An HIV-infected infant with Bacille Calmette-Guérin disease, recurrent and multidrug-resistant tuberculosis complicated by acute cor pulmonale and hepatitis while on antiretroviral therapy
Date
2007
Authors
van Montfrans J.M.
Rabie H.
Schaaf H.S.
Hesseling A.C.
Cotton M.F.
Shipton S.E.
Victor T.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
We describe the management of an HIV-infected infant with multisystem disease. The infant presented with severe disease at 3 months of age. Initiation of antiretroviral therapy (ART) was delayed through initial lack of access, after which she developed immune reconstitution inflammatory syndrome to BCG. At this time she was also infected with Mycobacterium tuberculosis, with a later recurrence due to multidrug-resistant (MDR) tuberculosis (TB). During this episode she presented with acute cor pulmonale, possibly due to a pulmonary embolus and also transaminitis. Although such infants are seen frequently in sub-Saharan Africa, there are few guidelines or case descriptions to assist clinicians.
Description
Keywords
amikacin, amphotericin B, BCG vaccine, cefuroxime, cotrimoxazole, didanosine, ethambutol, ethionamide, heparin, Human immunodeficiency virus antibody, hydrochlorothiazide, isoniazid, ofloxacin, pyrazinamide, rifampicin, ritonavir, stavudine, terizidone, tuberculostatic agent, warfarin, abscess drainage, anticoagulation, article, bacterium culture, BCG vaccination, case report, CD4 lymphocyte count, differential diagnosis, drug dose increase, drug sensitivity, drug substitution, drug withdrawal, enzyme linked immunosorbent assay, hepatitis, highly active antiretroviral therapy, human, Human immunodeficiency virus 1, Human immunodeficiency virus infection, infant, infant disease, liver toxicity, multidrug resistance, Pneumocystis pneumonia, polymerase chain reaction, pulmonary hypertension, thorax radiography, tuberculin test, tuberculosis, tuberculous lymphadenitis
Citation
Southern African Journal of HIV Medicine
26
26