Opportunistic penicilliosis infection causing intestinal obstruction in people living with HIV complicating antiretroviral therapy
| Autor: | Rajeevan Philip Sridhar, Suchita Chase, Victor Vijay Coelho, Beulah Roopavathana |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Unusual Presentation of More Common Disease/Injury medicine.diagnostic_test business.industry 030231 tropical medicine General Medicine Anastomosis medicine.disease Pylorus Surgery Bowel obstruction 03 medical and health sciences Penicilliosis 0302 clinical medicine medicine.anatomical_structure Double-balloon enteroscopy Biopsy medicine Abdomen 030212 general & internal medicine Jejunal Obstruction business |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | We report a retroviral positive patient who presented to us with recurrent skin lesions along with intermittent, colicky periumbilical abdominal pain associated with non-projectile, postprandial vomiting. Contrast-enhanced CT (CECT) of abdomen and pelvis was suggestive of proximal jejunal obstruction. Double balloon enteroscopy done which showed extensive deep ulceration with surrounding nodular surface and friable mucosa at 60 cm from pylorus with luminal narrowing. The biopsy from this region as well as the skin lesion on the forehead grew Talaromyces marneffei. She was initially treated with liposomal amphotericin B for 2 weeks following which she received itraconazole for 3 weeks for disseminated talaromycosis infection. She had already been started on antiretroviral therapy (ART) 1 year back however her cluster of differentiation 4 (CD4) counts did not show any improvement. Proximal bowel obstruction leading to poor nutritional status compounded with ineffective ART therapy due to suboptimal absorption, dictated the staged management of her condition. Feeding jejunostomy was done with a plan to offer her resection and anastomosis of affected jejunal segment, should she require one, after optimising her nutritional and immunological status. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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