Ösophago-mediastinale Fisteln als seltene Komplikation der Tuberkulose bei einem HIV-infizierten Patienten
| Autor: | T. Greten, R. M. Huber, A. Trauner, H. Hautmann |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Tuberculosis medicine.diagnostic_test business.industry Mediastinum General Medicine Pyrazinamide medicine.disease Surgery medicine.anatomical_structure Erythrocyte sedimentation rate medicine Sputum medicine.symptom business Chest radiograph Ethambutol Rifampicin medicine.drug |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 119:1613-1617 |
| ISSN: | 1439-4413 0012-0472 |
| Popis: | A 57-year-old man with an HIV infection, diagnosed a year ago, complained of fever and cough. The haemoglobin level was 7.5 g/dl, white cell count 3800/microliters, T-helper cell count 60/microliters and the CD4-CD8 ratio 0.1. Erythrocyte sedimentation rate was raised to 21/39 mm. Bacteriological tests were at first negative. The chest radiograph showed slight widening of the upper mediastinum which further increased over the next 10 days, at which time it also revealed a shadow in the right upper lobe. Computed tomography suggested necrotizing mediastinal lymph-nodes. Treatment was begun with rifampicin (600 mg daily) ethambutol (1.2 g daily), pyrazinamide (1.5 g daily) and ciprofloxacin (500 mg twice daily). Oesophagoduodenoscopy, performed after 3 weeks, revealed several fistulae which, after ingestion of contrast medium, were demonstrated to communicate with the mediastinum, presumably as a result of lymph-node liquefaction. Mycobacterium tuberculosis was demonstrated in gastric juice, sputum and stool only after tuberculostatic drugs had been started. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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