Disseminated Histoplasmosis and Miliary Tuberculosis Imitating Colon Cancer in Patient with HIV Who Refuses to Antirretroviral Treatment.
Raúl MontalvoGisel PomalazaMagaly SandovalJocelyn QuispePublished in: Mycopathologia (2020)
Simultaneous infection with histoplasmosis and miliary tuberculosis is rare and mainly affects people with severe immunosuppression, they can present very diverse clinical forms, similar to other infectious and neoplastic pathologies. We present the case of a 27-year-old woman diagnosed with HIV infection for 08 years who refuses to receive antiretroviral treatment (ART) and conceals her diagnosis, comes to the Hospital for pain, abdominal distension and ulcer in the oral cavity. The patient was diagnosed with likely cancer by presenting irregular intestinal thickening with homogeneous gray pattern in colon tomography and signs of intestinal obstruction, that after hemicolectomy was evidenced histoplasmosis in the pathological study, during the treatment with amphotericin B deoxycholate and improvement of the oral ulcer, the patient presented dyspnea, micronodular pattern on the chest radiograph that had not previously existed and the lipoarabinomanan antigen in the urine was positive for tuberculosis. In immunosuppressed patients, intestinal histoplasma infection may have clinical and tomographic characteristics similar to colon cáncer.
Keyphrases
- hiv aids
- mycobacterium tuberculosis
- case report
- antiretroviral therapy
- hiv infected
- end stage renal disease
- emergency department
- hiv positive
- chronic pain
- chronic kidney disease
- spinal cord injury
- pulmonary tuberculosis
- newly diagnosed
- pain management
- prognostic factors
- early onset
- adverse drug
- hiv infected patients
- drug induced
- acute care