Clinical Significance of Splenic Tuberculosis in Patients Infected with Human Immunodeficiency Virus

Abstract

To assess the clinical significance of splenic tuberculosis in patients infected with human immunodeficiency virus (HIV) type 1, we compared 20 patients who had splenic tuberculosis with 20 randomly selected, HIV-infected patients with culture-proven tuberculosis for whom splenic involvement had been ruled out by ultrasonography. All of the patients were male prison inmates and intravenous drug users. Statistically significant differences (P < .05) were detected between patients with splenic involvement (median CD4+ cell count, 54/mm3) and those without splenic involvement (median CD4+ cell count, 92/mm3). No specific symptoms suggesting splenic involvement were detected in the patients with splenic tuberculosis. All patients received antituberculous drugs, and none of these patients required splenectomy. The median survival was similar in both groups. Splenic tuberculosis occurs in more-severely immunocompromised HIV-infected patients, the prognosis is generally good, the clinical response to therapy is usually favorable, and splenectomy is rarely necessary.

Case report of lymph nodal, hepatic and splenic tuberculosis in an HIV-positive patient

“…Splenic involvement is common in the milliary or disseminated forms of this mycobacteriosis [25], especially in HIV-positive patients with extra-pulmonary tuberculosis [1,[26][27][28], but this isolated form of presentation is very rare [1,8,14].…”

“…[1][2][3][4][5][6][7]. Projections show that up to 70% of patients coinfected with HIV and Mycobacterium tuberculosis will develop at least one extra-pulmonary form of this mycobacteriosis [8][9][10].…”

“…In abdominal forms, peritoneal [6,[11][12][13] and lymph nodal [8] tuberculosis predominate, and they sometimes are associated with involvement of other solid organs, such as the liver. Splenic tuberculosis is very rare [1,8,[14][15][16][17]; it occurs predominantly in patients with CD4 counts less than 100/mm 3 [1,18,19]. We report a case of an HIV-positive patient with hepatosplenic and lymph nodal forms of tuberculosis.…”

Extrapulmonary Tuberculosis in Human Immunodificiency Virus Infection

“…In lymph node tuberculosis, peripheral and retroperitoneal lymph node involvement was the commonest (52%) followed by mediastinal lymph nodes (16%). The finding of small multiple hypoechoic lesions in spleen in HIV-infected patients on sonography is highly suggestive of splenic tuberculosis [7] and is associated with greater immunosuppression than those without splenic involvement [8].…”

Splenic Tubercular Abscess in an Immunocompromised Patient–Rapid Diagnosis by Line Probe Assay

“…Rupture into adjacent organ can occur with the resulting fistulae into the gastrointestinal tract, the pleural space, or lung parenchyma. Splenic tuberculosis coinfection with Human Immunodeficiency Virus (HIV) infection is extremely rare clinical condition [3,4,5]. Line probe Assay (LiPA) is based on nucleic acid amplification technology which allows for rapid detection of Mycobacterium Tuberculosis (Mtb) complex along with genes for rifampicin (RMP) and isoniazide (INH) resistance.…”