Pursuing a diagnosis in a Caribbean man.

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Pursuing a diagnosis in a Caribbean man.

AIDS Clin Care. 1997 Aug;9(8):62-3. Unique Identifier : AIDSLINE MED/97702768
Gulick RM; Clearinghouse, AIDS Newsletter Database, P.O. Box 6003, Rockville, MD; 20849-6003. 800-458-5231 ext. 5714. A fee will apply.; New York University, Medical Center, New York, NY.

Abstract: A case study of an HIV-infected Caribbean male with extrapulmonary tuberculosis details his diagnosis, treatment regimens, and follow-up. His presenting symptoms included epigastric pain and fever. Endoscopy and gastric biopsy showed gastritis and helicobacter infection, which were treated symptomatically, and TMP-SMX was given for possible salmonellosis. Serologic tests for common opportunistic infections were negative. After all other expected conditions were ruled out, concurrent symptoms were diagnosed as extrapulmonary tuberculosis, and multi-drug treatment was successfully conducted. The problem of interactions between protease inhibitors and anti-tuberculosis drugs in treating HIV and tuberculosis concurrently is discussed. Three options are addressed: (1) discontinue (or delay starting) the protease inhibitor until at least 6 months of a standard rifampin-containing tuberculosis regimen is completed; (2) discontinue (or delay starting) the protease inhibitor until 2 months of a standard rifampin-containing regimen are completed; and (3) use of rifabutin rather than rifampin.

Keywords: *HIV Infections/COMPLICATIONS *Tuberculosis/DIAGNOSIS
971230
M97C1556

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