Document 0932
 DOCN  M9470932
 TI    [Splenic abscesses caused by Mycobacterium tuberculosis in AIDS]
 DT    9409
 AU    Salazar A; Carratala J; Santin M; Meco F; Rufi G; Servicio de
       Enfermedades Infecciosas, Hospital de; Bellvitge-Princeps d'Espanya,
       Universidad de Barcelona.
 SO    Enferm Infecc Microbiol Clin. 1994 Mar;12(3):146-9. Unique Identifier :
       AIDSLINE MED/94281312
 AB    BACKGROUND: Up to 70% of the patients with tuberculosis and HIV
       infection develop extrapulmonary disease. Abdominal participation is
       generally of the lymph node type with splenic tuberculosis being rare.
       METHODS: Two cases of splenic tuberculosis from a series of 557 patients
       diagnosed with AIDS in a general hospital from March 1984 to March 1993
       are described. RESULTS: Splenic tuberculosis was the first manifestation
       of AIDS in these 2 patients. On pulmonary gammagraphy with gallium-67
       both cases presented peripheral polyadenopathies and enhancement of
       hiliary and paratracheal lymph nodes. Abdominal ultrasound scan and
       computerized tomography revealed multiple hypoechogenic and hypodense
       splenic lesions, respectively, in the 2 cases. Diagnosis was made
       following isolation of Mycobacterium tuberculosis in blood cultures.
       Rapid response to tuberculostatic drugs was shown in one patient while
       the second responded favorably on the addition of glucocorticoids.
       CONCLUSIONS: The homogenicity of the clinical-radiological picture of
       the 2 cases herein presented and those previously described in the
       literature allows the initiation of empiric anti-tuberculous treatment.
       A treatment schedule with glucocorticoids may be effective in patients
       presenting slow response to tuberculostatic treatment, thus avoiding
       therapeutic splenectomy.
 DE    Abscess/DIAGNOSIS/DRUG THERAPY/*MICROBIOLOGY  Acquired Immunodeficiency
       Syndrome/*DIAGNOSIS  Adult  Antibiotics, Combined/THERAPEUTIC USE
       Antitubercular Agents/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/DIAGNOSIS/DRUG THERAPY/  *MICROBIOLOGY
       Bacteremia/MICROBIOLOGY  Case Report  Drug Therapy, Combination  English
       Abstract  Fatal Outcome  Human  Male  Mycobacterium
       tuberculosis/ISOLATION & PURIF  Prednisone/THERAPEUTIC USE  Sarcoma,
       Kaposi's/COMPLICATIONS  Tuberculosis, Splenic/DIAGNOSIS/DRUG
       THERAPY/*MICROBIOLOGY  JOURNAL ARTICLE  REVIEW  REVIEW OF REPORTED CASES

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).