Opportunistic penicilliosis infection causing intestinal obstruction in people living with HIV complicating antiretroviral therapy.
BMJ Case Rep
; 13(2)2020 Feb 13.
Article
in En
| MEDLINE
| ID: mdl-32060105
ABSTRACT
We report a retroviral positive patient who presented to us with recurrent skin lesions along with intermittent, colicky periumbilical abdominal pain associated with non-projectile, postprandial vomiting. Contrast-enhanced CT (CECT) of abdomen and pelvis was suggestive of proximal jejunal obstruction. Double balloon enteroscopy done which showed extensive deep ulceration with surrounding nodular surface and friable mucosa at 60 cm from pylorus with luminal narrowing. The biopsy from this region as well as the skin lesion on the forehead grew Talaromyces marneffei She was initially treated with liposomal amphotericin B for 2 weeks following which she received itraconazole for 3 weeks for disseminated talaromycosis infection. She had already been started on antiretroviral therapy (ART) 1 year back however her cluster of differentiation 4 (CD4) counts did not show any improvement. Proximal bowel obstruction leading to poor nutritional status compounded with ineffective ART therapy due to suboptimal absorption, dictated the staged management of her condition. Feeding jejunostomy was done with a plan to offer her resection and anastomosis of affected jejunal segment, should she require one, after optimising her nutritional and immunological status.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
Enteral Nutrition
/
AIDS-Related Opportunistic Infections
/
Anti-Retroviral Agents
/
Intestinal Obstruction
/
Mycoses
Limits:
Adult
/
Female
/
Humans
Language:
En
Journal:
BMJ Case Rep
Year:
2020
Document type:
Article
Affiliation country:
India