of the dissemination of the infection from near lymphatic nodes. When needle aspiration of a pancreatic abscess is made, it is necessary to effect a culture in order to diagnose tuberculosis. The recommended treatment comprises a four antifimic scheme for 72 doses followed by a triple intermittent scheme for 60 more doses.

UI	MeSH Term	Description	Entries
D007538	Isoniazid	Antibacterial agent used primarily as a tuberculostatic. It remains the treatment of choice for tuberculosis.	Isonicotinic Acid Hydrazide,Ftivazide,Isonex,Isonicotinic Acid Vanillylidenehydrazide,Phthivazid,Phthivazide,Tubazide,Acid Vanillylidenehydrazide, Isonicotinic,Hydrazide, Isonicotinic Acid,Vanillylidenehydrazide, Isonicotinic Acid
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010182	Pancreatic Diseases	Pathological processes of the PANCREAS.	Disease, Pancreatic,Diseases, Pancreatic,Pancreatic Disease
D011718	Pyrazinamide	A pyrazine that is used therapeutically as an antitubercular agent.	Tisamid
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000163	Acquired Immunodeficiency Syndrome	An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive T-lymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993.	AIDS,Immunodeficiency Syndrome, Acquired,Immunologic Deficiency Syndrome, Acquired,Acquired Immune Deficiency Syndrome,Acquired Immuno-Deficiency Syndrome,Acquired Immuno Deficiency Syndrome,Acquired Immuno-Deficiency Syndromes,Acquired Immunodeficiency Syndromes,Immuno-Deficiency Syndrome, Acquired,Immuno-Deficiency Syndromes, Acquired,Immunodeficiency Syndromes, Acquired,Syndrome, Acquired Immuno-Deficiency,Syndrome, Acquired Immunodeficiency,Syndromes, Acquired Immuno-Deficiency,Syndromes, Acquired Immunodeficiency
D000904	Antibiotics, Antitubercular	Substances obtained from various species of microorganisms that are, alone or in combination with other agents, of use in treating various forms of tuberculosis; most of these agents are merely bacteriostatic, induce resistance in the organisms, and may be toxic.	Antitubercular Antibiotics
D000995	Antitubercular Agents	Drugs used in the treatment of tuberculosis. They are divided into two main classes: "first-line" agents, those with the greatest efficacy and acceptable degrees of toxicity used successfully in the great majority of cases; and "second-line" drugs used in drug-resistant cases or those in which some other patient-related condition has compromised the effectiveness of primary therapy.	Anti-Tuberculosis Agent,Anti-Tuberculosis Agents,Anti-Tuberculosis Drug,Anti-Tuberculosis Drugs,Antitubercular Agent,Antitubercular Drug,Tuberculostatic Agent,Tuberculostatic Agents,Antitubercular Drugs,Agent, Anti-Tuberculosis,Agent, Antitubercular,Agent, Tuberculostatic,Anti Tuberculosis Agent,Anti Tuberculosis Agents,Anti Tuberculosis Drug,Anti Tuberculosis Drugs,Drug, Anti-Tuberculosis,Drug, Antitubercular