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CHEST RADIOLOGY |
| Case 4: |
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A 28 year old male presented with the chief complaints
of dysphagia and loss of weight since 3 months. Lab parameters showed a high ESR and white
cell count, and positive HIV. X-ray chest showed superior mediastinal widening. A barium
swallow was performed. |
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Diagnosis: Tracheo-oesophageal fistula secondary to caseating tuberculous lymphadenopathy Discussion Although atypical mycobacterial infections occur in 10% of patients with AIDS, the incidence of mycobacterium tuberculosis (TB) is rising, TB tends to occur early in the course of AIDS, before the immuno-defeciency has fully developed. The clustering of TB infections around the time of AIDS diagnosis suggests that most infections are due to reactivation of previously latent infections rather than de novo infection. The manifestation of TB infections in patients with AIDS is frequently atypical; extra pulmonary infection and non-cavitatory non-apical pulmonary diseases are common, and often the disease becomes widely disseminated. |
Contribution : Dr Harsh
Merchant, Mumbai, India |