       Document 0106
 DOCN  M9620106
 TI    [Tuberculous anal fistula in acquired immunologic deficiency syndrome]
 DT    9602
 AU    Musch E; Tunnerhoff-Mucke A; Medizinische Universitatsklinik Bonn.
 SO    Z Gastroenterol. 1995 Aug;33(8):440-4. Unique Identifier : AIDSLINE
       MED/96080927
 AB    We report here on a 36-year old, HIV-positive patient, who was sent to
       hospital with an anal fistula. A short time later during the course of
       an extensive diagnosis the anal fistula was recognized as an
       extrapulmonary manifestation of a miliary tuberculosis stemming from an
       immunodeficiency syndrome. A rapid conversion of the sputum, a
       normalization of the radiological findings and the absence of relapse
       are the results of the classic systemic fourfold therapy with myambutol,
       isoniazid, rifampicin and streptomycin. The danger of overlooking the
       fact that an anal fistula can be the clinically primary manifestation of
       a tuberculosis and the problems of a mixed infection within the scope of
       the acquired immunodeficiency syndrome are discussed. Tuberculosis as a
       frequent complicating infection of HIV-positive patients--often
       diagnosed some time before the AIDS-infection as in our patient--can be
       successfully cured by a high dose of intravenous pharmacotherapy, even
       when additional complications (parasitic stomatitis, increasing
       deterioration of the immunological parameters) are present. In order to
       show the large spectrum of the problems involved in the diagnosis, the
       therapy and the course of the active acquired immunodeficiency syndrome,
       we have focused here on the detailed description of the case report.
 DE    Adult  Antitubercular Agents/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/*DIAGNOSIS/DRUG THERAPY  Case Report  Diagnosis, Differential
       Drug Therapy, Combination  English Abstract  Human  Male  Rectal
       Fistula/*DIAGNOSIS/DRUG THERAPY  Tuberculosis,
       Gastrointestinal/*DIAGNOSIS/DRUG THERAPY  Tuberculosis,
       Miliary/DIAGNOSIS/DRUG THERAPY  JOURNAL ARTICLE

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

