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Unusual association of diseases/symptoms
CASE REPORT
Tuberculosis treatment failure in AIDS: vengeance with renal and ocular manifestations
  1. Muhammad Ahsan Saeed1,
  2. Hanan Tahir Lodhi1,
  3. Faisal Inayat2,
  4. Stephen Walters3,
  5. Marilou Corpuz4
  1. 1University of Nebraska Medical Center, Omaha, Nebraska, USA
  2. 2Allama Iqbal Medical College, Lahore, Pakistan
  3. 3Columbia University Medical Center, New York, New York, USA
  4. 4Montefiore Medical Center, Bronx, New York, USA
  1. Correspondence to Dr Faisal Inayat, faisalinayat{at}hotmail.com

Summary

Tuberculosis treatment failure is not uncommon in patients with AIDS. Treatment failure is defined as a positive sputum smear or culture at month 5 or later in the course of the treatment. The clinical presentations in these patients show remarkable heterogeneity. In this report, we chronicle the case of a patient with treatment failure presenting as the disseminated disease, specifically ocular and renal tuberculosis. Additionally, we undertake here a brief literature review highlighting the increased resistance to tuberculosis treatment in patients with AIDS, the rarity of ocular tuberculosis and the importance of tailoring drug regimens on an individual basis in these coinfected patients.

  • HIV/AIDS
  • tb and other respiratory infections

http://dx.doi.org/10.1136/bcr-2018-225955

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    Footnotes

    • Contributors MAS: designed the study, reviewed the literature, drafted and revised the manuscript. HTL: contributed to the case presentation and discussion. FI: reviewed the literature, drafted the manuscript, reviewed and revised the manuscript for the important intellectual content. SW: reviewed the manuscript and suggested pertinent modifications. MC: reviewed the final version of the manuscript and gave the approval for the version published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Editor’s note This case illustrates the difficulty of treating tuberculosis in HIV-patients with profound lymphopenia. The report describes a case of recurrence of extrapulmonary tuberculosis in an HIV positive patient with profound lymphopenia. CD4 + T-lymphocytopenia is a well-defined risk factor for the development of active tuberculosis in HIV patients as well as relapse of disease, reinfection or even failure of treatment.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.