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Case Report

Acquired Immunodeficiency Syndrome Presenting with Abdominal Tuberculosis

Byung Sung Koh, Sang-Jung Kim, Kyoung Hwa Yoo, Kyung Han Lee, Gi Tark Noh, Won Seok Heo
The Ewha Medical Journal 2015;38(3):112-116. Published online: October 31, 2015

Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.

Corresponding author: Sang-Jung Kim. Department of Internal Medicine, Bundang Jesaeng Hospital, 20 Seohyeon-ro 180 beongil, Bundang-gu, Seongnam 13590, Korea. Tel: 82-31-779-0202, Fax: 82-31-779-0897, sj0816@gmail.com
• Received: April 17, 2015   • Accepted: July 14, 2015

Copyright © 2015, The Ewha Medical Journal

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • The incidence of tuberculosis (TB) had gradually been declining all over the world, but in recent years, TB has been increasing due to the spread of the human immunodeficiency virus (HIV). When immune-suppression status deteriorates further, extrapulmonary TB generally appears more often. Abdominal TB is one type of extra-pulmonary TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera. We encountered a case who had initially been diagnosed as having abdominal TB, had progressed to acute respiratory distress syndrome and was eventually confirmed as having developed acquired immune deficiency syndrome. In cases of coinfection of TB and HIV, it is reported that immunological responses become poor and complications with higher morbidity frequently occur. Therefore, the Korean guidelines for TB should be revised to ensure whether HIV infection exists in TB patients.
  • Keywords: Tuberculosis; HIV
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Fig. 1

Initial colonoscopic examination. (A, B) Deep and wide ulcerative lesions with irregular margin are observed on the terminal ileum. (C, D) An oval shaped elevated lesion with normal looking mucosa is observed on the ascending colon. The surface mucosal defect is considered as the orifice.

emj-38-112-g001.jpg
Fig. 2

Tissue biopsy findings. (A) Chronic granulomatous inflammation with caseous necrosis is observed (H&E, ×100) (B) AFB are observed on an AFB stain (×400).

emj-38-112-g002.jpg
Fig. 3

Abdominal computed tomography (CT) findings, sagittal plane (A, B) and transverse plane (C) views. The CT scan shows a thickened terminal ileum, enlargement of multiple lymph nodes and a cold abscess (arrows).

emj-38-112-g003.jpg
Fig. 4

Follow-up colonoscopic examination. (A-C) Ulcerative lesions on the terminal ileum has healed and whitish scars are observed. (D) The orifice and elevated lesion on the ascending colon have disappeared (circle).

emj-38-112-g004.jpg

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      Acquired Immunodeficiency Syndrome Presenting with Abdominal Tuberculosis
      Ewha Med J. 2015;38(3):112-116.   Published online October 31, 2015
      DOI: https://doi.org/10.12771/emj.2015.38.3.112
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      Acquired Immunodeficiency Syndrome Presenting with Abdominal Tuberculosis
      Ewha Med J. 2015;38(3):112-116.   Published online October 31, 2015
      DOI: https://doi.org/10.12771/emj.2015.38.3.112
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      Acquired Immunodeficiency Syndrome Presenting with Abdominal Tuberculosis
      Image Image Image Image
      Fig. 1 Initial colonoscopic examination. (A, B) Deep and wide ulcerative lesions with irregular margin are observed on the terminal ileum. (C, D) An oval shaped elevated lesion with normal looking mucosa is observed on the ascending colon. The surface mucosal defect is considered as the orifice.
      Fig. 2 Tissue biopsy findings. (A) Chronic granulomatous inflammation with caseous necrosis is observed (H&E, ×100) (B) AFB are observed on an AFB stain (×400).
      Fig. 3 Abdominal computed tomography (CT) findings, sagittal plane (A, B) and transverse plane (C) views. The CT scan shows a thickened terminal ileum, enlargement of multiple lymph nodes and a cold abscess (arrows).
      Fig. 4 Follow-up colonoscopic examination. (A-C) Ulcerative lesions on the terminal ileum has healed and whitish scars are observed. (D) The orifice and elevated lesion on the ascending colon have disappeared (circle).

      Fig. 1

      Fig. 2

      Fig. 3

      Fig. 4

      Acquired Immunodeficiency Syndrome Presenting with Abdominal Tuberculosis
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