       Document 0301
 DOCN  M9610301
 TI    [A case report of the atypical tuberculosis associated with AIDS]
 DT    9601
 AU    Arai Y; Sato R; Katsura T; Komatsu H; Kawata K; Fujino T; Ouchi M;
       Yakumaru K; Division of Respiratory Diseases, National Sanatorium;
       Minami-Yokohama Hospital, Kanagawa, Japan.
 SO    Kekkaku. 1995 Jul;70(7):431-7. Unique Identifier : AIDSLINE MED/96047778
 AB    A 49-year-old Japanese male who had been imprisoned for five years then
       lived with other men complained of fever, constitutional symptoms and a
       12 kg weight loss over four-month period. He was referred to us as his
       gastric washings were positive for acid-fast bacilli (AFB). Chest X-ray
       showed patchy, infiltrative small shadows primarily in the right upper
       lung field without hilar adenopathy. Before transfer to our hospital,
       tuberculosis chemotherapy composed of SM, INH, RFP and PZA was
       initiated. Over the next three weeks, fever dropped, and the above
       described abnormal shadows on the chest X-ray improved, leaving small
       cystic lesions. Although a sputum smear was negative for AFB, M.
       tuberculosis was isolated from cultured samples and sensitive to all
       standard anti-tuberculous drugs. AFB were also demonstrated on a touch
       imprint of biopsied cervical lymph nodes. Sputum samples turned negative
       one month later both on smear and culture. Moreover, high fever
       developed and another abnormal shadow indicative of Pneumocystis carinii
       (PCP) appeared in the left lung field one month after the admission.
       White plaque was noted in the oral cavity. Dark red nodules were
       observed on the upper extremities and chest wall, and diagnosed
       histologically as Kaposi's sarcoma. Serologic testing for HIV was
       positive both by PA and Western blot methods, thus AIDS was diagnosed
       according to the CDC surveillance case definition for AIDS with the
       diagnosis of tuberculosis. The patient died of wasting syndrome on the
       90th hospital day. On autopsy, small thin-walled cavities were observed
       in the right upper lung, correlating with earlier X-ray and CT
       findings.(ABSTRACT TRUNCATED AT 250 WORDS)
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY
       AIDS-Related Opportunistic Infections/*COMPLICATIONS/PATHOLOGY  Case
       Report  Cytomegalovirus Infections/COMPLICATIONS/PATHOLOGY  English
       Abstract  Human  Male  Middle Age  Pneumonia, Pneumocystis
       carinii/COMPLICATIONS/PATHOLOGY  Sarcoma,
       Kaposi's/COMPLICATIONS/PATHOLOGY  Skin Neoplasms/COMPLICATIONS/PATHOLOGY
       Tuberculosis, Pulmonary/*COMPLICATIONS/PATHOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

