RESUMEN
Tuberculosis (TB) is a major global health burden, particularly in developing countries like India. While the most common presentation is pulmonary TB, extrapulmonary TB involving other body systems can also occur, posing diagnostic challenges. We present the case of a 24-year-old immunocompetent man from India who exhibited an uncommon and complex presentation of disseminated extrapulmonary TB. The patient had an asymptomatic brain cavitated lesion, likely tuberculoma, cervical lymphadenopathy, a small subcutaneous collection in the neck, a destructive lytic lesion in the sacrum, and a subcutaneous collection in the left gluteal/paraspinal region, all in the absence of pulmonary involvement. This combination of manifestations has not been previously reported. The presence of cervical lymphadenopathy and a slowly growing subcutaneous abscess were important clues that guided the diagnostic workup. Maintaining a high index of suspicion for TB, even in atypical presentations and immunocompetent individuals, is crucial, particularly in high-TB-burden regions. This case highlights the importance of considering disseminated extrapulmonary TB in the differential diagnosis, even in the absence of pulmonary involvement and typical risk factors. A high index of suspicion, a multidisciplinary approach, and a comprehensive diagnostic workup are essential for the timely recognition and management of these challenging conditions.
RESUMEN
Backgrounds People living with human immunodeficiency virus (HIV) are at a greater risk of chronic kidney disease (CKD) compared to people not having HIV. Evaluating the prevalence of CKD in people living with HIV in Dammam, Saudi Arabia was the main objective of this study. Methods This cross-sectional study included adult HIV patients who were followed at Dammam Medical Complex. The patients' demographic data, comorbid conditions, and HIV history were reviewed from their electronic medical records. Results A total of 729 patients were counted. The glomerular filtration rate (GFR) of 235 patients could not be estimated. The data for the remaining 494 patients were analyzed. The cohort consisted of 406 male patients (82.19%) and 88 female patients (17.81%). The mean ± standard deviation for the patients' age and HIV duration were 39.08±10.93 years and 4.37±3.15 years, respectively. Ten patients (2.02%) had a GFR of <60 mL/min/1.73 m2. Among 136 patients who had an estimated GFR of ≥60 mL/min/1.73 m2 and were tested by a urine examination, 27 patients (19.85%) had albuminuria. Combining the two figures resulted in an estimated prevalence of CKD in HIV patients of 21.47%. Only one patient (0.02%) was receiving dialysis. Conclusions The prevalence of CKD in people living with HIV in Dammam, Saudi Arabia was higher than the general population. The findings highlight the elevated risk of CKD among people living with HIV and emphasize the importance of regular monitoring and early detection of kidney dysfunction in this population.