[Serious course of a miliary tuberculosis in a 34-year-old patient with ulcerative colitis and HIV infection under concomitant therapy with infliximab]

Med Klin (Munich). 2010 Apr;105(4):314-8. doi: 10.1007/s00063-010-1046-2.
[Article in German]

Abstract

A 34-year-old HIV-positive patient with ulcerative colitis was transferred to the authors' hospital because of progressive worsening of his general condition with intermittent fever, increasing lymphopenia, anemia, thrombopenia and neutropenia under anti-tumor necrosis factor-(TNF-)alpha therapy with infliximab. In spite of negative screening tests before initiation of infliximab therapy and intermittent tests during treatment, miliary tuberculosis was finally diagnosed and a tuberculostatic therapy was started. The patient's clinical condition worsened due to the development of a serious exudative necrotizing pancreatitis which was likely to be caused by the tuberculostatic treatment. Due to severe pulmonary infiltrates and pleural effusions with respiratory failure the patient finally passed away.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • Adult
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use*
  • Antitubercular Agents / therapeutic use
  • Colitis, Ulcerative / diagnosis*
  • Colitis, Ulcerative / drug therapy*
  • Comorbidity
  • Diagnosis, Differential
  • Disease Progression
  • Drug Therapy, Combination
  • Fatal Outcome
  • Humans
  • Infliximab
  • Male
  • Pancreas / pathology
  • Pancreatitis, Acute Necrotizing / diagnosis
  • Tomography, X-Ray Computed
  • Tuberculosis, Miliary / diagnosis*
  • Tuberculosis, Miliary / drug therapy

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Antitubercular Agents
  • Infliximab