Vidal F, Vilades C, Peraire J, Sirvent JJ, Richart C; International Conference on AIDS.
Int Conf AIDS. 1998; 12: 288 (abstract no. 22134).
Hospital Joan XXIII Tarragona, Spain.
OBJECTIVES: To evaluate the etiology, clinical aspects, and outcome of HIV 1-infected patients with fever of unknown origin (FUO) and granulomatous hepatitis (GH). PATIENTS AND METHODS: From January, 1985 to July, 1997, we detected granulomas in 93 samples of liver tissue. Forty-five (48%) were from patients being investigated because of FUO. Fourteen of the latter were HIV1+ and their charts were reviewed retrospectively. RESULTS: All but one of our patients were male. Eleven (78%) were intravenous drug users. The 14 patients were in advanced stage of HIV1 disease, with a CD4 cell count (mean +/- SD) of 70 +/- 47 cells/mm3 (from 0 to 130/mm3). Among clinical data, hepatomegaly and/or splenomegaly were present in all patients. Mild elevation of GGTP was the most constant biochemical abnormality, being elevated in 13/14 subjects. Mycobacterium tuberculosis was obtained in the culture of the biopsy in the 14 patients. Additionally, in 11 patients (78%), acid-fast baccilli were documented in other localizations (sputum, gastric aspirate, other). Four patients had a milliary pattern in the chest X-ray, whereas five subjects had residual fibrotic lesions. Treatment whit rifampin + isoniazid + pyrazinamide + ethambutol was established in all patients. Three of them died shortly because of other complications related to advanced HIV1 disease, and the remaining 11 were doing well up to one year later. Among 31 additional cases of FUO + GH hat were HIV1-, only 3 cases of tuberculosis were noticed. CONCLUSIONS: Mycobacterium tuberculosis is responsible of almost all cases of FUO and GH in patients with advanced HIV1 infection. Empiric treatment whit antituberculous drugs is justified in this clinical setting.
Publication Types:
Keywords:
- CD4 Lymphocyte Count
- Fever
- Fever of Unknown Origin
- Granuloma
- HIV-1
- Hepatitis
- Hepatomegaly
- Humans
- Infection
- Liver
- Liver Diseases
- Male
- Mycobacterium tuberculosis
- Substance Abuse, Intravenous
- Tuberculosis
Other ID:
UI: 102228788
From Meeting Abstracts